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48 Cards in this Set
- Front
- Back
- 3rd side (hint)
drug of choice for hyperlipidemia
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statins
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side effect is rhabdomyolysis
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how often do you check total serum cholesterol
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every 5 years
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if CAD, DM, PAD, prior stroke….treat more often
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Most common cause of secondary htn in older indiviuals
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renovascular disease
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How often do you screen for breast cancer?
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annual cbe + mammogram through age 70
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continue after age 70 if at least a 4 year life expectancy; discuss choices with patient
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When do you screen for colorectal cancer?
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age 50 if at average risk; colonoscopy every 10 years, or FOBT annually plus a flexsig every 5 years
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stop screening around 75-80
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A yearly PSA test and DRE are recommended by the ACS to age 75 if…
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the have at least a 10 year life expectancy
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At what age should you begin total body examinations for skin cancer?
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40
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When do you screen for DM?
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every 3 years in patients over 45;…not recommended for patients 75-80 years old….after 65, screening does not prevent renal disease and blindness in those who are found to be diabetic
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Screening for thyroid disease is recommended yearly for asymptomatic women of what age?
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>/ to 50….order a TSH….free T4 should be ordered if abnormal TSH
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What are the two widely used screening test for dementia?
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mini mental state exam and mini-cog exam (score of 2 or less on mini cog = dementia)
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List the activities of daily living.
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bathing, dressing, eating, transferring, continence, toileting
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List the instrumental activities of daily living.
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transportation, shopping, cooking, use of telephone, managing money, taking medications, cleaning, laundry
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A brand new decline in an activity of daily living
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indicates disease process
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get up and go test measures
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balance, gait, strength
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if you fail, you are at increased risk of falling
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Acute MI in elderly may present how?
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without chestpain, asymptomatic, SOB, pulmonary edema, CHF, caridiac rupture, and shock;
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This may be the presenting symptom after an MI in the elderly
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Delerium
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Most common cause of CHF in geriatric population
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prolonged systolic hypertension
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This is associated with acute rheumatic fever.
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mitral stenosis
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Most common valvular disorder in the elderly.
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mitral regurgitation
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What may happen if peritonitis in the elderly is left untreated?
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hypotension and cardiovascular collapse
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What is a complication of acute renal failure?
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hyperkalemia
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make sure to monitor electrolytes
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How do people present with hyperkalemia
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fatigue, nausea, muscle twitching, slow, weak pulse
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can be overlooked because these are also associated with aging
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For elderly patients, what is the initial therapy for osteoarthritis?
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acetaminophen…
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in the younger population, we would give NSAIDs first
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For geriatrics with gout, what do we prescribe?
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NSAIDs or prednisone….indocin is given in younger patients, but is not well tolerated in elderly
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Precursor to squamous cell cancer
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actinic keratosis
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scaly, rough, white, and adherent
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Treatments for BPH
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alpha-1 receptor blockers, 5-alpha reductase inhibitors, surgery
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most common cause of vitamin B-12 deficiency in elderly is…
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malabsorption due to…..
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atrophic gastritis or hypochlorhydria
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If a person is in a state of delerium and you need to sedate them, what do you use?
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Haldol is 1st line, Ativan is second line
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The primary cause of permanent cognitive impairment among older patients
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Dementia
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Cortical dementias are characterized by
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prominent amnesia, aphasia, apraxia, and or agnosia
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Triad of symptoms for normal pressure hyudrocephalus
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early gait ataxia, urinary incontinence, later progression of cognitive changes (dementia)
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dementia ofter head trauma suggests
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subdural hematoma
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Most common drug used for the treatment of alzheimers
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Aricept
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Fluent (Wernicke's) aphasia
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words don't make sense when they speak
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Non-Fluent (Broca's) aphasia
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can't get the words out, but they understand
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Most common cause of aphasia
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left middle cerebral artery infarction
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Inability to perform previously learned motor acts in the presencej of motor strength
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apraxia
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an inability to recognize specific visual stimuli in the absence of visual impairment or aphasia
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agnosia
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Recommended medications for elderly with schizophrenia
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clozaril, risperdal, zyprexa
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Who is at the greatest risk for suicide?
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elderly males
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What class of medications do we treat primary depression with?
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SSRI's
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How do we treat secondary depression?
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TCA's
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What type of medications may dry the vagina increasing the risk of painful intercourse?
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antihistamines
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What types of pills reduce alertness and may blunt interest in sex?
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sleeping pills
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restless leg syndrome is thought to be related to
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dopamine dysfunction
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What are the symptoms associated with RLS, and what medication is given?
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aching, burning, cramping, tingling, or pain; Requip
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What is the best drug to use in the elderly for sleep disorders?
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ambien
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most common causes of execessive sleepiness
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OSA, PLM
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