PDCI 7 Geriatrics

Question 0

Geriatric problems

Answer 0

Falling
Dementia
Incontinence
Osteoporosis

Question 1

What % of 65+ have at least 1 chronic disease?

Answer 1

80%

Question 2

Prevalence of chronic diseases with aging

Answer 2

Heart disease and cancer increase with age

Hypertension and diabetes level off after 65

Question 3

Prevalent disabilities/limitations

Answer 3

Hearing
Vision
Teeth

Question 4

There are 26 geriatric competencies for med students. What are the 8 categories?

Answer 4

1) medication management
2) cognitive and behavioral disorders
3) self care capacity
4) falls, balance, gait disorders
5) health care planning & promotion
6) atypical presentation of disease
7) palliative care
8) hospital care for elders

Question 5

What is health literacy, and what % of 65+ have basic or below basic health literacy?

Answer 5

Ability to understand health issues

60%

Question 6

What % 85+ have dementia?

Answer 6

40%

Question 7

What % of older adults live in the community / not nursing homes?

Answer 7

Over 95%

Question 8

Office environment for gathering history

Answer 8

Physical comfort for patient
Lighting
Overcoming hearing issues
Safety

Question 9

What are examples of atypical geriatric symptoms?

Answer 9

No chest pain with MI (because of diabetes)

Less likely to have fever

Question 10

Activities of daily living

Answer 10

Bathing
Dressing
Toileting
Transferring (bed to chair)
Continence
Feeding/eating

Question 11

Instrumental activities of daily living (IADLs)

Answer 11

* requires cognition and physical ability
Using phone
Shopping
Making food
Housekeeping
Laundry
Transportation
Medication administration
Managing finances

Question 12

Information needed for medications

Answer 12

Name
Dose
Frequency
Indication (used for what?)
Problems with med
Rx and non rx meds
Supplements

Question 13

What can cause unexplained weight loss (15 pounds) or low weight (under 100)

Answer 13

Cancer
Depression
Dementia

Question 14

Nutrition issues can be caused by

Answer 14

Procurement (food to home)
Preparation
Ingestion (dental issues?)

Question 15

What % of geriatric OVs involve a pain complaint?

Answer 15

80%

Question 16

Cutoff between acute and persistent pain

Answer 16

3 months

Question 17

Common causes of acute pain

Answer 17

Post surgical
Trauma
Headache

Question 18

Common causes of persistent pain

Answer 18

Arthritis
Cancer
Clarification
Leg cramps
Neuropathy 
Radiculopathy (pain radiating from spine)

Question 19

CDC’s definition of moderate alcohol use

Answer 19

1 drink per day up to 5 a week

Question 20

Prevalence of alcohol related problems in older adults

Answer 20

10%

Question 21

Alcohol related problems

Answer 21

Memory
BP
Diabetes
Balance
Depression

Question 22

What % of older adults fall each year?

Answer 22

35-40%

Question 23

Questions about falls

Answer 23

Falls or near falls
Situation
Associated symptoms
Injuries

Question 24

When should you talk about end of life issues?

Answer 24

When patient is healthy

Question 25

Health promotion topics

Answer 25

``` Sensory complaints Exercise Immunizations Home safety Cancer screening Mood Cognition Elder mistreatment ```

Question 26

What is considered bad vision?

Answer 26

Less than 20/40

Question 27

Presbyopia

Answer 27

Worse close up vision with aging

Question 28

What is the biological cause of presbyopia?

Answer 28

Loss of water content - not as stretchy

Question 29

What should you do before hearing test?

Answer 29

Check ear canals for wax

Question 30

Presbycusis

Answer 30

Worsened hearing with aging | - especially higher pitch

Question 31

Immunizations for elderly

Answer 31

``` Flu - annually Pneumovax - once after age 65 Td (tetanus and diphtheria) - primary series, 10 year booster, 5 years for high risk wounds Tdap - 1 time booster Zostavax - once after 60 ```

Question 32

What vaccine should you get once after age 60?

Answer 32

Zostavax

Question 33

What vaccine should you get once after age 65?

Answer 33

Pneumovax

Question 34

Cancer screenings for older adults

Answer 34

Breast Colon Prostrate Cervical

Question 35

Mood issue prevalence

Answer 35

10%

Question 36

Who has the highest rates of successful suicide?

Answer 36

Men over 65

Question 37

Most common cognition problem

Answer 37

Dementia

Question 38

Delirium vs dementia

Answer 38

Delirium - acute onset - lasts hours to weeks Dementia - insidious (slow growing) - months to years

Question 39

Causes of delirium

Answer 39

- delirium tremens - uremia - acute hepatic failure - drug toxicity

Question 40

Causes of dementia

Answer 40

- Alzheimer's - vascular - past head trauma - low vitamin B12 - thyroid disease

Question 41

10 minute geriatric screener: 3 major areas

Answer 41

Cognitive Psychosocial Physical

Question 42

Sections of 10 minute geriatric screener

Answer 42

``` Vision Hearing Leg mobility Urinary incontinence Nutrition/weight loss Memory Depression Physical ability ```

Question 43

What is considered bad hearing?

Answer 43

Worse than 40 dB

Question 44

What is a normal result of the get up and go test?

Answer 44

Less than 15 seconds

Question 45

Causes of urinary incontinence

Answer 45

``` DIAPERS Delirium Infection Atrophic urethritis/vaginitis Pharmaceuticals Excess urine from hyperglycemia or heart failure Restricted mobility Stool compaction ```

Question 46

6 questions to measure physical disability

Answer 46

``` Strenuous activities Housework Shopping Places farther than walking Shower Get dressed ```