Intro to Geriatrics

Question 1

What is the life span @ birth for females?

Answer 1

79 y.o.

Question 2

What is the life span @ birth for males?

Answer 2

74 y.o.

Question 3

What is weakness d/t in aging?

Answer 3

1. Loss of muscle mass

2. Loss of bone density

Question 4

What are the “normal” changes of aging a result of?

Answer 4

Gradual loss of homeostatic mechanisms

Question 5

What two things does the functional performance of an organ in an older person depend on?

Answer 5

1. Rate of deterioration

2. Level of performance needed

Question 6

What is the hallmark of agin?

Answer 6

How an organism performs during EXTERNAL STRESS

Question 7

How frequently should weight be checked in the elderly?

Answer 7

@ every visit

Question 8

How often should you check heigh in elderly?

Answer 8

Annually

Question 9

What is a decrease in height due to in elderly?

Answer 9

1. Osteoporosis

2. Arthritis

Question 10

How should you take BP in the elderly?

Answer 10

in BOTH arms for @ least 30 seconds

Question 11

why can BP be false overestimated in elderly?

Answer 11

Pseudohypertension: Noncompressibility of thickened, stiff arteries

Question 12

What must you perform to avoid pseudo hypertension?

Answer 12

Osler’s maneuver: Palpate radial artery while cuff is being inflated to ensure pulse wave actually disappers

Question 13

Why should you check blood pressure in both arms?

Answer 13

obstructive atherosclerotic vascular dz

Question 14

What does a respiratory rate >25 breaths/min indicate in elderly?

Answer 14

1st sign of lower respiratory tract infections

Question 15

What is the cardinal sx of dry eyes?

Answer 15

Tearing

Question 16

What are elderly @ an increased risk for d/t lens thickening?

Answer 16

Narrow-angle glaucoma

Question 17

Define presbyopia

Answer 17

Blurred near vision

Question 18

Define presbycusis

Answer 18

Diminished hearing in old age:

Loss of high pitched sounds

Question 19

What can basilar rales/crackles be due to in elderly? How do you check?

Answer 19

Atelectasis from decreased use of lungs

Should clear with deep inhalation and cough

Question 20

What can Kyphoscoliosis cause?

Answer 20

Displacement of apical impulse

Question 21

How long should you listen to heart sounds?

Answer 21

30 sec-1 min

Question 22

What increases in elderly in order to maintain CO?

Answer 22

SV

Question 23

What heart murmur DOES radiate to the carotids?

Answer 23

Aortic valve stenosis

Question 24

Where can you hear mitral regurgitation the loudest?

Answer 24

@ apex and radiates to axilla

Question 25

What does hypertrophic cardiomyopathy increase with?

Answer 25

Valsalva maneuver

Question 26

What are COMMON peripheral vascular system changes, but NOT normal aging changes?

Answer 26

Arterial and venous changes: i.e. atherosclerosis

Question 27

Who is at an increased risk for AAA?

Answer 27

Back/Abd pain: Male 65+, smoker

Question 28

What can further worsen respiratory function in the elderly?

Answer 28

Kyphosis from aging

Question 29

When would you want to perform an anal wink? What is it? What are you testing for?

Answer 29

Sudden Fecal Incontinence: Herniated disc (above S2) SF visceral reflex: Afferent= Pudendal nerve Efferent=S2-S4

Question 30

What percentage of men does ED and BPH effect?

Answer 30

50%

Question 31

At what age range do we see cessation of menstrual periods?

Answer 31

45-52

Question 32

How often should you perform a Pelvic exam + Pap smear?

Answer 32

every 2-3 years until age 65

Question 33

If the patient lacks hip mobility, what side should they lay on?

Answer 33

Left side

Question 34

What does palpable ovaries 10 years post-menopause suggest?

Answer 34

CA

Question 35

Where do we see loss of height occur most frequently?

Answer 35

Trunk: Intravertebral disc thinning

Question 36

List OA findings

Answer 36

1. Hebedern's Nodes: DIP | 2. Bouchrd Nodes: PIP

Question 37

List RA findings

Answer 37

1. Subluxation of MCP's w/ ulnar deviation (chronic) 2. Swan neck deformity 3. Boutonnier deformity

Question 38

Lis the age-related findings in feet

Answer 38

Hallux valgus Hammer toe Claw toe

Question 39

What can toe deformities result from?

Answer 39

1. Ill-fitting foot war 2. RA 3. DM 4. Neuro d/o

Question 40

Who should be referred to podiatry?

Answer 40

ANY patient with a foot disorder

Question 41

Define Benign Forgetfulness

Answer 41

Difficulty recalling names of people/objects or details of specific events

Question 42

Define Bell Phenomenon

Answer 42

Reflex upward movement of eyes during closure is sometimes absent Normal aging change

Question 43

What is decreased sense of smell due to?

Answer 43

1. Decreased olfactory neurons 2. Numerous URI's 3. Chronic Rhinitis

Question 44

What is decreased tase due to?

Answer 44

1. Decreased sense of smell | 2. Medications that cause dry mouth

Question 45

Define Sarcopenia

Answer 45

- Decrease in muscle mass - MCly affect. hand muscles - Insignificant findings unless there is a decline or change in function (pt has to use chair arms to stand)

Question 46

What parts of the body do we see vibratory sensory loss?

Answer 46

Feet and Ankles

Question 47

Neurogenic claudication etiology

Answer 47

Lumbar spinal stenosis

Question 48

Neurogenic claudication si/s's

Answer 48

Pain, numbness, weakness during walking | Decreases with sitting

Question 49

Difficulty initiating walking etiology

Answer 49

1. Frontal/subcortical d/o 2. Isolated gait initiation failure 3. Parkinsons

Question 50

Truncal instability (sway) etiology

Answer 50

1. Hip/Knee Arthritis | 2. Cerebellar/Subcortical/Basal Ganglia dysfunction

Question 51

Step asymmetry etiology

Answer 51

1. Focal neuro deficit 2. Pain or weakness in one leg 3. Unilateral msk deficit

Question 52

Step discontinuity etiology

Answer 52

1. Fear of falling | 2. Frontal lobe d/o

Question 53

Stride with abnormalities etiology

Answer 53

1. Cerebellar d/o 2. Hip d/o 3. Normal pressure hydrocephalus

Question 54

What test do we use to measure stability?

Answer 54

Romberg