Geriatrics: Immune System and Confusion

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Questions and Answers

What do X-ray shadows of small opacities under 1 cm correspond to according to the International Labour Office Standardisation?

A, B, C

p, q, r

Sij, Sil, Sitbc

RU, RM, RL (correct)

Which of the following is a typical chest X-ray sign of simple silicosis?

Generally pattern of small and round opacities (correct)

Enlargement of cardiac silhouette

Presence of large conglomerate opacities

Presence of pleural effusion

Which treatment option is included for carpal tunnel syndrome?

Topical antihistamines

Neural therapy

Corticosteroid injections

Endoscopic surgery (correct)

What is the characteristic of early localized infection of Lyme disease?

Erythema migrans Signup and view all the answers

What condition is the Neer test used to assess?

Impingement syndrome of upper extremities Signup and view all the answers

Which of the following is a known etiological agent for cancer of the nose and paranasal sinuses?

Hard wood dust Signup and view all the answers

What measurement does plethysmography assess?

Measurement of capillary volume changes Signup and view all the answers

What is considered the gold standard for the diagnosis of tuberculosis (TBC)?

Quantiferon test Signup and view all the answers

Which characteristic is true about the immune system of a geriatric patient?

Immune-deficit due to malnutrition Signup and view all the answers

What is the term for a short and reversible acute state of confusion?

Delirium Signup and view all the answers

What does ageism refer to?

Discrimination of seniors in society Signup and view all the answers

Which statement is true regarding sleeping disorders in the elderly?

They include hypersomnia Signup and view all the answers

Which of the following is NOT a risk factor for immobility?

Uroinfection Signup and view all the answers

What should be prioritized regarding potential drug interactions in elderly patients?

They should be searched for at every visit Signup and view all the answers

Which medication is generally not necessary to stop before a planned surgical operation?

ASA Signup and view all the answers

What is the average life expectancy at age 65 according to current estimates?

5.5 years Signup and view all the answers

Which typical X-ray sign is associated with complicated silicosis?

Bronchiectasis Signup and view all the answers

Raynaud phenomena is not associated with which of the following conditions?

Rheumatic fever Signup and view all the answers

What percentage of the elderly regularly use nonprescribed drugs that may cause significant symptoms?

Nearly three-quarters Signup and view all the answers

What was a key finding of the HYVET study despite its premature ending?

Tendency to reduce incidence of dementia by active therapy Signup and view all the answers

What effect can nonsteroidal anti-inflammatory drugs (NSAIDs) have on the elderly?

Hampering control of hypertension and causing GI bleeding Signup and view all the answers

Insomnia can be classified as which of the following conditions?

Iatrogenous and associated with medication usage Signup and view all the answers

Which statement about COX-2 inhibitors in the elderly is incorrect?

They are safer than nonselective NSAIDs. Signup and view all the answers

Which of the following is an important age-related change in the hematologic/immune system?

Decreased production of autoantibodies Signup and view all the answers

Which type of drugs are considered frequent offenders in controlling antihypertension?

Nonprescribed agents for insomnia Signup and view all the answers

Which class of antihypertensive drugs is considered most favorable for elderly patients?

ACE-inhibitors Signup and view all the answers

What is a common age-related consequence in the musculoskeletal system?

Functional impairment and osteopenia Signup and view all the answers

Which statement best describes pharmacotherapy in geriatric patients?

Incidence of polypharmacy Signup and view all the answers

How do older patients typically respond to drugs in comparison to younger patients?

Less sensitive to some drugs and more sensitive to others Signup and view all the answers

Which option correctly identifies a substance that can induce psychosis when intoxicated?

Lead (Pb) Signup and view all the answers

Which method is the most appropriate for diagnosing dermatosis?

All claims are correct Signup and view all the answers

What is considered the gold standard in the diagnostic algorithm of occupational asthma?

Specific bronchoconstriction test Signup and view all the answers

What is a common physiological change related to aging in body composition?

Increase body fat and decrease total body water Signup and view all the answers

Which of the following is considered a health chemical hazard at work?

Gases Signup and view all the answers

Which of the following skin diseases is most commonly reported in occupational settings?

Contact allergic dermatitis Signup and view all the answers

What is true about the pharmacokinetics of digitales, procainamide, and quinidine in older patients?

They have prolonged half-lives and narrow therapeutic windows Signup and view all the answers

In which patient group is lithium primarily indicated for treatment?

Psychiatric patients Signup and view all the answers

Which category represents the most common occupational diseases?

