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Geriatric Jeopardy
Brought to you by The UCLA School of
Medicine Division of Geriatrics
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TODAY'S CATEGORIES
Physiology
Pharmacology
Nursing Homes
Famous Seniors
Longevity Survival
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Geriatric Jeopardy
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The effect of agingon renal function
Physiology - 200
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Decreased
Physiology - 200 The effect of aging on renal
function

• Renal function decreases with aging.
• Glomerular filtration rate decreases about 1 per
  year after age 30.
• Urine concentrating ability also decreases

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The effect of agingon resting heart rate
Physiology - 400
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Decreased
Physiology - 400 The effect of aging on resting
heart rate

• Normal aging results in
• decreased resting heart rate
• decreased maximum predicted heart rate with
  exercise
• decreased VO2 Max and maximum CO with exercise
• Cardiac output remains normal at rest largely
  related to increased stroke volume

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This physiologic effect is the result of eating a
large meal and is associated with drowsiness and
unsteady balance.
Physiology - 600
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Post-prandial Hypotension
Physiology - 600 This physiologic effect is the
result of eating a large meal and is associated
with drowsiness and unsteady balance

• Post-prandial hypotension (orthostatic
  hypotension) often follows a large meal,
  presumably as a result of shift in blood flow
  from the periphery to the mesenteric bed and can
  be an important cause of falls

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The effect of aging on gastric acid secretion
Physiology - 800
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None
Physiology - 800 The effect of aging on gastric
acid secretion

• Until recently it was widely thought that gastric
  secretion diminished as a result of normal aging
  processes. Recent studies, excluding those with
  atrophic gastritis, smoking and H.pilori have
  shown no change in acid secretion with aging.

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The effect of aging on collagen
Physiology - 1000
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Increased Crosslinking
Physiology - 1000 The effect of aging on collagen

• Aging results in abnormal collagen and elastin
  metabolism. The result is increased collagen
  crosslinking which may explain decreased tensile
  strength, fragility, tissue strains and tears.
• Elastin also undergoes increased cross linking
  and results in decreased elastic recoil in skin
  and other tissues.

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Term for multiple drug use in elderly people
associated with increased risk for adverse drug
reactions
Pharmacology - 200
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Polypharmacy
Pharmacology - 200 The term for multiple drug
use in elderly people associated with increased
risk of adverse drug reactions

• The risk of adverse drug events in elderly people
  rises with number of medications. ADRs occur in
  4 of those taking 5 drugs 10 in those taking
  6-10 drugs 28 in those taking 11-15 drugs and
  54 in those taking 16 or more drugs.

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This single drug can be effective for both
incontinence and hypertension in elderly men
Pharmacology - 400
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doxazocin (Cardura), prazocin (Minipress),
terazocin (Hytrin)
Pharmacology - 400 This single drug can be
effective for both incontinence and hypertension
in elderly men

• Alpha adrenergic blockers are known to decrease
  the effect of BPH and bladder outlet obstruction
  as well as decrease blood pressure.

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Drug commonly used to treat congestive heart
failure in therapeutic doses can cause anorexia,
delirium and depression
Pharmacology - 600
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Digoxin
Pharmacology - 600 Drug commonly used to treat
congestive heart failure in therapeutic doses
can cause anorexia, delirium and depression

• Digoxin even with normal therapeutic drug levels
  can cause anorexia, delirium and depression in
  elderly people.

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The effect of aging on adipose tissue
Pharmacology - 800
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Increased
Pharmacology - 800 The effect of aging on
adipose tissue

• Aging is associated with an increase in fat/lean
  body weight ration. Muscle mass tends to
  decrease and fat tends to increase. This effect
  can have a significant effect on drug
  distribution and elimination.

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The MS Contin doseequivalent toMS elixir 30mg
q6h
Pharmacology - 1000
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MS Contin 60mg q12h
Pharmacology - 1000 The MS Contin
doseequivalent toMS elixir 30mg q6h

• The conversion from MS elixir to
• MS Contin is 11
• The 24 hr dose of MS elixir is 120mg
• The equivalent dose of MS Contin is 120mg or 60mg
  q12h

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The majority of elderly people live innursing
homes
Nursing Homes - 200
True or False
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False
Nursing Homes - 200 The majority of elderly
people live in nursing homes

• Less than 5 of all elderly people live in
  nursing homes.
• About 20 of those over age 85 reside in nursing
  homes
• The lifetime chance of spending some time in a
  nursing home is abut 20

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Term for this skin lesion that has become an
important indicator of quality of care
Nursing Homes - 400
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Pressure Sore(Bed Sore, Decubitus Ulcer or
Pressure Ulcer)
Nursing Homes - 400 Term for this skin lesion
that has become an important indicator of quality
of care

• Pressure sores are caused by unrelieved pressure
  or shear
• They are considered predictable and preventable
• Nursing homes can be liable for their development

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The source of reimbursement for care of most
nursing home residents
Nursing Homes - 600
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Medicaid (Medical)
Nursing Homes - 600 The source of reimbursement
for care for most nursing home residents

• Only about 5 of care in nursing homes is
  reimbursed by Medicare.
• About 50 of nursing home residents are paid by
  Medicaid (Medical)
• About 45 are paid out of pocket

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The number of nursing home residents that have
dementia
Nursing Homes - 800
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50
Nursing Homes - 800 The number of nursing home
residents that have dementia

