NR 601 MIDTERM EXAM REVIEW:
PRIMARY CARE FOR AGING
QUESTIONS AND ANSWERS
Not considered a restrictive medical condition for engaging in physical activity. ✅✅ANSW-
Depression
Best recommendation for a patient who has no equipment to exercise. ✅✅ANSW-Improvise with
recommended objects
Advice to consider for all types of exercise for the elderly. ✅✅ANSW-Start low and go slow
Abnormal findings are often due to physiological aging. ✅✅ANSW-Lab values in the elderly
Each individual's variation is often much smaller than that of a larger group. ✅✅ANSW-
Biochemical individuality
Underlying chronic disease has little impact on drug absorption. ✅✅ANSW-Drug absorption
Involves enzymes that are generally inhibited or induced by drugs. ✅✅ANSW-Cytochrome P
system
Decreased sensitivity to oral anticoagulants is not shown to be true. ✅✅ANSW-
Pharmacodynamic changes with aging
A decrease in the body's ability to respond to stressors. ✅✅ANSW-Reduced physiological reserve
Diminished ability of the body to maintain internal stability. ✅✅ANSW-Reduced homeostatic
mechanisms
,A weakened ability of the immune system to respond to pathogens. ✅✅ANSW-Impaired
immunological response
Research studies that follow the same subjects over a period of time to observe changes.
✅✅ANSW-Longitudinal studies
Changes in how the body processes drugs as a person ages. ✅✅ANSW-Pharmacokinetic changes
w/aging
Drugs distributed in water have lower concentration. ✅✅ANSW-Drug distribution in the elderly
The process by which the body chemically alters drugs, which is faster and more efficient in men due
to testosterone. ✅✅ANSW-Biotransformation of drugs
Symptoms that do not follow the typical patterns, such as MI with chest pain and diaphoresis.
✅✅ANSW-Atypical presentation of disease in elderly
Taking even a single medication if there is not a clear indication for its use. ✅✅ANSW-
Polypharmacy
The major difference is the vessels that are affected. ✅✅ANSW-Varicose veins vs atherosclerosis
5th ICS left of MCL. ✅✅ANSW-PMI position in poorly controlled HTN
Most likely indicates mitral stenosis. ✅✅ANSW-Audible diastolic murmur
Group of tests that provide quantifiable measurement of lung function, used to diagnose respiratory
abnormalities or assess progression/resolution of lung disease. ✅✅ANSW-PFTs
Forced Expiratory Volume in 1 second (80-120%). ✅✅ANSW-FEV1
Forced Vital Capacity (80-120%). ✅✅ANSW-FVC
, <0.7 (70%). ✅✅ANSW-Normal FEV1/FVC ratio
Mild; FEV1 >/= 80% predicted. ✅✅ANSW-GOLD 1 criteria
Moderate; FEV1 50-79% predicted. ✅✅ANSW-GOLD 2 criteria
Severe; FEV1 30-49% predicted. ✅✅ANSW-GOLD 3 criteria
Very severe; FEV1 <30% predicted. ✅✅ANSW-GOLD 4 criteria
Dyspnea, chronic cough with sputum, decreased activity tolerance, wheezing. ✅✅ANSW-Signal
symptoms of COPD
Common, preventable, treatable; characterized by persistent airflow limitation. ✅✅ANSW-
Characteristics of COPD
Smoking, second-hand smoke, environmental pollution (endotoxins, coal dust, mineral dust).
✅✅ANSW-Risk factors for COPD
May be normal in early states; as severity progresses: lung hyperinflation, decreased breath sounds,
wheezes at bases, distant heart tones, accessory muscle use, pursed lip breathing, increased
expiratory phase, neck vein distention. ✅✅ANSW-Physical exam findings in COPD
Spirometry is the gold standard (pre and post bronchodilator); irreversible airflow limitation is
hallmark. ✅✅ANSW-Diagnosis of COPD
Bronchodilators: beta agonists (long/short), anticholinergics (long/short), or combination.
✅✅ANSW-Treatment of COPD
Stimulates beta-2-adrenergic receptors, increasing cyclic AMP, resulting in relaxing airways.
