AAFP Family Medicine Board EXAM Review 585 Questions with 100% Correct Answers

AAFP Family Medicine Board EXAM Review 585 Questions with 100% Correct Answers Document Content and Description Below AAFP Family Medicine Board EXAM Review 585 Questions with 100% Correct Answers Which tests are most accurate for detecting ACL tears? - Lachman -- anterior drawer -- pivot shift test What is McMurray test used for? - Meniscal tears What evidence suggests MGUS has progressed to Multiple Myeloma? - Evidence of end-organ damage; 1% annual risk of progression *hypercalcemia *renal failure *anemia *skeletal lesions DM w/ lower left leg weakness giving away at the knee, dicomfort in anterior thigh. Decreased sensation to pinprick and light touch over left anterior thigh and reduced motor strength on hip flexion and knee expansion? - Femoral neuropathy What is meralgia paresthetica? - numbnes and paresthesia over the anterolateral thigh with NO MOTOR DYSFUNCTION Spinal stenosis? - Pain in legs; no knee problems DM w/ intermittent claudication involving one or both calf muscles w/ NO motor weakness? - Iliofemoral atherosclerosis Low doese estrogen OCP reduces risk of what cancer by 50%? - Epithelial ovarian cancer*also reduced risk of postmenopausal fractures *less endometrial and colorectal cancers Hallmarks of polymyalgia rheumatica? - *inflammatory disorder 50yo *white women of european ancestry *pain and stiffness in shoulder and pelvic girdle *4-13% have normal ESR *systemic sx: fever common, night sweats, depression, fatigue, malaise, anorexia, weight loss Treatment for polymyalgia rheumatica? - Corticosteroids *dramatic response w/in 2-3 days Classic electroyle abnl in refeeding syndrome? - Hypophosphatemia How can oral candidiasis be reduced when using inhaled corticosteroid for asthma? - Using a valved cholding chamber & rinsing mouth after administration *AE of corticosteroids -- sore throat, coughing on inhalation of medication, hoarseness, oral candidiasis When is laryngoscopy indicated in hoarness? - 3 months or when serious underlying cause is suspected What's a common cause of hoarseness? - Inhaled corticosteroids Morphine may be positive in UTOX screen in what type of patient? - Taking coideine or codeinecontaining medication Treatment of mono? - Supportive: hydration, NSAIDs, throat sprays or lozenges*avoid contact or collision type activities for 3-4 weeks bc of increased splenic rupture When would steroids be used in patient w/ mono? - When airway is compromised/acute airway obstruction What organ is enlarged in mono? - Spleen How is hypercalcemia of malignancy managed? - Fluid replacement w/ normal saline IV to correct volume depletion that is invariable present and to enhance renal calcium excretion What is the mainstay tx of hypercalcemia of malignancy? - IV pamidronate. Considered only after pt has been rendered euvolemic by saline repletion myomectomy over hysterectomy? - If patient desires future pregnancy *general anesthesia not required *blood transfusion unlikely Brown to black leopard spotting o the colonic mucosa in sigmoidoscopy? next step? - Review meds. this is MELANOSIS COLI. Look for laxative use *anthraquinone laxatives such as cascara, senna, or aloe What does valsalva maneuver do to venous return of heart? - DECREASES -- decreased cardiac output What murmur INCREASES doing a valsalva? - Hypertrophic obstructive cardiomyopathy Age group for slipped capital femoral epiphysis? - 8-15; common in overweight/obese childrenPresentation of slipped capital femoral epiphysis? - Limping and pain, limited INTERNAL rotation of the hip What is associated w/ PEG tube use? - Discomfort and agitation -- increased use of restraints What is the best test for dx of COPD? - spirometry FEV/FVC ratio 70% Pain w/ eye movement suggests? - Orbital inflammation, infection, or tumor invasion Colon cancer screening guidelines? - *first degree relative 60yo or 2 second degree reatives are the highest risk group. -- start at 40 or 10 years before earliest age at which affected relative was dx; RE SCREEN q5 YEARS What drugs can induce pleurisy? - Hydralazine, procainamide, quinidine, amiodarone, bleomycin, bromocriptine, cyclophosphamide, MTX, minoxidil and mitomycin What should be avoided in WPW