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20 terms

clin med 5

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Acute gingivitis:
vitamin C deficiency
Periodontal disease:
malnutrition/zinc deficiency
Odontophagia:
pain on swallowing
Dysphagia:
Pain on swallowing: Mechanical causes-affect large solids
Motility disorders-intermittant, liquids
Changes in small intestine w aging
Decreased clearing of debris from small intestine to colon:
-Gastric hypochlorhydria (low gastric acid) /jejunal diverticula with small intestinal bacterial overgrowth
-Decreased vitamin D and Calcium absorption
with elderly, Colonic transit time is
normal, rectosigmoid transit is delayed, and Rectal contents are expelled more slowly
Dieulafoy's lesions
rupture of exposed submucosal artery that bleeds
This is more likely to be only colonic and to perforate...
Crohn's dz.
Fatigue, shortness of breath, angina are common elder symptoms in
-colon cancer
-Adenomatous polyps become cancerous over 5-10 years
epigastric/back pain
weight loss
painless jaundice
glucose intolerance
malabsorption
may be signs of
Pancreatic Cancer (CA 19-9 may aid in dx)
diseases with higher energy requirements like....
cancer, infections, COPD, wounds, burns, fractures
Elderly Screening (must have symptoms)
-Diabetes
-Hypothyroidism/hyperthyroidism
-Anemia
Elderly Screening-no symptoms needed
-Dementia (mini-mental)
-Social (able to get food, do ADL's, IADL's, help if disabled, church, family nearby)
-Osteoporosis, pap smear, etc.
Immunosenescence
Greatest effect of aging is on cell mediated immunity-- everything decreases (including response to vaccines), except auto antibody production INCREASES
These 3 factors make respiratory infection more likely:
-Less forceful cough reflex
-Lower ability to eliminate bacteria from tracheobronchial tree thru cilaiary action
-Physiologic changes in chest wall, bronchi, etc.
There is a 2-4 fold increase in plasma/serum levels of....
Cytokines and other inflammatory mediators
-increased fat
-decreased sex steroids
-smoking
-subclinical infections
-chronic diseases
Aging may be associated with dysregulated cytokine response following stimulation
This occurs in 1/3 of pesons >60 increases absorption mightily of Penicillin G
achlorhydria (absent production of gastric acid)
Izoniacid in those over 50=
hepatotoxicity 2.3%
Fatalities are higher in elderly with this dz that presents as sudden onset of flu like/ fever transmitted between birds/ mosquitoes. CNS dz is rare
West Nile. Can also cause flaccid paralysis.
Ramsey-Hunt syndrome:
(of the geniculate ganglion) pain/vesicles external auditory meatus, loss of taste, ipsilateral facial paralysis

Maxillary/mandibular trigeminal nerve involvement= intraoral lesions