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Special Populations > Geriatrics Exam > Flashcards

Geriatrics Exam Flashcards

1
Q

Exercise Dosage for Geriatrics

A

50 + hours, 2x/wk for 6 months minimum

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2
Q

A one day hospital stay where the patient is immobile = a _____% decline in function

A

30%

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3
Q

Sx of older pt with PNA, UTI, peritonitis, abscess

A

Absence of fever

Falls, decreased appetite or fluid intake, confusion, change in functional status

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4
Q

Sx of older patient with silent acute abdomen

A

Silent presentation
Mild discomfort and constipation
Some tachypnea and possibly vague respiratory sx

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5
Q

Sx of older patient with MI

A

Fatigue, N and decline in functional status

Classic presentation: SOB

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6
Q

Sx of older patient with silent malignancy

A

Back pain secondary to metastases from slow growing breast masses
Silent masses of the bowel

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7
Q

Sx of older patient with pulmonary edema

A

Insidious w/ change in function, food or fluid intake, or confusion

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8
Q

Sx of older patient with hyperthyroidism

A

Apathetic thyrotoxicosis

Fatigue and a slowing down

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9
Q

Sx of older patient with hypothyroidism

A

Confusion and agitation

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10
Q

Sx of older patient with depression

A 
Somatic complaints (appetite changes, vague GI sx, constipation, sleep disturbances)
Hyperactivity
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11
Q

Medical illness that presents as depression

A

Hypo and hyperthyroid dz that presents as low energy and apathy

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12
Q

Mild Cognitive Impairment Definition

A

Memory loss noted by pt or family
Detailed testing shows abnormal memory
Pts have no functional impairment
Do not meet criteria for dementia
Not neurologically normal; memory is worse than age-matched controls
Increased rate of progression to dementia

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13
Q

Short term memory loss with other cortical deficits
Problems with language and praxis
Relative preservation of social graces early in dz

A

Alzheimer’s

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14
Q

Stepwise progression and/or evidence of focal neurological deficits on exam

A

Vascular Dementia

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15
Q

Prominent behavioral and personality change early in the course of cognitive impairment
Inhibition, trouble with the law, impulse control, reactivation of primal reflexes

A

Frontotemporal Dementia

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16
Q

Frontal release signs of frontotemporal dementia

A

Snout, grasp, palmomental reflexes

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17
Q

Trouble with stiffness and slowness starting insidiously around same time as cognitive loss.
First symptom is often hallucinations

A

Lewy Body Dementia

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18
Q

> 1 area of progressive cognitive impairment that persists after a patient with a history of chronic EtOH abuse stops drinking

A

Wernicke-Korsakoff Dementia

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19
Q

Triad of normal pressure hydrocephalus

A

Cognitive Decline
Falls
Incontinence

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20
Q

Delerium

A

Symptom, not a dz
Acute mental status d/o characterized by abnormal and fluctuating attention
Disturbance in level of awareness
Decreased ability to direct, focus, sustain, and shift attention

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21
Q

Pressure sores - blanchable hyperemia

A

Stage 1

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22
Q

Pressure sores - extension through the epidermis

A

Stage 2

23
Q

Pressure sores - full thickness skin loss

A

Stage 3

24
Q

Pressure sores - full thickness with extension into muscle bone or supporting structures

A

Stage 4

25
Q

Pressure sores - eschar/slough overlies the wound

A

Unstageable

26
Q

Suspected deep tissue injury

A

Area of blistered skin or area which is discolored

27
Q

Risk factors for elder abuse

A

Frail
Female
White

28
Q

____% of abusers are the adult child living in the same home, usually financially dependent

A

50%

29
Q

Different types of incontinence

A

Stress - cough
Overflow - bladder is not emptying
Urge - inability to delay
Functional - cannot get there in time

30
Q

____% of people >65 y/o drink daily

_____% may experience health risks due to alcohol

A

50%

15-20%

31
Q

Legal document that delineates kinds of tx wanted under various circumstances

A

Advanced Directive

32
Q

Medicare A Coverage

A

3 night inpatient hospital stay required within 30 days admission into skilled nursing facility
Days 1-20 medicare A covers 100%
Days 21-100 medicare A covers all but $157.50/day

33
Q

Medicare B Coverage

A

Covers outpatient rehab serves (PT/OT, home health)

Yearly cap of $1900

34
Q

The quality or state of being healthy in body and mind, especially as the result of deliberate effort

A

Wellness

35
Q

Mini cognitive exam

A

Apple Table Penny

36
Q

How long to complete clock drawing test

A

3 min

37
Q

What percentage of elderly patients suffer from depression?

A

25%

38
Q

Bacteria in urine does not always have to be treated in _________, but it does always have to be treated in ________

A

Females

Males

39
Q

1st line in elderly for sleep

A

Trazodone and Remeron

40
Q

______% of people > 65 fall yearly
______% of people > 80 fall yearly
______% of older adults that fall, fall repeatedly

A

30%
50%
50%

41
Q

______% of older fallers are injured
______% of older fallers are admitted to the hospital
______% of fractures in older adults result from falls

A

20%
15%
87%

42
Q

_____ of patients die within 12 mo of hip fracture

_____% of patients with hip fracture have limited functional recovery

A

1/3

50%

43
Q

No risk factors = _____% chance of fall

>4 risk factors = _____% chance of fall

A

8%

78%

44
Q

_____% of women > 80 y/o with depression taking an SSRI fell in the last year

A

60%

45
Q

_____-_____% of people fall in the first year post-stroke

A

40-70%

46
Q

After hospital discharge, pts should be evaluated for fall risk within _______

A

2 weeks

47
Q

8 dimensions of wellness

A 
Nutritional
Intellectual
Environmental
Emotional
Physical
Social
Community
Spiritual
48
Q

Most frequent dz present in the elderly

A 
Hypertension
Arthritis
Heart Dz
Cancer
Diabetes
49
Q

Pharmacokinetics of the elderly

A

Decreased kidney function
Decreased gastric emptying
Decreased total body water
Increased body fat

50
Q

Medications to be careful with the elderly

A 
NSAIDs
Diltiazem
Benzos
Morphine
Warfarin
ACEI
Albuterol
Diphenhydramine
Loop Diuretics
51
Q

START Initiation

A

58% of pts missing meds for appropriate indication.
Statins
Warfarin for AFib
Antiplatelet drugs for arterial dz
Calcium/Vitamin D
ACEI, SSRI, SNRI, BPH meds, topical estrogen, opioids, laxatives, flu and pneumococcal vaccinations

52
Q

STOPP Criteria

A 
Warfarin, digoxin, insulin
Don't use antipsychotics first line for dementia
Don't add meds to push A1c below 7.5%
Don't use BZDs or other sedative-hypnotics
Verapamil/Diltiazem
BB with CCB
Loop Diuretics
ASA > 160 mg
Ticlopidine
TCAs
BZDs
1st gen antihistamines
53
Q

Beers Man

A 
TCAs (anticholinergics)
Alpha Agonists (Clonidine)
Xanax
Benadryl
ZZZ
Antiarrhythmics
NSAIDs
Metoclopramide (tardive dyskinesia)
Nitrofurantoin
Skeletal Muscle Relaxants
Prostate Alpha Blockers (Just don't use for HTN)

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