The Portal of Geriatrics Online Education

17 ATYP: Identify 3 physiologic changes for each organ system

17. For each organ system identify at least 3 changes of normal aging (e.g., normal labs for older adults) and their impact on the patient, including their contribution to homeostenosis (the age-related narrowing of homeostatic reserve mechanisms). Know when clinical signs and presentations are normal aging and not disease.

Urinary Incontinence

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Abstract: 

This web-based module for third-year medical students reviews acute and established forms of urinary incontinence, clinical features, and the importance of history and exam in evaluating this geriatric syndrome.  Nonpharmacologic, pharmacologic, and invasive treatments are presented in appropriate detail for a student learner. Faculty-led small group discussions focus on the cases for application of the content.  One of several goals of the cases is to increase the learner’s sensitivity to the social and emotional consequences of urinary incontinence. 

Educational objectives: 
  1. Relate potential social and emotional consequences of incontinence.
  2. List at least 5 potential etiologies for acute (transient) urinary incontinence.
  3. Describe features of the 4 types of chronic (established) physiologic urinary incontinence.
  4. Identify age-related changes that may predispose older adults to develop incontinence.
  5. Describe the complex physiology involved in normal micturition.
  6. Discuss potential pathophysiologic causes of incontinence.
  7. Discuss important features of history, exam and testing in evaluating a patient with UI.
  8. Identify various nonpharmacologic treatments with appropriate conditions/situations for their use.
  9. Cite examples of pharmacologic treatment for SUI, OAB/UUI, and Overflow UI.
  10. Relate specific concerns of antimuscarinic agents in older adults, and examples of choices to minimize risk.
  11. Explain the IFIS risk for patients who have used alpha-adrenergic antagonists as a class, and tamsulosin in particular.
  12. Discuss urology referral for various invasive treatment interventions.
Additional information/Special implementation requirements or guidelines: 

This product is reviewed internally each year by the program core faculty.

DeMaagd, G., & Geibing, J. D.  (2006).  An overview of overactive bladder and its pharmacological management with a focus on anticholinergic drugs.  P&T; 31(8); 462-474.  Available online at: http://www.ptcommunity.com/ptjournal/fulltext/31/8/PTJ3108462.pdf

[Note:  the student is directed to the excellent discussion of anticholinergic and antimuscarinic pharmacology in this Pharmacy and Therapeutics article.]

DeMaagd, G. (2007).  Urinary incontinence:  Treatment update with a focus on pharmacological management.  U. S. Pharmacist; 32(6):34-44.  Available online at: http://www.uspharmacist.com/content/t/urology/c/10310/

Haas, P.  (2008, July 2).  Consider cataracts before prescribing alpha blockers for your patients.  AAFP News Now.   Available online at:  http://www.aafp.org/online/en/home/publications/news/news-now/clinical-care-research/20080702alpha-cataract.html

Ellsworth, P., & Kirshenbaum, E.  (2010). Update on the pharmacologic management of overactive bladder:  The present and the future.  Available online at:  http://www.medscape.com/viewarticle/718789 (posted April 7, 2010)

Date posted: 
Thu, 07/28/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 07/28/2011
Contact Person/Corresponding Author:



Suggested Citation:
, and . Urinary Incontinence. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/124

Physiologic Aging

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Abstract: 

This web-based module will expose learners to the basic concepts of physiologic changes with aging. A specific focus is on the loss of physiologic reserve and narrowing of the homeostasis capacity, increased heterogeneity with aging, and the difficulty of defining "pure aging" versus common-age related diseases. This module provides information on all the common age-related changes across organ systems.

Educational objectives: 

A review of physiologic changes in body systems. The learner will be able to describe physiologic aging in cardiovascular system, respiratory system, renal system, musculoskeletal system, vision, hearing, thermoregulation, gastrointestinal system and immune system.

Additional information/Special implementation requirements or guidelines: 

This exercise is used in the third year geriatrics clerkship.

