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Fundies 2 Final
Fundies final
215
Other
Undergraduate 1
04/20/2011

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Cards

Term
People over age 65 are what percent of the population
Definition

13%

 

Term
What is the expected percent of people over the age of 65 in the year 2030
Definition
20%
Term
Middle Aged
Definition
45-64
Term
Elderly
Definition
65-84
Term
Oldest old
Definition
85-94
Term
Frail Elderly
Definition
over 95
Term
What age group is the most rapidly increasing segment of many populations
Definition
85 or older
Term
What aspects need to be included in the geriatric history
Definition
medical, functional, social, psychological
Term
third most common chronic problem in older Americans
Definition
Hearing impairment
Term
What instruments and tests could be used to test hearing impairment
Definition
audioscope, otoscopic examination, whispered voice test
Term
How do you test for cognitive impairment
Definition
Mini-mental status exam
Term
at what age should you start assessing for fall risk
Definition
>65
Term
What are two indicators of a fall risk patient
Definition

>2 falls in the last year

 

History of vertebral, wrist, and or humerus fractures

Term
What are several keys to primary prevention of falls
Definition
regular exercise, reduce environmental hazards in the home, prevent osteoporosis with vitamin D and calcium
Term
What are some secondary and tertiary prevention keys
Definition
Home fall hazards checklist, treat risk factors, adjust dosing/frequency of medications
Term
What are some secondary and tertiary prevention keys
Definition
Home fall hazards checklist, treat risk factors, adjust dosing/frequency of medications, avoid sedatives, prescribe exercise, physical therapist
Term
What should be prescribed to older adults at fall risk
Definition

(800 IU) Vitamin D. 

 

(1200mg) Calcium

Term
How is osteoporosis most commonly diagnosed. What are some other ways it can be diagnosed
Definition
Most commonly diagnosed by dual-energy x-ray absorptiometry of the total hip, femoral neck, or lumbar spine. It can also be diagnosed clinically or radiographically.
Term
What is the score that tells a physician that a patient has osteoporosis
Definition
T-score of 2.5 or below
Term
When taking a fall risk what are some of the aspects that need to be included in the history
Definition
circumstance of falls, history of previous falls, associated symptoms, problems with movement, medications, co-morbid conditions, previous stroke, parkinsonism, cardiac disease, seizures, and osteoporosis
Term
What should be included in the physical exam of a fall risk patient
Definition
orthostatic blood pressure, timed up and go test, tandem walking, stance and gait, foot exam, mental status exam
Term
What is the unintentional leakage of urine
Definition
urinary incontinence
Term
How many people are affected by urinary incontence
Definition
15 million
Term
What other physical problems can be caused by urinary incontinence
Definition
decubitus ulcers, sepsis, renal failure, urinary tract infections, death
Term
What are a few psychosocial implications of urinary incontinence
Definition
loss of self esteem, restriction of activities(less exercise), depression
Term
What is the number one reason for nursing home placement
Definition
Urinary incontinence
Term
What should the assessment of an incontinent patient include
Definition
fluid intake, meds, cognitive functions, mobility, and previous urologic surgeries
Term
What is the  number one question you should ask patients about incontience
Definition
"Do you have a strong and sudden urge to void that makes you leak before reaching the toilet?"
Term
always evaluate the patients ability to do what?
Definition
hear, see, understand and provide an accurate history
Term
What do you do when a patient comes in with multiple complaints
Definition
Set priorities
Term
What is the term for multiple drugs.
Definition
polypharmacy
Term
What is the brown bag method
Definition
Ask the patient to bring all of their medications, vitamins, herbs, etc with them in a brown paper bag
Term
Who should receive the influenza vaccine and how often
Definition
All adults over 50. Annually
Term
Who should receive the pneumococcal vaccine and how often
Definition
All adults over 65. Usually only once
Term
Who should receive the varicella zoster vaccine and how often
Definition
All adults over 60. Only once.
Term
How often should an individual receive the TDP vaccine
Definition
Everyone every 10 yers
Term
How many people are abused in the US(over 65)
Definition
>500,000
Term
How many incidents of geriatric abuse are estimated to go unreported?
Definition
2 million(4x as many as are reporte
Term
How many incidents of geriatric abuse are estimated to go unreported?
Definition
2 million(4x as many as are reported)
Term
What percentage of elderly abusers are family members
Definition
90%
Term
Are men or women more likely to be elder abusers
Definition
There is an equal ratio of men and women abusers
Term