syndrome? - adenosine, digoxin, and calcium channel antagonists bc they block conduction through AV node -- increase ventricular rate paradoxically -- initiating V fib TOC for WPW syndrome? - Procainamide *amiodarone may be used too Doxy CI in 2nd/3rd trimesters of prego? - Risk of discoloration of tooth enamel in the fetus Initial tx for newly diagnosed mild persistent asthma? - Low dose inhaled corticosteroid daily +short acting B agnost PRN What type of drug is infliximab (remicade)? - Tumor necrosis factor inhibitor -- increased risk of infections including TB What do you need to screen before starting infliximab for rheumatoid arthritis? - Hep B and C + TB Initial test to detect HCV? - Enzyme immunoassay If enzyme immonoassay is positive for HCV, next step? - Confirm w/ recombinant immunoblot assay if this is negative -- false positive antibody test If recombinant immunoblot assay is positive in HCV, next step? - HCV RNA PCR used to measure amount of virus If lots of RNA -- active infection If negative RNA -- past infection that is now resolved In which procedure would you stop metformin use? - CT Angio Nursing home acquired pna sx? - New infiltrate on chest radiograph, fever, leukocytosis, purulent sputum, hypoxia ABX for nursing home acquired pna? - empiric coverage: for MRSA and pseudomonasceftazidime, levofloxacin, vancomycin In pregnancy, which drugs may cause cleft lip/palate? - Benzos such as alprazolam Which SSRI is CI in prego? - Paroxetine for concern of increased first trimester cardiac malformations Fluoxetine OK in prego? - Yes Paroxysms of colicky abd pain in 11mo boy? palpable mass in 2/3 pts. - Intussusception RUQ pain, jaundice and palpable mass? - Choledochal cyst Painless lower GI bleeding in 11mo boy? - Meckel diverticulum Tx for severe osteoporosis? - Teriparatide (forteo) SQ *indicated in multiple osteoporosis risk factors & bisphosphonate therapy failure Guidelines about teriparatide treatment? - *Only for 2 years *CI in hx of bone malignancy, Paget disease, HYPERcalcemia, previous tx w/ skeletal radiation What is zoledronic acid? - Parenterally administrated bisphosphonate used to treat osteoporosis What time in get up and go test is severe? - 20 seconds Patient walking with arms abducted, wide based stance, and "en bloc" turns? - Cautious gait assoc w/ visual impairmentWide based gait and staggering? - Cerebellar Magnetic gait? - Frontal lobe degeneration *start and turn hesitation and freezing Steppage gait? - Motor neuropathy; +slapping quality Family based vs. teen based therapy for anorexia nervosa? - Family based is more successful Sudden onset malaise, myalgia, headache, fever, rhinitis, sore throat, cough? - Influenza likely Complications: encephalitis, resp failure, death CDC recommendations for influenza tx? - 1) antiviral tx asap *base on clinical symptoms USPSTF recommendations for aspirin to prevent CVD? - *men 45-79 when reduction in MI harm from increased GI hemorrhage *women 55-79 for same reason *insufficient evidence for 80yo M & F *AGAINST in women 55 and men 45 Which of the asthma drugs should NOT be used as monotherapy? - LABA Bc risk of asthma exacerbation & asthma-related deathPrelim eval for IBD? - CBC, WBC count, platelet cound, K level, ESR 3 day old F w/ skin macules, papules and pustules 2-3 mm in ace, trunk, proximal extremities & EOSINOPHILIA? - Erythema toxicum neonatorum Vesicular rash w/ PMLs and clusters of G+ bacteria? - Staph pyoderma Next step in ID'd 8mm polyp in sigmoid colon in pt w/ no history of colon cancer? - F/U in 10 years. Little evidence it is neoplastic. *F/u in 5-10 years if 1 or 2 tubular adenomas present *3 years if 3 tubular adenomas Tx for symptomatic MVP? - Propanolol (inderal) Sx for altitude illness? - Malaise, h/a. Tx: dexamethasone If patient has sulfa allergy and wants prophylaxis for altitude illness, what do you recommend against? - Using acetazolamide Which abx are implicated in intersitial nephritis? - Abx: penicillins, cephalosporins, sulfonamides (esp in elderly) Can be tx w/ corticosteroids What can improve sx of varicose veins? - Horse chestnut seed extract. Can relieve pain, tiredness, tension, swelling in legs*includes escin (reduces edema and lowers fluid exudation by decreasing vascular permeability) What can milk thistle