Date posted: 
Mon, 08/24/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 07/30/2012
Contact Person/Corresponding Author:



Suggested Citation:
and . Physiologic Aging. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/124

SAGE Tips for History and Physical Exam Teaching for First and Second Year Medical Students

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

This product is a collection of short tips ready to be integrated into your first or second year medical student curriculum, wherever you teach basic history and physical exam skills (Introduction to Clinical Medicine, Doctoring, etc). At UT Southwestern, we teach these skills during the first year, in a course called the "Colleges." Students are divided into groups of 6 and taught by a faculty mentor for a half day weekly during the first and second years. These tips have been integrating into the weekly sessions-- woven into that day's syllabus and explained/emphasized to the mentors during the weekly mentor faculty development sessions. Our Reynolds program at UT Southwestern is called SAGE (Southwestern Aging and Geriatrics), hence the "SAGE Tips." The same logo is used throughout the curriculum to highlight aging knowledge and skills.

Educational objectives: 

Highlight the differences in the physical examination and history taking of older patients.

Date posted: 
Thu, 11/19/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 10/19/2012
Contact Person/Corresponding Author:



Suggested Citation:
SAGE Tips for History and Physical Exam Teaching for First and Second Year Medical Students. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/124

Elder Care: A Resource for Interprofessional Providers: Hypothyroidism in the Very Old

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Sponsors: 
Product Information
Estimated time to complete: 
1
Abstract: 

"Hypothyroidsim in the Very Old" is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites,  they are useful for students and health care professionals from many fields and across a very broad range of health care settings.

Educational objectives: 

Objectives:
1. Explain the association between hypothyroidism and coronary heart disease
2. Describe the approach to dosing of thyroid hormone supplementation for very old individuals and for people with known coronary heart disease
3. Specify the goal level of thyroid stimulating hormone when providing thyroid hormone supplementation to very old individuals
Additional information/Special implementation requirements or guidelines: 
Subscribers to POGOe are free to reprint Elder Care on their own stationery or in other publications without obtaining specific permission, so long as
(1) content is not changed, 
(2) no one is charged a fee to use or read the publication, 
(3) authors and their affiliated institutions are noted without change, and 
(4) the reprint includes the following statement: “Reprinted courtesy of the Arizona Reynolds Program of Applied Geriatrics and the Arizona Geriatric Education Center."
Publications from, presentations from, and/or citations to this product: 
The Elder Care provider sheets are occasionally published in the Arizona Geriatrics Society Journal, which is published twice yearly.
 
Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.
 
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care: A Resource for Interprofessional Providers: Hypothyroidism in the Very Old. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/124

Texas Tech Medcast Reynolds Geriatric Step2CK Prep Series: No. 53--Bleeding Betty

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

The Step2CK Test Prep Series was created by fourth-year students at the Texas Tech School of Medicine in Lubbock as a project of the fourth-year geriatrics rotation. It was developed as part of the Reynolds Geriatrics Podcast series, which is supported by an Aging and Quality of Life grant from the D.W. Reynolds Foundation. The episodes in this series are based on questions that have geriatrics content and patient vignettes from the 2009 Step 2CK Sample Exam. For more information on the series, go to http://www.ttuhsc.edu/som/fammed/ttmedcast/gerseri....

Educational objectives: 

This episode is based on Question 53 of the 2009 Step2CK Sample Exam.

Learning Objectives - the third-year medical student studying for the Step2CK exam should be able to:

  • identify a differential diagnosis for postmenopausal bleeding
  • recognize risk factors for gynecologic neoplasms
  • differentiate the different types of gynecologic neoplasms by history and physical
  • have a basic knowledge of guidelines for screening and treatment of gynecologic neoplasms
Date posted: 
Mon, 11/02/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 01/22/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , and . Texas Tech Medcast Reynolds Geriatric Step2CK Prep Series: No. 53--Bleeding Betty. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/124

Frailty

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

This PowerPoint presentation reviews recent literature with a focus on clinical tools to identify frail patients and evidence based interventions to improve outcomes. The presentation was developed as a keynote for an annual HRSA funded Geriatric Education Center conference on frailty and other geriatric syndromes. It should be suitable for a broad audience of providers or trainees interested in the concept of frailty.

Educational objectives: 

-Understand what frailty is and why it is important to patient outcomes. -Learn how to identify frail patients in practice. -Be able to apply evidence based interventions to improve outcomes in frail patients.

Date posted: 
Tue, 09/29/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 09/29/2009
Contact Person/Corresponding Author:



Suggested Citation:
Frailty. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/124

Cadaver Treasure Hunt Faculty Guide

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
3
Abstract: 

This faculty guide is designed to assist medical schools interested in implementing the Cadaver Treasure Hunt anatomy course program. The program consists of 2 components: (1) a lecture at the very beginning of medical school introducing them to geriatrics, using the extreme old age of their cadavers and their death certificate diagnoses as a window to the importance of aging; and (2) a workshop in the anatomy lab in which geriatricians review the gross anatomical findings of the cadavers and provide important clinical perspectives. This low-cost, high-yield geriatrics intervention has been well received by Brown medical students; 82% rated the experience very positively.

Educational objectives: 

Goals of the program: 1. To introduce geriatrics early in the medical education curriculum. 2. To use the demographic information and the gross anatomical findings of the cadavers as teaching points for normal aging and common medical problems in aging. 3. To provide a medical and clinical context for students about how their cadavers may have lived and died. 4. To remind students of the sacrifice and gift that the cadavers had provided to them. 5. To evaluate how this program influenced students’ perceptions of their cadavers.

Additional information/Special implementation requirements or guidelines: 

Collaboration with the anatomy course directors is a key component for scheduling the lecture and anatomy lab session. You will also need to obtain death certificate data.

Publications from, presentations from, and/or citations to this product: 

Presented at the May 2009 American Geriatrics Society Conference as a paper session as well as during the education methods swap session. McNicoll L, Nanda A, Besdine RW. Cadaver Treasure Hunt: Introducing Geriatrics Concepts in the Anatomy Class. J Am Geriatr Soc 2009:57 (Supplement); S8.

Gillespie, S. M. and Medina-Walpole, A. (2010, October). Teaching Undergraduate Geriatrics in the Anatomy Laboratory. Journal of the American Geriatrics Society, 58(10), 2000-2002. Also available online.

McNicoll L,Shield R, Ritter D, Besdine RW. Cadaver Treasure Hunt: Introducing Geriatrics Concepts in the Anatomy Class. J Am Ger Soc  2012:60(5);962-6.

 

Date posted: 
Fri, 08/07/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 08/06/2012
Contact Person/Corresponding Author:



Suggested Citation:
, and . Cadaver Treasure Hunt Faculty Guide. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/124

Texas Tech Medcast Reynolds Geriatric Step2CK Prep Series: No. 108--The One-Eyed Grandma

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

The Step2CK Test Prep Series was created by fourth-year students at the Texas Tech School of Medicine in Lubbock as a project of the fourth-year geriatrics rotation. It was developed as part of the Reynolds Geriatrics Podcast series, which is supported in part by an Aging and Quality of Life grant from the D.W. Reynolds Foundation. The episodes in this series are based on questions that have geriatrics content and patient vignettes from the 2008 Step2CK Sample Exam. For more information on the series, go to http://www.ttuhsc.edu/som/fammed/ttmedcast/gerseri....

Educational objectives: 

This episode is based on Question 108 on page 62 of the 2008 Step2CK Sample Exam.

