NR I601 Iweek I2 Iquiz Ireview
Week I1
• Know Ithe Iphysical Iand Iphysiological Ichanges Iin Ithe Ielderly
*Appendix IA Ipgs I643-650*
3 IPrimary IPoints I1. IReduced Iphysiological Ireserve Iof Imost Ibody Isystems, Iespecially Icardiac,
Irespiratory, Iand Irenal. I2. IReduced Ihomeostatic Imechanisms Ithat Ifail Ito Iadjust Iregulatory Isystems
Isuch Ias Itemperature Icontrol Iand Ifluid Iand Ielectrolyte Iimbalances. I3. IImpaired Iimmunological
Ifunction: Irisk Ifor Iinfection Iis Ihigher Iand Iautoimmune Idiseases Iare Imore Iprevalent.
Never Ibe Icomplacent Iand Iassume Ithe Iissue Iis Ionly Iage Irelated I(pg I2-3)
• How Iaging Ieffects ILab Ivalues Iin Ielderly
**Appendix IB Ipgs I651- I652**
Many Ifactors Iinfluence Ilab Iresults Iin Ithe Ielderly, Iincluding Iphysiologic Ichanges Iwith Iaging, Ithe
Iprevalence Iof Ichronic Idisease, Ichanges Iin Inutritional Iand Ifluid Iintake, Ilifestyle Iand Iactivities, Iand
Imedications Ibeing Itaken. IBiochemical Iindividuality Iis Iimportant Iin Idetecting Iasymptomatic
Iabnormalities Iin Iolder Iadults. ISignificant Ihomeostatic Idisturbances Iin Ithe Isame Iindividual Imay
Ibe Idetected Ithrough Iserial Ilab Itests, Ieven Ithough Iall Iindividual Itest Iresults Imay Ilie Iwithin Inormal
Ilimits Iof Ithe Ireference Iinterval Ifor Ithe Ientire Igroup. ILab Iwork Ican Ibe Iaffected Iby Iinadequate
Iprotein Istores Iwithin Ithe Ibody, Iand Ithe Ielderly Iloose Ithese Iprotein Istores. IThe Iserum Icreatinine
Ilevels Imay Ibe IWNL Iyet Iindicate Irenal Iimpairment Iin Ipt’s Iwith Iinadequate Iprotein Istores. IThe
Icalculation Iof Ithe Icreatinine Iclearance, Iused Ito Iestimate Irenal Ifunction, Iis Isignificant Ito Ithe
Iprovider.
Reduced Irenal Ifunction, Iespecially Ithe IGFR, Iaffects Ithe Iclearance Iof Imany Idrugs, Iand ICrCl
provides Ian Iindex Iof Irenal Ifunction Ifor Iuse Iin Ichoosing Irenally Ieliminated Ior Inephrotoxic Idrugs
Isuch Ias Idigoxin, IH2 Iblockers, Ilithium, Iand Iwater Isoluble Iantibiotics. I(pg I3-4)
• How Idisease Ipresents Iin Ielderly
4 Ifactors: I1. Inonpresentation Iof Iillness I– Iunderreporting Iof Is/s Ir/t Ierroneous Iassociation Iof Iaging
Iwith Idisease, Idisuse, Iand Idisability. IThe Ielderly Ibasically Isee Ithese Ichanges Ias Iinevitable Iso Ithey
Ieither Ido Inot Igo Ito Ithe Idoctor Ior Iif Ithey Ido, Ithey Ido Inot Ichallenge Ithe Idoctor Iwhen Ithey Iare Itold
Iit Iis Iage Irelated. I2. Imultiple Icomplaints I– Ibecause Iof Ithe Iprevalence Iof Ichronic Idisease Iin Ithe
Ielderly Ipopulation, Ithey Imay Ipresent Iwith Imultiple Icomplaints. IThe Iprovider Ishould Iexplore Ithe
Ipossibility Iof Ia Iconstellation Iof Isymptoms Iand Isigns Ithat Iwhen Ianalyzed Imay Irepresent Imore
Ithan Ione Icondition/problem. IAfter Icareful Iexploration, Idepression Ican Ialso Ibe Iconsidered Igiven
Idepression Ican Imanifest Iatypically Iin Iolder Iadults Iand Isomatic Is/s Iare Inot Iuncommon. I3. IAn
Ialtered Ipattern Iof Iillness I– Ipatterns Iof Idisease Imay Ibe Idifferent Iin Ithe Ielderly. IFor Iexample,
Ijaundice Iin Ia Iyounger Ipt Iindicates Iviral Ihepatitis Ibut Iin Ithe Ielderly Imay Iindicate Ia Imalignancy Ior
Igallbladder Idisease. IAnother Iexample Iis Idelusions Iand Ihallucinations Iin Ia Iyounger Ipt Ican Iindicate
Ibipolar Idisorder Ibut Iin Ithe Ielderly Ican Iindicate Idementia Ior Imedication Iside Ieffects.
