Behavioral Health Flashcards
(68 cards)
1
Q
Characterized by excessive, uncontrollable and often irrational fear about everyday issues and not about a specific thing or at specific time
Symptoms have been occurring for more than 6 months.
A
Generalized anxiety disorder
2
Q
Generalized anxiety, panic attack treatment
A
CBT SSRIs SNRIs TCAs Benzodiazepines - short term therapy Pregabalin (Lyrica) Gabapentin
3
Q
Examples of SSRIs
A
fluoxetine (Prozac) sertraline (Zoloft) paroxetine (Paxil) citalopram (Celexa) escitalopram (Lexapro)
4
Q
Examples of SNRIs
A
Duloxetine (Cymbalta)
Venlafaxine (Effexor)
5
Q
Benzodiazepine that is commonly used for short term treatment of anxiety disorders
A
Alprazolam (Xanax)
6
Q
extreme anxiety which typically lasts less than an hour =
A
panic attack
7
Q
Symptoms of panic attack
A
tachycardia, palpitations excessive perspiration dizziness SOB sensation of choking fear of next panic attack
8
Q
What is cognitive behavior therapy (CBT)?
A
teaches a person different ways of thinking, behaving, and acting to situations to help patient feel less anxious and fearful
9
Q
A ________ is an overwhelming, persistent and unreasonable fear of an object or situation that poses little real danger.
A
phobia
10
Q
fear of other people or social situations such as performance anxiety or fears of embarrassment by scrutiny of others
A
social phobia
11
Q
What are the fears involved in agoraphobia?
A
generalized fear of leaving home
fear of having panic attack in place where patient can’t escape or get to safety
12
Q
Diagnostic criteria of PTSD:
A
Symptoms for + 1 MONTH
Exposure to traumatic event
Persistent re-experiencing of the event
Persistent avoidance and emotional numbing
Hyperarousal symptoms not present before (hypervigilance, hyper startle reflex)
Feeling of detachment from other people
Significant Impairment
13
Q
How to treat PTSD?
A
CBT SSRIs, TCAs Prazosin for nightmares Clonidine or propranolol for hyperarousal and sleep problems Anti-convulsants, mood stabilizers Exercise
14
Q
Key features of anorexia nervosa
A
Intense fear of gaining weight
Distorted body image
Unable to maintain healthy body weight
Depression and anxiety around food
15
Q
Risks associated with having anorexia nervosa
A
Iron-deficiency anemia Abd pain, constipation, diarrhea Loss or disturbance of menses Kidney failure Osteoporosis Compromised immune system Bradycardia, or other arrhythmia
16
Q
Treatment of anorexia nervosa
A
Monitored nutrition plan
Psych therapy
Anti-depressants
17
Q
Eating disorder characterized by binging and purging
A
bulimia nervosa
18
Q
DSM diagnostic criteria for bulimia are:
A
- Repeatedly binge eating
- Post-binge vomiting, excessive exercise, fasting, or misuse of laxatives, diuretics, enemas
- Bingeing and purging at least 2x per week for at least three months
- Body shape and weight influence feelings of self-worth
- No presence of anorexia, extremely restrictive eating behaviors
19
Q
Signs of purging in bulimia nervosa
A
Russell’s sign: calluses on knuckles
Broken blood vessels in eyes
Poor dentition
Hypokalemia
20
Q
Clinical dx of obesity
A
BMI > 30
21
Q
Certain medications that may cause weight gain
A
Antidepressants Anti-seizure meds Antipsychotic meds Corticosteroids Beta blockers
22
Q
Lab workup of obesity
A
Cholesterol LFTs Fasting blood glucose Thyroid ECG
23
Q
Popular prescribed weight loss med and how it works
A
Orlistat - lipases inhibitor, unabsorbed fat is eliminated in stool
24
Q
Age of Autism onset? when is it usually diagnosed?
