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Geriatrics > Health Maintenance > Flashcards

Flashcards in Health Maintenance Deck (37)
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1
Q

Goals of Health Promotion/Prevention in the Elderly

A

Maximize quality & quantity of life
Contribute to preserving indepence & decreasing discomfort
Focus on elements of lifestyle, environment & health care management that delays onset of chronic disease

2
Q

Define Aging

A

Characterized by the gradual decline of physical & physiologic capacity

3
Q

Define Promotion

A

Prevention of avoidable decline, frailty & dependence

4
Q

Goals of Screening

A

Reduce premature mortality caused by acute & chronic illness
Maintain function
Enhancing QOL
Extending active life expectancy

5
Q

Role of PCP

A

Promote health at every opportunity

Individualize in terms of age, functional status, patient preference, culture, SES

6
Q

Modifiable Risk Factors for CV Disease & Cerebrovascular Disease

A
HTN
Smoking
Inactivity
Cholesterol
Obesity
DM
7
Q

Single Most Important Activity in Reducing Morbidity & Mortality in the Elderly

A

BP

Especially orthostatic BP

8
Q

Screening for Cholesterol

A

Controversial
Less likely to increase after 65 years of age
Those on meds should be screened yearly

9
Q

Screening for DM

A

High risk for DM2

Established DM patients need A1C & glucose monitoring

10
Q

Screening for Smoking

A

Counseling

Education on smoking cessation

11
Q

2nd Leading Cause of Death in the Elderly

A

Cancer

12
Q

Things to Think About with Cancer Screening in the Elderly

A

Expected time-to-benefit
Risk of developing the cancer in the patient’s lifetime
Individual’s estimated life expectancy
Focus on colorectal, breast, cervical & lung cancer screening

13
Q

Potential Harms with Screening for Cancer

A

False positive leading to interventions & anxiety
Over diagnosis
Cost, discomfort, & embarrassment associated available tests

14
Q

Breast Cancer Screening

A

Yearly PE
SBE
Mammograms suggested every 1-2 years through age 75 & with a life expectancy of at least 10 years
75+ if woman is at high risk

15
Q

Cervical Cancer Screening

A

May be discontinued for women 65+ with 3 normal Pap smears over preceding 10 years
Discontinue for hysterectomy for benign indication

16
Q

Prostate Cancer Screening

A

50-69 most likely to benefit
Routine screening not recommended
Discuss risks vs. benefits
Stop after age 69 or life expectancy less than 10 years

17
Q

Colorectal Cancer

A

50-75 who have 5+ years to live
76-85 depends on prior screening, risk factors, co-morbidities
Not over age 86
Colonoscopy

18
Q

Other Screening Tests for Colorectal Cancer

A

CT colonography
Flexible sigmoidoscopy
Stool testing for blood or stool
DNA testing

19
Q

Lung Cancer Screening

A

Education on smoking cessation

55-80: low dose spiral CT to HIGH RISK individuals until 15 years out from discontinuing or limited life expectancy

20
Q

Define High Risk in Lung Cancer

A

At least 30 pack year history of smoking

Currently smoking or within 15 years of quitting

21
Q

Skin Cancer Screening

A

Yearly skin exam

Recommend sunscreen

22
Q

Oral Cancer Screening

A

Assess yearly

Education on risk: ETOH, smoking

23
Q

Important Immunizations in the Elderly

A

Tetanus every 10 years
Influenza yearly
Pneumococcal
Herpes Zoster: immunocompetent >60 or immunocompromised persons

24
Q

Osteoporosis Screening

A

DEXA scans
65+
Routine screening at 60 for increased risk of osteoporotic fractures

25
Q

Vision Screening

A

Periodically
Senile chart
Amsler grid
Optometrist or ophthalmologist

26
Q

Hearing Screening

A

Periodically
Screened with questionnaire
Whisper test
Audiogram

27
Q

Social Support

A

Family & friends available for assistance & emotional support
Simple questionnaire
Emotional & cognitive problems

28
Q

Fall Prevention Screening

A

Annual visit
Get up & go test (mobility)
MMSE
Medication assessment

29
Q

Function Screening

A

ADLs

IADLs

30
Q

Cognition Screening

A

MMSE

31
Q

Depression Screening

A

Depression scale

32
Q

Medication Screening

A

Brown bag test

Have patient bring in all their medications

33
Q

Health Promotion that Correlate the Strongest with Healthy & Successful Aging

A

Physical activity

Nutrition

34
Q

Exercise & the Elderly

A

Counseled on benefits of aerobic & resistance exercise & life-style modification

35
Q

Long Term Effects of Sedentary Lifestyle

A

Functional limitations
Obesity
Diabetes
CV disease

36
Q

Benefits of Exercise in the Elderly

A

Resilient with respect to CV endurance & strength
Improves functional limitations, overall sense of well-being & self esteem, longevity, blood lipids, osteoarthritis, & conditioning
Decreases progression to disability
Reduces BP & CV disease
Reduces abdominal fat & insulin resistance
Reduces falls
Minimizes or reverses physical frailty
Prevents hip fractures

37
Q

Dynamic Aerobic Exercise for the Elderly

A
Swimming
Brisk walking
Running
Bicycling
Muscle strengthening