Week 1 Flashcards by Sarah Gordon

Age changes: prostate
Heart function
Weight
Bone density
Renal perfusion

Prostate- increase 100%
Max heart rate Decreases from 195 to 155 bpm
Weight decreases by 7%
Bone mineral content decreases by 10 to 30%
Renal perfusion decreases by 50%

How well did you know this?

Not at all

Perfectly

Causes of age related nocturia

Changes in bladder physiology include decreased capacity and increased residual volume
Altered control of fluid excretion related to low nighttime ADH levels and increased nighttime natriuretic polypeptide levels

How well did you know this?

Not at all

Perfectly

Frailty occurs when? 3/5

Unintentional weight loss
 self-reported exhaustion 
weakness 
slow walking speed and 
low physical activity

How well did you know this?

Not at all

Perfectly

Icebergs

Frequently and reported symptoms that are not normal response to ageing

How well did you know this?

Not at all

Perfectly

Most common iatrogenic problems in geriatrics

Adverse drug affects, acute kidney injury, adverse surgical outcomes

How well did you know this?

Not at all

Perfectly

Pneumonia vaccine schedule BC

Eligibility?

Conjugate 1st (ie Prevnar 13) then 8 weeks later = ppv23
ppv23 1st-wait 1 year then conjugate
Older than 65 years or high risk

How well did you know this?

Not at all

Perfectly

4 As of smoking cessation approach

Ask, advise, assist, arrange follow-up

How well did you know this?

Not at all

Perfectly

Type of physical activity to improve:
Cardiovascular
Body comp
Metabolism
Bone health
Psychological wellbeing

Aerobic activity 
Aerobic activity 
Aerobic activity
Weight bearing exercise
Aerobic

How well did you know this?

Not at all

Perfectly

Indication of poor nutritional intake: BMI ? Weight loss

BMI ≤20

Weight loss ≥ 10 lbs in 6 months

How well did you know this?

Not at all

Perfectly

Fat Dietary recommendations: sat fat? Dietary cholesterol?

Sat fats- 10% caloric intake?

<300mg diet cholesterol

How well did you know this?

Not at all

Perfectly

Eg. Monounsaturated fat

Benefit?

Olive oil

Lower LDL and leave HDL intact

How well did you know this?

Not at all

Perfectly

Sunflower, corn, soy beans, are examples of what fats?

What’s their impact on lipoproteins?

Polyunsaturated fats

Lower HDL and LDL

How well did you know this?

Not at all

Perfectly

Recommended fibre intake

14g. per 1000 cal

How well did you know this?

Not at all

Perfectly

% Of diet that should be made up of proteins

12-20% total cal

How well did you know this?

Not at all

Perfectly

Four domains of assessment

Physical, functional, emotional, socioeconomic

How well did you know this?

Not at all

Perfectly

Five I’s of subjective assessment

Immobility
Instability 
incontinence 
intellectual impairment
iatrogenic complications

How well did you know this?

Not at all

Perfectly

Name three geriatric Giants

Dementia, depression, delirium, incontinence, orthostatic hypotension, falls in dizziness, osteoporosis, polypharmacy, pain in the elderly, failure to thrive/frailty

How well did you know this?

Not at all

Perfectly

Ultrasonography is helpful in evaluating the biliary tree, looking for urethral obstruction, evaluating vascular structures, but has limited utility in _______ patients.

Obese

How well did you know this?

Not at all

Perfectly

Best imaging method of the brain parenchyma when used with gallium contrast

MRI- MR angiography

** Gallium is not nephrotoxic

How well did you know this?

Not at all

Perfectly

Uses ultrasound to delineate the cardiac size, function, ejection fraction and presence of valvular disease

Echocardiography

How well did you know this?

Not at all

Perfectly

Radio pig die injected into the various vessels and radiographs or fluoroscopic images are used to determine vascular structure, occlusion, cardiac function, or valvular integrity

Angiography

Test used to test individuals at risk for coronary heart disease, monitor blood pressure, heart rate, chest pain, and ECG while increasing oxygen demands

Treadmill stress test

Normal TSH level

0.5-5mIU/L

New York Heart Ass functional classes

1- no
2- slight
3- marked
4- inability

Normal Na and K serum levels

K- 3.5-5.5 | Na- 135-145

CKD - ‘normal to mild increase’ ACR level

<3 mg/mmol

CKD- ‘moderately increased’ ACR

3-30 mg/mmol

CKD ‘severely increased’ ACR

> 30 mg/mmol

HF likely with level greater than - (>55yrs) Nt-proBNP BNP

Nt-proBNP- >300pg/ml = likely | BNP- <100pg/ml = unlikely >400pg/ml = likely

Levothyroxine wt based dosing and follow-uptime?

1.6 mg/kg/d | FU- 6 weeks

Polypharmacy is how many meds

≥5

Age when stamina reduction begins

20 yrs

Woman with normal paps x3 can stop @ what age

69yrs

Follow up interval For men with normal PSA tests (age specific).

Less than two year intervals not recommended

Mini mental status exam score of 10 to 20 means?

Moderate impairment

Mini mental status exam results 20 to 25 means?

Mild impairment

Mini mental status exam result 0 to 10 means?

Severe impairment

Iatrogenic disease is?

Caused by medical intervention

ADL mnemonic & common assessment tool

``` D-dressing E- eating A- ambulating T-toileting H-hygiene ``` Katz index of independence

IADL mnemonic and tool

``` S- shopping H-housework A-accounting F-food prep T-transport T-telephoning T-taking meds ``` Lawton IADL tool

Pneumovax 23- who? | Booster?

All over 65- covered Or <65 and high risk Booster after 5 years if high risk

Prevnar13- vaccine type? Who? When?

Conjugate vaccine High risk people often >65y Give 8 weeks BEFORE pneumo23 Give 1 year AFTER pneumo23

Who should get the shingles vaccine? Coverage? Doses?

>50 at risk of shingles 2 doses, 2-6 months apart No coverage

When can shingrix be given IF pt had shingles or has had zostavax? Who should get zostavax?

1 year after both shingles and shingrix vaccine | Those who can’t get shingrix

MMR vaccine in olde adults?

Born pre 1970 considered immune- maybe get one time dose

Breast cancer screening for average risk- 50 to 74? >74?

``` 50-74= q2y >74= q2-3y ```

BC Cancer higher than average risk = ? | breast cancer screening- 40-74 years

1st degree relative with BCa | Q1year

BC Cancer high risk? | Screening for 30-74y?

High risk- BCa in 1st deg relative, strong fam hx, previous chest radiation Q1year

Who is not eligible for mammogram? (5)

1. Breast implants 2. Pregnant/ breast feeding 3. Previous history of breast cancer 4. New breast complaints ie. lump/ discharged 5. Has had mammogram on both breasts in last 12 months

When does cervical cancer screening begin? And what interval? When can it stop if 3 normal results in 10 years?

25 y/o Q3 years 69 y/o

Colon cancer screening- Average risk, asymptomatic, 50 to 74 years old

FIT q2y | Or- colonoscopy q10y