✅✅ANSW-MOA of beta agonists
PRIMARY CARE FOR AGING
QUESTIONS AND ANSWERS
Not considered a restrictive medical condition for engaging in physical activity. ✅✅ANSW-
Depression
Best recommendation for a patient who has no equipment to exercise. ✅✅ANSW-Improvise with
recommended objects
Advice to consider for all types of exercise for the elderly. ✅✅ANSW-Start low and go slow
Abnormal findings are often due to physiological aging. ✅✅ANSW-Lab values in the elderly
Each individual's variation is often much smaller than that of a larger group. ✅✅ANSW-
Biochemical individuality
Underlying chronic disease has little impact on drug absorption. ✅✅ANSW-Drug absorption
Involves enzymes that are generally inhibited or induced by drugs. ✅✅ANSW-Cytochrome P
system
Decreased sensitivity to oral anticoagulants is not shown to be true. ✅✅ANSW-
Pharmacodynamic changes with aging
A decrease in the body's ability to respond to stressors. ✅✅ANSW-Reduced physiological reserve
Diminished ability of the body to maintain internal stability. ✅✅ANSW-Reduced homeostatic
mechanisms
,A weakened ability of the immune system to respond to pathogens. ✅✅ANSW-Impaired
immunological response
Research studies that follow the same subjects over a period of time to observe changes.
✅✅ANSW-Longitudinal studies
Changes in how the body processes drugs as a person ages. ✅✅ANSW-Pharmacokinetic changes
w/aging
Drugs distributed in water have lower concentration. ✅✅ANSW-Drug distribution in the elderly
The process by which the body chemically alters drugs, which is faster and more efficient in men due
to testosterone. ✅✅ANSW-Biotransformation of drugs
Symptoms that do not follow the typical patterns, such as MI with chest pain and diaphoresis.
✅✅ANSW-Atypical presentation of disease in elderly
Taking even a single medication if there is not a clear indication for its use. ✅✅ANSW-
Polypharmacy
The major difference is the vessels that are affected. ✅✅ANSW-Varicose veins vs atherosclerosis
5th ICS left of MCL. ✅✅ANSW-PMI position in poorly controlled HTN
Most likely indicates mitral stenosis. ✅✅ANSW-Audible diastolic murmur
Group of tests that provide quantifiable measurement of lung function, used to diagnose respiratory
abnormalities or assess progression/resolution of lung disease. ✅✅ANSW-PFTs
Forced Expiratory Volume in 1 second (80-120%). ✅✅ANSW-FEV1
Forced Vital Capacity (80-120%). ✅✅ANSW-FVC
, <0.7 (70%). ✅✅ANSW-Normal FEV1/FVC ratio
Mild; FEV1 >/= 80% predicted. ✅✅ANSW-GOLD 1 criteria
Moderate; FEV1 50-79% predicted. ✅✅ANSW-GOLD 2 criteria
Severe; FEV1 30-49% predicted. ✅✅ANSW-GOLD 3 criteria
Very severe; FEV1 <30% predicted. ✅✅ANSW-GOLD 4 criteria
Dyspnea, chronic cough with sputum, decreased activity tolerance, wheezing. ✅✅ANSW-Signal
symptoms of COPD
Common, preventable, treatable; characterized by persistent airflow limitation. ✅✅ANSW-
Characteristics of COPD
Smoking, second-hand smoke, environmental pollution (endotoxins, coal dust, mineral dust).
✅✅ANSW-Risk factors for COPD
May be normal in early states; as severity progresses: lung hyperinflation, decreased breath sounds,
wheezes at bases, distant heart tones, accessory muscle use, pursed lip breathing, increased
expiratory phase, neck vein distention. ✅✅ANSW-Physical exam findings in COPD
Spirometry is the gold standard (pre and post bronchodilator); irreversible airflow limitation is
hallmark. ✅✅ANSW-Diagnosis of COPD
Bronchodilators: beta agonists (long/short), anticholinergics (long/short), or combination.
✅✅ANSW-Treatment of COPD
Stimulates beta-2-adrenergic receptors, increasing cyclic AMP, resulting in relaxing airways.
✅✅ANSW-MOA of beta agonists
