Term
One complication of aging: unusual drug side effects
Antihistamines (diphenhydramine)
Loop diuretic
Dig
Sympathomimetics |
|
Definition
Antihistamines (diphenhydramine): confusion
Loop diuretic: urinary incontinence
Dig: Depression, anxiety, confusion
Sympathomimetics: urinary retention |
|
|
Term
| What cacner screening should be done in the elderly? |
|
Definition
breast
lung (no screening seems to be effective)
prostate
colorectal |
|
|
Term
| what vitamins are old people prone to be deficient in? |
|
Definition
|
|
Term
Bone health:
__% of women over 80 have osteoporosis
All women >__ y/o should get DEXA scans & ___ screening |
|
Definition
|
|
Term
sx presentation common in older adults, most of which are multifactorial
ex? |
|
Definition
geriatric syndromes
delirum
dementia
incontinence
falls
pressure ulcers
polypharmacy
osteoporosis |
|
|
Term
Mental disturbanced marked by illusions, hallucinations, short unsystemized delusions, cerebral excitement, physical restlessness and incoherence, and having a coparatively short course
Develops as an interaction btwn predisposing factors in vulnerable older people and noxious insults or precipitating factors |
|
Definition
|
|
Term
pathognomonic feature of delirium
sx? |
|
Definition
acute change in baseline mental status over hours to days
sx: fluctating course of inattention, disorganized thinking, altered levels of conciousness, hallucinations, paranoia, |
|
|
Term
major predisposing risk factor for delirium?
other risk factors? |
|
Definition
dementia (preexisting cognitive impairment)
others: drugs (>40% of elderly)
emotions
low o2
infection
urinary or fecal retention
ictal state
metabolic origin
undernutrition/dehydration
subdural hematoma
sleep deprivation
hearing or vision loss
immobility |
|
|
Term
which gender has more traumatic brain injuries?
Which gender has more hip injuries? |
|
Definition
|
|
Term
| complications of delirium |
|
Definition
increased morbidity/mortality
functional decline
immobility - pneumonia, ulcers, dvts, pe's
UTIs
|
|
|
Term
|
Definition
non-pharmacological
pharmacological:
- neuroleptics #1
- haloperidol for agitation
- benzos for sedation and alcohol withdrawal (lorazepam) |
|
|
Term
| ___ is the safest benzo in geriatrics |
|
Definition
|
|
Term
When should elderly get these vaccines?
flu
pneumonia
tetanus
zoster |
|
Definition
flu - yearly
pneumonia - age 65
tetanus - every 10 years
zoster - 60 |
|
|
Term
| drugs that may increase risk of falls |
|
Definition
sedatives (especially benzos)
tricyclics
tranquilizers (pheothiazines and butyrophenones)
antiHTN
cardiac meds
corticosteroids
NSAIDs
anticholinergics
hypoglycemics
|
|
|
Term
ability to use the phone
shopping
food prep
housekeeping
laundry
transportation
responsibility for meds
managing finances
are examples of? |
|
Definition
| IADLs - instrumental ADLs |
|
|
Term
| PE for Falls: IHATEFALLING |
|
Definition
I: Inflammation of joints/joint deformity
Hypertension
Auditory and visual abn
Tremor
Equilibrium
Foot problems
Arrhythmias
Leg length discrepency
Lack of conditioning
Illness
Nutrition
gait disturbance |
|
|
Term
| First 3 tests to order when assessing elderly fall risk |
|
Definition
|
|
Term
___ is regarded as the harshest kind of punishment
___ is the most common form of abuse in US |
|
Definition
|
|
Term
| Incontinence is influenced by what 5 things? |
|
Definition
lower urethral trigone
mobility
cognition
motivation
dexterity |
|
|
Term
| ___ is the leading cause of instituinalizaiton in elderly |
|
Definition
|
|
Term
| Meds that can influence incontinence |
|
Definition
sedative
psychotropic
alpha agonists
alcohol
caffeine |
|
|
Term
| detrusor muscle ___ due to parasympathetic stimulation and ___ due to sympathetic |
|
Definition
|
|
Term
| Causes of urinary incontinence |
|
Definition
Age, other disease, meds, DIAPPERS
Delirium
Infection or increased fluid intake
atrophic vaginitis/urethritis
pharms
psych
excessive urine output
restricted mobility
stool impaction |
|
|
Term
4 types of incontinence:
1. increased abd pressure. in 50% of women. laugh, cough, sneeze.
2. over activity of detrusor. common in older women and men. don't get the signal that they need to go until it's too late
3. due to obstruction of urethra - constant leakage. common in men due to prostatic problems.
4. most commmon type |
|
Definition
1. stress
2. urge
3. overflow
4. mixed |
|
|
Term
| tests to get when evaluating incontinence |
|
Definition
UA
GLucose
BUN/Cr
Ca
Cytology
B12
stress test
post void residual - >100 ml left is abnormal |
|
|
Term
| first line tx for incontinence? |
|
Definition
|
|
Term
| tx for each kind of incontinence |
|
Definition
stress: surgery
urge: vaginal cone, antimuscarinics, oxybutin, alpha agonists (sudafed, tamuosin)
overflow: alpha blockers for BPH |
|
|
Term
clinical syndrome in which 3+ of these are present:
- unintentional weight loss >10 lb in past year
- feeling exhausted
-poor grip strength
= slow walking speed
- low physical activity |
|
Definition
|
|
Term
| most commonly reported comorbidities |
|
Definition
DM
Ca
lung dz
heart failure
BMI >25
current smoker |
|
|
Term
| depressive sx present in >__% of elderly |
|
Definition
|
|
Term
| antidepressants to avoid in elderly |
|
Definition
|
|
Term
| ____ are the most common cuase of Traumatic brain injury |
|
Definition
|
|
Term
| most common fractures in elderly |
|
Definition
|
|
Term
| preventative interventions for elderly |
|
Definition
vaccines
daily aspirin for heart pts
1200 mg Ca and 800 units Vit D
exercise: 150 min/week |
|
|
Term
|
Definition
| 10-25 g fiber/day, 1500 ml fluid/day, laxative |
|
|
Term
| average drug use for elderly |
|
Definition
|
|
Term
| most consistent risk factor for adverse drug reactions? |
|
Definition
|
|
Term
| elderly need higher/lower drug doses than orhters? |
|
Definition
|
|
Term
| drugs most commonly associated with adverse reactions in elderly |
|
Definition
benzos
anti-HTN
diuretics
dig
NSAIDs
corticosteroids
warfarin
theophelline |
|
|
Term
| first line tx for osteoporosis |
|
Definition
|
|
