A. Aging & Physiologic Changes
● Cardiovascular: ↑ systolic BP and arteriosclerosis; ↓ vessel elasticity → ↑ afterload; ↓
ventricular compliance → ↓ stroke volume in some elders.
● Neurologic: Slower reaction time from myelin breakdown; reduced peripheral nerve
conduction; preserved general intelligence.
● Respiratory: ↑ residual volume and ↓ vital capacity → ↑ work of breathing; ↓ cough
efficacy.
● Skin/Subcutaneous: Thinner epidermis, ↓ dermal collagen, ↓ subcutaneous fat →
fragile skin, slower wound healing; subQ meds absorb more slowly (common
distractor: “faster”).
● Musculoskeletal: ↓ bone mass and marrow, dehydrated intervertebral disks; sarcopenia;
fall risk rises.
● Functional changes: New fecal incontinence in LTC often functional/cognitive—screen
cognition, meds, mobility before labeling “GI.”
Rapid‑Recall: Aging lungs → ↑ residual volume; aging vessels → ↓ elasticity; aging skin →
slower absorption of subQ meds.
B. Genetics & Inheritance Essentials
● Autosomal Dominant (AD): One affected allele → phenotype. Examples: Huntington
disease, polydactyly. Aa × Aa with a dominant trait: 75% phenotype.
● Autosomal Recessive (AR): Two abnormal alleles. Examples: Cystic fibrosis, PKU.
● X‑Linked Recessive: Example: Hemophilia A. Carrier mother → 50% affected sons;
affected father → all daughters carriers.
● Aneuploidy syndromes:
○ Turner (45,X): Female phenotype, short stature, webbed neck, streak gonads.
○ Klinefelter (47,XXY): Tall habitus, hypogonadism, potential learning
differences.
Pitfall: Don’t confuse inheritance risk with phenotype certainty—penetrance/expressivity
matter, but exam stems stick to classic ratios.
C. Male Reproductive Disorders
● BPH (benign prostatic hyperplasia): LUTS = frequency, urgency, weak stream,
hesitancy, incomplete emptying. Patho: periurethral gland hyperplasia compresses
urethra.
○ Meds:
● Cardiovascular: ↑ systolic BP and arteriosclerosis; ↓ vessel elasticity → ↑ afterload; ↓
ventricular compliance → ↓ stroke volume in some elders.
● Neurologic: Slower reaction time from myelin breakdown; reduced peripheral nerve
conduction; preserved general intelligence.
● Respiratory: ↑ residual volume and ↓ vital capacity → ↑ work of breathing; ↓ cough
efficacy.
● Skin/Subcutaneous: Thinner epidermis, ↓ dermal collagen, ↓ subcutaneous fat →
fragile skin, slower wound healing; subQ meds absorb more slowly (common
distractor: “faster”).
● Musculoskeletal: ↓ bone mass and marrow, dehydrated intervertebral disks; sarcopenia;
fall risk rises.
● Functional changes: New fecal incontinence in LTC often functional/cognitive—screen
cognition, meds, mobility before labeling “GI.”
Rapid‑Recall: Aging lungs → ↑ residual volume; aging vessels → ↓ elasticity; aging skin →
slower absorption of subQ meds.
B. Genetics & Inheritance Essentials
● Autosomal Dominant (AD): One affected allele → phenotype. Examples: Huntington
disease, polydactyly. Aa × Aa with a dominant trait: 75% phenotype.
● Autosomal Recessive (AR): Two abnormal alleles. Examples: Cystic fibrosis, PKU.
● X‑Linked Recessive: Example: Hemophilia A. Carrier mother → 50% affected sons;
affected father → all daughters carriers.
● Aneuploidy syndromes:
○ Turner (45,X): Female phenotype, short stature, webbed neck, streak gonads.
○ Klinefelter (47,XXY): Tall habitus, hypogonadism, potential learning
differences.
Pitfall: Don’t confuse inheritance risk with phenotype certainty—penetrance/expressivity
matter, but exam stems stick to classic ratios.
C. Male Reproductive Disorders
● BPH (benign prostatic hyperplasia): LUTS = frequency, urgency, weak stream,
hesitancy, incomplete emptying. Patho: periurethral gland hyperplasia compresses
urethra.
○ Meds: