ABIM Geriatric Medicine flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Sarcopenia

Age-related loss of skeletal muscle mass, strength, and function that increases falls, disability, and mortality risk; diagnosis uses low muscle strength plus low muscle quantity or performance.

Presbycusis

Age-related bilateral high-frequency sensorineural hearing loss caused by cochlear and neural degeneration; it impairs speech discrimination in noise and increases isolation, delirium, and fall risk.

Age-related GFR decline

After age 30, glomerular filtration rate falls about 8 mL/min/1.73 m2 per decade; reduced muscle mass can keep serum creatinine normal despite substantially impaired kidney function.

Comprehensive geriatric assessment

A multidimensional process evaluating medical, cognitive, affective, functional, social, nutritional, and medication domains to create an individualized care plan; it improves outcomes in hospitalized older adults.

Katz ADL index

A six-item measure of basic self-care: bathing, dressing, toileting, transferring, continence, and feeding; dependence in these activities signals need for caregiver support and higher mortality risk.

Mini-Cog

A brief cognitive screen combining three-word recall with clock drawing; a positive result is zero recalled words or one to two recalled words plus an abnormal clock.

Timed Up and Go

A mobility test measuring time to stand, walk three meters, turn, and sit; times above 12 seconds indicate increased fall risk and warrant multifactorial assessment.

Orthostatic hypotension

A drop of at least 20 mm Hg systolic or 10 mm Hg diastolic within three minutes of standing; in older adults it causes falls, syncope, and is often drug-related.

Hip fracture repair timing

For most operable hip fractures, surgery within 48 hours reduces complications and mortality; delay is reserved for reversible acute illness or when goals favor comfort-focused care.

Fear of falling

Persistent worry about falling that can lead to activity restriction, deconditioning, social isolation, and paradoxically higher fall risk; screen after any fall or gait change.

Alzheimer disease

The most common dementia, marked by insidious short-term memory loss and progressive impairment in language, visuospatial skills, and executive function; medial temporal atrophy is typical.

Lewy body dementia

A dementia with fluctuating cognition, recurrent visual hallucinations, parkinsonism, and REM sleep behavior disorder; affected patients often have severe sensitivity to antipsychotic drugs.

Frontotemporal dementia

A younger-onset dementia causing prominent personality, behavior, or language changes before severe memory loss; cholinesterase inhibitors are generally ineffective and may worsen symptoms.

Delirium versus dementia

Delirium has acute onset, fluctuating attention, and altered awareness, while dementia has chronic progressive cognitive decline; delirium frequently complicates dementia and is often hypoactive and missed.

Hypoactive delirium

A delirium subtype with quiet withdrawal, reduced motor activity, and poor attention; it is commonly mistaken for depression or fatigue and predicts higher mortality than hyperactive delirium.

Confusion Assessment Method

A structured delirium screen requiring acute onset with fluctuation, inattention, and either disorganized thinking or altered consciousness; it is brief, validated, and widely used at the bedside.

Serotonin syndrome

A toxic reaction to serotonergic drugs causing agitation, tremor, clonus, hyperreflexia, fever, and autonomic instability; older adults are vulnerable during antidepressant combinations or dose increases.

Beers criteria

An expert consensus list of potentially inappropriate medications for older adults, used to identify drugs whose risks usually outweigh benefits; it supports review, not automatic discontinuation.

Anticholinergic burden

The cumulative effect of drugs blocking acetylcholine, which can cause confusion, constipation, urinary retention, dry mouth, and falls; minimizing this burden may improve cognition and bladder function.

Prescribing cascade

When a drug's adverse effect is treated with another drug rather than the first being stopped; example: amlodipine causing edema then a diuretic is added.

Urge incontinence

Involuntary detrusor contractions causing sudden urgency and urine loss; treatment includes bladder training, pelvic floor therapy, and antimuscarinics or beta-3 agonists after excluding infection.

Braden scale

A pressure injury risk tool scoring sensory perception, moisture, activity, mobility, nutrition, and friction/shear; lower scores indicate higher risk and trigger offloading and skin care.

Elder mistreatment

Intentional acts or neglect harming an older adult, including physical, emotional, sexual, financial abuse, and caregiver neglect; screening requires private interview and mandatory reporting when suspected.

Heart failure with preserved ejection fraction

Heart failure with normal or near-normal ejection fraction and diastolic dysfunction; common in older adults with hypertension, causing dyspnea, edema, and exercise intolerance.

CHA2DS2-VASc score

A stroke risk score in atrial fibrillation assigning points for heart failure, hypertension, age, diabetes, stroke, vascular disease, and sex; anticoagulation is generally recommended at scores of two or more.

Hypoglycemia unawareness

Loss of warning symptoms before low blood glucose, common with long-standing diabetes or beta-blockers; older adults may present with confusion, falls, or syncope instead of sweating and tremor.

USPSTF colorectal screening

Average-risk adults should begin colorectal cancer screening at age 45 and continue through 75; after 75, screening is individualized based on health, prior results, and life expectancy.

POLST form

A portable medical order documenting seriously ill patients' preferences for resuscitation, medical interventions, and antibiotics; it converts goals of care into actionable orders across care settings.

Delirium prevention bundle

Nonpharmacologic hospital measures including reorientation, sleep protection, early mobility, hydration, pain control, sensory aids, and bowel/bladder care; they reduce incident delirium in at-risk older adults.

Hospice eligibility

Hospice typically requires a prognosis of six months or less if the illness follows its usual course, plus goals focused on comfort; eligibility can be recertified if decline continues.

Double effect

A principle holding that an action with a good intended effect, such as relieving pain, may be permissible even if a foreseen but unintended harmful effect, such as respiratory depression, may occur.

Decision-making capacity

A patient's ability to understand relevant information, appreciate consequences, reason about options, and communicate a choice; capacity is decision-specific and assessed clinically, not by diagnosis alone.