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Flashcards in Lecture 4 from Profs Deck (54):
1

what are age related changes in the epidermis

skin more fragile
altered turnover rate & DNA repair; photo-aging

2

what are age related changes with the dermis?

loss of thickness
decrease mast cells and histamine
decrease vascular supply and collagen synthesis

3

What changes with the SubQ with age?

decreased volume (face and hands)
increase volume in abdomen and thighs

4

which level of vit d is tested for?

25-hydroxycholecalciferol

5

where do you get Vitamin D?

Dairy, fish, sun
must go through a process to be used

6

why does hair grey?

hair follicles produce less melanin

7

what causes senile purpura?

Capillary fragility

8

why is temp regulation difficult?

atrophy of sweat glands

9

what causes pressure ulcers?

decreased SubQ fat

10

what is dry skin?

xerosis

11

what are purple spots in skin exposed areas? not raised or painful.

actinic purpura

12

what is the name for age spots/ liver spots?

solar lentigo

13

what are waxy, raised lesions?
tan, brown-black, or gray, waxy to verrucoid papules and plaques, stuck-on appearance; benign

seborrheic keratosis
use cryosurgery to remove

14

sun exposed area, crusty, reddened, circular

Seborrheic keratosis
do a biopsy, or totally remove can turn into squamous cell

15

reddish bump, large, a bit irregular. can have a crust on it

Squamous cell

16

Red bump with waxy, with telangiectasia

Basal cell carcinoma

17

what biopsy do you not do with melanoma?

shave

18

perpendicular force to skin surface

Pressure

19

parallel force to skin surface

Shearing

20

4 things for pressure ulcers?

Pressure
Friction
Shearing force
moisture

21

main symptom of arterial dz?

claudication

22

what test do we do to check for peripheral arterial dz?

ABI

23

cutaneous vesicular eruption & excruciating pain (burning, knifelike, deep & boring)

Herpes Zoster

24

Tx for herpes zoster.

Antiretrovirals & analgesia = minimize sequelae (post-herpetic neuralgia)

25

Diagnostics for anemia

CBC w/differential
reticulocyte count
blood smear
erythrocyte indices
nutritional status

26

what might be a first sign of anemia?

Worsening of angina

27

PE changes in anemia

pallor
tachycardia
evidence HF
change in cognitive tests

28

What does high MCV indicate?

Megaloblastic- B12 and folate deficiences

29

what does normal MCV indicate?

Anemia of chronic dz
early Fe deficiency

30

Low MCV indicates what?

Fe deficiency
anemia of chronic dz
sideroblastic

31

what can cause iron deficiency?

Dietary or blood loss

32

Will ferritin be low or high with microcytic/ hypochromic anemia?

Low ferritin

33

How do you treat microcytic/ hypochromic anemia?

Ferrous sulfate 2-3 times a day

34

what is a microcytic/ hypochromic anemia that is congenital and acquired. Associated w/ chronic alcohol abuse, RA, cancer, lead poisoning.

Sideroblastic anemia

35

diagnostics for sideroblastic anemia

CBC- microcytic, hypocrhomic + ringed sideroblasts
increased iron and transferrin saturation
TIBC normal
ferritin normal

36

how do you treat sideroblastic anemia?

trial pyridoxine
transfusion
look for cause

37

what can be a problem with transfusion w/ sideroblastic anemia

iron overload

38

what can sideroblastic anemia turn into?

myeloblastic leukemia

39

labs with anemia of chronic dz?

decrease serum iron
high or normal ferritin
TIBC low

40

how do you manage anemia of chronic dz?

treat underlying dz or malignancy
EPO
transfusion

41

Signs of B12 deficiency

loss of vibratory and position sense
dementia
neuro-psych

42

how to treat b12 anemia?

Supplement, correct nutritional or underlying GI issue

43

labs for B12 deficiency

CBC: macrocytic, hyperchromic, hypersegmented neutrophils; BM: megaloblasts; B12 & folate levels

44

causes of folate macrocytic/ megalobalstic anemia

chronic alcohol abuse
inadequate dietary intake
drugs- anticonvulsants, triameterene

45

signs of folate deficiency anemia?

no neuro symptoms

46

who are vit d deficiency seen in lost

bed bound
nursing home patients

47

what vitamins do you worry about ODing on?

A D E K

48

: non-palpable ecchymotic areas, no hx anticoagulation, abuse, trauma

actinic purpura

49

a small, sharply circumscribed, pigmented macule surrounded by normal appearing skin/melanin pigment, aka “age spot”, spots represent areas of melanin overproduction in the skin from lifetime of chronic sun exposure, benign

Lentigo

50

tan, brown-black, or gray, waxy to verrucoid papules and plaques, stuck-on appearance; benign

Seborrheic keratoses

51

condition of thick, scaly, or crusty patches of skin, pre-malignant lesion, progression to squamous cell CA

Actinic keratosis

52

translucent, "pearly" or "waxy" papule; associated telangiectasia, sometimes central ulceration

Basal cell carcinoma

53

a flesh-colored or reddish bump or patch

Squamous cell carcinoma

54

4 stages of pressure ulcers

Non blanching erythema → dermis → fascia → bone