WVSOM -- Geriatrics
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| show | age 55 and up even though literature and medicare says it is 65 and up
🗑
|
||||
| When does Medicare pay benefits | show 🗑
|
||||
| What are social issues surrounding geriatrics? | show 🗑
|
||||
| What kind of approach is needed when caring adequately for geriatric patients? | show 🗑
|
||||
| show | private-for-profit; private not for profit; governmental; religious groups
🗑
|
||||
| What is Medicare Part a? | show 🗑
|
||||
| show | outpatient care and all physicisan charges (80%)
🗑
|
||||
| show | portion of outpatient medication costs
🗑
|
||||
| What is the single most critical issue facing geriatric patients? | show 🗑
|
||||
| What are the 5 ADLs? | show 🗑
|
||||
| show | becomes the responsibility of the state Medicaid
🗑
|
||||
| who is responsible for the 20% medicare part B doesn't cover? | show 🗑
|
||||
| show | clincal studies of mature adults and aging.
🗑
|
||||
| show | aging
🗑
|
||||
| What are the three senescence variations? | show 🗑
|
||||
| show | slow but persistant. Placental mammals
🗑
|
||||
| What is cellular senescence | show 🗑
|
||||
| What blocks proliferation of damaged cells? | show 🗑
|
||||
| show | aging
🗑
|
||||
| What will help improve health and slow senescence? | show 🗑
|
||||
| What is the goal of proper prevention? | show 🗑
|
||||
| show | accumulation of random damage (random error). free radical damage; lack of dna repairs; somatic mutations from radiation; glycosylation of protiens
🗑
|
||||
| show | holds that degeneration of the hypothalamic-pituitar-endocrine axis is central to aging as evidenced by hormonal control.
🗑
|
||||
| what is immunologic theory of aging? | show 🗑
|
||||
| What is hutchinson-gilford Syndrome? | show 🗑
|
||||
| What is werner syndrome | show 🗑
|
||||
| What is eye anatomy from external to internal? | show 🗑
|
||||
| show | caused by lipid depositis in teh deep layer of the peripheral cornea. NO clincial significatnce with vision
🗑
|
||||
| What is cataract? | show 🗑
|
||||
| show | cataract
🗑
|
||||
| show | cataracts
🗑
|
||||
| show | blurred vision; impaired visual acuity in low ambient light; can significantly impair ability to read adn drive at night
🗑
|
||||
| What is seen in physical exam with cataract? | show 🗑
|
||||
| What is hyperopic eyes | show 🗑
|
||||
| what is myopic | show 🗑
|
||||
| what is presbyopia | show 🗑
|
||||
| what is the result of presbyopia? | show 🗑
|
||||
| show | glaucoma; cornea injury due to dry eye syndrome; macular degeneration
🗑
|
||||
| show | hearing loss; loss of cochlea and auditory nerve neurons
🗑
|
||||
| show | tinnitius
🗑
|
||||
| What do teleomeres have to do with aging? | show 🗑
|
||||
| Why do elderly loose height? | show 🗑
|
||||
| show | decreases
🗑
|
||||
| show | involves the subcutaneous tissue
🗑
|
||||
| What happens with skeletal senescence? | show 🗑
|
||||
| show | decreaed cartilage hydration; reduced condrocytes and proteoglycan get smaller in size
🗑
|
||||
| show | decrease muscle mass and strength;
🗑
|
||||
| What will increase short-term endurance muscle strength? | show 🗑
|
||||
| show | nonblanchable eyrhtema of intact skin
🗑
|
||||
| what is stage II decubitus? | show 🗑
|
||||
| what is stage III pressure sore? | show 🗑
|
||||
| show | full-thickness injury with damage or necrosis of underlying muscle and joint
🗑
|
||||
| what happens to the skin with aging? | show 🗑
|
||||
| What does aging of the skin result in? | show 🗑
|
||||
| Is cancer a normal sign of aging? | show 🗑
|
||||
| What does skeletal muscle aging result in as far as daily living? | show 🗑
|
||||
| What happens with nervous system aging? | show 🗑
|
||||
| What happens in autonomic aging? | show 🗑
|
||||
| What happens in central, motoar and senesory nervous system aging? | show 🗑
|
||||
| What happens to the heart in aging? | show 🗑
|
||||
| show | 30%
🗑
|
||||
