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CM Aging & Preventio

CM Aging & Prevention

QuestionAnswer
Immunizations Flu vaccine yearly, Tetanus-diptheria every 10 years, Pneumococcal vaccine once - repeat in 5 yrs for immunocompromised, annual PPD for those in LTC
Four pronged exercise approach Endurance, Resistance, Range of Motion, Balance
USDA nutrition recommendations for elderly (2005) 8 glasses of water daily, Calcium, Vit D, B12, 14g fiber/1000 calories, Protein should make up 12-20% of calories
____ is loss of muscle mass and strength sarcopenia
Unintentional Weight loss: at risk patients 5% wt loss/1month or 10%/6 months, Food intake <75% x 7days, BMI < or equal to 18.5, Albumin<3.2
Causes of unintential weight loss in the elderly Medications, depression, thyroid dz, oral problems, cancer, unpalatable diet, ETOH, abuse, swallowing problems, functional difficulties, poverty, dementia, GI disorders, etc.
gradual onset, normal albumin, no edema Marasmus
Acute onset, high mortality, edeam, low albumin, low cholesterol Kwashiokor
Edematous malnutrition Kwashiokor
__ percent of homebound older adults are obese 1/3
Common non-specific presentations confusion, self-neglect, anorexia, falls, dyspnea, incontinence, fatigue
Vague abdominal pain may be peritonitis
Altered presentations: Depression without sadness, silent acute abdomen, Silent MI, infections without typical findings, apathetic hyperthyroidism, non-dyspneic pulmonary edema
Depigmentation is due to loss of melanocytes, which is normal in elderly
Better test for turgor than hand tenting oral hydration
Normal HEENT changes in elderly small pupils, loss of upward gaze, arcus senilis,loss of near vision
Noramal Cardiovascular changes in the elderly Systolic murmur (usually aortic sclerosis), S4 gallops (probably nl in an asx pt, causesd by noncompliant left ventricle), pseudohypertension
Normal Neurologic changes in the elderly wide based gait, decreased ankle reflexes and decreased vibratory sense, frontal release signs
Normal Musculoskeletal changes kyphosis, loss of lordotic curve, loss of height, loss of muscle mass
Normal GU changes in the elderly Atrophic vaginal mucosa, non-palpable ovaries
Common abnormalities in the elderly Systolic HTN, High frequency hearing loss, S3 gallop (never normal in older pts), crackles at lung bases, forgetfulness, entropion/ectropion, senile purpura
S3 gallop in elderly sign of heart failure
Created by: ltm12
 

 



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