Musculoskeletal diseases Signup and view all the answers

What does secondary elimination refer to in toxicology?

Removal of toxic substances from the body post-absorption Signup and view all the answers

According to the definitions provided, what is included in the concept of Occupational Health?

Promotion and maintenance of workers' well-being Signup and view all the answers

Which of the following is considered an occupational disease?

Herniation of lumbar disc with radicular syndrome Signup and view all the answers

Which role is NOT part of Occupational Health Services?

Check up of workers specifically to risk factors of atherosclerosis Signup and view all the answers

What method can confirm latent tuberculosis infection?

Tubercolin skin test and interferon gamma release assays test Signup and view all the answers

What is the most frequent cause of occupational lung cancer?

Asbestos Signup and view all the answers

Which type of cancer is the most frequent in occupational settings?

Lung cancer Signup and view all the answers

What percentage of people who have lived to age 65 are still alive?

Two third to three quarter Signup and view all the answers

Byssinosis is best described as which of the following?

An occupational respiratory disease associated with inhalation of cotton dust Signup and view all the answers

Anemia, neutropenia, and thrombocytopenia are typical for which condition?

Dermatomyositis Signup and view all the answers

Study Notes

Immune System in Geriatrics

Characterized by improved response to antigens
No autoantigen production
Immune-deficit due to malnutrition
Cell immunity (T-lymphocytes) function maintained at a young adult level

Confusion in Elderly

Acute confusion (relatively short, reversible) is called delirium
Other options are: disorientation, anxious hopelessness, dementia

Ageism

Giving preference to senior citizens in society
Showing increased interest in seniors
Discrimination against seniors

Sleeping Disorders in Elderly

May include hypersomnia
Parasomnias are possible
Insomnia is not excluded

Immobility Risk Factors (Not Included)

Dementia
Sudden coronary stroke
Uroinfection
Osteoporosis

Drug Interactions in Elderly

Drug interactions are often important
Potentially unrecognized by clinicians
Need to be checked at every visit

Surgical Operations Pre-op Considerations

Administering ASA prior to surgery not always necessary
Other anticoagulants (e.g. LMWH) may need discontinuation

Average Life Expectancy

Increasingly (e.g., 9 years at age 65)

Disease Presentation in Elderly

Often atypical
Symptoms appear later in the disease process
Multiple abnormalities are common
Smaller improvements

Gastrointestinal Changes in Elderly

Increase in colonic motility
Decrease in gastric acidity
Increase in anorectal function
Increase in hepatic function

Cardiovascular Changes in Elderly

Increased baroreceptor sensitivity
Increased sinoatrial (SA) automaticity
Increased arterial compliance
Decrease in systolic blood pressure (BP)

Renal Function in Elderly

Serum creatinine not a great measure of renal function (unless elevated)
Should be cautious with drug administration, especially those excreted by kidneys

Disability in Elderly

Fewer than 30% of individuals over 85 live in nursing homes
20% are impaired in activity of daily living

Nasal Provocation Tests

Evaluating rhinomanometry and acoustic rhinometry
Symptom scores are used in some tests

Pneumoconiosis Diagnosis

Requires combination of occupational history, clinical symptoms and examination methods
Includes pulmonary function tests
Chest X-rays and HRCT scans, bronchoscopy sometimes required

Typical Occupational Cancers

Includes brain cancer, pleural mesothelioma
Excludes colorectal cancer

EU Safety and Health at Work

Includes directives, recommendations and opinions

Vocal Cord Disorders Risk

The highest risk among these is pharmacists

Occupational Rhinitis Etiology

Common culprits are dusts (coal, isopropyl alcohol, silica) and flour.

X-Ray Signs of Simple Silicosis

Enlargement of lymph nodes
Large shadow conglomerates (diameter > 10 mm)
Pleural adhesions are sometimes present
Small, round shadows (diameter < 10 mm) is a more general pattern

Carpal Tunnel Syndrome Treatments

Endoscopic surgery and local pain relievers (e.g. procaine injection)
Muscle relaxants and vasodilators (e.g. calcium channel blockers)

Lyme Disease Early Signs

Migratory polyarthralgia
Localized scleroderma
Erythema migrans
Lyme polyradiculitis

Upper Extremity Impingement Syndrome

Neer test is used to assess this

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Description

This quiz explores vital concepts in geriatrics, focusing on the immune system, confusion in the elderly, ageism, sleeping disorders, and drug interactions. Test your understanding of how these elements impact the health and well-being of senior citizens.