Who are most likely to be abused

 

 

Definition
Elderly women <80 are more likely to be abused than men
Term
What are the two main settings of elderly abuse
Definition
Domestic, institutional(nursing home)
Term
What are the five basic types of elderly abuse
Definition
Physical, sexual, psychological, neglect, financial
Term

What percentage of cases of elderly abuse are neglect

 

Definition
70%
Term
How many of the cases of elderly abuse are physical
Definition
1/7
Term
Is weight gain or weight loss more common in elderly patients
Definition
Weight loss. Malnutrition is common
Term
What are some factors of emergency preparedness that need to be taken into account
Definition
plans for any illness or functional decline, plans for emergency, availability of emergency help, plans for any change in caregiver misfortune or ill health
Term
Should you provide the patient with information of chances of recovery or not
Definition
Yes. Always be truthful with the patient.
Term
Short-term life expectancy
Definition
Death within the next year
Term
Midrange life expectancy
Definition
Death within the next 5 years
Term
Long term life expenctancy
Definition
Death beyond five years
Term
When should the physician become worried about weight loss
Definition
When it is acute (>3%)
Term
What physical measurement may indicate osteoporosis
Definition
Height reduction
Term
When should the physician be worried about changes in postural blood pressure
Definition

>20mmHg fall in systolic pressure

 

>10mmHg fall in diastolic pressure

 

The patient experiences dizziness, lightheadedness, weakness, or syncope

Term
Is high or low frequency hearing loss more common
Definition
high
Term
What are ADL's and what are six of them
Definition

Activities of Daily Living

 

Eating, Dressing, Bathing, Toiletting, Able to get out bed alone, able to walk without assistance, difficulty going up and down stairs

Term
What are the IADLs and what are four of them
Definition
Cooking, banking, making appointments, and ability to drive themselves
Term
Besides vitamin D and calcium supplements how can you help osteoporosis
Definition
Strength training
Term
What is the six-second rule
Definition
Give the patient an extra six seconds to answer all your questions and requests before you become concerned about cognition
Term
How are health benefits related to physical activity
Definition
Health benefits are typically proportional to the amount of physical activity
Term
What are two economic effect of activity in older adults
Definition
It lowers medical expenditures and even sedentary adults who become active see a decrease in medical expenditures
Term
What should be prescribed to a patient with cardiovascular disease
Definition
increased physical activity to improve quality of life
Term
Prescription for patient with bad cholesterol
Definition
physical activity is essential to the nonpharmocologic treatment of elevated cholesterol.
Term
prescription to patient with chronic lung disease
Definition
lower and upper extremity training should be coupled with pulmonary rehabilitation
Term
Prescription to patient with diabetes mellitus
Definition
Aerobic exercise with precautions to prevent foot injury, as well as moderate weight training programs
Term
Prescribed to fall risk patients
Definition
long term exercise and balance training.
Term
Prescribed to patients with high blood pressure
Definition
Aerobic physical activity like walking 30 min/day 5days/wk
Term
Prescribed to patients with osteoporosis
Definition
Exercise in late years in the presence of adequate calcium and vitamin D intake. Especially resistance and high impact activities
Term
What is vigorous aerobic activity
Definition
20 minutes of vigorous physical activity 3 or more days a week
Term
What is moderate aerobic activity
Definition
Brisk walk or equivalent for 10 minutes at a time for a total of 30 min/day 5 day/wk.
Term
What is the recommended amount of resistance training
Definition
Working major muscle groups 2 to 3 days/wk with 48 hours of rest in between at a moderate intensity.
Term
What is the most feasible and safest method of resistance training for elderly adults
Definition
Weight machines
Term