Week I1
• Know Ithe Iphysical Iand Iphysiological Ichanges Iin Ithe Ielderly
*Appendix IA Ipgs I643-650*
3 IPrimary IPoints I1. IReduced Iphysiological Ireserve Iof Imost Ibody Isystems, Iespecially Icardiac,
Irespiratory, Iand Irenal. I2. IReduced Ihomeostatic Imechanisms Ithat Ifail Ito Iadjust Iregulatory Isystems
Isuch Ias Itemperature Icontrol Iand Ifluid Iand Ielectrolyte Iimbalances. I3. IImpaired Iimmunological
Ifunction: Irisk Ifor Iinfection Iis Ihigher Iand Iautoimmune Idiseases Iare Imore Iprevalent.
Never Ibe Icomplacent Iand Iassume Ithe Iissue Iis Ionly Iage Irelated I(pg I2-3)
• How Iaging Ieffects ILab Ivalues Iin Ielderly
**Appendix IB Ipgs I651- I652**
Many Ifactors Iinfluence Ilab Iresults Iin Ithe Ielderly, Iincluding Iphysiologic Ichanges Iwith Iaging, Ithe
Iprevalence Iof Ichronic Idisease, Ichanges Iin Inutritional Iand Ifluid Iintake, Ilifestyle Iand Iactivities, Iand
Imedications Ibeing Itaken. IBiochemical Iindividuality Iis Iimportant Iin Idetecting Iasymptomatic
Iabnormalities Iin Iolder Iadults. ISignificant Ihomeostatic Idisturbances Iin Ithe Isame Iindividual Imay
Ibe Idetected Ithrough Iserial Ilab Itests, Ieven Ithough Iall Iindividual Itest Iresults Imay Ilie Iwithin Inormal
Ilimits Iof Ithe Ireference Iinterval Ifor Ithe Ientire Igroup. ILab Iwork Ican Ibe Iaffected Iby Iinadequate
Iprotein Istores Iwithin Ithe Ibody, Iand Ithe Ielderly Iloose Ithese Iprotein Istores. IThe Iserum Icreatinine
Ilevels Imay Ibe IWNL Iyet Iindicate Irenal Iimpairment Iin Ipt’s Iwith Iinadequate Iprotein Istores. IThe
Icalculation Iof Ithe Icreatinine Iclearance, Iused Ito Iestimate Irenal Ifunction, Iis Isignificant Ito Ithe
Iprovider.
Reduced Irenal Ifunction, Iespecially Ithe IGFR, Iaffects Ithe Iclearance Iof Imany Idrugs, Iand ICrCl
provides Ian Iindex Iof Irenal Ifunction Ifor Iuse Iin Ichoosing Irenally Ieliminated Ior Inephrotoxic Idrugs
Isuch Ias Idigoxin, IH2 Iblockers, Ilithium, Iand Iwater Isoluble Iantibiotics. I(pg I3-4)
• How Idisease Ipresents Iin Ielderly
4 Ifactors: I1. Inonpresentation Iof Iillness I– Iunderreporting Iof Is/s Ir/t Ierroneous Iassociation Iof Iaging
Iwith Idisease, Idisuse, Iand Idisability. IThe Ielderly Ibasically Isee Ithese Ichanges Ias Iinevitable Iso Ithey
Ieither Ido Inot Igo Ito Ithe Idoctor Ior Iif Ithey Ido, Ithey Ido Inot Ichallenge Ithe Idoctor Iwhen Ithey Iare Itold
Iit Iis Iage Irelated. I2. Imultiple Icomplaints I– Ibecause Iof Ithe Iprevalence Iof Ichronic Idisease Iin Ithe
Ielderly Ipopulation, Ithey Imay Ipresent Iwith Imultiple Icomplaints. IThe Iprovider Ishould Iexplore Ithe
Ipossibility Iof Ia Iconstellation Iof Isymptoms Iand Isigns Ithat Iwhen Ianalyzed Imay Irepresent Imore
Ithan Ione Icondition/problem. IAfter Icareful Iexploration, Idepression Ican Ialso Ibe Iconsidered Igiven
Idepression Ican Imanifest Iatypically Iin Iolder Iadults Iand Isomatic Is/s Iare Inot Iuncommon. I3. IAn
Ialtered Ipattern Iof Iillness I– Ipatterns Iof Idisease Imay Ibe Idifferent Iin Ithe Ielderly. IFor Iexample,
Ijaundice Iin Ia Iyounger Ipt Iindicates Iviral Ihepatitis Ibut Iin Ithe Ielderly Imay Iindicate Ia Imalignancy Ior
Igallbladder Idisease. IAnother Iexample Iis Idelusions Iand Ihallucinations Iin Ia Iyounger Ipt Ican Iindicate
Ibipolar Idisorder Ibut Iin Ithe Ielderly Ican Iindicate Idementia Ior Imedication Iside Ieffects.
