Shared Flashcard Set

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CMS II Final FOCUSED Review - Geriatrics
Winter Semester 2011
47
Medical
Graduate
03/25/2011

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Cards

Term
What type of walking aid is best to aid w/ walking if the pt has left leg hemiparesis and the Pt’s arms do not have weakness and are not needed for balance?
Definition
Hemi-walker
Term
For an ED disorder, how long can an O-ring be safely left on?
Definition
30 minutes
Term
What are ADLs?
Definition
Bathing, Dressing, Transferring, Toileting, Grooming, Feeding, Mobility
Term
What are the IADLs?
Definition
(Instrumental Activities of Daily Living) Telephone use, Preparing Meals, Managing Finances, Medication management, Doing Laundry, Doing housework, Shopping, Managing Transportation
Term
What med has a SE of green vision?
Definition
Digoxin toxicity
Term
What are the MC drug-drug interactions?
Definition
Confusion/delirium
Cognitive Impairment
Hypotension
Acute Renal Failure
Term
How does estrogen help elderly women?
Definition
Increase vaginal lubrication
Term
Which med is used in ED (not approved as an FDA tx) that causes parasympathetic stimulation which may increase libido, and also stimulates HR and may cause mild dizziness and nervousness?
Definition
Yohembine (Horney Goat Weed)
Term
If a pt presents with fever and confusion, what tests are required?
Definition
LP
CBC
Drug Screen
Term
Which of the following statements is correct?
(A) Caloric restriction has been shown consistently to increase life span in mice
(B) Animal studies have demonstrated positive effects of caloric restriction on fertility
(C) Calorically restricted rodents, non-human primates, and healthy men demonstrate lower fasting insulin levels and lower body temperature
(D) Calorically restricted mice live longer, are more fit, and are more likely to reproduce than control mice with unlimited access to food
Definition
(C) Calorically restricted rodents, non-human primates, and healthy men demonstrate lower fasting insulin levels and lower body temperature
Term
Which of the bruise characteristics raises suspicion of physical abuse?
A) Size
B) Shape
C) Number
D) Location
E) Color variation
Definition
D) Location
Term
Are androgens approved by the FDA in the treatment of sexual dysfunction in women?
Definition
No
Term
Is increased sexual dysfunction a normal component to successful aging?
Definition
No
Term
How do we track the progression of AD?
Definition
MMSE (not CT, MRI, freq blood test)
Term
What communication strategies are important when setting an environment to assess an elderly adult?
Definition
Use well-lit room
Avoid backlighting
Minimize extraneous noise
Minimize interruptions
Term
Pt has no signs of malnutrition, nephew feeds him but has skipped lunch for 3 weeks because he has to work on his car, he could buy food for him but doesn’t b/c of cost. Is this abuse?
Definition
Yes according to the National … guidelines
Term
Pt has pain, fatigue, and insomnia w/ dizziness, what is the dizziness associated w/?
Definition
depression
Term
What is the 1st step in the evaluation of a pt with c/o of dizziness?
Definition
Ask pt what he/she means by dizziness
Term
What is the senile arc? Is it benign?
Definition
graying of the limbus; benign
Term
If an elderly pt presents with unrelenting back pain, what should you r/o?
Definition
metastatic CA
Term
What is the triad of symptoms with Normal Pressure Hydrocephalus?
Definition
urinary incontinence, memory loss, gait disturbance
Term
A pt presents with complaints of trouble walking and UI, his wife also mentions that he has had memory issues recently, what is your dx?
Definition
NPH
Term
Pt gives daughter checkbook for now, he complains that daughter wants to get his money, what should we do 1st?
Definition
get a comprehensive geriatric assessment
Term
With geriatric treatment what should be the physician's primary focus?
Definition
Geriatric goals, not on pt cc
Term
What is a common cardiovascular problem in elderly women?
Definition
A-fib
Term
What are the risk factors for ADEs?
Definition
6 or more concurrent chronic conditions
12 or more doses of drugs/day
9 or more medications
Prior adverse drug event
Low body weight or low BMI
Age 85 or older
Estimated CrCl < 50 mL/min
Term
What are some helpful tips for managing polypharmacy?
Definition
-M – Minimize the number of drugs
-A- Alternatives should be considered
-S- Start low and go slow with meds
-T- Titrate therapy to the desired goal
-E- Educate the patient, their family or caregiver
-R- Review drug plan at each visit
Term
Suspect abuse from caregiver to pt, what do we do?
Definition
Interview each separately and document.
Term
MC cause of mortality in the elderly at home?
Definition
Falls
Term
MC Urinary Incontinence?
Definition
Urge Incontinence
Term
Pt c/o of urinary leakage with coughing and laughing?
Definition
Stress UI
Term
What is the 1st line treatment for urge incontinence?
Definition
bladder training
Term
What is the 1st line treatment for stress incontinence?
Definition
Pelvic floor exercises
Term
What does family bring to the interview with an elderly pt?
Definition
knowledge of culture
Term
What labs do not need to be done for the evaluation of dementia?
Definition
ABGs
Term
Which type of ulcer is described as full thickness, does not go through the fascia?
Definition
Stage 3 pressure ulcer
Term
What is the best way to cleanse a wound from a pressure ulcer?
Definition
Isotonic Saline
Term
What is the MC type of dementia?
Definition
AD
Term
What is the Meniere’s dz triad?
Definition
tinnitus, hearing loss, vertigo
Term
What meds are contraindicated with the use of Sildenafil?
Definition
nitrate drugs
Term
Which ocular neuro sx is NEVER normal in the elderly?
Definition
papilledema
Term
Pt wandering, only took cholesterol and HTN meds, is alert and oriented, was lost b/c “houses looked alike”, what do you suspect?
Definition
AD; sundowning
Term
What is the MC cause of delirium?
Definition
Polypharmacy
Term
If a pt presents with a resting tremor and masked facies, what do you suspect?
Definition
Parkinson's Dz
Term
Pt hallucinations, hitting husband, memory loss started ~1 yr ago, shuffling gait, tremors started ~1month ago. What condition do you suspect?
Definition
Lewy-bodied dementia
Term
What dysfunction is common in postmenopausal women?
Definition
increase in sexual dysfunction
Term
What is important in successful pharmacotherapy in the elderly?
Definition
less risky diagnostic tests and use necessary meds
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