be used for? - Hepatic cirrhosis What can st. johns wort be effective for? - Mild to moderate depression CI to breastfeeding? - Active HSV on breasts OK in chronic HBV, CMV, tobacco, undifferentiated fever Common cause of erythema multiforme? - HSV. 20-40yo. 50% of cases Pain in index fingers for 4 days, swollen and held in flexed position, pain increases w/ passive extension of fingerness, tenderness to palpation from tip of the finger into palm? - Pyogenic tenosynovitis Tx of pyogenic tenosynovitis? - *within 48 hrs -- oral abx and splinting may prevent spread of infx *lover -- surgical drainage and abx *delay in tx -- ischemia of tendons and damage to flexor tendon and sheath -- impaired funtion of the finger *steroids CI in presence of infection Metformin CI? - renal insufficiency Tx for ciguatera poisoning? - supportive Also for shellfish poisnoing Tx for scombroid fish poisoning? - *includes tuna, mackerel, wahoo, bonito *poisoning due to high levels of histamine and saurine*sx within min to hours -- flushing of skin, oral paresthesias, pruritus, urticaria, n/v/d, vertigo, headache, bronchospasms, dysphagia, tachy, hypoTN *tx: as if treating allergic rxns and anaphylaxis Postural orthostatic tachycardia syndrome (POTS) - *15-50 yo F *do not actually pass out, but can if prolonged standing *correlated w/ chronic fatigue syndrome *genetic predispo Initial management of POTS? - *adequate fluid and salt intake *regular aerobic exercise w/ lower extremity strength training *then use B blockers RF for Abd aortic aneurysm? - SMOKING! 5x more likely *DM is protective *women develop later than men (60s) * in whites Labs in subclinical hypothyroidism? - *slightly elevated TSH (5-10 range) *normal TH or Free T3/4 *asymptomatic pt *have increased risk for CV events; tx doesnt reduce this risk Which tinea infection in children always requires systemic antifungals? - Tinea capitis in order to penetrate affected hair shaftsElevated BNP levels assoc w/? - Renal failure (bc reduced clearance), PE, pulm HTN, chronic hypoxia *not specific for heart failure status What test needs to be performed in pre-op eval of elevtive vascular surgery? - Dipyridamolethallium scan PPI side effects? - *Decreased vitamin B12 absorption *decreased Ca abs -- increased risk of hip fracture *increased risk of comm-acqu pna & c diff Next step in pt 35yo w/ abnl vaginal bleeding? - Endometrial biopsy to exclude endometrial hyperplasia or cancer *if normal -- lab eval for thyroid dysfunction Next step in pt w/ rales, jugular venous distention, hepatojugular reflux, hypotension, angina, EKG atrial flutter 2:1 block? - Immediate cardioconversion Tx for HTN in pt w/ PMH stroke? - Diuretic/ACE-I combination reduces risk of recurrent stroke Most common type of psoriasis? - Chronic plaque. Sx: redness, thickness, scaling Tx: high potency corticosteroids + vitamin D analogue topical *corticosteroids better bc fewer local reactions Tx for tx resistant unipolar depression? - Lithium bicarb or low dose T3*need lithium level 0.5 for 2 weeks or more for good response What can be used to r/o pathogenic proteinuria in kid w/ persistent proteinuria? - Spot first morning urine protein/creatinine ratio Tx for patient w/ acute cervical radiculopathy and normal radiograph? - NSAID. Vast improve w/o surgery *TCA, tramadol, venlafaxine help chronic neuropathic pain *cervical MRI indicated w/ red flags like fever and meylopathy Malaria dx? - prodrome of delirium or erratic behavior, unarsouable coma -- generalized convulsion, fever, lack of focal neuro signs, diffuse & symmetric encephalopathy When patient performs a task delayed and spontaneously after you tell him to? - Apraxia When do you do C section w/o a trial of labor? - *4500g in mom w/ DM *5000g in mom w/o DM Tx for cutaneous erytharasma? - Erythromycin What is intertrigo? - Inflammation of skinfolds caused by skin on skin friction. Assoc w/ corynebacterium minitissimum reddish brown macules that coalesce into larger patches w/ sharp borders CAGE-AID? - substance abuse screenRetraction of proximal nail fold, absence of cuticle, erythema and tenderness around the nail fold area in 6yo boy for 3 months? - Chronic paronychia First line tx: topical corticosteroid cream Assoc of chronic paronychia? - Immersion