Elderly Health Conditions and Nutritional Deficiency

Written at November 28, 2023 on English with a size of 15.3 KB.

***CASES:

-85 year old + DM/osteoporosis....(B)--------->Insufficient physical activity... Calcium!

-68 year old ...6-8 , 2-3(C)-------->Nitro 100mg x2 ,t 4mg(B)--------->J/UC/CRP/US(-82 YO +Pn+ Peyonephritis (B)-------> Cetrizxone 750 mg Once!-86 YO_+On_C dificiline Tx(D)--------->discontinue cetiaxone....Vanco

-84 year old, Not Fall in elderly------>Shorterst( Not fatigue or agility)

Women, depression-------CITALOPRAM!*** Q:

-GI Changes with Age(D)-------->...↓Salivary Gland....Decrease Live ↓ , Detox potential ↓.

-Constipation def(B)----->2-3 days( Longest option)

-Dementia+ UI(D)------->Reminder+Adaptation-GI malaria Exacerbation(C)---->Longest( NSAID----oprharin)

-Hypothyroidism(A) -----> 5.5 ines( 2-5%.... decrease cognitive function)

-Microcytic(B)--------->MCV 85 MCH26-Anemia in elderly(C)---->2sentence 1 word with CHF! in it!-CD 1-Tx in elderly (A)--->2.8 lines (hypoglycemia.... glycemic control)2-Feature)B------>2.8 lines( Asx,Classic sx...CD complication)-Diverticulosis(B)----------->Motor dysfunction( LI)...-Menopause(A)----> 4.5 lines LDL+TG↑ .HDL ↓-Osteoporosis + DEXA(B)------->1.5 line(2 clinical fracture.... osteoporosis fracture)-IBD (C) -----> UTI....Neurological -BM change(B)--------> ↓Stem cell in blood, ↓ Granulocyte!-Most common condition ..-------->Shortest(Stroke.....Dry mouth)-Malnutrition------> ↑ Morbidity....↑Mortality-Hypothyroidism Sx (A)------>2,5... impaired function!-Anemia(C)----->...CHF...^^Elderly

YES	NO
-Gastric Ph ↑-↓ H2O X	-Progressive Memory loss-Hyperglycemia-Quick Doc Referral-PRT ↑,Fat ↓

^^Iron Formula :
Body weight (kg) x (78 x0.35xHb(g/l)

^^Megaloblastic Anemia:
-Cause: gastritis/Malfunction/malabsorption/Gastrectomy!
-Sx: weakness/Pale brushed tongue/Dementia/Parasthesia/Psychosis!
(B12 def= Pernicious)

^^Nutrition:
1.5g / kg protein, water 30ml / kg / d, vit D 1000TV, folio r- 800microg
- Proteins 1-1,2-1,25 g/kg/d
- Vitamin D – 800-1000 UA
- Vitamin B12 - 1 mg (1000 μg)
- Folic ac. – 800 μg
- Vitamin C – 75-90 mg
- Potassium – 3500-4700 mg
- Magnesium - 300-350 mg
- Calcium – 1200 mg
- Iron - 8,7-10 mg
- Zinc - 8,7-15 mg
- Selenium - 55 μg

^^Malnutrition , Nutritional Deficiency:
I- BMI 20-22 ,
II- mid upper arm circumference
III-skinfold measurement -men 12.5mm, female 16.5mm or <10% by age and sex
IV-laboratory tests
1-lymphopenia indexes

2- albumin
3-pre-albumin
4- transferrin
5- Other indices decrease : cholesterol, Mg, Fe, Glu, Zn, creatinine

^^Rome Criteria(functional constipation)
-
- Feeling of anorectal obstruction in more than 25% of cases
- Straining with bowel movements in more than 25% of defecation cases
- Hard stool in more than 25% of cases
- The sensation of incomplete bowel evacuation 25% of cases
- Manual help during defecation in more than 25% of cases
- Not enough criteria to diagnose the irritable bowel syndrome
- Rare normal (soft) stool without laxatives

^^^Hyperthyroidism:I-Tx:-Rirostatis Metizole 20-30-40mg/d-Propylthoiuraccil 50 mg or Methomazole 5 + 10mg tabII-Sx-25% if people >65-CVS/ GI/ Neuropsychiatric/Neuromuscular!^^^Hyperthyroidism:-Tx: Thyroxine 75micro

-Sx: bradycardia, dementia, depression, weight loss, loss of weight, loss of appetite, lack of
appetite, myxedema face, syncope

^^Chaos theory:----->Physical & Mental Exercise, Intermittent X use!^^Sleeping Tx:

hypnotics, melatonin, BDZ mean, duration, PGJS-miorelaks, NKS dopamine
agonists, omo-operaci, CPAP,

^^Vascular Dementia vs ALZ:

Atherosclrotic	IschemicStrokeDM	Less common
Onset	Sudden/Gradual	Gradual
Progress	Slow	Slow progress
Gait	early disturbance	Normal
Memory	Mild (-)	Severe (-)

executive function	early impair	late impair
Dementia	Subcortical	Cortical
Ischemic Score	>7

Neuroimage

infarction of white matter

hippocampal atrophy

Athero Diseases: (Ischemic/DM )(Less Common)Onset (Sudden/Gradual) (Gradual)

^^Energy (WHO and HARRIS BENEDICT):
I-WHO:
○ – Men: 13,5 x weight (kg) + 487
○ – Women: 10,5 x weight (kg) +596

II-H-B:
Men: 66+(13.7x weight)+(5x height)-(6.8xage )
Women: 665+(9.6x weight)+(1.8 x

^^PK/PD Changes:

↓ H2O	↓ Vd of H2O Drugs	↓ digoxin threshold
↓ Albumin	↑Vd and T1/2 of Fat soluble X	↑ X interactons ↑ proranolol ↑Diazepam
↓ heart minute volume	↓ hepatic BF ↓ metabolism!
↓ Body mass	↓ X distribution	↓ X low therp index!!

^^Dx thyrotoxicosies:1-CVD: Atrial Arrythimia/ HF/ Angina!2- GI ------> Failure to thrive . Anorexia ,Dyspepsia,Abd Stress,Rapid weight Loss!3-Neuromuscular presentation( proximal and distal myopathy)^^Severe Pn Test :1-Xray :-Infiltrate is made 24 H follow the SX2-Sputum Specific are unretliable!3-Gram Statining > Culture4-Blood culture NOT in Febrile Patients!

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