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GERIATRICS: INFECTIOUS DISEASE
Terms in this set (17)
Which component of the immune system is most effected by aging?
adaptive (T/B cells decline)
what are the challenges of Abx use in the elderly?
1) LTC have common outbreaks of resistant bacteria
2) routine use of Abx increases risk for C. diff
3) poor IV access
How many people will develop shingles in their lifetime?
Why is shingrix favored over zostavax?
shingrix is not a live vaccine and has greater efficacy 4 years after vaccination
T/F two doses of shingrix is required if the patient had shingles?
Why is high dose flu vaccine recommended?
the elderly immune system needs extra antigen to produce a sufficient response
How long should pneumonia treatment last in the elderly patient?
Who gets oseltamivir?
anyone 65 and older
any LTCF resident
a patient has a CrCl of 45 and has early signs of influenza, how do you dose tamiflu?
30mg once daily - need renal dose adjustment if CrCl < 60ml/min
When should you treat a UTI?
only if symptomatic with acute dysuria and pain
T/F prophylaxis for UTIs should be used?
False - want to prevent resistant organisms
List the four A's for C. diff infections:
Antibiotics: FQs/carbapenems/clinda/3+4 gen cephalosporins
Why is HIV a problem in the elderly population?
increased rate of unprotected sex since pregnancy is no longer an issue
What is the most common reason for HIV treatment failure in the elderly population?
immune senescence (aging) immune system is not as robust and does not respond to ART like a younger person would
Why is the elderly population more susceptible to COVID?
lower levels of ACE2 receptor prevent the clearance of COVID virus from the lungs
Why is diarrhea a common symptom in COVID infections?
There are ACE2 receptors in the GI tract as well
What is the recommendation for remdesivir in COVID infections?
only used if pt is on supplemental oxygen = greatest benefit
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