What is the best method of resistance training for individuals with lower fitness levels

 

Definition
body or free weights
Term
How often should an elderly adult do flexibility training
Definition
minimum of 2x/ wk
Term
What is the point of flexibility training...besides becoming more flexible
Definition
It permits and facilitates the types of physical activity that have health benefits
Term
What are the advantages of moderate activity
Definition

No special skills, equipment, or facilities are needed. 

 

Relatively low risk of injury

Term
Being identified as "old"is related to what?
Definition
chronological age, health, functional ability, social roles, and self perception
Term
What four things can contribute to communication difficulties in geriatric patients
Definition
Cognition impairment, hearing loss, dysphasia, cultural barriers
Term
What clues can you tell simply from observation about cognition and function
Definition
unkept dress, poor personal hygiene, urinary incontinence, undue crying and anxiety.
Term
How does the geriatric assessment differ from a normal assessment
Definition
includes nonmedical domains, emphasizes functional capacity and quality of life, and it often incorporates a multidisciplinary team
Term
What is different about illness presentation in older persons
Definition
They often have atypical responses to illness. Ex: confusion due to an infection rather than to a neurologic problem
Term
What percent of adults 85 years and older have dementia
Definition
30%
Term
What is the third most common chronic condition in older Americans
Definition
Presbycusis
Term
What are the first and second most common chronic conditions in older Americans
Definition
Hypertension and arthritis
Term
What sensory evaluations need to take place
Definition
Seeing and hearing
Term
Who should get a fall risk assessment
Definition
All individuals over 65 with >/= 2 falls within the past 12 months, or those with a history of fractures, if they are unable to get out of a chair without using their arms, have to use a cane or walker, or if they have an unsteady gait.
Term
What are three things that should be included in the fall risk assessment
Definition
muscle weakness eval, balance, and orthostatic changes in blood pressure.
Term
What will endurance and flexibility training always be prescribed with
Definition
Strength training
Term
How often is it estimated that a family member is the abuser
Definition
90% of the time. Most often adult children or spouses
Term
What over what age tend to be victimized more than men
Definition
80
Term
What are the four things that the geriatric physical exam includes
Definition
mental status exam, postural blood pressure, visual and hearing assessment, and gait assessment
Term
How long should the timed up and go test take?
Definition
no more than 10 seconds
Term
there are 11 things overall that need to be included in the general screening assessment. What are they
Definition
Functional status, visual impairment, hearing impairment, urinary incontinence, malnutrition, gait, balance, falls, depression, cognitive problems, osteoporosis
Term
What does regular physical activity have an effect on
Definition
Most if not all organ systems
Term
what are the mortality rates of those who exercise compaired to those who dont
Definition
Inactive adults have mortality rates that are 2x as high as those who are active
Term
What is the life expectancy of a 65 year old woman who is not a smoker if she is inactive. What about active
Definition
12.7 for inactive and 18.4 for active
Term
Cardiovascular disease risk decreases most with what type of activity
Definition
aerobic
Term
bone density is most related to what kind of exercise
Definition
resistance and high impact activities
Term
What are the benefits of exercise for elderly patients with CVD
Definition
reduction in mortality, symptoms, improvement in exercise tolerance and functional capacity and improvement in the quality of life.
Term
What does cholesterol have to do with exercise
Definition
Physical activity is regarded as ESSENTIAL to nonpharmalogic treatment of elevated cholesterol.
Term
What type of exercise is recommended for patients with diabetes mellitus
Definition
aerobic exercise. as well as moderate weight training.
Term
