ABPTS GCS flashcards
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32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Sarcopenia
- Age-related progressive loss of muscle mass and strength, leading to functional decline, frailty, and increased fall risk. Diagnosed by low muscle mass plus low strength or performance.
- Osteoporosis T-score
- A bone mineral density T-score ≤ -2.5 at the hip or spine indicates osteoporosis. A fragility fracture also defines severe osteoporosis regardless of T-score.
- Fried Frailty Phenotype
- Five criteria: unintentional weight loss, exhaustion, weakness, slow gait, low activity. Meeting ≥3 criteria indicates frailty; 1-2 indicates prefrailty.
- Gait speed threshold
- Gait speed <0.8 m/s suggests frailty and increased fall risk; <0.6 m/s predicts higher mortality and hospitalization. >1.0 m/s generally indicates community ambulation.
- Dual-task cost
- The decline in performance when performing a secondary task while walking. Older adults show greater dual-task cost due to reduced cognitive reserve and divided attention.
- Timed Up and Go
- Measures time to rise from chair, walk 3 meters, turn, and return. ≥12 seconds indicates increased fall risk; ≥13.5 seconds predicts falls.
- Berg Balance Scale
- 14-item scale (0-56) assessing static and dynamic balance. Score <45 indicates increased fall risk; ≤40 indicates high risk.
- 30-second Chair Stand
- Counts number of full stands from a chair in 30 seconds. Below age-normative values indicates lower extremity weakness and increased fall risk.
- 4-Stage Balance Test
- Assesses static balance by ability to hold feet together, semi-tandem, tandem, and single-leg stance for 10 seconds. Inability to hold tandem stance predicts falls.
- Short Physical Performance Battery
- Combines balance, gait speed, and chair stand tests (0-12). Score ≤9 indicates mobility disability; ≤7 indicates severe mobility limitation.
- Grip strength weakness
- Grip strength below 26 kg for men and 16 kg for women (by some criteria) indicates weakness, associated with frailty and functional decline.
- Resistance training dosage
- For older adults: 2-3 days/week, 2-3 sets of 8-12 repetitions at 60-80% of 1RM to improve strength and function.
- Balance training frequency
- Progressive balance training at least 3 times/week, including static and dynamic tasks, eyes open/closed, and dual-task challenges to reduce falls.
- Osteoporosis exercise precautions
- Avoid spine flexion and twisting if vertebral fractures are present. Emphasize weight-bearing and resistance training to stimulate bone formation.
- Cane use
- A cane is typically used in the hand opposite the affected hip for hip pain, or opposite the affected leg for weakness, to reduce joint loading and improve balance.
- Walker indication
- A walker is indicated for wide-based gait, severe balance impairment, or weight-bearing restrictions to provide maximal stability and reduce fall risk.
- Aerobic exercise guidelines
- Older adults should aim for 150-300 minutes/week of moderate-intensity or 75-150 minutes/week of vigorous aerobic activity, starting low and progressing gradually.
- Osteoporosis screening
- DXA screening recommended for women ≥65 and men ≥70. Earlier screening if risk factors (e.g., low body weight, prior fracture, glucocorticoid use).
- Protein needs in older adults
- Healthy older adults: 1.0-1.2 g/kg/day; with illness or malnutrition: 1.2-1.5 g/kg/day to maintain muscle mass and function.
- Vitamin D supplementation
- Recommended 800-1000 IU/day for older adults to support bone health, muscle function, and fall prevention, especially with limited sun exposure.
- Fall prevention strategies
- Multifactorial approach: exercise (balance, strength), medication review, vision correction, home hazard modification, and education to reduce fall risk.
- Smoking cessation benefits
- Quitting smoking at any age reduces cardiovascular and respiratory risks, improves overall health, and should be supported with counseling and pharmacotherapy.
- Delirium
- Acute, fluctuating disturbance in attention and cognition, often triggered by infection, medications, or hospitalization. Requires prompt identification and management.
- Polypharmacy
- Use of ≥5 medications concurrently. Increases risk of adverse drug events, falls, and cognitive impairment; requires regular medication review.
- Orthostatic hypotension
- Drop in systolic BP ≥20 mmHg or diastolic ≥10 mmHg within 3 minutes of standing. Common cause of dizziness and falls in older adults.
- Multimorbidity
- Presence of ≥2 chronic conditions. Highly prevalent in older adults (≥80% in those ≥80) and complicates clinical management and outcomes.
- Pressure injury prevention
- Repositioning every 2 hours, maintaining skin integrity, adequate nutrition, and pressure-relieving surfaces to prevent pressure ulcers in immobile older adults.
- Urinary incontinence types
- Stress (leak with cough/sneeze), urge (sudden need), overflow (retention), functional (inability to reach toilet). Pelvic floor exercises help stress and urge.
- Medicare Part B therapy
- Covers outpatient physical therapy when medically necessary. No hard cap, but above-threshold services require KX modifier to attest medical necessity.
- Patient Self-Determination Act
- Federal law requiring healthcare facilities to inform patients of their right to make advance directives and to refuse or accept treatment.
- Ethical principle autonomy
- Respect for patients' right to make decisions. In older adults, assess decision-making capacity, especially with cognitive impairment or fluctuating status.
- Home health eligibility
- Medicare covers home health if patient is homebound, needs skilled therapy, and plan of care is certified by a physician. Services must be medically necessary.