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Geriatrics iRAT
2nd iRAT
95
Other
Graduate
07/25/2015

Additional Other Flashcards

 


 

Cards

Term
% of geriatric population over 65
Definition
12-17%
Term
between 1989 and 2030 geriatric population will be..
Definition
12.5%-22% of total population
Term
% of patient visits
Definition
21% of patient visits are geriatric
Term
% of geriatrics that purchase prescriptions
Definition
1/3
Term
the over 85 group
Definition
is 3 million people in the US
Term
% of those over 65 that live in a nursing home
Definition
5%
Term

% of people with no difficulty in self care actitivies

 

Definition

65-69: 80%

 

80-84: 66%

Term
1/3 of individuals over 80 have no problem with:
Definition

walking 1/4 mile

 

lifting 10 lbs

 

climbing 10 steps without resting

Term
young-old
Definition

65-75

 

maintained a level of fitness that lets them participate in recreational and daily activity requirements

Term
middle old
Definition

75-85

 

independent with daily activities but need help with more demanding tasks

Term
old-old
Definition

older than 85

 

disabled patients that require nursing home care

Term
10 most common chronic conditions in elderly
Definition

OA

hypertension

hearing impairement

heart disease

orthopaedic deformity

chronic sinusitis

visual impairment

diabetes

varicose veins

abdominal hernia

Term
what accounts for 75% of death in seniors?
Definition

heart disease

 

cancer 

 

stroke

Term
suicide rate in elderly
Definition
5x more
Term
death rate associated with hip fx complications
Definition
15%
Term
most common musculoskeletal conditions in elderly
Definition

arthritis

osteoporosis

paget's

fat pad syndrome

Term
most common neurological problems
Definition

alzheimer's

parkinson's

multi infarct dementia

depression

normal pressure hydrocephalus

Term
EENT most common conditions
Definition

vision loss

hearing loss

tinnitus

chronic sinusitis

Term
most common endocrine problems
Definition

diabetes

 

hyperthyroid

 

hyperparathyroid

Term
most common cardio/renal issues
Definition

CHF

coronary artery disease

hypertension

stroke

AAA

temporal arteritis

chronic renal failure

incontence

Term
most common female/male reproductive
Definition

breast cancer

ovarian cancer

prostate cancer

Term
GI problems most common
Definition

hiatal hernia

constipation

diverticulitis

colorectal cancer

Term
baseline evaluation of geriatric patients
Definition

focused hx

an exam

evaluate mental function

evaluate socioeconomic health

nutritional status

 

screening risks

non-fasting total blood cholesterol/ua/thyroid

electrocariogram

Term
strategy for symptomatic patient
Definition

consider most common conditions in elderly

 

look at symptoms and determine if they're drug related

 

screen for cancer

 

perform comprehensive exam

Term
manage musculoskeletal complaints by:
Definition

emphasizing stability

 

pain reduction

 

maintain as much joint mobility as possible

Term
interventions considered and recommended for periodic health exam: the leading causes of death
Definition

heart disease

malignant neoplasm

cerebrovascular disease

COPD

pneumonia and influenza

Term
screening procedures for the general population
Definition

blood pressure

heigh and weight

fecal occult blood test/sigmoidoscopy

mammogram (<69 or equal)

pap test

vision screening

hearing impairment

drinking problem

 

Term
HR1
Definition
HIV positive and close contact with TB people
Term
HR2
Definition
living or traveling in areas where there is an endemic
Term
HR3
Definition
gay men after 1975
Term
HR4
Definition
people who haven't had vaccine
Term
HR5
Definition
75 and older with one or more additional risk factors
Term
HR6
Definition
65-75 with addtional risk factors
Term
HR7
Definition
hx of skin cancer
Term
HR8
Definition
blood product recipients
Term
HR9
Definition
exchange sex for money or partner with STD
Term
HR10
Definition
persons who continue to inject drugs
Term
HR11
Definition
healthy adults without a hx of chickenpox or pervious immunization
Term
modifications for technique
Definition

flat hand contact for anteriors

 

avoid excessive rotation techniques

 

avoid extreme spinal flexion

 

allow the head piece 

 

provide some distraction prior to thrusting for extremities

Term
light force techniques
Definition

logan basic

 

cox traction

 

pelvic blocking: SOT

 

activator

Term
somatic mutation theory
Definition
aging results from cumulative spontaneous mutations
Term
error catastrophe theory
Definition
aging is due to errors in protein synthesis
Term
intrinsic mutagenesis theory
Definition
aging reults from DNA rearrangements
Term
aging does this at the molecular level:
Definition

protein deamidation

dna-cross linking

single-strand breakage

decrease DNA methylation

decrease DNA telometric sequence

Term
in addition to chief complaints, also screen for:
Definition

current drug hx

 

dietary hx

 

hx of falling

 

hx of incontinence

 

questionnaires evaluation depression,anxiety, and mental functioning

Term
generally a rise in ____ is a significant rise in temp
Definition
1.33 degrees C or 2.4 degrees F
Term
bp of what consititutes beginning hypertension
Definition
160/90mmHG
Term
% of US seniors that are visually impaired
Definition
8%
Term
hearing loss is claimed by ___% of individuals
Definition
30% but tests reveal that 60% actually have a deficit
Term
the most common age related problem in seniors
Definition
presbycusis
Term
basic ADLs
Definition

bathing

 

dress/grooming

 

self-feeding

 

toileting

 

maintaining contience

 

mobility level

 

transferring

Term
intermediate ADLs
Definition

using telephone

 

preparing meals

 

performing work around the house

 

doing laundry

 

shopping

 

transportation

 

self-medication

 

managing money

Term
advanced ADLs
Definition

strenuous physical activity

 

heavy work around the house

 

number of times one can walk one mile or more without rest

Term
ESR
Definition

increases at .22mm/hr/yr beginning at 20y/o

 

levels over 80mm/hr coorelate with findings of neoplasm, rheumatic disease, or infection

 

less than 50 isn't usually an issue

Term
anemia
Definition

below:

7.5mmol/L in women

 

8.3mm/L in men

 

80% of anemic women and 92% of anemic men have normocytic anemia

Term
ANA
Definition
16% of normal older individuals have positive ANA
Term
RF
Definition
increases iwth age to 15-25% of healthy individuals testing positive in the over 70 group
Term
as many as ____ patients between 75-84 test positive for monoclonal protein
Definition
10-23%
Term
study on monoclonal protein
Definition

55% had monoclonal gammopathy of unknown

 

18% multiple myeloma

 

12% amyloidosis

 

about 30% of MGUS patients develop a malignant process in the future

Term
two main causes of dementia
Definition
Alzheimer's disease and mult-infarct dementia
Term
common problems dominate in multi infarct dementia
Definition

dysarthria

 

dysphasia

 

pseudobulbar paralysis

 

seizures

 

gait disturbances

Term
ddx for DEMENTIA
Definition

Drugs

Emotional illness

Metabolic/endocrine disorder

Eyes/ear/environment

Nutritional/neurologic

Tumor/trauma

Infection

Alcoholism

Term
delirium
Definition

acute,reversible brain dysfunction

 

often worse later in the day-sundowning

 

clouding of consciousness

confusion

irritability

inappropriate behavior

delusions

hallucintions

Term
5 most common mental/behavioral disorders
Definition

depression

anxiety

alcohol abuse

somatoform disorders

eating disorders

Term
mini-mental status exam(MMSE)
Definition

first test used when patients have memory or cognitive dysunction

 

24 is the cutoff point for normal

 

sensitivity of 87-90%

specificity of 80-82%

 

17 or less is abnormal in those with 8 years or less of education

Term
Alzheimers
Definition

most common cause of dementia in US nd accounts for 65-75% of all cases

 

more than 4million affected by it

 

accumulation of senile plaques in the cerebral cortex and subcortical gray matter

Term
memantine
Definition
uncompetitive NMDA receptor antagonist that is effective in reducing clinical deterioration in moderate to severe Alzherimer's disease
Term
early onset of AD
Definition

gene mutations on chromosomes 21, 14, and 1

 

it only accounts for 2% of all cases

Term
late onset AD
Definition
APOEe4 allele on chormosome 19
Term
factors that may be protective for AD:
Definition

higher education

 

exogenous estrogen

 

NSAIDs

 

vitamin E

 

high monounsaturated fatty acid intake

Term
diagnostic criteria for AD
Definition

memory impairment and one or more of:

aphasia, apraxia, agnosia, or disturbance in executive functioning

Term
% of older patients affected with dementia
Definition
7-10%
Term
% correctly identified by the questionnaires
Definition

90%

 

from BDI, GDS

Term
elderly account for ___% of prescription drug purchases
Definition
30%
Term
elderly account for ____% of nonprescription drug purchases
Definition
40%
Term
over a __ year period ___% of the elderly are takingat least one medication
Definition
5 year period, 90%
Term
____% of the elderly must take medications in order to perform their ADLs
Definition
40%
Term
in a 2007 survey, how may adults were under chiro care?
Definition

4.6% annually

 

over a 4 year period, 10.3% had seen a chiro atleast once

Term
theories of aging NOT supported by literature
Definition

somatic mutation theory

 

error catastrophe theory

 

intrinsic mutagenesis theory

Term
factors that have signficance in the elderly
Definition

family hx of cancer

 

Alzheimer's

 

Huntingtons

 

osteoporosis

 

hypertension

Term
Osler's maneuver
Definition

distinguishes pseudohypertension from hypertension

 

compresses the proximal artery while occluding the pulse with a finger or bp cuff

Term
bone mass declines at a rate of ___?
Definition
5-10% per decade after 40 years old
Term
fasting blood sugar
Definition
increases by 5mg/dl after 50
Term
SPLAT
Definition

symptoms associated with fall

 

prior falls

 

location

 

activity during fall

 

time of day

Term
patient reported falls
Definition

1/3 of patients report one or more falls per year 

 

the rate increases over 85

Term
urinary incontience
Definition

30-50% of older adults affected

 

in community dwelling individuals over 65 its 15-30%

Term
most common causes of incontence
Definition

women: stress incontinence and urge

 

men: overflow and urge

Term
erectile dysfunction
Definition

52% of males 40-70 have it

 

but most common btwn 50-70

Term
low testosterone
Definition
<300ng/dL
Term
elder abuse
Definition

1/3 deny it when questioned specifically

 

physicians report as few as 2% of all cases

Term
absolute contraindications to office exercise testing:
Definition

1. recent ECG changes or acute MI

2. unstable angina/3rd degree hart block or acute CHF

Term
relative contraindications to office exercise testing
Definition

uncontrolled hypertension

 

cardiomyopathies

 

uncontrolled metabolic diseases like diabetes, thryoid or adrenal disorders

Term
percentage of Maximum heart rate desired for seniors
Definition
60-80%
Term
runners
Definition
runners older than 60 that ran for 3 hours per week for 12 years had 40% greater bone density
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