in water, soaps/detergents, finger sucking Which frequencies are lost in the elderly? - Higher frequency ones and sounds such as consonants Pertussis in adults? - Prodrome phase 1-2 weeks like URI Severe cough after second week. Paroxysmal and may be severe to cause vomiting or fracture ribs Rarely febrile Tx for thrombosed external hemorrhoid dx within 24 hours? - Thrombectomy under local anesthesia Patellofemoral pain syndrome - *common overuse injury in adolescent girls *sx: anterior knee pain assoc w/ activity *pain exacerbated by going up or down stairs or running in hilly terrain *assoc w/ inadequate hip abductor and core strength *rehab program for tx Which colon adenoma is most likely to become malignant? - Villous How do repaglinide and nateglinide act in DM treatment? - Nonsulfonylureas that act on portion of the sulfonylurea receptor to STIMULATE INSULIN SECRETIONMOA Pioglitazone? - Thiazolidinedione -- reduces insulin resistance Activates PPAR-Y, which affects several insulin-responsive genes MOA Acarbose? - Competitive inhibitor of a-glucosidases, enzymes that break down complex carbs into monosachharides -- delays absorption of carbs but does not affect abs of glucose Sitagliptin MOA - DDP-IV inhibitor -- inhibits enzyme responsible for breakdown of incretins Exenatide MOA - incretin mimetic that stimulates insulin secretion in a glucose-dependent fashion, slows gastric emptying, & promote satiety Tx for hypothyroid? - Levothyroxine *rapid replacement can increase metabolic rate & myoardial oxygen demand too quickly -- can precipiate complications of CAD such as a-fib, angina, and MI. Assoc of vacuum-assisted delivery? - *neonatal cephalhematoma & retinal hemorrhage *less maternal soft-tissue traume compared to forceps Imaging for woman w/ acute pelvic pain? - Transvaginal US -- detail regarding uterus and adnexae What will you need to monitor in patient w/ E coli O157? - Renal function bc of risk of HUS Why is mirtazapine good in elderly? - Useful for patients w/ insomnia and sleeping loss Which diuretics increase/decrease uric acid blood levels? - *HCTZ -- increase uric acid levels *Losartan -- decrease themWhere do you want Hb blood levels to be in patient w/ CKD for best outcome? - 10-12g/dL Vocal cord dysfunction age group & mimics? - *20s-30s *cords partially or fully collapse on inspiration *mistaken for asthma Sx of vocal cord dysfunction? - *SOB, tightness of throat, choking sensation, coughing *worse on inspiration *PFTs are normal *FLATTENED INSPIRATORY LOOP What features, when evaluating dyspnea, suggest heart failure? - *orthopnea *rhonci Mom pulls kids hand up forcefully to restrain, help him up? - *nursemaid's elbow *5yo *elbow forced into extension, radial head slips out of the annular ligament *subluxation of the head of the radius First line treatment empirally for child w/ full sepsis workup? - *amp and gent *amp and cefotaxime Initial management of acute asthma exacerbation in ED for children? - *repeated doses of shortacting B2 agonist and correction of hypoxia *ADD magnesium sulfate IV!! Shown to improve lung function and reduce the need for hospitalization What characterizes anemia of chronic disease? - *mild, Hb 9-11 *normocytic-normochromic (can be microcytic)*serum iron and total iron-binding capacity are decreased *Ferritin is increased *TX the underlying systemic disease Age for SIDS? - 6 months!! *quiet death in sleep in previously healthy infant What may you see in SIDS? - *clenched fists *serosanguinous, blood-tinged, mucoid discharge from the mouth or noise *mottled skin in dependent areas Which is the most common kidney stone? - *calcium oxalate What diet helps w/ calcium oxalate stones? - *low-sodium, restricted protein w/ increased fluid intake *oxalate restriction (spinach, chocolate, tea, nuts) *take potassium citrate w/ meals Metabolic acidosis of unknown cause + subsequent renal failure should raise suspicion for? - Ethylene glycol poisoning *TX: Fomepizole (antizol) *pt appears intoxicated but does not have the odor of alcohol. Anion gap acidosis. HYPPOcalcemia, urinary crystals, and nontoxic blood alcohol levelsWhat level of creatinine should metformin be avoided? - 1.5 in men 1.4 in women What anti-DM is safe in patients w/ chronic renal