What type of exercise is recommended for fall risk patients
Definition
long term exercise and balance training
Term
What type of exercise for high blood pressure
Definition
aerobic physical activity such as brisk walking 30 min/ day most days a week
Term
What type of exercise for knee osteoarthritis
Definition
aerobic exercise and physical therapy involving range of motion exercises.
Term
What exercise is recommended for an obese patient
Definition
it should be an integral part of weight loss therapy and weight maintenance.
Term
What type of exercise is recommended for patients with osteporosis
Definition
Resistance and high impact activity alone with calcium and vitamin D intake
Term
What should be considered besides medication for depression and mental health
Definition
psychotherapy and exercise
Term
How often should flexibility training be done
Definition
2x a week
Term
What is age-related decreases in skeletal mass and quality
Definition
sarcopenia
Term
What are three ways to encourage increased activity in older patients
Definition
recommend exercise classes, set goals, increase activity over time.
Term
WHat is the main risk of physical activity
Definition
musculoskeletal injurty
Term
What are the 5 A's for promoting physical activity
Definition
Assess(patients activity level at least 1x/year), Advise(patient of recommended activity level), Agree(collaboratively with patient on goals), Assist(counseling/ self help materials), Arrange(follow up contact with the patient to monitor progree
Term
Are pedometers an accurate way to measure progress. Why or why not.
Definition
They can be, but they often miscount steps in adults with slow gaits, many steps do not count towards exercise, and a universal step goal is inappropriate.
Term
What is the largest organ of the body
Definition
The skin
Term
What are a few of the functions of the skin
Definition
protection, temp homeostasis, excretion, synthesis, non-verbal communication
Term
What are the three layers of the skin from top to bottom
Definition
epidermis, dermis, hypodermis
Term
What are the fiver layers of the epidermis
Definition
corneum, lucidum, granulosum, spinosum, and basale
Term
What is the epidermis made out of
Definition
stratified squamous epithelim
Term
How often does the epidermis replace itself
Definition
every 35-45 days
Term
What type of cells are in the epidermis
Definition
stem cells, keratinocytes, melanocytest, merkel cells(nerve receptors, and Langerhans cells(immune cells)
Term
What are the upper layers of the epidermis made of
Definition
dead cells filled with keratin
Term
What type of tissue is the dermis made out of
Definition
Strong, flexible connective tissue
Term
What is located in the dermis. Specifically
Definition
Gel like matrix containing collagen, elastin, and reticular fibers. It is rich in nerves, vessels, receptors, and hair follicles and sweat glands are located here.
Term
What type of tissue is the hypodermis made out of
Definition
mainly fatty tissue
Term
What is another name for the hypodermis
Definition
subcutaneous layer
Term
What is the purpose of the hypodermis
Definition
it is a good insulator
Term
Who has less fatty tissue(which layer of the skin is that) and are therefore more sensitive to the cold
Definition
It is less of the hypodermis and it is infants and the elderly.
Term
Where is hair located on the body
Definition
Covers the entire body except palms, soles, lips, nipples, and parts of external genitalia.
Term
Growth of this skin derivitive is sensitive to hormones
Definition
Hair
Term
How many hair follicles are babies born with
Definition
As many as they will every have. We don't grow or develop any more hair follicles.
Term
What are the fastest growing cells in the body
Definition
Hair cells
Term
What is hair heavily filled with or made out of.
Definition
Keratin
Term
What type of glands are associated with hair follicles
Definition
Sebaceous glands
Term
What are two types of sweat glands
Definition
eccrine and apocrine
Term
What are eccrine glands
Definition
They are sweat glands that cover the entire body, mostly on the palms, soles, scalp, and armpits.
Term
What are apocrine glands
Definition
Sweat glands the produce phermomones. Limited to the armpits and genital areas.
Term
What is in the secretions of apocrine glands
Definition
