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Geriatrics > Physiologic Changes in Aging > Flashcards

Physiologic Changes in Aging Flashcards

1
Q

What are some factors that influence aging?

What are the enviornmental factors that can impact age?

A
  • Chronologic age
  • Nutrition
  • Enviormental
  • Illness
  • Injury
  • Social Support
  • Hormone Replacement
  • Shift-work

Stress, tobacco, ETOH, sun exposure

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2
Q

What is an important body system to keep in mind when caring for elderly patients?

A

Psychology and Mental Health

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3
Q

What is Senescence?

What is the short definition?

A

Term that means predictable age related to changes as opposed to those caused by disease. Not everyone experiences these disease processes, but everyone does undergo senescence. When superimposed, they can exhaust reserve and predispose to poor outcomes.

Everyone gets older whether or not you have pathological changes or not

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4
Q

What is homeostenosis?

What are some causes that may lead to mortality due to homeostenosis?

A

Reduction in the ability to maintain homeostasis. Stenosis is a narrowing of the resilience window, and increasing vulnerability to additive stress and illness.

Hip fracture, infection

*Examples because they cause death in elderly but not younger adults

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5
Q

What are some normal cardiovascular changes associated with age related changes?

A
  • Decreased arterial elasticity
  • Decreased compliance
  • Elevated afterload
  • Elevated SBP, decreased DBP, widened PP
  • LVH (compensatory)
  • Decreased beta adrenergic responsiveness
  • Decreased resitng HR and max HR
  • Decreased baroreceptor reflex
  • Decreased number of pacemaker cells in sinus node as well as conduction velocity
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6
Q

What are some common cardiovascular pathophysiology associated with increasing age?

A
  • Atherosclerosis
  • CAD
  • Essential HTN
  • CHF
  • Cardiac arrhythmias
  • Aortic Stenosis
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7
Q

Does the risk of valvular heart disease (VHD) increase significantly with age?

What is the most common VHD associated with aging?

A

Yes

Mitral Regurgitation

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8
Q

Decisions about surgical treatment vs medical management of valvular disease requires what?

A

Shared decision making with a consideration of QOL and life expectancy

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9
Q

Do elderly patients typically have surgery to correct AVR?

What is an alternative?

A

No, they are not good surgical candidates

TAVR (Transcatheter aortic valve replacement)

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10
Q

What is a reasonable SBP goal in elderly patients?

Why are there different recommendations?

A

< 120 (functional adult)
< 150 (less functional or higher fall risk)

Fall risk and risk of orthostatic hypotension

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11
Q

What side effects of antihypertensive agents should be considered in elderly patients?

A
  • Fatigue
  • Constipation
  • Risk for orthostatic hypotension
  • Electrolyte abnormalities
  • Dizziness
  • Falls
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12
Q

What agent can reverse warfarin anticoagulation?

A

Vitamin K

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13
Q

What agent can reverse DOAC treatment (apixaban/rivaroxaban)?

What agent can reverse Dabigatron?

A

Andexanet alfa

Idarucizumab

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14
Q

What are first line treatments for AF and VTE?

Why are these preferred to Warfarin?

A

DOACS

No INR testing and don’t have same response to leafy greens or vit K

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15
Q

What are some normal respiratory physiologic changes that occur with aging?

A
  • Decreased pulmonary elasticity
  • Decreased alveolar surface area
  • Increased residual volume
  • V/Q mismatch
  • Increased chest wall rigidity (decreased compliance)
  • Decreased muscle strength (diaphragm, intercostal, abdominal)
  • Decreased cough
  • Blunted response to hypercapnia and hypoxia
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16
Q

What are some pathologic respiratory conditions that may be associated to aging?

A
  • Emphysema
  • Chronic bronchitis
  • Pneumonia
  • Asthma
  • Interstitial Lung Disease
17
Q

What are the four types of comorbidities?

A
  • Coincidental
  • Intercurrent
  • Sharing common pathways
  • Complicating
18
Q

What are some chronic lung diseases that increase in prevalence with age?

A
  • Idiopathic pulmonary fibrosis (IPF)
  • COPD
  • Emphysema
19
Q

What urinary medication can cause pulmonary fibrosis when used for a long time for UTI prophylaxis?

A

Nitrofurantoin

20
Q

What are some normal renal physiologic changes associated with increasing age?

A
  • Decreased renal blood flow
  • Decreased GFR
  • Decreased renal mass
  • Decreased tubular function
  • Impaired handling of sodium
  • Decreased concentrating/diluting ability
  • Decreased drug excretion
21
Q

What are some common renal pathologic changes associated with increasing age?

A
  • Diabetic nephropathy
  • Hypertensive nephropathy
  • Urinary obstruction (prostate)
22
Q

At what age does the kidney volume start to shrink?

What co-morbidity can increase or accelerate?

A

Age 50

Atherosclerosis

23
Q

What equation can calculate glomerular filtration?

A

MDRD equation

24
Q

What is presbyphagia?

Is it a pathologic or physiological change associated with aging?

A

Changes in swallowing in the older adult

Physiologic

25
Q

Is the ability to absorb B12 impaired with increasing age?

What is required to digest and absorb B12?

A

Yes

Intrinsic Factor

26
Q

What are some common pathologic GI conditions associated with aging?

A
  • GERD
  • Dysphagia
  • Esophageal spasm
  • Achalasia
  • Xerostomia
  • Diverticular disease (-osis, -itis)
  • Constipation
  • Sensory/gustatory changes
27
Q

Is the decrease in number and function of insulin producing beta cells a normal physiologic change associated with aging?

A

Yes

28
Q

What are some common endocrine pathophysiology associated with aging?

A
  • Hypothyroidism
  • Hyperthyroidism
  • Male impotence
  • Diabetes
  • Osteoporosis (F > M)
29
Q

What age related endocrine changes occur in women?

A
  • Decreased estrogen
  • Lower FH
  • Lower LSH
  • Bone loss
  • Decreased cardioprotection
30
Q

What age related endocrine changes occur in men?

A
  • Decreased testosterone and estradiol
  • Lower sperm count
  • Delayed sexual response
  • Decreased libido
  • Muscle atrophy
31
Q

What are some common hematologic pathologic changes associated with aging?

A
  • Anemia
  • Leukemia
  • Lymphoma
  • Plasma cell disorders
32
Q

Do elderly have the same response to vaccines as younger individual?

A

No, reduced response due to weakened immune response

33
Q

Does muscle mass decline annually as we age?

A

Yes

34
Q

What are some common external mechanisms that lead to disease specific mechanisms in elderly?

Are they modifiable or non-modifiable risks?

A
  • Vitamin D deficiency
  • Undernutrition
  • Malnutrition
  • Decreased muscle or physical activity
  • Decreased protein intake
  • Immobilization

Modifiable

35
Q

What symptoms shound not be overlooked in older patients?

A
  • Dyspnea
  • Falls
  • LOC
  • Chest pain
  • Dizziness
  • Confusion
  • Fatigue
  • Depression**
36
Q

How does the quality of life and overal morbidity and mortality for elderly patients with Asthma-COPD overlapping syndrome compare to asthma patients without COPD?

A

Worse outcomes and mortality

Geriatrics (5 decks)

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