61 the aging process results in a variety of

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61 The aging process results in a variety of physiological changes. One change is A. a decreased absorption of fat-soluble vitamins. B. an increase in pupil size. C. an increase of enzymatic activity. D. an increase in spleen size. A- the heart valve o Lab results- Dunphy Table 77.2 TABLE 77.2 Changes in Laboratory Values for Older Adults Laboratory Test Normal Values Changes With Age Comments URINALYSIS Protein 0–5 mg/100 mL Rises slightly May be due to kidney changes with a pathology Specific gravity 1.005–1.020 Lower maximum in elderly 1.016–1.022 Decline in nephrons impairs ability t HEMATOLOGY Erythrocyte sedimentation rate Men: 0–20 Women: 0–30 Significant increase Neither sensitive nor specific in aged Iron binding 50–160 mcg/dL 230–410 mcg/dL Slight decrease Decrease Hemoglobin Men: 13–18 g/100 mL Men: 10–17 g/mL Anemia common in the elderly Women: 12–16 g/100 mL Women: none noted Hematocrit Men: 45%–52% Women: 37%–48% Slight decrease speculated Decline in hematopoiesis Leukocytes 4,300–10,800/mm 3 Drop to 3,100– 9,000/mm 3 Decrease may be due to drugs or sep immediately to age Lymphocytes 500–2,400 T cells/mm 3 50–200 B cells/mm 3 T-cell and B-cell levels fall Infection risk higher; immunization e Platelets 150,000–350,000/mm 3 No change in number BLOOD CHEMISTRY Albumin 3.5–5.0/100 mL Decline Related to decrease in liver size and malnutrition common Globulin 2.3–3.5 g/100 mL Slight increase
Total serum protein 6.0–8.4 g/100 mL No change Decreases may indicate malnutrition Blood urea nitrogen Men: 10–25 mg/100 mL Women: 8–20 mg/100 mL Increases significantly up to 69 mg/100 mL Decline in glomerular filtration rate; Creatinine 0.6–1.5 mg/100 mL Increases to 1.9 mg/100 mL seen Related to lean body mass decrease Creatinine clearance 104–124 mL/min Decreases 10%/decade after age 40 years Used for prescribing medications for Glucose tolerance 62–110 mg/dL after fasting; >120 mg/dL after 2 hours postprandial Slight increase of 10 mg/dL/decade after 30 years of age Diabetes increasingly prevalent; drug Alkaline phosphatase 13–39 IU/L Increase by 8–10 IU/L Elevations >20% usually due to dise bone abnormalities, drugs (e.g., narc all of the following are true about lab results except : abnormal findings are usually due to physiological aging. o Atypical disease presentations 1. Acute abdomen Absence of symptoms or vague symptoms, acute confusion, mild discomfort and constipation, some tachypnea and possibly vague respiratory symptoms, appendicitis pain may begin in right lower quadrant and become diffuse 2. Depression Anorexia, vague abdominal complaints, new onset of constipation, insomnia hyperactivity, lack of sadness 3. Hyperthyroidism Hyperthyroidism presenting as “apathetic thyrotoxicosis,” i.e., fatigue and weakness; weight loss may result instead of weight gain; patients report palpitations, tachycardia, new onset of atrial fibrillation, and heart failure may occur with undiagnosed hyperthyroidism 4. Hypothyroidism Hypothyroidism often presents with confusion and agitation; new onset of anorexia, weight loss, and arthralgias may occur 5. Malignancy
New or worsening back pain secondary to metastases from slow growing breast masses Silent

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