proteins and fatty acids in addition to sweat.
Term
Name the four types of skin glands we talked about
Definition
sebaceous, sweat, mammary, and ceruminous
Term
What is another name for natural aging
Definition
Chronological aging
Term
What are some reasons for chronological aging
Definition
atrophy of dermal tissues and vascularity, decreased protein production, shrinkage of sebaceous glands, fine lines, benign growths, dryness of skin.
Term
what is photoaging
Definition
Responsible for most of what we consider "old" skin.
Term
How is photoaging caused
Definition
Ultraviolet light
Term
What does photoaging cause
Definition
hyperplasia and hypertrophy, deterioration of collagen and elastin, atypical cells in the basla layer and in melanocytes, abnormal pigmentation, dilated blood vessels, actinic changes, and skin cancers.
Term
What is type 1 glogau photoaging classification wrinkle scale
Definition
minimal wrinkles, mild pigment changes, no keratoses (age 20-30's)
Term
What type of classification on the wrinkle scale would be someone with keratoses palpable but not visible, smile lines and early lentigines
Definition
Type 2 (30-40's)
Term
WHat types on the wrinkle scale is someone with obvious dyschromia, wrinkles even when not moving, telangiectasia, and visible keratoses.
Definition
Type 3 (over 50)
Term
What type of photoaging causes a person to have yellow gray skin, no normal skin, wrinkles everywhere, and skin cancers may occur
Definition
Type 4 (>60)
Term
What happens to the stratum corneum as we age
Definition
It becomes drier, and more brittle.
Term
What happens to the epidermis as we age
Definition
smaller rete ridges(less adhesion, more easily torn), decreases number of langerhan cells(decreased immunity), and decreased melanocytes(dyschromia)
Term
What happens to the hair with aging
Definition
scalp has a decresed rate of growth as well as decreased diameter of hair, and decrease in pigment.
Term
What happens to hair in males over 65
Definition
decreased hair on scalp and in beard, increased hair in nose, eyebrows, and ears
Term
what happens to hair in females over 65
Definition
increased hair on lip and chin, decreased hair on scalp, axillae, and pubis.
Term
What happens to the eccrine glands with aging
Definition
fewer, and the ones remaining are less active. They have less ability to thermoregulate
Term
What happens to the apocrine glands with aging
Definition
Less activity(less hormonal stimulation) less odor and less need for antiperspirants and deodorants
Term
What happens to the sebaceous glands with aging
Definition
less acitvity(hormonal stimulation) and less oil leads to more dryness of the skin.
Term
What does purpura mean?
Definition
bruising
Term
What is a circumscribed, flat discoloration which may be brown, blue, red, or hypopigmented
Definition
macule
Term
elevated solid lesion of to .5 cm in diameter
Definition
papule
Term
Circumscribed elevated solid lesion more than .5 cm in diameter
Definition
nodule
Term
A large nodule
Definition
tumor
Term
Circumscribed, elevated, superficial solid lesion more than .5 cm in diameter
Definition
plaque
Term
A firm edematous plaque resulting from the infiltration of the dermis with fluid; they are transient and last only a few hours
Definition
wheal.
Term
A circumscribed collection of free fluid less than .5 cm in diameter
Definition
vesicle
Term
a circumscribed collection of free fluid greater than .5 cm in diameter
Definition
Bulla
Term
A circumscribed collection of leukocytes and free fluid that varies in size
Definition
pustule
Term
What are the ABDCE's of skin lesion evaluation
Definition
Asymmetry, border, color, diameter, evolution, (in kansas elevation)
Term
Life expectancy at birth in Europe and America before 1800
Definition
35 years
Term
Life expectancy at age 2
Definition
60 years
Term
US only (whites) life expectancy
1900
1955
2009
Definition
46-49
66-75
76-81(African Americans 70-74)
Term
What is the projected life expectancy by 2025-2030 in developed and undeveloped regions
Definition
devoloped 80. undeveloped 71
Term
What is projected life expectancy in 2045-2050 in developed and undeveloped countries
Definition
83 in developed. 74 in undeveloped regions
Term
When is the number of older persons expected to exceed the number of children for the first time since 1998
Definition