• Dementia and psychological problems are common in
  the nursing home
• It has been estimated that 50 of all nursing
  home residents have some dementia

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The national standardized assessment of patients
required within 2 weeks of admission to any
nursing home
Nursing Homes - 1000
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Minimum Data Set (MDS)
Nursing Homes - 1000
Nursing Homes - 1000 The national standardized
assessment of patients required within 2 weeks of
admission to any nursing home

• The Minimum Data Set is a national standardized
  assessment of each nursing home resident within 2
  weeks of admission, at regular intervals or on
  any significant change in overall condition
• Usually completed by staff nurses or other nurses
  hired by each facility

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Common geriatric problem that prevented this
elderly comedian from playing the London
Palladium on his 100th birthday
Famous Seniors - 200
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Fractured Hip
Famous Seniors - 200

• Comedian/actor, George Burns, preformed
  professionally up until a few months prior to his
  100th birthday when he suffered a fall and
  fractured hip resulting in his inability to
  fulfill a contract signed years earlier to play
  the London Palladium on his 100th birthday

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Common geriatric problem suffered by this famous
athlete
Famous Seniors - 400
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Parkinsons Disease
Famous Seniors - 400 Common geriatric
problem suffered by this famous athlete

• Mohammad Ali suffered severe disability for many
  years from Parkinsons disease
• Pugilism or Pugilistic Parkinsonism is a
  condition mimicking Parkinsons disease
  associated with boxing or a history of repeated
  head trauma

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Daily Double

• Make a Wager

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This famous senior invented bifocal glasses at
the age of 78
Famous Seniors The Daily Double
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Benjamin Franklin
Famous Seniors The Daily Double This famous
senior invented bifocal glasses at the age of 78

• Inventor, statesman, ambassador, framer of the
  constitution was the inventor of bifocal glasses
  when he we 78 years of age.

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This famous grandmother gave up making quilts in
her 70s when afflicted by arthritis and took up
painting miniatures.
Famous Seniors - 800
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Grandma Moses
Famous Seniors - 800 This famous grandmother
gave up making quilts in her 70s when afflicted
by arthritis and took up painting miniatures.

• Born Anna Mary Robertson on September 7, 1860,
  she lived 101 years and 3 months until December
  13, 1961.
• A remarkable lady, a mother of ten who started
  painting in earnest in her late 70's and
  continued until the summer of 1961
• Also known for folk wisdom Life is what we make
  it always has been, always will be.

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Famous Seniors - 1000
Despite (some say because) of this affliction,
Claude Monet, painted this and other masterpieces
after age of 60
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Cataracts
Famous Seniors - 1000 Despite (some say because)
of this affliction, Claude Monet, painted this
and other masterpieces after age of 60

• Claude Monet (1840-1926) suffered for over 30
  years from severe cataracts for which he refused
  surgical extraction.
• At age 84 visitors found him robust, vibrant and
  still painting.

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Percent of U.S. population over age 65
Longevity and Survival - 200
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Longevity and Survival - 200 Percent of U.S.
population over age 65

• In 1998, 12.7 of the population was over age 65.
• Those over age 85 are the fastest growing
  segment.
• By 2030, elderly will account for about 20 of
  the population, equal to the number below 5 years.

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Life expectancy at birth
Longevity and Survival - 400
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76.5 years
Longevity and Survival - 400 Life expectancy at
birth

• The life expectancy for a child born 1997 was
  76.5 years
• For males 71 years for females 78 years
• The gender differential in life expectancy is
  largely related to cumulative differences in
  disease specific mortality

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The oldest age to which any human has ever lived
Longevity and Survival - 600
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122 years
Longevity and Survival - 600 Oldest age to which
any human has ever lived

• The oldest fully authenticated age to which any
  human has ever lived is 122 years and 164 days,
  by Jeanne Louise Calment. She was born in France
  on February 21, 1875, and died at a nursing home
  in Arles, southern France on August 4, 1997.

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Name for landmark observation that human diploid
cells cease to grow after a limited number of
doublings
Longevity and Survival - 800
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Hayflick Phenomenon(Clonal Senescence)
Longevity and Survival - 800 Name for landmark
observation that human diploid cells cease
to grow after a limited number of doublings

• Leonard Hayflick made the important discovery
  relevant to aging and cancer, that normal human
  cells are not immortal and will cease to divide
  after a finite number of doublings
• Cells from older donor survived fewer doublings
  that cells from younger donors.

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Longevity and Survival - 1000
The only intervention proven to increase
maximum life potential in mammalian species
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Longevity and Survival - 1000 The only
intervention proven to increase maximum life
potential in mammalian species
Caloric Restriction

• Mice, rats and primates have been shown to live
  40 longer if they are restricted to a diet that
  contains adequate levels of all micronutrients
  and only 60 of the calories they would normally
  eat.

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FINAL JEOPARDY
Final Jeopardy Category Geriatric Organizations
Make a Wager
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Final Jeopardy
The Nations largest organization of older people
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Final Jeopardy The nations largest organization
of older people
AARPThe American Association of Retired Persons

• Founded in 1958, the organization boasts more
  than 30 million members over age 50
• One year dues are 10 (including spouse)
• Activities include information and education
  community service and legislative, judicial, and
  consumer advocacy

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Thanks for Playing
Geriatric Jeopardy
Brought to you by The UCLA School of
Medicine Division of Geriatrics