FRAIL ELDER MIDTERM EXAM QUESTIONS AND
ANSWERS 100% CORRECTLY VERIFIED GRADED A++
The ability of an organism to maintain optimal internal environment in face of physiologic stress, the
process in which the body maintains internal equilibrium
homeostasis
narrowing of reserve capacity, the chance of developing some diseases increases with age, the normal
decline the the body's functional reserves
homeostenosis
the limit beyond which homeostasis cannot be restored
physiologic limit
describe the structural changes of the heart normally seen with aging
^ LV wall thickness, decreased LV chamber size, aortic valve/mitral annulus calcification
describe normal cellular changes of the heart with aging
decrease in number of cardiomyocytes, increased myocyte size, increased apoptosis, lipid deposits,
fibrosis, thickening of arterial intima
what are normal molecular changes seen in the heart with aging
altered ca2 handling, decreased beta-adrenergic responsiveness
what are normal functional changes seen in the heart with aging
,increased after load, diastolic dysfunction, decreased contractility and maximum heart rate
the HRmax decreases progressively by about ___ BPM/year
1
SVxHR=
CO
what is the clinically measured index of contractility
ejection fraction
what are changes with aging that effects blood pressure
hypertension (systolic), predisposed to hypotension, baroreflex decreases with age, arterial stiffening,
decline of cerebral autoregulation
what are SX of dehydration
AMS, lethargy, syncope, weakness
what are causes of dehydration
poor intake, DM, diarrhea, CKD, febrile illness, vomiting, diuretics
what does the physical exam of dehydration show
decreased skin turgor, dry MM, orthostatic hypotension
what does lab work show with dehydration
^ HCT, BUN/cr ratio (normally 10:1)
what is the treatment for dehydration
, Unless patient in shock, safely correct 2-3 days, Oral rehydration if possible, Isotonic saline, Monitor labs
and PE
what is orthostatic hypotension associated with
dizziness, presyncope, syncope, falls, stroke, MI
Fall in systolic BP of >20mm Hg OR Diastolic drop of >10mm Hg
orthostatic hypotension
what are differential diagnoses of orthostatic hypotension
Common: Medications such as diuretics, anticholinergics, nitrates, antihypertensives, anti-Parkinsonian,
Dehydration, Blood loss/anemia, Hypokalemia, Bed rest/deconditioning, Malnutrition, Less common:
aortic stenosisSevere venous insufficiencyParkinson's DiseaseDiabetic autonomic
neuropathyIdiopathicPerhaps more w/ tall thin elderly men
how do you assess for orthostatic hypotension
Measure BP and HR after 10 min of rest in supine position AND 1 AND 3 minutes after standing
what is the treatment for orthostatic hypotension
medication adjustment, liberalize salt and fluid intake, rise slowly, florin or midodrine in refractory cases
what are consequences of frailty symptoms
weight loss, weakness, fatigue, inactivity, decreased food intake, social withdrawal, sarcopenia,
balance/gait abnormalities, de-conditioning, decreased bone mass
decline in muscle mass associated with aging
sarcopenia
ANSWERS 100% CORRECTLY VERIFIED GRADED A++
The ability of an organism to maintain optimal internal environment in face of physiologic stress, the
process in which the body maintains internal equilibrium
homeostasis
narrowing of reserve capacity, the chance of developing some diseases increases with age, the normal
decline the the body's functional reserves
homeostenosis
the limit beyond which homeostasis cannot be restored
physiologic limit
describe the structural changes of the heart normally seen with aging
^ LV wall thickness, decreased LV chamber size, aortic valve/mitral annulus calcification
describe normal cellular changes of the heart with aging
decrease in number of cardiomyocytes, increased myocyte size, increased apoptosis, lipid deposits,
fibrosis, thickening of arterial intima
what are normal molecular changes seen in the heart with aging
altered ca2 handling, decreased beta-adrenergic responsiveness
what are normal functional changes seen in the heart with aging
,increased after load, diastolic dysfunction, decreased contractility and maximum heart rate
the HRmax decreases progressively by about ___ BPM/year
1
SVxHR=
CO
what is the clinically measured index of contractility
ejection fraction
what are changes with aging that effects blood pressure
hypertension (systolic), predisposed to hypotension, baroreflex decreases with age, arterial stiffening,
decline of cerebral autoregulation
what are SX of dehydration
AMS, lethargy, syncope, weakness
what are causes of dehydration
poor intake, DM, diarrhea, CKD, febrile illness, vomiting, diuretics
what does the physical exam of dehydration show
decreased skin turgor, dry MM, orthostatic hypotension
what does lab work show with dehydration
^ HCT, BUN/cr ratio (normally 10:1)
what is the treatment for dehydration
, Unless patient in shock, safely correct 2-3 days, Oral rehydration if possible, Isotonic saline, Monitor labs
and PE
what is orthostatic hypotension associated with
dizziness, presyncope, syncope, falls, stroke, MI
Fall in systolic BP of >20mm Hg OR Diastolic drop of >10mm Hg
orthostatic hypotension
what are differential diagnoses of orthostatic hypotension
Common: Medications such as diuretics, anticholinergics, nitrates, antihypertensives, anti-Parkinsonian,
Dehydration, Blood loss/anemia, Hypokalemia, Bed rest/deconditioning, Malnutrition, Less common:
aortic stenosisSevere venous insufficiencyParkinson's DiseaseDiabetic autonomic
neuropathyIdiopathicPerhaps more w/ tall thin elderly men
how do you assess for orthostatic hypotension
Measure BP and HR after 10 min of rest in supine position AND 1 AND 3 minutes after standing
what is the treatment for orthostatic hypotension
medication adjustment, liberalize salt and fluid intake, rise slowly, florin or midodrine in refractory cases
what are consequences of frailty symptoms
weight loss, weakness, fatigue, inactivity, decreased food intake, social withdrawal, sarcopenia,
balance/gait abnormalities, de-conditioning, decreased bone mass
decline in muscle mass associated with aging
sarcopenia