2045
Term
How much has fertility dropped from 1955-2010 in the less developed regions.
Definition
from 6.0 to 2.7
Term
What is the fertility in the least developed countries.
Definition
4.4
Term
What is the fertility in Eastern Africa, Middle Africa, and Wester Aftrica
Definition
5.2
Term
What is the median age for the world today
Definition
28
Term
What country has the youngest population. What is the median age
Definition
Niger. 15
Term
What country has the oldest population. What is the median age
Definition
Japan. 44
Term
What will the world's median age likely be in 2050
Definition
38
Term
How much has life expectancy at birth increased globally since 1950
Definition
21 years. from 46.6-67.6
Term
What age group is the fastest growing segment
Definition
>85
Term
What is the estimation for the year 2030 of people >/=65
Definition
70 mill
Term
What is the even that is 2x the size of the olympics only for older adults. It is held every 4 years
Definition
World Winter Masters Games
Term
What events are at the WWMG
Definition
ice hockey, alpine skiing, biathlon, cross country skiing, ski jumping, futsal
Term
How many indivuals compete in the summer national senior games
Definition
12,750
Term
What type of cholesterol increases with age
Definition
LDL
Term
Do triglycerides increase or decrease with age
Definition
increase
Term
Does the basal metabolic rate increase or decrease
Definition
decrease
Term
does glucose tolerance increase or decrease with age
Definition
decrease
Term
What happens to HDL and LDL cholesterol with exercise
Definition
HDL raises, LDL lowers
Term
What is the most common injury in older adults who exercise
Definition
muscle strains
Term
What factors play into the increased likelihood of dehydration in older adults
Definition
impaired thirst mechanism, increased water output by kidneys, decreased total body water, attenuated increases in skin blood flow with elevated core temp, medication effects
Term
Are senior athletes at greater risk of sudden death?
Definition
NO
Term
What would an ECG be looking for in a preparticipation evaluation of an older athlete
Definition
evidence of cardiovascular disease
Term
Would would bone density testing be looking for in an older exercising adult
Definition
risk of fracture
Term
What test would you do on an older adult before they started exercising (with diuretic use)
Definition
BMP
Term
What test would you perform on an older adult who wanted to start exercising but has a history of renal disease
Definition
UA
Term
What is a lipid analysis a test of
Definition
CAD risk factor evaluation
Term
What is exercise testing prior to exercise recommended
Definition
Moderate risk/vigorous exercise.
High risk/moderate and vigorous exercise
Term
FITT
Definition
frequency
intensity
time
type
Term
What is a 5-6 on a ten point activity scale. What is a 7-8
Definition
5-6moderate
7-8 vigorous
Term
How often should individuals who exercise at a moderate intensity engage in exercise
Definition
5 day/wk
Term
How often should individuals who engage in vigorous exercise, work out?
Definition
3 nonconsecutive days/wk
Term
What is prescribed for cardiorespiratory fitness
Definition
20-60 minutes of exercise/day
Term
exercises that improve cardiovascular fitness
Definition
walking swimming biking
Term
exercises that improve flexibility and balance
Definition
stretching, yoga, tai chi, pilates
Term
What does valsalva cause
Definition
syncope
Term
Why is the quality of the diet more important in elderly patients
Definition
older adults require less caloric intake based on decreased lean body mass
Term
What should be the percentage of carbs and fats?
Definition
55% carb
no more than 30% fat
Term
what is the min of protein an elderly person should be getting
Definition
.8gm/kg/day
Term
how many oz water are recommended per minute of exercise
Definition
4-6 oz/10-15 min
Term
What effect do diuretics have on exercising patients
Definition
increased risk of dehydration
Term
What do CCB/nitrates do
Definition
cause peripheral vasodilation, reduce performance, but could improve exercise tolerance by improving blood flow to the heart.
Term
What are the side effects of NSAID's
Definition
fluid retention, HTN, gastric ulceration, increased risk of cardiac effects
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