Geriatric

Question 1

functional reserve

Answer 1

“safety margin for function above basal needs”

• peaks at 30 and gradually declines
• if patient has 4 mets, patient has cardiovascular and respiratory reserve

Question 2

total body water ____ with age, mainly in the ____cellular compartment

**affects

Answer 2

decreases, intra

higher plasma drug levels of hydrophilic drugs

Question 3

adipose tissue _____ with age

**affects on drugs distribution and metabolism

Answer 3

increases

increased reservoir and longer half-life for lipid soluble drugs

Question 4

basal metabolic rate _____ with age

Answer 4

declines

Question 5

CNS changes with aging

Answer 5

• decreased mass, number of neurons, synthesis of neurotransmitters, receptors, blood flow
• autoregulation stays intact
• post-operative cognitive dysfunction, cause unknown

Question 6

MAC decreases ____ per decade

Answer 6

6%

Question 7

Propofol dose is ______ in elderly versus young adults

Answer 7

15% lower

Question 8

cardiovascular changes with aging

Answer 8

• hypertension due to loss of vascular elasticity
• difficulty increasing cardiac output: reduced efficacy of beta agonists, diminished baroreceptor response, endogenous beta blocked
• diastolic dysfunction, dependent on atrial kick
• prolonged circulation time
• more volume (preload) dependent

Question 9

pulmonary changes with aging

Answer 9

• loss of elastic recoil
• decreased VC, response to hypercapnia and hypoxia, airway protective reflexes
• increased work of breathing, V/Q mismatch

Question 10

hepatic changes with aging

Answer 10

• little change in enzyme function

- decreased liver size, blood flow, rate of plasma clearance

Question 11

renal changes with aging

Answer 11

decreased blood flow, mass, GFR, response to aldosterone and ADH

Question 12

skeletal muscle _____ with age

**affects

Answer 12

decreases

decreased O2 consumption, CO, heat production

Question 13

keep blood pressure with ____ of normal

Answer 13

20%

Question 14

regional anesthesia and the elderly

Answer 14

• decreased post-dural puncture headaches

- may block sympathetic outflow causing hypotension

Question 15

elderly have ____ PONV than adults

Answer 15

less