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48 Cards in this Set
- Front
- Back
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where is it ideal to evaluate geriatric pts?
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in dedicated office space, not in their rooms
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what should pts/ caregivers bring to every visit?
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eyeglasses, hearing aids, dentures and mobility aids, medications, OTCs, herbal and supplements
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T/F
older adults overestimate health |
true
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T/F
demented = unreliable |
False
demented does NOT = reliable |
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what is functional impairment?
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decreased ability to meet one's needs
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what is so important about functional impairment/ loss?
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it may be the only symptom or sign of underlying dz when more specfic s/s are absent
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T/F
cooking is in the under the category of one taking care of their personal space. |
false
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what are some examples of activities of daily living?
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Bathing
Grooming/ hygeine Dressing Feeding Toileting Continence Transferring Walking |
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what are some examples of instrumental activities of daily living?
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Housework
Laundry Using telephone Transportation Managing Finances Shopping Cooking Managing medications |
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what makes instrumental activities of daily living different from regular activities of daily living?
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it requires more executive fxn than just getting out of bed.
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what percentage of adults 65 and older fall each year?
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>33%
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what is the leading cause of injury deaths in the older population?
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falls
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what is a better predictor of functional deficits than formal neuromuscular exam?
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get up and go test
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what are the intrinsic factors relating to a fall?
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Gait/balance problems Peripheral neuropathy Orthostasis
Vestibular dysfunction Muscle weakness Vision Impairment Impaired ADL’s Advanced Age Dementia |
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what are the extrinsic factors relating to a fall?
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Medications
Environmental hazards Poor/inadequate footwear Restraints |
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what are the precipitating events associated with the fall?
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Infection
Infarction Drop Attack (Medical Illness) Syncope Dizziness Trips and Slips |
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how do prevent falls in the elderly?
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exercise reg, medication review, annual eye exam, optimize lighting in home, reduce hazards in home that increase fall risk, durable medical equipment
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what is the most reliable indicator of undernutrition?
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weight (obese- sarcopenia)
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what does alcohol abuse increase risk of ?
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death w/n 2 years
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what is the 5th vital sign?
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pain
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what are the three tests that you can do to measure cognitive impairment?
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mini-mental state exam, clock-draw test, mini-cog
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what would rigidity and weakness be an early sign of in the elderly?
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early signs of parkinson's
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what does a failure of caregiver role precipitate ?
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harm, hospitalization or institutionalization
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what factors make caregivers more vulnerable?
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advanced age, alcoholism, depression, presence of other caregiving demands.
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what are the risk factors for osteoporosis?
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female, white, menopause, androgen deprivation, tobacco, glucocorticoid exposure, metabolic contributors, PE
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what are the metabolic contributors that can cause osteoporosis?
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chronic renal insufficiency- secondary hyperparathyroidism
hyperthryoidism |
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what is a sign shown on PE that predicts early coronary artery disease if present before age 60?
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arcus senilis
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what is xanthelasma?
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cholesterol deposits under the skin
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T/F
Turgor is a reliable sign of hydration status in the elderly |
FALSE
not a reliable sign |
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what are decubitus ulcers? where do you search for decubitus ulcers?
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pressure ulcers.
sacrum, heels, toes, elbows, shoulder blades, pinnae. |
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what is the stage 1 for decubitus ulcers?
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non-blanching erythema
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what are the 5 frontal release signs?
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snout, palmomental, root, suck, glabellar tap
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what is the glabellar tap?
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tap on the forehead, if the pt continues to blink then they have some frontal lobe problem
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what percentage of older adults is associated with frontal release signs?
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10-35%
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what are the functionally significant changes associated with the elder in the neurologic exam?
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absent ankle reflexes
decreased vibratory sense decreased position sense at great toe inability to hold unipedal stance of 10 sec |
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what individuals do not need a pneumonia vaccine even over the age of 65? what should they take?
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diabetes, HF, COPD, hx of cancer or chemotherapy, on inhaled corticosteroids, disease modifying rheumatologic agents; need something else every 5 years.
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what aspects of the physical exam are pertinent to driving?
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visual acuity, visual fields, range of motion at neck and upper extremities, strength and sensation in all extremities, cognition/ executive function
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what are the three major predictors of failing a road test?
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advanced age
prolonged time to complete trails B (letters and numbers) Neurologic disease |
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what is elder mistreatment?
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“actions that cause harm or create a serious risk of harm (whether or not intended) to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder”
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what might sexual abuse look like to the clinician?
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Fear of being touched
Unexpected/new modesty on exam Bruising inner thighs Genital blood, bruising, tenderness Bowel/bladder dysfunction (sexual abuse can lead to this) Sexually transmitted infections |
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what are the 6 red flags of abuse?
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Bruising patterns
Patient is withdrawn, especially if Δ Difficulty interviewing patient separately Poor/vague explanations for injuries Inconsistent stories Lifestyle/income discrepancy Known abuse of pets |
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T/F
with the elderly population, you should always address them by Mr. or Mrs. or Ms? |
true
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what is the clock draw test? what does this test correlate with?
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The individual is asked to draw the face of a clock, but the numbers on the face of a clock, and have the hands of the clock indicate either 2:45 or 10 minutes until 11. The clock can be scored as correct or incorrect; scored on a 4 point scale; or scored on the Freund scale. This last grading system has been validated among older drivers and the score from it this method correlates with driver fitness
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what is the mini-cog assesment?
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. The Mini-Cog uses a three-item recall test for memory and a simply scored clock-drawing test (CDT).
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T/F
Risk of breast cancer is almost zero in the elderly, so there is no need to do a breast exam. |
FALSE
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an elderly male has a life expectancy of 11 years, what should he be screened for?
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colon cancer
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T/F
76 yoM must be screened for colon cancer. |
false
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what is the association between women who fall and break a hip and death? what about for men?
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increased risk of death by 20%
men- increased risk of death is 30% |
