Geriatrics - Apex Flashcards
One metabolic equivalent (MET) corresponds to how much oxygen consumption?
3.5mL/min/kg
Walking up two flights of stairs without stopping is equal to _____ METs.
4 METs
A 70kg patient can walk up two flights of stairs without stopping. How much oxygen consumed per minute during this activity?
1,000mL O2/min
Inability to achieve a METs of _____ is associated with increased perioperative risk
4
For every MET a patient can achieve, mortality decreases by?
11%
Which factor increases in the elderly?
Dead space
Lung elasticity
PaO2
Chest wall compliance
Dead space
The increased dead space in elderly necessitates an increase in ______ to maintain a normal_______
Minute ventilation to maintain a normal PaCO2
In an elderly patient which lung volumes and capacities are increased?
Residual Volume
Functional Residual Capacity
Closing Capacity
In an elderly patient which lung volumes and capacities are decreased?
Vital Capacity
Expiratory Residual Volume
In an elderly patient which lung volumes and capacities are unchanged?
Total Lung Capacity
The following changes occur in the cardiovascular system in response to aging EXCEPT:
-diastolic dysfunction
-loss of elastin in arterial wall
-fibrosis of the cardiac conduction system
-increased Venous capacitance
-increased Venous capacitance
Cardiac disease is the most common coexisting disease seen in the elderly. The four most common conditions are?
Hypertension
CAD
CHF
Myocardial ischemia
In the geriatric population, what pharmacokinetic behavior is observed during neuromuscular blockade?
A. aging of the motor and plate is responsible for prolonged duration of action.
B. initial dose is required to achieve blockhead or typically lower.
C. Onset of blockage is typically accelerated because of decreased muscle mass.
D. pharmacokinetics of cisatracurium are minimally affected by aging
D. pharmacokinetics of cisatracurium are minimally affected by aging
Eliminated via Hoffman Elimination
Which attribute of the pulmonary system decreases in the elderly?
A. closing capacity.
B. pulmonary vascular resistance.
C. Response to hypoxia.
D. total lung capacity.
C. Response to hypoxia. (ventilator responses to hypoxia, hypercapnia, and mechanical stress are impaired due to reduced CNS activity.)
Hypoxic pulmonary vasoconstriction is also blunted in the elderly in this can cause a difficulty with one lung ventilation
What lung variables/volumes are increased in the elderly?
Anatomical dead space
Closing capacity
Functional residual capacity
Residual volume, by approximately 5 to 10% per decade
What lung variables/volumes are decreased in the elderly?
Diffusion capacity
Alveolar surface area
Vital capacity
Forced expiratory volume in the first second (FEV1)
Forced vital capacity