| show | irregularities in size and shape of endothelial cells; fragmetnaion of elastin; increased lumen diamater, length adn wall thickness; collegen increase; decreased basal and stimulated NO production; increase in pulse pressure
🗑
|
||||
| show | resting HTN; orthostatic hypotension; blunted heart rate response to stress; S4; sclerotic murmurs
🗑
|
||||
| what are aortic stenosis? | show 🗑
|
||||
| show | prevents normal opening of heart valves and result in rheumatic heart disease
🗑
|
||||
| What happens with lung aging? | show 🗑
|
||||
| What is the respiratory impact due to aging? | show 🗑
|
||||
| What happens in GI tract aging? | show 🗑
|
||||
| show | esophageal fucntion persist until very advanced age; gastric emptying of solids; small bowel transit times
🗑
|
||||
| What declines in the absorption secretion functions of the GI? | show 🗑
|
||||
| show | intrinsic factor; duodenal glucose; protein digestion; fat absorption; thiamin, B12 and C abosrption; iron abosrption
🗑
|
||||
| show | result of pathological changes secondary to disease
🗑
|
||||
| show | kidney mass and size in 4th decade; progressive delcine in renal fucntion; renal blood flow decrease by 10% per decade; GFR declines; tubular function slowly declines
🗑
|
||||
| show | makes them more sensitive to neprhotoxic injury
🗑
|
||||
| Progressive renal decline results in ? | show 🗑
|
||||
| show | gatehr data; diagnosis etiology; review therapy choices; discuss therapy with patient or care giver; implement plan; evaluate outcome; go back to step 3!
🗑
|
||||
| What is the plan for medication (6) | show 🗑
|
||||
| show | review for efficacy, adverse reactions, exacerbaion of co-morbidities, new/improved therapies; if any problems adjust dose or restart process
🗑
|
||||
| show | personal knowledge; reference; avoid allergies, contraindications, adverse outcomes; review previous therapy success; consider cost/compliance
🗑
|
||||
| What are abosprtion considerations when perscribing a medication? | show 🗑
|
||||
| What are some acidic drugs that may be absorbed slower? | show 🗑
|
||||
| What is creatine clearance? | show 🗑
|
||||
| What is the distribution of hydrophillic drugs in geriatrics? | show 🗑
|
||||
| show | lower and have longer half lives; e.g. benzos
🗑
|
||||
| show | higher serum concentrations (less bound) due to decreased albumin; e.g. dig, warfarin, theophyline
🗑
|
||||
| show | hepatic mass and blood flow are decreased so drugs metabolied by first pass Phase I reactions will be available in higher concnetrations ane exibit longer half life
🗑
|
||||
| What are 2 drugs unaffected by metabolism adn age | show 🗑
|
||||
| How is excretion measured? | show 🗑
|
||||
| show | age, polypharmacy, female, lower body weight, hepatic/renal insufficiency, hx of previous reactions
🗑
|
||||
| What are the drugs to avoid? | show 🗑
|
||||
| show | valium
🗑
|
||||
| What barbituate should be avoided? | show 🗑
|
||||
| what analgesics should be avoided? | show 🗑
|
||||
| show | cyclobenzaprine (flexiril)
🗑
|
||||
| show | metoclopramide (reglan)
🗑
|
||||
| show | first generation like diphenhydramine
🗑
|
||||
| what antidepressents should be avoided? | show 🗑
|
||||
| what antispasmotics shoudl be avoided? | show 🗑
|
||||
| What cardiovascular drugs should be avoided? | show 🗑
|
||||
| What drugs shoudl be avoided with DM? | show 🗑
|
||||
| what drugs should be avoided in COPD patients? | show 🗑
|
||||
| show | beta blockers
🗑
|
||||
| what drugs should be avoided with ulcers? | show 🗑
|
||||
| show | ASA, NSAID and corticosteroids
🗑
|
||||
| What drugs should be avoided with BPH? | show 🗑
|
||||
| What drugs should be avoided with constipation? | show 🗑
|
||||
| show | TCA
🗑
|
||||
| What drugs should be avoided with insomnia? | show 🗑
|
||||
| What drugs should be avoided with cgnitive dysfunction? | show 🗑
|
||||
| What should be avoided with osteoporosis? | show 🗑
|
||||
| does warfarin does need to be increased in patients with liver disease? | show 🗑
|
||||
| show | 12
🗑
|
||||
| what is optimal pharmocotherapy? | show 🗑
|
||||
| show | HTN; orthostatid hypotension; atherosclerosis
🗑
|
||||
| What diseases occur with coronary atherosclerosis? | show 🗑
|
||||
| show | thrombotic infarction; embolic infarction; hemorrhagic infaction; transient ischemic attacks
🗑
|
||||
| What deficits are seen with cerebral atherosclerosis? | show 🗑
|
||||
| What are the diseases that occur with peripheral vascular disease? | show 🗑
|
||||
| show | exertional ischemic pain; reduced endurance; sudden death
🗑
|
||||
| What is seen with venous insufficiency? | show 🗑
|
||||
| show | A-Fib; complete heart block; PVC; tachy brady syndrome (sick sinus); sinus bradycardia
🗑
|
||||
| what is treatment of bradycardia? | show 🗑
|
||||
| What is the common cause of death in patients with major co-morbidity? | show 🗑
|
||||
| show | systolic HTN
🗑
|
||||
| What does impaired ventricular filling result in? | show 🗑
|
||||
| show | decreased response to beta-adernergic stimulation
🗑
|
||||
| What does degeneration of the conduction system result in? | show 🗑
|
||||
| show | prostate, lung and colon
🗑
|
||||
| show | breast, lung, uterine
🗑
|
||||
| How many ischmic strokes per year? | show 🗑
|
||||
| show | 100,000
🗑
|
||||
| show | thromobit and embolic
🗑
|
||||
| What are thrombotic strokes? | show 🗑
|
||||
| what are ebolic strokes? | show 🗑
|
||||
| what is hemorrhagic stroke? | show 🗑
|
||||
| what is most common DM in geriatrics? | show 🗑
|
||||
| show | rare due to prsence of at least a small amount of insulin
🗑
|
||||
| show | happens do to dehydraion in Type II diabetics with a chornic BS of 500-100.
🗑
|
||||
| show | control BP; control lipids; keep HgbA1c < 7.0; smoking cessation
🗑
|
||||
| show | PVD; nuropathy; retinopahty, macrualr degenration, cataracts; nephropathy
🗑
|
||||
| show | focus on the disease producing the highest mortality.
🗑
|
||||
| show | significant loss of function adn quality of life
🗑
|
||||
| What is leading causes of death among US adults aged 65 and older? | show 🗑
|
||||
| What is dementia? | show 🗑
|
||||
| What is the differential diagnosis for Alzheimer's? | show 🗑
|
||||
| What physiological impairments contribute to AD? | show 🗑
|
||||
| What is used in Alzheimer treatment? | show 🗑
|
||||
| show | tacrine; donepezil
🗑
|
||||
| show | memantine
🗑
|
||||
| show | infarcts on CT or MRI imaging; neuro exam with focal deficits; deterioration in discreet steps; onset with a stroke; slow improvement following acute onset; medcial history consistent with arterial disease
🗑
|
||||
| how do you treat vascular dementia? | show 🗑
|
||||
| How is lewy body dementia different from parkinsons | show 🗑
|
||||
| How is demential with lewy body treated? | show 🗑
|
||||
| How is lewy body dementia diagnosed? | show 🗑
|
||||
| How is parkinson's treated? | show 🗑
|
||||
| show | gradual behavioral change and language dysfunction; characterized by focal atrophy of the frontal and temporal lobes; occurs between 35 and 75
🗑
|
||||
| What is reversible dementia? | show 🗑
|
||||
| How is delirium diagnosed? | show 🗑
|
||||
| what is MMSE? | show 🗑
|
||||
| what is normal mini mental exam? | show 🗑
|
||||
| what is mild deficit in mini mental exam? | show 🗑
|
||||
| show | 10-19
🗑
|
||||
| show | < 10
🗑
|
||||
| show | an unintentional positional change that results in a person coming to rest on the ground, floor or other lower level
🗑
|
||||
| What are falls an indicator of? | show 🗑
|
||||
| What sensory impairments cause falls? | show 🗑
|
||||
| show | age;female; vit d def; lower ext weakness; poor grop str; balance disorder; podiatric problem; visual defecit; low gait speed; incontinence; depression; hypotension; hemeplegia; perifpheral neuropathy; fear of falling
🗑
|
||||
| show | poor lighting; loose carpets; lack of bathroom safety equipment
🗑
|
||||
