Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Geri EOR > Health maintenance > Flashcards

Health maintenance Flashcards

(108 cards)

Start Studying
1
Q

cardiac changes in the elderly

A
  1. Increased wall thickness
  2. Decreased maximal heart rate; decreased cardiac output
  3. Increased systemic vascular resistance
  4. Baroreceptor dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

endocrine changes in the elderly

A

Impaired glucose tolerance; decreased testosterone and estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

white, gray, or blue ring or arc around the cornea of the eye.

A

arcus senellis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what contributes to changes in drug pharmacokinetics in the elderly

A

A decline in gastric acid may affect absorption of those drugs that require a low pH for full absorption

Moderate reductions in free water and serum proteins occur w/ aging, resulting in higher active drug concentrations

Decline in liver mass and hepatic blood flow + declines in renal clearance affect drug clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

vitamin deficiciency map

A

ii. Vitamins C, D, B12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Sarcopenia

A

Sarcopenia is the degenerative loss of skeletal muscle mass (0.5–1% loss per year after the age of 50),

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

USPST recommendations around vitamin D

A
  1. USPST recommends daily allowance for vitamin D supplementation is currently 600 IU for adults age 51-70 and 800 IU for >70
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hyperopia

A

Hyperopia (farsightedness

distant objects may be seen more clearly than objects that are near

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Astigmatism

A

eye does not focus light evenly onto the retina, causes images to appear blurry and stretched out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

RF for cataracts

A

aging (>60y), cigarette smoking, corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Shafer’s sign

A

clumping of brown-colored pigment cells in the anterior vitreous humor resembling tobacco dust

indicates a retinal break or rhegmatogenous detachmen

this is an emergency

Pt will see sees floaters / gray cloud on funduscopic exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who is most at risk of Macular degeneration

A

Risk factors – age >50y, Caucasians, smokers

MC cause of permanent legal blindness & visual loss in the elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

two types of macular degeneration

A
  1. Dry (atrophic)

2. Wet (neovascular or exudative)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are drusen spots

A

Drusen = small, round, yellow-white spots on the outer retina

associated with macular degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what do you typically see with wet macular degeneration

A

a. New, abnormal vessels grown under the central retina, while leak and bleed  retinal scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

CM of macular degeneration

A
  1. Bilateral blurred or loss of central vision (including detailed & colored vision)
  2. Scotomas (blind spots), metamorphopsia (straight lines appear bent)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

dx of wet/exudative macular degeneration is typically made with

A
  1. Fluorescein angiography
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

management of dry macular degeneration

A
  1. Dry = Amsler grid @ home

a. Zinc, vitamin A, C, E may slow progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

management of wet/exudative macular degeneration

A

a. Intravitreal anti-angiogenics ex – Bevacizumab (reduces neovascularization)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the MCC of hearing loss in the elderly

A

i. Cerumen impaction and presbycusis are common causes of hearing loss in the elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how does sensorineural loss occur and what are the results with weber and rinne test

A

Sensorineural loss – occurs w/ damage/impairment of the inner ear or neural pathways

  1. Weber test  lateralization to the unaffected side
  2. Rinne test  air conduction > bone conduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

if weber lateralizes to the affected ear than suspect

A

conduction issue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is cor pulmonale and what might you see on a EKG

A

RVH and RAE, RAD, and R sided HF

a. MULTIFOCAL ATRIAL TACHYCARDIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the only therapy and intervention proven to reduce mortality in COPD pts

