Intro to Geriatrics

Question 1

Anatomical changes in the CV system

Answer 1

decreased contraction and filling capacity → less CO

Question 2

Physiological changes in the CV system

Answer 2

changes in conduction → tachy and bradyarrhythmias, decreased efficiency, decreased catecholamines

Question 3

Changes in the conduction system of the heart

Answer 3

decreased due to fibrosis or ischemia, “irritable” → trigger → increased HR → tachyarrhythmias.

Generally slows down

Question 4

Arterial changes in the CV system

Answer 4

increased stiffness, atherosclerosis

Question 5

Venular changes in the CV system

Answer 5

decreased valves, thrombosis, PE

Question 6

Disease r/t aging CV system

Answer 6

HTN, TIA/CVA (carotid- occlusion, vertebral- hypotension)

Question 7

CNS changes in the elderly: conduction and transmission

Answer 7

moving slower and not as strong → results in not having the same coordination or muscle control

Question 8

CNS changes: threshold for arousal

Answer 8

Blurred, needs a greater signal

Question 9

CNS changes: adaptation to physiologic stressors

Answer 9

Reduced

Question 10

CNS changes: recovery time in autonomic system

Answer 10

Increased time needed to return to baseline

Question 11

Respiratory changes in the elderly

Answer 11

Normal at rest, compromised under stress

Question 12

Anatomical changes in the respiratory system

Answer 12

decreased expiration → decreased elasticity, muscle weakness, skeletal deformities and reduced capacity of lungs

Question 13

Functional changes in the respiratory system

Answer 13

decreased ventilation and PaO2

Question 14

Anatomical changes in the kidneys

Answer 14

Nephron degeneration

Question 15

Physiologic changes in the kidneys

Answer 15

decreased ability to concentrate urine, decreased renal blood flow, decreased acid-base adaptation when stressed

Question 16

Diseases and problems with the kidneys in the elderly

Answer 16

inadequate fluid intake, fluid loss d/t vomiting and diarrhea, shock due to hemorrhage, cardiac failure, sepsis, injudicious use of diuretics, sodium phosphate enemas

Question 17

Bladder changes in older women

Answer 17

estrogen deprivation, atrophy, decreased secretions → urinary incontinence, dyspareunia, menopause signs/symptoms

Question 18

Bladder changes in older men

Answer 18

gradual decrease in testosterone, decreased libido and sexual function, decreased energy, increased body fat, osteoporosis, decreased muscle mass, decreased body hair

Question 19

General GI changes

Answer 19

Dentition and nutrition changes because they’re eating less

Question 20

Esophageal changes

Answer 20

decreased motility, hiatal hernia (stomach pushing up through the LES)

Question 21

Stomach changes

Answer 21

decreased acid, intrinsic factor, motility

Question 22

Colon changes

Answer 22

decreased motility

Question 23

Pancreatic changes

Answer 23

decreased secretions

Question 24

Liver changes

Answer 24

decreased size and blood flow; decreased CYP450 activity

Question 25

Musculoskeletal changes: structure and function

Answer 25

atrophy, decreased O2

Question 26

Joint changes

Answer 26

erosion, degeneration, calcification/ossification of ligaments

Question 27

Skeletal degeneration changes

Answer 27

osteoporosis → kyphosis

Question 28

Musculoskeletal changes in the elderly can lead to what?

Answer 28

Fractures and falls

Question 29

Skin and derm changes

Answer 29

Changes in skin, nails, hair → decreased elasticity and turgor, increased pigmentation

Question 30

Sensory changes

Answer 30

decreased vision and hearing

Question 31

Frality defintion

Answer 31

a state of vulnerability to poor resolution of homeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homeostatic reserves until minor stressor events trigger disproportionate changes in health status.

Question 32

Geriatric syndromes definiton

Answer 32

multifactorial health conditions that occur when the accumulated effects of impairments in multiple systems render an older person vulnerable to situational challenges

Question 33

Types of geriatric syndromes

Answer 33

Dementia, delirium, urinary incontinence, falls, gait disturbances, dizziness, syncope, hearing impairment, visual impairment, osteopenia, malnutrition, eating and feeding problems, pressure ulcers, sleep problems

Question 34

Comprehensive geriatric assessment

Answer 34

Cost and coverage Adherence Safety Attaining therapeutic goals History-taking problems Medication organization Assessing and monitoring drug therapy

Question 35

Drug-related problems in the elderly

Answer 35

Underuse Overuse Inappropriate prescribing

Question 36

5 Ms of Geriatrics

Answer 36

Mind, mobility, medications, multi-complexity, matters most

Question 37

Prescribing cascade: what is it?

Answer 37

One drug is prescribed to combat the effects of another one and so on and so forth. Some of these prescribing cascades are legit and CAN help with symptomatic relief, but knowing that a symptom a patient is experiencing is a side effect of the drug is the most important part!