dz? - *GLIPIZIDE When patient can't take B blockers for essential tremor, what can be used that might even be superior? - Primodone (Mysoline) First line for urge incontinence? - *behavioral therapy *anticholinergic therapy Pain characteristics in spinal stenosis? - *relieved by sitting *aggravated by standing Vitamin D supplementation guidelines in babies? - *400 IU/day for infants, children and adolescent *breastfeeding does not provide adequate levels *formula does provide levels, but 1 L *should start supplementation within first 2 months of birth Does weight loss improve CV outcomes? - NO *B blocker, statin, smoking cessation do PTSD pharmacotherapy? - SSRI What increases the success of a voiding trial? - Starting a-blocker (tamsulosin aka flomax) at the time of catheter insertion 0.4mg dailyTOC for alcohol withdrawal? - BENZOs Pseudogout findings - *large number of polymorphonuclear leukocytes *CPPD crystals *short, blunt rods, rhomboids, cuboids *22yo male, comatose, decreased breathing, slow pulse, small pupils? - naarcotic overdose *TX: naloxone *foul smelling, soft, loose stools; foul smelling flatus, belching, marked abdominal distention; absent mucus/blood in stool? - Giardiasis Beefy red rash surrounding vulva and anus in 3yo F? - Group A Strep pyogenes Next step in 10% right pneumothorax? - Repeat CXR 2-3 days 3 month hoarseness, noctural wheezing, clearing throat repetitively, globus sensation in throat? - *acid laryngitis related to GERD *MOA: gastric contents irritating the larynx and hypopharynx Foods that cross react w/ latex? - Avocado, banana, chestnut, kiwi Methadone can lead to what cardiac arrhythmia? - Torsade de pointes bc QT prolongation Outbreaks of otitis externa, dermatitis, folliculitis in swimming pools and hot tubs associated w/? - PseudomonasWhat is the CHADS 2 score? - *CHF *HTN *Age 75 *DM *Stroke or TIA *stroke gets 2 points 4 = high risk 2-3 = moderate risk 1 = low risk Management for A fib in patient w/ CHADS 2 score of 0? - Aspirin 81-325mg daily *moderate risk = warfarin Which side effect of opioids does not decrease over time? - *constipation Others that do: n/v, mental status changes, sedation, pruritis Initial therapy for RA? - NSAIDs BUT metotrexate is the best choice initial therapy Acute bronchitis likely what etiology? - Viral Tx w/ supportive care: antitussive What is the next step when treating a person with mild asthma that is not well controlled w/ albuterol? - Inhaled FLUTICASONE (flvoent) dailyWhat can be added to TMP/SMX in treating PCP in HIV+? - Coricosteroids When should metformin be stopped in terms of creatinine? - 1.5 in men 1.4 in women Sprained wrist and tenderness in anatomic snuffbox should raise suspicion for? - Fracture of the scaphoid bone Tx: thumb spica cast Empiric treatment for men w/ purulent discharge? - Azithromycin 1g orall OR doxy 100mg oral BID 7 days PLUS Ceftriaxone 125mg IM **if patient returns in 3 months, then add metronidazole All children should get how many doses of varicella? - 2 Black box warning for thiazolidinediones (pioglitazone aka Actos)? - Contraindicated in heart failure patients Also CI in T1DM, hepatic dz, and premenopausal anovulatory women Tx for otitis media in 2yo? - Amoxicillin for 10 days Sx of candida infection in breastfeeding woman? - Bilateral nipple pain that happens between feedings after initial sorenessSx of mastitis? - Usually unilateral and has wedge-shaped erythema Eczema on nipple sx? - Isolated to the nipple; unusual Which abx is indicated in bartonella infection? - Azithromycin Can also use rifampin, cipro, TMP/SMX, gentamycin Enlarged tongue can be assoc w/? - Down, amyloidosis, acromegaly Mainstay tx of allergic rhinitis? - Intranasal corticosteroids Secondary hyperparathryoidism can result as a consequence of? - Abnl renal function CI to mirena (levonorgestrel IUD) - Current PID; also uterine anomalies, postpartum endometritis, untreated cervicitis, current inflammatory dz Sudden onset of severe abd pain, v/d, in a patient w/ cardiac source of emboli likely has? - Emobolization to superior mesenteric artery Threshold for prophylactic platelet transfusion? - 10,000/uL Meds that prevent hip fracture? - Alendronate (fusamax) + zoledronic acid, risedronate these are anti-osteoporosis Define