A

Oxygen and smoking cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what atypical symptoms might you seen a pt with PNA
1. Less cough, absent fever, absent or unimpressive leukocytosis 2. Often, only confusion and tachypnea are seen 3. CXR
26
CI to COPD anticholinergics
ii. CI = BPH, glaucoma
27
salmeterol is CI in
Albuterol, Terbutaline, Salmeterol (LABA) CI: caution in pt’s with DM (can cause hyperglycemia)
28
why are geriatric pts more predisposed to PNA
decreased ciliary activity, less effective cough, decreased vital capacity
29
FIRST LINE for OSA
1. In-laboratory polysomnography = First line
30
other than a CPAP what can you do for OSA
2. Behavioral = weight loss, exercise, abstain from alcohol, changes in sleep positioning 3. Surgical correction a. Tracheostomy = definitive tx
31
overall 5 year survival rate for pts with lung cancer
i. Overall 5 year survival rate = 15%
32
MC type of bronchogenic carcinoma
adenocarcinoma
33
NSCLC that is bronchial in origin and a centrally located mass. presents with bloody sputum and pleuritic CP
Squamous cell
34
NSCLC that arises from mucous glands, usually appears in the periphery of the lung
Adenocarcinoma
35
Large cell carcinoma
doubling time is rapid and early metastasis Central or peripheral masses NSCLC
36
SCLC
2. Originates in the central bronchi and metastasizes to regional lymph nodes a. Prone to early metastases and aggressive clinical course 1. More likely to spread early and rarely is amenable to surgery
37
clinical features of lung CA
1. New or changing cough, hemoptysis, pain, anorexia, weight loss, LAD, hepatomegaly, clubbing of fingers
38
dx test if suspecting lung ca
1. CXR and CT 2. Cytologic exam of sputum 3. Bronchoscopy – examination of pleural fluid and biopsy 4. PET scan
39
typical mngmt strategies for Lunc Ca
1. NSCLC --> surgery | 2. SCLC --> combination chemotherapy
40
TIMI what is it and how do you use it
Useful to assess the risk of death & ischemic events in patients w/ UA or NSTEMI a. Age ≥65y b. ≥3 CAD risk factors (FHx, HTN, Chol, smoker, DM) c. Known CAD (stenosis >50%) d. ASA use in past 7 days e. Recent (<24h) severe angina f. Cardiac markers g. ST elevation 0.5mm 3. Score ≥3 = high risk
41
ECG finding with angina pectoris
ST depression (especially horizontal or downsloping) = classic finding ii. Resting EKG normal in 50% of pts
42
gold standard eval of angina pectoris
b. GOLD STANDARD = Angiography
43
how can stress echos help in evaluating angina pectoris
assesses LV function, valvular dz, pts w/ pathologic Q waves
44
two occasions in which nitroglycerin is CI
CI = SBP <90; RV infarction, use of PDE-inhibitors i. If no relief with 1st dose  give 2nd/3rd q5 minutes
45
NSTEMI medication regimen
``` ANTI-PLATELET anticoagulants BB nitrates morphine ``` CCB (if pts can't have BB)
46
antiplatelet drugs for NSTEMI
ASA Clopidogrel (Plavix) good in pts w/ ASA allergy GpIIb/IIIa inhibitors 1. Eptifibatide 2. Tirofiban 3. Abciximab
47
anticoagulants for NSTEMI
i. Unfractionated heparin  binds to & potentiates antithrombin III’s ability to inactivated Factor Xa, inactivates thrombin LMWH --> same MOA; S/E – thrombocytopenia 1. Enoxaparin (Lovenox) 2. Dalteparin (Fragmin)
48
gold standard dx for CHF
2. Gold standard = cardiac cath
49
S/E OF thiazide diuretics
SE = Dehydration, hyperuricemia, hyponatremia, hypokalemia
50
PVD is most commonly due to
MC d/t atherosclerosis
51
PAD sxs
Skin changes = loss of hair, shiny atrophic skin, and pallor w/ dependent rubor Femoral and distal pulses will be weak or absent Thigh or buttock pain w/ walking
52
gold standard for peripheral arterial dz dx
Doppler ultrasound flow ABI (ankle-brachial index) ≤0.9 indicates significant disease GOLD STANDARD = Angiography
53
what is the Tx for PvD
a. STOP tobacco use; control Diabetes, HTN, and hyperlipidemia B-blockers, ACEI, statins, progressive exercise, ASA and/or Plavix Cilostazol If all above fail, then revascularization
54
MNMGT of varicose veins
1. Graduated elastic stockings 2. Leg elevation and regular exercise 3. Small venous ulcers heal w/ leg elevation and compression bandages 4. Large ulcers may require compression boot dressing (Unna boot) or skin grafts
55
ddx when dealing with a pt that has syncope
Arrhythmias, aortic stenosis, carotid sinus hypersensitivity, MI, hypoglycemia, orthostatic HoTN, postprandial HoTN, PE, vagal faint
56
paroxysmal Afib
1. Paroxysmal – self terminating within 7 days (usually <24h)
57
persistant vs permanent AFIB
2. Persistent – fails to self-terminate, >7 days | 3. Permanent – persistent AF >1 year
58
rate control AFIB
i. Beta blockers – Metoprolol, Esmolol ii. CCB – Diltiazem iii. Digoxin +/- used in the elderly
59
rhythm control Afib
Synchronized cardioversion Amiodarone, Ibutilide, Flecainide, Sotalol Radiofrequency ablation – permanent pacemaker
60
how does venous insufficiency occur