A
Before age 3
Dx’d 3-4 yo
25
Signs of Autism
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Repetitive behaviors
Likes strict routines
Communication difficulties
Poor social interaction
Inappropriate responses to sensory info
Prefers to play alone
Short attention span
Narrow interests
```
26
7 yo boy with severe temper outbursts out of proportion to situation. Reckless disregard for others and aggressive/irritable behavior nearly every day. What dx are you thinking?
Disruptive Mood Dysregulation disorder (DMDD)
27
Criteria in diagnosing ADHD
Diagnosis is made clinically with input from teachers and parents
At least 6 separate symptoms for at least 6 months
Must occur in multiple settings (ie. home and school)
An adult must have had symptoms as child to be dx'd
28
Symptom categories of ADHD
Inattentive
Hyperactive
Impulsive
29
Medications to treat ADHD
```
Stimulant Medications
- Ritalin (methylphenidate)
Non-stimulant medications that are used as alternatives
- Atomoxetine
- Bupropion
- Guanfacine
- Clonidine
```
30
For an adjustment disorder to be diagnosed, the following criteria must be met:
Having emotional or behavioral symptoms within three months of a specific life stressor
Experiencing more stress than would normally be expected in response to stressor
An improvement of symptoms within six months after stressful event ends
Symptoms are not the result of another diagnosis
31
Bipolar I vs Bipolar II
I: one or more manic episodes, +/- major depression episode
II: one or more major depressive episodes + at least one hypomanic episode NO MANIC
32
What is cyclothymic disorder?
Milder form of bipolar hypomania and depression not severe enough to meet bipolar criteria
33
Symptoms of manic episode
4-7 days of at least 3 mood elevation sx’s
```
Euphoria
Racing thoughts
Inflated self-esteem
Poor judgment
Rapid speech
Aggressive behavior
Agitation or irritation
Increased physical activity
Risky behavior
Spending sprees or unwise financial choices
Increased drive to perform or achieve goals
Decreased need for sleep
Delusions or a break from reality (psychosis)
Poor performance at work or school
```
34
Medications for bipolar disorders
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Mood stabilizers
- Lithium
- Valproic acid
- Carbamazepine
Antipsychotics
- Risperidone
Acute manic episode
- Haloperidol
- Benzodiazepines
```
35
A mental disorder characterized by a pervasive and persistent low mood and low self-esteem and by a loss of interest or pleasure in normally enjoyable activities
Depressive disorder
36
DSM Criteria for Major Depressive Disorder
5 or more of these sx's during same 2 week period (* = required)
- *depressed mood most of day
- * anhedonia most of day
- Unintentional weight loss/gain or appetite change
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- fatigue or loss of energy
- worthlessness or excessive guilt
- suicidal ideation
37
Caution with using Lithium therapy
narrow therapeutic window
| check serum level every 4-8 wks
38
Med that is a norepinephrine and dopamine reuptake inhibitor
Bupropion (Wellbutrin)
39
Less severe depression that occurs over at least a 2 years, and never asymptomatic longer than 2 consecutive months
Persistant depressive disorder
40
Persistent depressive (or dysthymic) vs major depression
Persistent depressive only needs 2 sx's instead of 5 and does not include suicide ideation, weight changes, or guilt
41
What BMI indicates hospitalization for anorexic patient?
less than 15
42
A patient has seen several plastic surgeons and no less than three dermatologists in the past 6 months. Which somatoform disorder might she be suffering from?
Body dysmorphic disorder
43
Two diagnostic criteria for schizophrenia that must be met over most of a month with significant changes in social functioning over the past 6 months.
```
Delusions
Hallucinations
Disorganized speech
Catatonic behavior
Negative symptoms
```
44
Duration of symptoms that differentiate different schizophrenia spectrum disorders?
Brief psychotic disorder – less than 1 month
Schizophreniform – 1 to 6 months
Schizophrenia – over 6 months
45
What is Conversion disorder?
Sx's of altered motor or sensory function that are incompatible with any recognized neuro or medical pathology
Causes significant distress and impairment
46
How old to be dx'd with a personality disorder?
18 yo
47
Very suspicious of others.
Patients tend to blame problems on others.
