Grey Is Grace

Grey Is Grace

Signs of myocardial infarction
1. Cardiac Injury Profile
  1. Testing Enzymes and proteins ( cardiac damage )
    1. Troponin I
    2. Creatinine Kinase MB
    3. Myoglobin
  2. Done for patient with Chest pain
2. STEMI (ECG)
  1. Elevation in ST segment
  2. Because of major coronary artery complete occlusion
Symptoms Of MI
1. Anxiety
2. Crushing Chest Pain
3. Left arm pain
4. Jaw and Back pain
5. Nausea
Trigger 3 Symptoms Reasons
1. Left arm ache
  1. Brain Overloading
2. Tightness of the chest
  1. Angina
3. SOB/Dyspnea
  1. Non-efficient Heart Pumping
4. Diaphoresis and Excessing Sweating
  1. Over Activation of sympathetic nervous system
Immediat MI treatment
1. Emergency Drug therapy
2. Oxygen Administration
3. Analgesia Administration
4. Anti-emetics and nitrates
5. High level of supervision and suscitation facilities
6. Aspirin
events that take place in typical MI
1. Coagulation activation
2. Platelet activation
  1. thromboxane A2 releasing and ADP
  2. Serotonin releasing
3. thrombin evolve to CAL
4. -atheromatous plaque disruption
  1. subendothelial collagen and necrotic hemorrhage
Myocardial response to ischemia
1. Vascular Obstruction
  1. Aerobic glycolysis ceases
    1. Drop of ATP
      1. potentially noxious metabolites Accumulation in cardiac myocytes
        Rapid loss of contractility
2. Ultrasound changes ( rapidly apparent)
3. Severe ischemia (20-40) minutes leads to myocyte death
  1. ischemia in longer periods= vessel injury-microvascular thrombosis
4. Arrhythmias
Cell Death
1. Necrosis
2. Apoptosis
3. causes
  1. chemical agents
  2. Infectious agents
  3. genetic factors
  4. Oxygen deprivation
Aging
1. Decline in structure and function
2. impaired maintenance and repair
3. Elderly age = 65
Physiological changes during Elderly
1. Cardiovascular system
  1. atrial wall thickness -decrease collagen and elasticity
    1. Heart Attack
    2. Sinus Node syndrome
2. Nervous system
  1. CNS 30% mass loss
    1. Alzheimer Disease
  2. PNS: Loss of motor ,sensory and autonomic fibers
3. Sensory system
  1. Loss of eye accommodation
    1. Presbyopia
4. Respiratory system
  1. Loss of muscle mass and weakening or respiratory muscle
    1. pulmonary diseases
5. Urinary system
  1. Renal mass decreasing
    1. Tubular atrophy
6. Musculoskeletal Changes
  1. Loss of skeletal muscle mass
    1. Osteoarthritis
7. Endocrine system
  1. Decreased ability to hormone response
8. Integumentary system
  1. Impairment of barrier function
9. some reproductive system diseases : Erctile dysfunction - vaginal yeast infection
Qatar Demographics regarding age
1. young elderly : 65-74
2. Moderate elderly : 75-84
3. Very old :85 and more
Qatar services for elderly people
1. different inpatient hospital facilities
2. Geriatric department clinics ( Rumaila Hospital )
3. Enaya Center
Pharmacological changes in Elderly
1. Age Effect of basic Pharmacokinetics
  1. Administration
  2. Absorption
  3. Distribution
  4. Metabolism Phases: I-II
  5. Elimination
Compliance with medication and Elderly
1. Hardships to comply to the medication because of :
  1. Lack of knowledge
  2. not knowing how to take medication
  3. Scared of the side effects
2. Compliance Improvement
  1. disease and treatment education
  2. drug routine simplification
  3. involving the families in disease management
Metabolism during fasting
1. Energy Reserves
  1. Liver and muscle glycogen
  2. Muscle protein
  3. Liver releasing of glucose
  4. Adipose TGs
2. Mechanism of Protein Conservation
3. Ketone Body mentbolism
4. The Role of the kidney
5. Hormonal Control during Starvation
6. Fasting and weight loss
Orthostatic hypotension
1. effect:
  1. Syncope
  2. agina
  3. stroke
  4. Dizziness
2. Upright posture assumption
  1. pooling of 500 -1000 ml of blood in lower extremities and splenic circulation which cause:
    1. diminished cardiac output and BP
    2. sympathetic outflow raises:
      1. peripheral vascular resistance
      2. cardiac output
      3. venous return
    3. rapid decreasing in venous return to the heart
Healthy life style
1. Healthy mind
2. physical exercise
3. Good health care
4. H.diet and weight control
5. Personal safety
Diet for losing weight in elderly
1. Challenging process
2. Requires extreme caution and healthcare
  1. prevention of the weakness and muscle mass loss
3. medication history before starting
4. Drinking plenty of water
5. adding the training to reduce muscle mass deterioration
6. increasing the protein intake
7. calories balance
Psychological changes in widows
1. death after spouse death
2. Economic hardship
3. financial stress
4. higher levels of mental illness
5. high levels of traumatic grief
6. loneliness

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	Created by Mohammad Blaidah about 8 years ago