Loss of wall tension in veins --> stasis of venous blood and often is associated w/ hx of DVT, leg injury, or varicose veins
61
what are the sxs of venous stasis
Progressive edema starting at ankle Itching, dull pain w/ standing & pain w/ ulceration is common Skin is shiny, thin, and atrophic w/ dark pigmentary changes & subq induration Ulcers usually right above the ankle (stasis ulcer)
62
management of venous insufficiency
Elevation of legs, avoidance of extended sitting or standing and compression hose Ulcerations may be treated w/ wet compresses, compression boots or stockings, and maybe skin grafting
63
what is the hallmark of IDA
Pica= hallmark
64
what is dx lab for IDA
Plasma ferritin <20 ug/L
65
mnmgt of IDA
Ferrous sulfate 325mg TID orally Hgb/Hct within normal range in 2 months BUT therapy should be continued for up to 6 months or longer
66
what are the tests associated with anemia of chronic dz
Normal or increased ferritin + decreased TIBC decreased serum Fe
67
treatment of anemia of chronic dz if it is secondary to renal dz
1. Tx underlying dz | 2. EPO if d/t renal dz
68
what is the MCC of vitamin B 12 deficiency
i. MCC = pernicious anemia d/t lack of intrinsic factor which is needed for vitamin B12 absorption
69
Sxs of vitamin B 12 deficiency .
1. Smooth tongue, glossitis, cheilosis | 2. Stocking-glove parasthesias, loss of vibratory and position sense, balance problems and ataxia, dementia
70
difference between B12 and folic acid deficiency
NO NEURO SXS in folic acid deficiency 1. Sore tongue (glossitis) 2. Vague GI symptoms 3. NO NEURO SYMPTOMS
71
folic acid deficiency what would you see on a smear
1. Macro-ovalocytes + Hypersegmented polymorphonuclear cells = pathognomonic 2. Howell-Jolly bodies
72
what is the treatment for folic acid deficiency
Oral replacement (1g/day) w/ folic acid = 1st line
73
18) Diagnostic of DM II
Fasting >126 twice • Random or 2hr GTT >200 • Postprandial glu 250 + sxs
74
MC location of prostate cancer
peripheral zone
75
• Drusen spots; loss of central vision
macular degeneration
76
MCC of demntia
Alzheimer
77
22) Mild-moderate Alzheimer’s treatment
Ach-esterase inhibitor = Donepezil (Aricept) | also slows down alzheimer's
78
Dexa-scan osteoporosis screening what age
65
79
Optic disc cupping w/o rise in IOP?
gluacoma
80
what is the initial management of glaucoma
Acetazolamide (decreases IOP) Timolol (topical B-blocker) iii) Picocarpine
81
II, III, and ___ are ann inferior lead
AvF
82
elderly becoming more tachy or brady
tachy
83
worsens after resting OA or Ra
RA
84
morning stf >60 mins OA or Ra
RA
85
osteophytes on XR OA or RA
OA
86
asymettric joint narrowing | OA or Ra
OA
87
boggy and warm joints OA or Ra
RA
88
heberden's nodes OA or Ra
OA
89
affects the DIP OA or Ra
OA
90
constipation treatment -bulk forming l
psyllium methlcellulose (Citrucel) polycarbohil wheat dextran
91
osmotic laxatives
``` polyethylene glycol (PEG) aka miralax ``` sorbitol lactulose saline laxitives -MOM
92
stimulant laxatives
bisacodyl (DUlocolax) senna stimulat senna
93
signs of PNA and tx
hypotension cough low 02 llevofloxacin
94
actinic keratosis puts you at risk for
• Squamous cell carcinoma
95
mc fx in the elderly
Pathologic fra ctures: MC vertebral, hip & distal radius (Colie’s) with or without trauma.
96
sudden halos and peripheral vision loss-tx
axetozolamide or topical BB acute
97
Gradual peripheral vision loss
glaucoma PG analog anything that ends in prost
98
actinic keratosis
Dry, rough, scaly "sandpaper" skin lesion or erythematous, hyperkera totic (hvperpigmen ted) plaques* can lead to squamous cell ca
99
IDA is what type of cells
Hypochromic, microcytic RBC
100
what are the bisphosphinates
Alendronate, Risedronate, Etidronate
101
tachyphylaxis
rapidly diminishing response to successive doses of a drug, rendering it less effective. The effect is common with drugs acting on the nervous system.
102
Abdominal pain, rectal discomfort, anorexia, n/v Acute confusional state suspect ...
suspect fecal impaction
103
Abdominal cramps, diarrhea, fever, tenderness, strikingly increased lymphocytosis suspect
Abdominal cramps, diarrhea, fever, tenderness, strikingly lymphocytosis Pseudomembranous colitis C. diff Caused by clindamycin FQ
104
Mngmt. for UGIB
Replace coag factors as needed Octreotide 25-50micrograms bolus followed by 25-50micrograms IV for patients w/ UGIB
105
Colorectal cancer
MC site of metastatic spread = LIVER
106
what are the RF for colorectal CA
familial adenomatous polyposis; age >50y; diet low in fiber and high in red/processed meat
107
Clinical manifestations of colorectal CA
CRC MC cause of large bowel obstruction in adults R sided (proximal) = lesions tend to bleed and cause diarrhea L sided (distal) = bowel obstruction, present later, changes in stool diameter, hematochezia
108
transmission of Hep A
1. Transmission = Fecal-oral (international travel 40%)

Geri EOR (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions