Examining the Doctor
Important Note
Older patients present “atypically” for several reasons. Some of them relate to the doctor’s beliefs and attitudes.
Physicians know that children are physiologically, anatomically, and socially different from adults so we do not expect their presentation of illness to be the same as in adults. However we often forget that after 70 many people (not all) are physiologically, anatomically, and socially different from how they were during their middle (“not old”) years.
If we assessed kids, expecting them to be the same as adults, we would frequently go wrong (First rule of pediatrics: “Children are NOT just little adults!”). Similarly, if we go into the room thinking that older people are the same as middle-aged adults, we will frequently go wrong (First rule of geriatrics: “Old people ARE just old adults – but they’re different!”).
Discussion: Examining the Doctor
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More detailed HP
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important to remember
Recordar siempre los cambios fisiológicos en los adultos mayores
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the patient should have a full work up
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great way of looking at the elderly
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Interesting
good to know
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…
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oh yes I see
thank you
very important
HYEAH
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Yes,Indeed!
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true
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yes
okay
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good case
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The differential needs to be broad
This can not be aid enough. Also, one 70 year old is not the same as the next.
clinical presntation is very good
yes the presentation is good
pretty
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sure
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Older people express different.
lots to learn
great
good to remember they are older adults
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They are there for some reason. So basic workup then add from there.
get info from multiple sources
Agree
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lot of needs
lots of needs
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true
no two patients are the same and it is important to create a rapor with patients and deal with patients based on their presentation as opposed to categorizing them.
older persons are unique and they express their concerns differently from adults.
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you need to think out side the box and look for the norm first
Indeed, older adult are different and each has their own uniqueness
Agreed
very true
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i see
very interesting
Muy buena observación
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good point
Extremes of age are similarly difficult to assess-I tell my residents that an 85 year old is equally as difficult to assess as an 85 day old, but with a much greater chance of being very sick.
Well said.
I think that recognising the ‘differences’ between older and younger adults is the key to understanding ‘atypical’ presentations in older people.
important information
Good point we need to consider the physiological changes older adults are experiencing before coming to a conclusion of their diagnosis.
important
this is important to consider.
great
so important to remember
I think this is a great way to view our elderly patients. We don’t expect infants and toddlers to be able to clearly communicate their symptoms, same with some elderly patients. And also need to recognize they present with serious illness with very non=specific symptoms just like infants do!
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awesome
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Good point!!
interesting
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Interesting
Good info
great
Older patients present differently than others. This is why it is important for healthcare providers to know different SS.
Very interesting.
very enlightening
lots to be aware of
Good to know
true
be thorough
Noted
I think that recognising the ‘differences’ between older and younger adults is the key to understanding ‘atypical’ presentations in older people.
definately
good review
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no hard and fast rules with geris
assess the loss of desire to live. too many birthdays can cause this
slow down. take care. consider things carefully. check for loss of sparkle in the eyes.
learning the differences
I think that recognising the ‘differences’ between older and younger adults is the key to understanding ‘atypical’ presentations in older people.
think atypical presentations
encuenta always take the physiological changes of aging
hay que tomar en cuenta los cambios de la vida
tomar entrevista con tiempo
tomar tiempo para la entrevista
Always individualize our patients! Elderly people will test us every day in our knowledge!
The pt. requires a complete work up.
I agree,with out a full assessment,formulating working diagnoses will be hard
Comprehensive geriatric assessment is essential
atypical
sss
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With old people we have to think broad and to keep in mind every thing is possible,no classical presentation.
good discussion – we need to look for horses not zebras …. yet for the non-specific presentation in an elder, with few clues as to the involved system, the barn is full of horses.
Atypical presentations force you to think outside the box and really broaden your differential. I had a 70 year old female present to the ER with sore throat, she ended up having a NSTEMI
atypical presentation are more the norm than the exception
look for the horses, not zebras.
The differential needs to be broad