Intro to Geriatrics Flashcards Preview

Clinical Disciplines II- Exam 1 (Melicia) > Intro to Geriatrics > Flashcards

Flashcards in Intro to Geriatrics Deck (33)
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1

What is geriatric medicine?

Medical speciality focusing on medical issues/dieseas of aging and old age

> 65 y/o

2

How is geriatric medicine different?

older pt

understanding of aging process

multidisciplinary

end of life care

3

What is aging?

time dependent deterioration:

weakness, increased susceptibility to disease, loss of mobility and agility , age related physiologic change

4

Functional performance of an organ in an older person depends on...

the rate if deterioration

the level of performance needed

5

The hallmark of aging is assoc. with...

how an organ perform during external stress NOT how it performs at rest

6

Examples of atypical presentation in older persons? What is this due to?

failure to mount a white count or ever in response to infx, no pain with MI


due to failure of the stress response

7

Changes in aging can work together to...

produce a normal appearing resting state


I.e. normal Cr despite decreased in GFR and renal blood flow

8

How often should you check weight? Height?

at each visit

at least annually

9

Why can BP be overestimated in elderly?

due to stiff arteries (pseudohypertension)

10

How does skin change with aging?

skin becomes lax, loss of turgor

decreased vascularity in dermis > paler, more opaque

backs of hands/forearm: thin, fragile, loose and transparent skin with actinic purpura

11

How do nails change with age?

loose luster, may yellow and thicken, brittle

12

How does hair change with age?

scalp hair loses pigment

decrease in # of scalp hairs

women ~55 y/o will notice coarse facial hairs on upper lip and chin

13

How can pupils change with age? other eye changes?

become smaller an may be slightly irregular

dry eyes, presbyopia, cataract,, glaucoma and macular degeneration

thickening and yellowing of lens impeded light flow to the retina --> need more light to see

14

Changes with nose?

descent of nasal tip

enlarges

15

changes with ears?

presbycusis

16

Mouth changes with age?

darken teeth

fissures in the mouth/tongue

changes in tongue (ex. varicosities)

angular chelitis

TMJ- eval for osteoarthrosis

17

Thyroid changes? What else should you check in the neck?

can enlarge downward


carotid bruits, transmitted heart murmur

check neck for flexibility

18

On respiratory exam.....can be present at the lung bases but should clear with deep inhalation and cough

basilar rales (crackles)

19

Changes in HR with age?

bradycardia

check for irregular irregular rhythm

20

Systolic murmurs in elderly?

aortic valve sclerosis

aortic valve stenosis

mitral regurgitation

hypertrophic cardiomyopathy

21

Breast changes with ages?

breast become smaller, more flaccid and pendulous

granular tissue atrophies and is replaced by fat

ducts surrounding the nipple may become palpable as stringy strands

males can develop gynecomastia

22

Abdominal changes with age?

abd muscle weaken

soft, more protruding abd

changes in abd fat distribution

23

How can aging blunt the manifestations of acute abd disease?

pain can be less severe

lower/absent severe

guarding/rebound reduced or absent

24

When does ovarian func. begin to decline?

around the 5th decade, menstrual periods cease btwn ages 45-52 y/o

25

Why do women get urinary incontinence?

Denervation and contractility of the detrusor muscle

Loss of bladder capacity

Urinary flow rate

Inability to inhibit voiding

26

Musculoskeletal change with age?

M/W lose cortical and trabecular bone mass

27

Age related findings of the feet?

Hallux valgus

Hammer toes

Claw toe

28

Toe deformities can result from...

ill fitting foot wear, RA, DM, neurological disorder

29

Nervous system changes with age?

affects all aspects of nervous system

Brain volume, cortical brain cells, and intrinsic regional connecting networks decrease, and both anatomical and biochemical changes occur

30

Bell phenomenon may be absent in older adults, what is this?

reflex upward movement of eyes during closure

31

Where is vibratory sense frequently loss?

in the feet and ankles

(not skins or fingers)

32

Aging effect on walking?

typically little effect, elder lying walk upright unless there is a disorder present

33

Normal gait velocity? Slow gait velocity?

>0.8 m/s or <5seconds on a 4 meter walkway


<0.8m/s