ADHD, ADD, and misc Flashcards

1
Q

Fails to give close attention to details or makes careless mistakes in schoolwork
Has difficulty keeping attention during tasks or play
Does not seem to listen when spoken to directly
Does not follow through on instructions and fails to finish things
Has problems organizing tasks and activities
Avoids or dislikes tasks that require sustained mental effort
Often loses toys, assignments, pencils, books, or tools needed for tasks or activities
Is easily distracted
Is often forgetful in daily activities

A

Inattentive Symptoms

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2
Q

Fidgets with hands or feet or squirms in seat
Leaves seat when remaining seated is expected
Runs about or climbs in inappropriate situations
Has problems playing or working quietly
Talks excessively

A

Hyperactivity Symptoms

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3
Q

Blurts out answers before questions have been completed
Has difficulty awaiting turn
Interrupts or intrudes on others’ conversations

A

Impulsivity Symptoms

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4
Q

ADHD Diagnosis is made clinically with input from ___ and ___.
At least __ separate symptoms for at least __ months.

An ___ must have had symptoms as ____ for this diagnosis to be applied

A

Diagnosis is made clinically with input from teachers and parents.
At least 6 separate symptoms for at least 6 months.
An adult must have had symptoms as child for this diagnosis to be applied

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5
Q

Stimulant Medicationsn[1]

Non-stimulant medications that can be used as alternatives [4]

A
Stimulant Medications
Ritalin (methylphenidate)
Non-stimulant medications that can be used as alternatives
Atomoxetine
Bupropion
Guanfacine
Clonidine
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6
Q

To help a child with ADHD, the following is advised: [6]

A
Talk regularly with the child’s teacher
Consistent schedule
Limit distractions
Healthy diet
Sleep
Provide clear and consistent communication
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7
Q

abuse signs:

___ fractures from twisting injuries
Burns that are ___ ____ pattern or perfectly ____
___ is red flag(eye)

A

Spiral fractures from twisting injuries
Burns that are stocking glove pattern or perfectly round
Hyphema is red flag. This is blood in the anterior chamber of the eye.

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8
Q
Physical Abuse
- Inflicting physical pain or injury on a senior
- Slapping, bruising, or restraining by physical or chemical means
Sexual Abuse
Neglect
Financial or Material Exploitation
Emotional Abuse
Abandonment
A

Types of Elder Abuse

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9
Q

Types of Grief Reactions:
Anticipatory grief means what
Common grief means what

A

Types of Grief Reactions:
Anticipatory grief
occurs in anticipation of an impending loss
Common grief
Marked by a gradual movement toward an acceptance of the loss and managing to continue basic daily activities

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10
Q

Grieving Process [4]

A

1) Shock and Denial
- Initial reaction to loss
- Normally lasts two or three months
2) Intense Concern
- Manifests by being unable to think of anything else
- May last from six months to a year
3) Despair and Depression
- The long period of grief
- Involves a wide range of feelings, thoughts, and behaviors
4) Recovery
- Shows a new interest in daily activities and begins to function normally day to day

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11
Q

Phases of Suicide

A

Phases of Suicide
* Severe disappointment
Where standards were set and the circumstances fall far below from expectations
* Self-blame
Blaming one’s self for all of the disappointment in life.
“Demonize” self
* Self-absorption
Becoming obsessed with one’s own inability to measure up to the standards set up
Inward turn, shutting off from the world
* Depression and anxiety
“negative affect,”
* Cognitive deconstruction
Involves an “escape from meaningful thought,”
Thinking about the big questions going into an “emotional death”
* Disinhibition
Leaping over the last psychological hurdles that stand between the person and suicide

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12
Q

Many who attempt suicide seek professional care?

___% suicides are completed with a firearm

A

Many who attempt suicide never seek professional care

Over half of all suicides are completed with a firearm

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13
Q

Risk Factors for suicide [4]

gender?

A
Risk Factors
Mental disorder
Substance abuse
Problem gambling
Medical conditions triggering depression
Male > Female
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14
Q

suicide tx

A
Emergency Treatment
Psychotherapy
Medications
Antidepressants
Antipsychotic medications
Anti-anxiety medications
Addiction treatment
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15
Q

What % of woman in North America will have experienced sexual abuse by adulthood.

A

25%

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16
Q

A patient who has lost her husband 6 months ago believes she can hear his voice in the their home. Is this normal?

A

A patient who has lost her husband 6 months ago believes she can hear his voice in the their home. Is this normal?
Yes, auditory hallucinations can be a normal part of the grieving period.

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17
Q
Things you should know
Characteristic behavior and social interactions
Symptoms are apparent before 3 years old
Strong genetic basis
M > F
Asperger Syndrome
Rett Syndrome
A

Autistic Disorder

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18
Q

Autistic Disorder

Symptoms are apparent before ___years old
genetic basis?
gender

A
Autistic Disorder
Characteristic behavior and social interactions
Symptoms are apparent before 3 years old
Strong genetic basis
M > F
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19
Q
Autism:  Difficulty with communication
-social conversation
Communicates with \_\_\_ instead of \_\_\_
Develops language- pace
- gaze to look at objects that others are looking at
Does not refer to \_\_\_ correctly
-Points?
Repeats what?
A

Difficulty with communication
Cannot start or maintain a social conversation
Communicates with gestures instead of words
Develops language slowly or not at all
Does not adjust gaze to look at objects that others are looking at
Does not refer to self correctly
Does not point to direct others’ attention to objects – occurs in the first 14 months
Repeats words or memorized passages, such as commercials

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20
Q
Social interaction- autism
-make friends?
-play interactive games?
-respond to eye contact or smiles?
May treat others as if they are \_\_\_
-empathy?
A
Social interaction
Does not make friends
Does not play interactive games
Withdrawn
May not respond to eye contact or smiles, or may avoid eye contact
May treat others as if they are objects
Prefers to spend time alone, rather than with others
Shows a lack of empathy
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21
Q
Autism: Responses to sensory information
-loud noises?
Has heightened what?
May find normal noises what?
-physical contact ?
Rubs ....
-response to pain?
A

Responses to sensory information
Does not startle at loud noises
Has heightened or low senses of sight, hearing, touch, smell, or taste
May find normal noises painful and hold hands over ears
May withdraw from physical contact because it is overstimulating or overwhelming
Rubs surfaces, mouths or licks objects
Seems to have a heightened or low response to pain

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22
Q

autistic Play
imitate ?
Prefers ___ or ___ play
-pretend or imaginative play?

A

Doesn’t imitate the actions of others
Prefers solitary or ritualistic play
Shows little pretend or imaginative play

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23
Q
Autistic Behaviours
Behaviours
-tantrums
Gets stuck on a single \_\_\_ or \_\_\_
-attention span
-overactive or passive?
Shows aggression to \_\_\_ or \_\_\_
Shows a strong need for \_\_\_\_
Uses \_\_\_ body movements
A
Behaviours
“Acts up” with intense tantrums
Gets stuck on a single topic or task
Short attention span
With very narrow interests
Is overactive or very passive
Shows aggression to others or self
Shows a strong need for sameness
Uses repetitive body movements
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24
Q

What is the definition of obesity using BMI

A

> 30

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25
A four year old who has a flat affect and does not make eye contact during your interview might make you think about what diagnosis?
Autism
26
How does Orlistat work?
It is a lipase inhibitor
27
Is anorexia ego dyssyntonic or ego syntonic
ego syntonic
28
5 axis
I: clinic d/o, mental d/o, major syndromes, includes substance abuse and development d/o II: personality d/o and mental retardation III: any general medical condition or physical d/o IV: psychosocial and enviromental situations that contribute to the d/o V: global assessment of function-rating system
29
Disorganized schizophrenia
Disorganized schizophrenia is characterized by incoherent and illogical thoughts and behaviors; in other words, disinhibited, agitated, and purposeless behavior.
30
postpartum 1) blues 2) psychosis 3) depression
- blues within 2 weeks; no thoughts of hurting baby - 2-3 wks post-delivery, may have thoughts of hurting baby - 1-3 months post delivery, sleep disturbances and anxiety
31
pts recognize there behaviors as excessive and irrational products of their own minds they wish they could get rid of the obsessions and/or compulsions
OCD
32
anorexia %wt and BMI | -ego....
<85% and BMI < 17.5 | egosyntonic
33
bulemia binge eating incidence
once a wk for 3 or more months
34
prevalent: anemia or bulimia
bulemia
35
eating disorders electrolyte abnormalities 4
hypochloremia hypokalemia elev BUN metabolic alkalosis(anorexia); acidosis(bulemia)
36
obesity | % wt and BMI
20% over ideal wt | BMI >30
37
eating d/o | constitutional signs 4
cachexia hypothermia fatigue electrolytes
38
eating d/o | cardiac signs 5
``` arrhythmia sudden death hypoTN bradycardia prolonged QT interval ```
39
eating d/o | GI signs 3
dental erosions and decay abd pain delayed gastric emptying
40
eating d/o | GU 2
amenorrhea | nephrolithiasis
41
``` eating d/o derm heme neuro MS ```
lanugo leukopenia seizures OP, stress fx
42
alcohol abuse | MCV, BUN, LDL, RBC volume
MCV increased BUN decreased LDL decreased abn RBC volume
43
alcohol withdrawal starts when
6-18 hrs
44
alcohol tx | also hallucinations
``` benzo with (librium or valium), thiamine, folic acid, MTV haldol, risperadone disulfram- causes N/V, not used for withdrawal ```
45
wernickes encephalopathy
nystagmus, ataxia, confusion; def in vit B1, tx with thiamine replacement
46
korsakoff syndrome
wernicke with amnesia
47
la belle indifference
serious physical ailment; conversion disorder
48
schizoaffective d/o must have what
schizophrenia type sx plus depressive sx; | must have delusions/hallucinations for 2 weeks without mood changes
49
neuroleptic malignant syndrome - sx - lab - tx
mm rigidity, fever, autonomic instability, cognitive changes(delirium), increased CPK dantolene or amantadine
50
fears dissolution of relationships
dependent
51
disorganized patterns of speech and action
schizophrenia
52
lack trust
paranoid
53
what mimic manic symptoms (6)
AIDS, Cushings, hyperthyroidism, lupus, MS, brain tumor
54
what mimic depressive symptoms (9)
Stroke, parkinson, MS, huntington, B12 deg, hypothyroidism, cushing, pancreatic carcinoma, HIV
55
valproic acid increases and decreases what levels
increases warfarin | decreases lithium
56
tx for cocaine assoc infarct/ischemia
nitro
57
cocaine overdose - avoid what
BB. but it is ok for cocaine withdrawal
58
emotional reaction that a clinician has toward a pt based upon previous experience
countertransference
59
mania maintenance therapy
lithium 1st, then valproic acid, quetipine, lamotrigine
60
what d/o doesnt respond to anti-dep med
histrionic
61
QT prolongation SSRI
not in paroxetine | yes in fluoxetine
62
acute schizophrenia tx
risperdone
63
pupils - constriction/miosis (1) - dilation/mydriasis (3) - nystagmus
- constriction/miosis: opiods - dilation/mydriasis: amphetamines, cocaine, LSD - nystagmus: PCP
64
opiod overdose tx
naloxone; careful with methadone
65
amphetamine and cocaine overdose tx
haldol if severe | avoid BB in cocaine overdose
66
PCP overdose tx
benzo or haldol
67
LSD overdose anxiety
benzo; antipsychotic if needed
68
euphoria leading to apathy, CNS depression, constipation, respiratory depression
opiod intoxication
69
"hurts all over", DILATED PUPILS, dysphoria, insomnia, diaphoresis, rhinorrhea, piloerection, N/V, cramps, GI, diarrhea, yawning
opiod withdrawal; not life threatening
70
psychomotor agitation, HTN, tachycardia, fever, diaphoresis, anxiety, angina, prolonged wake, delusions, arrhythmias, seizures, hallucinations
amphetamine intoxication
71
post use "crash" with anxiety, lethargy, HA, GI cramps, hunger, fatigue, depression/dysphoria, sleep disturbance/nightmares
amphetamine withdrawal
72
psychomotor agitation, paranoia, hallucinations, "BUGS", sudden death
cocaine intoxication
73
post use "crash", severe craving, hypersomnolence, nightmares, depression, malaise, angina, suicidialistic, increased appetite
cocaine withdrawal
74
assaultiveness, belligerance, psychosis, violence, impulsiveness, psychomotor agitation, fever, tachycardia, ataxia, seizures, delirium, HTN, decreased judgment
PCP intoxication
75
recurrence of intoxication symptoms due to reabsorption in GI tract; sudden severe, random violence
PCP withdrawal
76
slowed sense of time, social withdrawal, increased appetite, dry mouth, conjunctival injection, hallucinations, anxiety, amotivational syndrome
marijuana intoxication
77
acidification of urine or gastric lavage when
with PCP intoxication
78
intoxication of what has a low safety margin and also respiratory depression
barbituates
79
anxiety, seizures, delirium, life threatening, CV collapse
barbituates withdrawal
80
what has a interaction with alcohol, amnesia, ataxia, somnolence, mild respiratory depression -what to give in an overdose
benzo intoxication | -give flumazenil
81
flumazenil
for benzo overdose
82
muscle twitching, arrhythmias, tachycardia, flushing, psychomotor agitation, restlessness, insomnia, diuresis
caffeine intoxication
83
HA, lethargy, depression, wt gain, craving, irritability
caffeine withdrawal
84
restlessness, insomnia, anxiety, arrhythmias
nicotine intoxication
85
irritability, HA, anxiety, wt gain, craving, bradycardia, insomnia, difficulty concentrating, decreased HR
nicotine withdrawal
86
tremor, tachycardia, HTN, malaise, nausea, seizures, DT, agitation, psychomotor sx, abn perception
alcohol withdrawal
87
alcohol withdrawal - N/V - DT - hallucinations
- N/V 8-12 hrs - DT 2-3 days - hallucinations 2 days
88
``` acne rosacea palmar erythema hepatomegaly dupuytren contracture gynecomastia testicular atrophy ```
chronic alcohol abuse