Preoccupied with the trustworthiness and loyalty of others
Feels threatened by others
Holds grudge
Paranoid Personality Disorder
48
Voluntary social withdraw with no desire for close relationships
They will choose to be alone and have no interest in others
No interest in praise or criticism.
Schizoid Personality Disorder
49
Patients exhibit “magical thinking” – believing in telepathy, clairvoyance and other fantasies
Most likely personality disorder to progress to schizophrenia
Severe social anxiety
Schizotypal Personality Disorder
50
Cluster A vs B vs C
```
A = mad/weird; paranoid, schizoid, schizotypal
B = bad; antisocial, borderline, histrionic, narcissistic
C = sad; avoidant, dependent, OCPD
```
51
antisocial vs conduct disorder
antisocial dx patient must be at least 18 yo, otherwise conduct disorder
52
Pattern of disregard for the rights of others
No empathy
Manipulative – may appear charming
Often a criminal pattern emerges
History of child abuse
History of starting fires, abusing animals etc.
Patient over 18
Antisocial Personality Disorder
53
Intense mood swings, impulsive behaviors, and severe problems with self-worth
Emotionally unstable and intense
Cannot tolerate being alone, but intense anger towards friends
Self-mutilation and manipulative suicide attempts
Borderline Personality Disorder
54
Long standing pattern of attention-seeking behavior and a tendency to exaggerate thoughts and feelings
Affected individuals are exuberant and extroverted
Easily influenced by others
Somatization and substance-use disorders are very common
Self-indulgence
Persistent manipulation
Histrionic Personality Disorder
55
Inflated self image, pattern of grandiosity, need for admiration and lack for empathy
Long to be special, with arrogance and haughty attitude
Fragile self-esteem, prone to depression
Exploitative and takes advantage of others
Narcissistic Personality Disorder
56
Intense sensitivity to rejection
Feel inferior and as though no one would want to be around them
Hunger for company, but may completely avoid social situations due to fear of rejection.
Self loathing
Avoidant Personality Disorder
57
Patients can not make decisions for themselves
Feel helpless
Clingy, submissive
Fear responsibility due to low self esteem
Fear being alone and need to form relationships for survival
Dependent Personality Disorder
58
Difference between OCD and OCPD
OCD ego-dystonic (patient doesn't want this behavior)
| OCDP ego-syntonic (patient thinks behaviors are acceptable)
59
```
Fixation on minute details and rules
Obsession with lists and schedules
Extreme perfectionism
Inflexible and change in routine may cause significant anxiety
Obsessive cleanliness or hoarding
```
Obsessive-Compulsive Personality Disorder (OCPD)
60
How long do symptoms have to occur for the diagnosis of acute stress reaction to change to PTSD?
1 month
61
What is a life-threatening alcohol withdrawal symptom and when do they start?
```
Delirium tremors (DTs)
begin 2-3 days after last drink
```
62
1st line medication for acute stress disorder
SSRI
63
DSM-5 criteria for conduct disorder
aggression to people and animals
destruction of property
deceitfulness or theft
serious violation of rules
64
Red flags of child abuse on PE
Injuries not consistent with history
Spiral fractures from twisting
Burns of perfect shapes
Hyphema (blood in anterior chamber)
65
Natural response to a loss with eventual recovery =
grief reaction
66
What is factitious disorder? What are 2 types?
Falsification of physical or psychological symptoms, or induction of injury/disease, with evidence of DECEPTIVE INTENT
* Not a malingerer who is wanting external gain
Munchausen: illness imposed on self
Proxy: illness imposed on another
67
Symptoms of REM vs non-REM sleep behavior disorders?
REM: failure of muscle inhibition, eyes closed, act out dreams
Non-REM: sleep walking and subtypes, sleep terror, eyes open
68
Current first line meds for tobacco cessation
- Nicotine Replacement Therapy; 5 routes (lozenge, gum, patch, nasal spray, inhaler)
- Bupropion (Wellbutrin)
- Varenicline (Chantix)