Learning Objectives: the third-year medical student studying for the Step2CK exam should be able to list the clinical manifestations and fundoscopic findings of:

  • Age-related macular degeneration
  • Background diabetic retinopathy
  • Central artery occlusion
  • Central vein occlusion
  • Proliferative diabetic retinopathy
Date posted: 
Fri, 08/07/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 01/22/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , and . Texas Tech Medcast Reynolds Geriatric Step2CK Prep Series: No. 108--The One-Eyed Grandma. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/124

Minimum Geriatric Competencies - Medical Students, Emergency Medicine Residents and IM-FM Residents

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

“Competency-based education prepares trainees to perform tasks occurring within the context of practice. Teaching to competency differs from traditional instruction. It begins by stating the performance we expect of our graduates in the workplace and then designing the medical school curriculum to prepare our learners to achieve that performance through deliberate practice in applying the underlying knowledge, skills, and attitudes.” As the elderly population in America "booms," medical education must address the issue at hand and modify their curriculum and teaching practices to give credence to geriatric principles within medical care. It is imperative for many reasons (socially, financially, etc.) that we ensure competency in the care of older adults for every physician.

To help achieve this lofty goal, the Minimum Geriatric Competencies have been developed for Medical Students and are being developed for multiple residency disciplines. The files within this product showcase the Medical Student Minimum Geriatric Competencies (published in Academic Medicine, May 2009), Internal Medicine – Family Medicine Resident Minimum Geriatric Competencies (published in Journal of Graduate Medical Education, Sept 2010), and Emergency Medicine Resident Minimum Geriatric Competencies (published in Academic Emergency Medicine, 2010).

Additional information/Special implementation requirements or guidelines: 

The "Side-by-Side" document shows the progression from Medical Student Competencies into resident education.

The documents included with this product are:

  • Emergency Medicine Resident Competencies
  • Medical Student Competencies
  • IM-FM Resident Competencies
  • Side-by-Side Competencies Comparison
Publications from, presentations from, and/or citations to this product: 

Leipzig R M, Granville L, Simpson D, Brownell Anderson M, Sauvigne K, and Soriano R P. (2009). Keeping granny safe on July 1: Consensus on minimum geriatric competencies for graduating medical students. Academic Medicine, 84, 604–610. Also available at http://journals.lww.com/academicmedicine/Fulltext/2009/05000/Keeping_Granny_Safe_on_July_1__A_Consensus_on.17.aspx

Hogan T M, Losman E D, Carpenter C R, Sauvigne K, Irmiter C, Emanuel L, and Leipzig R M. (2010). Development of geriatric competencies for emergency medicine residents using an expert consensus process. Academic Emergency Medicine, 17(3), 316-324. Also available at http://dx.doi.org/10.1111/j.1553-2712.2010.00684.x

Williams B, et al. (2010). Medicine in the 21st century: Recommended essential geriatrics competencies for Internal Medicine and Family Medicine residents. Journal of Graduate Medical Education, 2(3), 373-383. Also available at http://www.jgme.org/doi/abs/10.4300/JGME-D-10-00065.1

Date posted: 
Thu, 01/01/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 06/08/2011
Contact Person/Corresponding Author:



Suggested Citation:
Minimum Geriatric Competencies - Medical Students, Emergency Medicine Residents and IM-FM Residents. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/124

Texas Tech Medcast Reynolds Geriatrics Step1 Prep Series: No. 45--Doc, the Kids are Tiring Me Out!

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
0
Abstract: 

The Step1 Test Prep Series was created by second-year students at the Texas Tech School of Medicine in Lubbock as a project of the MS2 Aging Block of Systems Disorders II. It was developed as part of the Reynolds Geriatrics Podcast series,which is supported in part by an Aging and Quality of Life grant from the D.W. Reynolds Foundation. The episodes in this series are based on questions that have geriatrics content and patient vignettes from the 2009 Step1 Sample Exam, available from http://www.ttuhsc.edu/som/fammed/ttmedcast/gerseri....

Educational objectives: 

The second-year medical student studying for the Step1 exam should be able to:

  • Define acidosis and alkalosis and their lab values
  • List possible causes of renal failure and its consequences
  • Decide which diagnosis is most likely and explain the reason
Date posted: 
Fri, 08/07/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 01/22/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , , , , , , and . Texas Tech Medcast Reynolds Geriatrics Step1 Prep Series: No. 45--Doc, the Kids are Tiring Me Out!. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/124

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