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