| How do you do a Hx for falls? | show 🗑
|
||||
| show | caregive/housing; alcohol; treatements; affect (depression); syncopy; teetering; recetn illness; ocular problems; pain with mobility; hearing; environment
🗑
|
||||
| show | benzos; antidepressants; antiemetics; anticholinergics; antiHTN; NSAID; hypoglycemic agents; antipsychotics
🗑
|
||||
| What is acronym for physical exam for fallign? | show 🗑
|
||||
| what does IHATEFALLING stand for? | show 🗑
|
||||
| what lab work is done with fallign? | show 🗑
|
||||
| show | ecg; holor monitor; bone density imaging; brain imaging
🗑
|
||||
| What interventions are done with falls? | show 🗑
|
||||
| show | actual loss of consciousness
🗑
|
||||
| show | feellign right before fainting
🗑
|
||||
| show | orthostatic hypotension; cardiac arrhythhmia; chf; vasovagal episodes
🗑
|
||||
| show | related to Neuromuscular etilogies; neurosensory deficits in visiona nd proprioception
🗑
|
||||
| show | specific dizziness which has a major symptom of balance disorder; acute labryinthitis; cerbral vascular disease; otitis media
🗑
|
||||
| what is orthostatic hypotension | show 🗑
|
||||
| What are teh Geriatric 3 R's | show 🗑
|
||||
| show | prevent disease form happening
🗑
|
||||
| what is secondary prevention? | show 🗑
|
||||
| what is best prevention? | show 🗑
|
||||
| what is tertiary prevention? | show 🗑
|
||||
| show | may misudnerstand aging from disease adn not make informed decision; may be put off by cost of tests; may be put off by fear of test;
🗑
|
||||
| show | intact long and short term memory; sensory ability intact to recevie new information; cognitive ability to process information; confirmation of a decision when presented with teh same information on a second occasion
🗑
|
||||
| in the elderly patient secondary and tertiary screen take on more importance than primary screening. TRUE OR FALSE | show 🗑
|
||||
| what is physician role in screening | show 🗑
|
||||
| show | a specific document tested in law tha defines the patient wishes in the event of a terminal illness or persistant vegatative state that has no reasonalbe hope of a recovery
🗑
|
||||
| what are advanced directives/ | show 🗑
|
||||
| show | require hydration adn nutrition intervention to maintain life; may show reflexes; often exhibit sleep/wake cycles
🗑
|
||||
| show | legal document which designates another individual to make health care decision if the patient is not competent or able to make teh decisions
🗑
|
||||
| show | allow patients to specifyif they wish CPR int eh event of cardiac or respiratoyr arrest
🗑
|
||||
| show | NO cpr; no intubation; etc
🗑
|
||||
| show | maintain their dignity; to feel prepared to die; have physical touch; presence of family; have financial affairs in order
🗑
|
||||
| show | denial; anger; bargaining; depression; acceptance
🗑
|
||||
| What is the common course of death? | show 🗑
|
||||
| what is uncommon course of death? | show 🗑
|
||||
| show | somatic; visceral; neuropathic
🗑
|
||||
| what is somatic pain? | show 🗑
|
||||
| show | poorly localized; internal organs
🗑
|
||||
| what is neuropathic pain? | show 🗑
|
||||
| what is the therapy of pain? | show 🗑
|
||||
| show | oxygen; diuresis; anxiety management; opiod management
🗑
|
||||
| show | anausea/emesis; anorexia; starvation vs cachexia; delirium; constipation; seizures; muscle spams/restless leg sydroms
🗑
|
||||
| show | medicare covers the cost of equipment, medications, aned part time staff but does not cover the cost of housing and meals or fulltime staff. physician must certify life expectancey of six months or less
🗑
|
||||
| what is physicisan role after death? | show 🗑
|
||||
| show | patietn may stay in the place of their choosing assuming support is available; nursing visists to monitor and deliver care; can visits to maintain hygiene and provide equipment
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
tjamrose
Popular Medical sets