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Flashcards in Adult - Psychosocial Deck (36):
1

dysthymia defined

depression of long term standing

2

Three areas of causality for depression?

psychodynamic - anger directed inward
cognitive - negative belief system
biochemical

3

Depression mnemonic

IN SAD CAGES

INterest

Sleep disturbance
Appetite change
Depressed mood

Concentration difficulties
Activity alteration - hypo hyper
Guilty feelings
Energy loss
Suicidal ideaion

4

Important lab to order to rule out significant differential for depression:

TSH - R/O hypothyroid

5

Categories of feelings

mad
sad
glad
afraid
ashamed

6

Stages of grief

DABDA

denial
anger
bargaining
depression
acceptance

7

Most commonly prescribed antidepressant class

SSRIs

8

SSRI examples

paroxetine (Paxil)
fluoxetine (Prozac)
sertraline (Zoloft)
citalopram (Celexa)
flovoxamine (Luvox)

9

What are the advantages of SSRIs?

low overdose danger
fast symptom response
no postural hypotension

10

Risk of SSRI?

seratonin syndrome

high fever

11

Major concerns of tricylic antidepressant?

anticholinergic
suicide
prolonged QT

12

Examples of tricyclic antidepressants

amitriptyline (Elavil)
imipramine (Tofranil)
doxepin (Sinequan)

13

Dietary concerns with MAOi

wine + cheese = hypertensive crisis

14

Examples of MAOi

phenelzine (Nardil, Nardelzine)

15

Antianxiety medication classes

benzodiazepines
antihistamines
beta blockers
tricyclics and MAOi
buspirone (Buspar)

16

First rule out in anxiety

TSH to r/o hyperthyroid

17

What is the only anti-anxiety that is not classified as a tranquilizer?

buspirone (Buspar)

18

Groups in which suicide risk is particularly high?

adolescents and early adulthood
white males > 45 years
those > 65 years

19

Suicide mnemonic

SUICIDAL

Sex (men more successful if attempted)
Unsuccessful attempts
Identified family members with suicide attempts
CI chronic Illness
Depression, drug abuse, drinking
Age of patient
Lethal method available

20

Alcoholism mnemonic

CAGE

ever felt the need to Cut down?
have people Annoyed you by criticizing your drinking?
have you ever felt Guilty about your drinking?
have you ever had an Eye-opener drink in the morning to steady your nerves or get rid of a hangover?

21

What is the focus of the mental status assessment?

cerebral function

22

Mini-mental status exam mnemonic

ORAL 23 RWD

Orientation
Recognition
Attention
Recall
Language

2 - names of 2 objects
3 - follow 3 step command

Reading
Writing
Drawing

23

sudden, transient onset of clouded sensorium

delirium

"they'll be back"

24

Common causes of delerium

toxins
alcohol
anesthesia
trauma
poor nutrition

25

gradual memory loss with decreased intellectual functioning

dementia

"they will not be back"

26

Common cause of dementia

Alzheimer's

27

Dementia rule out mnemonic

DEMENTIA

Drug reactions
Emotional disorders
Metabolic / endocrine disorders
Eye and ear disorders
Nutritional problems
Tumors
Infection
Arteriosclerosis

28

Dementia -- Development of multiple cognitive defects characterized by both memory impairment and one or more of what?

aphasia
apraxia
agnosia
inability to plan, organize, sequence

29

Aphasia

difficulty with speech

30

Apraxia

inability to perform previously learned task

(no idea how to brush teeth or tie shoes; prompting them to do so does not help)

31

Agnosia

inability to recognize an object

as tested by STEREOGNOSIS test (eyes closed, object in palm)

"O in agnOsia, Object, and stereOgnosis"

32

What is the underlying cause of Alzheimer's?

acetylcholine deficiency

33

Mainstay of medications used in Alzheimer's?

acetylcholinesterase inhibitors

donepezil (Aricept)
galantamine (Razadyne)
rivastigmine (Exelon)

34

What is an adjunt medication used in Alzheimer's?

NMDA blockers

memantine (Namenda)

35

What is the cerebellum responsible for?

balance and coordination

36

What are three techniques for assessing cerebellar function?

Romberg
Finger to Nose test
Heel to Shin test