OAT Geriatric Pts Lect

Question 1

Subgroups of geriatrics and Ages

Answer 1

65-75: Young-old

75-85: Older-old

85+: Old-old

Question 2

Most common form of arthritis

Answer 2

Osteoarthritis

Hands, feet, knees, hips

Question 3

Leading cause of LE disability in older adults

Answer 3

Osteoarthritis

Question 4

Osteoarthritis presents with joint stiffness at what periods?

Answer 4

After periods of inactivity:

Just after waking up

Just after sitting

Question 5

Progression of osteoarthritis

Answer 5

Initial: pain in one joint

Progress to multiple joints

Night pain, interference with sleep

Question 6

What finding is classic on XR of osteoarthritis

Answer 6

Osteophytes

Narrowed joint spaces

Question 7

Medical treatment of osteoarthritis

Answer 7

Pain relief

Weight management, exercise

Walkingaids, braces, orthoses

Topical, oral analgesics

OMM/PT

Orthopedic intervention

Question 8

Fastest growing source of disability due to neurologic disorders

Answer 8

Parkinson’s disease

Question 9

Most common infectious cause of death in the elderly

Answer 9

Pneumonia

Question 10

Leading cause of injury among older adults in the US

Answer 10

Falls

Question 11

Fall Risk Assessment: Get up and Go test

Answer 11

Observe older person move from seated to standing without using arms for support

Walk 3 meters, turn, and return to chair

Sit back in chair w/o support

>12 seconds indicates fall risk

Question 12

Goals in geriatric management

Answer 12

Optimize function - ability to walk, daily activities

Avoid institutionalization - 80% prefer to die at home

Maintain sense of community

Question 13

Common gait changes in elderly:

Waddling gait indicates _______

Answer 13

Pelvis weakness (deconditioning)

Question 14

Common gait changes in elderly:

Antalgic gait indicates _____

Answer 14

Avoiding pain (mechanical change in low back/pelvis, LE)

Question 15

Common gait changes in elderly:

Hemiparetic gait indicates ______

Answer 15

Post stroke (neurologic compromise)

Question 16

Common gait changes in elderly:

Steppage gait indicates ______

Answer 16

Foot drop (neurologic compromise)

Question 17

Common gait changes in elderly:

Shuffling gait indicates ____

Answer 17

Parkinsons (neurologicl compromise)

Question 18

How do you want to modify OMT for geriatric patients? (3)

Answer 18

Caution with direct techniques

Avoid position changes (do seated, most cannot lay flat or pron)

Limited “doses” of treatment (poor reserve for compensation)

Question 19

The MOPSE trial showed what effect of OMT on pneumonia in the elderly?

Answer 19

OMT added to standard abx reduced length of hospital stay compared to light/no touch therapy

Question 20

The international Journal of Osteopathic Medicine showed what effect of OMT on chronic constipation?

Answer 20

Statistically significant improvement over:

1. Severity of constipation
2. Colonic transit time
3. Pt assessment of constipation sx, quality of life

Question 21

In the Journal of the American Osteopathic Association’s study on the effect of OMT on women with clinical depression, what was the outcome on the Zung Depression Scale?

Answer 21

All pts in OMT group reverted to normal range by 8 weeks

70% of pts in controlg roup still had signs of moderate depression