CM Aging & Prevention
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| Immunizations | Flu vaccine yearly, Tetanus-diptheria every 10 years, Pneumococcal vaccine once - repeat in 5 yrs for immunocompromised, annual PPD for those in LTC
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| Four pronged exercise approach | Endurance, Resistance, Range of Motion, Balance
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| 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
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| ____ is loss of muscle mass and strength | sarcopenia
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| 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
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| 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.
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| gradual onset, normal albumin, no edema | Marasmus
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| Acute onset, high mortality, edeam, low albumin, low cholesterol | Kwashiokor
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| Edematous malnutrition | Kwashiokor
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| __ percent of homebound older adults are obese | 1/3
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| Common non-specific presentations | confusion, self-neglect, anorexia, falls, dyspnea, incontinence, fatigue
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| Vague abdominal pain may be | peritonitis
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| Altered presentations: | Depression without sadness, silent acute abdomen, Silent MI, infections without typical findings, apathetic hyperthyroidism, non-dyspneic pulmonary edema
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| Depigmentation is due to | loss of melanocytes, which is normal in elderly
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| Better test for turgor than hand tenting | oral hydration
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| Normal HEENT changes in elderly | small pupils, loss of upward gaze, arcus senilis,loss of near vision
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| 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
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| Normal Neurologic changes in the elderly | wide based gait, decreased ankle reflexes and decreased vibratory sense, frontal release signs
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| Normal Musculoskeletal changes | kyphosis, loss of lordotic curve, loss of height, loss of muscle mass
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| Normal GU changes in the elderly | Atrophic vaginal mucosa, non-palpable ovaries
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| 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
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| S3 gallop in elderly | sign of heart failure
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