sensitivity? - Percentage of patients with a disease who have a positive test resultDefine specificity - Percentage of patients WITHOUT the disease who have a negative test result First line tx for PCOS? - Metformin and clomiphene +/- rosiglitazone Which abx are assoc w/ tendinopathy & tendon rupture? - Fluoroquinolones 1/6K prescriptions will cause an Achilles tendon rupture Risk higher in those taking corticosteroids & 60yo Compressive therapy + this is effective for treatment of venous ulcers - Pentoxifylline. Aspirin, too. *can be monotherapy in pts who can't tolerate compression therapy Pulmonary wedge capillary pressure of 8mmHg suggests? - Hypovolemia Tx: IV NS infusion Tx for acute exacerbation of COPD includes? - *oxygen + bronchodilators *systemic corticosteroids + abx What typically causes exacerbation of COPD? - Superimposed infection Most concerning early sx of a dangerous drug reaction? - Pruritus around the mouth and on the palms of the hands and soles of the feet *anaphylactic rxns start with this, and then go to rhinitis, conjunctivitis, angioedema of oral mucosa esp pharynx and larynx; severe urticaria; dyspnea; HYPOTENSIONHow do type IV (delayed) drug reactions present? - Benign, diffuse erythematous macules on the trunk and proximal extremities, often referred to as a drug rash Single dose prophylaxis for lyme disease after Ixodes tick bite? - Doxycycline 200mg within 72 hours can prevent dev of dz Recommendations for the pneumococcal vaccine? - *all adults 65yo receive a single dose *if received before 65, get another one at age 65 OR 5 years after the first dose, whichever is later Early palliative care results in what benefit for the patient? - Decreased depressive sx Secondary vs. tertiary prevention? - Secondary targets individuals who have developed an asymptomatic disease and institutes treatment to prevent complications (pap smears) Tertiary targets those who ALREADY have a disease to prevent complications Which CHD will have combined ventricular hypertrophy? - VSD since blood is shunted from one to the other (L -- R) Murmur is holosystolic, heard best at LLSB Most common cause of abnl liver tests in developed world? - Non-alcoholic fatty liver dz. It is considered as the liver manifestation of insulin resistance. *statin therapy is safe and can improve liver enzyme levels and reduce CV morbidity What should you check in urine for female admitted for community acquired pna? - Antigens for Legionella and pneumococcus*draw 2 blood cultures to do this imaging of choice for suspected testicular torsion? - Color duplex Doppler US *may also do transillumination clinically Next step for patients w/ acute low back pain wihthout paresthesias or other neuro sx? - return to normal activities as tolerated has been shown to be more beneficial than either bed rest or basic exercise program *bed rest 2-3 days may be harmful and ineffective Hypotension that is resistant to IV fluid resuscitation in a critical illness prompts testing for what hormone? - Cortisol. May reveal deficiency *need to treat w/ IV corticosteroids Treatment for eclampsia? - Mag sulfate Hx of sexual abuse is assoc w/ what in females? - Lifelong funcitonal GI disorders Greatest risk of developing colon cancer is a history of? - Familial adenomatous polyposis *hundreds of polyps, cancer may dev by 20yo; by 40yo most will have some cancer if preventive colectomy is not performed Flomax can treat? - Benign prostatic hyperplasia Famotidine (pepcid) treats? - GERDWhich treatment for chronic low back pain would produce the least amount of AE's? - Lidocaine patch (lidoderm) At 18 mo visit, what will prompt specific sign of autism? - Delayed attainment of social skill milestones. Earliest and most sepcific sign of autism What imaging study to go for patient w/ chronic neck stiffness assoc w/ left thumb tingling? - Cervical spine series In pt w/ pulmonary embolus, when can heparin be stopped in their treatment? - After 5 days, when INR has been 2.0 for 24 hours Changes in the elderly? - *decreassed cardiac output *decreased max HR *decreased SV *increased S & D BP *increase in residual lung volume nd decreased vital capacity *decreases in nerve conduction & balance What can reduce the degree of changes in the elderly? - Regular aero