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Exam 1 Flashcards

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1
Q

A cognitive disorder in which the patient’s reality is skewed or has an abnormal interpretation of reality

A

Paranoid Schizophrenia

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2
Q

What are the initial onset of symptoms for schizophrenia?

A

Lack of motivation, inability to pay attention, social isolation

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3
Q

What is the age range for paranoid schizophrenia?

A

18-30

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4
Q

What are the common signs and symptoms of schizophrenia?

A 
Hallucination/delusions -seeing hearing or tasting things that others do not
Socializing less often with friends
Trouble sleeping
Irritability  
Suspicious of others intentions
Difficulty thinking clearly
Decline in self-care
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5
Q

4 Medical interventions for schizophrenia

A

Physical exam-rule out
Tests and screenings- screen for drugs, order imaging
Psychiatric eval- discussion with family?
Diagnostic criteria

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6
Q

Treatment for schizophrenia

A

Medications**
-antipsychotic meds (1st gen more side effects) Chloropromazine, haloperidol
-2nd gen less effects abilify, saphris, rexulti
Psychosocial therapy
Side effects will decrease compliance

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7
Q

PT interventions

A 
Subjective- government implantation
Men>women 18-35
Suicide 4.9-22.3%
Mild childhood head injuries
Psychological stress 
Chronic LBP 
Anosognosia - adherence an issue (diff. Self awareness)
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8
Q

When do negative symptoms of schizophrenia occur?

A

Prodromal or onset

Active=positive

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9
Q

What % of schizophrenia patients have diabetes?

A

6%

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10
Q

Aerobic exercise can have what 3 impacts on schizophrenia?

A

Reduces psychiatric symptoms
Potentially improves mental and physical QOL
Reduces metabolic risk and wt gain

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11
Q

Adjusting needs of schizophrenic patient

A

+/- symptoms
Barriers: anxiety, loneliness,pain, feeling of judgement, depression, misunderstanding of exercise
Visual actualization
Do not crowd/overwhelm them, explain!

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12
Q

A condition in which a pt develops blindness, paralysis, or other neurological symptoms that can’t be explained

A

Conversion disorder “hysteria” “functional neurological symptom disorder

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13
Q

S&S of conversion disorder

A 
Vision issues
Loss of smell or speech
Muscle weak or paralysis
Numbness or abnormal sensation
Hearing problems or deafness
LOB
LOC or seizures
Unresponsiveness 
Uncontrolled Movements
 Difficulty swallowing
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14
Q

Diagnosis of Conversion disorder

A

Symptoms affect your movement or senses
Can be related to a stressful event
You’re not faking
Can’t be explained by another condition of medication
Symptoms can cause stress in social or work settings

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15
Q

medical interventions for conversion disorder

A

Hypnosis-little success
Psychotherapy-emotional basis of symptoms.
Speech therapy
Medication-haloperidol, tricyclics antidepressants, electroconvulsive therapy
PT/OT
Stress reduction and distraction technique
Treating underlying conditions
Education and reassurance they don’t have a serious med cond.

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16
Q

Interventions for conversion disorder

A

Psychiatric assistance- one disorder found in 89.5% of patients during follow-up
Prevent reinforcement of sickness
Treatment progression-rapport, WB, gait
Improve endurance, balance, posture, flexibility, strength

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17
Q

PT watch in conversion

A

Reintegration into society

  • develop rapport
  • pregnant activities
  • community reintegration
  • general mobility
  • supported gait activities
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18
Q

This theory states that consequences govern human behavior

A

Skinerian learning theory
If positive behavior enforced will continue
quality not quantity

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19
Q

Criteria for dx in conversion disorder

A
  1. 1 or more symptoms are present that either affect voluntary motor or sensory fxn LOC
  2. Found not to be medical cond. or affects of substance or culture behavior/ experience
  3. 1 or more diagnostic features are present that provide internal inconsistency or incongruity with recognized neuro disorder
  4. Symptom causes clinically significant distress of impairment in social, occupational, or other important area (med eval)
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20
Q

This disorder is characterized by the presence of 2 or more distinct personality states

A

Dissociative identity disorder

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21
Q

What % of the pop. Has DID?

A

1-3% US

6% make it obvious on ongoing basis

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22
Q

Cause of DID?

A

Childhood trauma -form of coping

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23
Q

S&S of DID

A

Memory loss of certain periods or info
Sense of being detached from self/emotions
Depression
Anxiety
Suicidal thoughts
Blurred sense of identity
Inabilityto cope with emotional stress
Perception of ppl around you is distorted
Significant stress in relationships and work

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24
Q

Medical interventions for DID

A

Hypnosis
New way to cope with stress
Cognitive behavioral therapy
Help identities become aware of one another and resolve conflicts
Meds may be antidepressants, anti-anxiety, antipsychotics

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25
What should a PT watch for in DID?
Amnesia Answering questions while interacting with multiple personalities Presence of other mental health issues Differing biological responses
26
Interventions for DID
Treat comorbidities with exercise Treat patient as WHOLE identity (don’t treat personalities separately) Do not neglect knowledge meant of other personalities Avoid triggers of past traumatic events
27
What % of the population is diagnosed with ADHD?
8.4% kids 2.5% adults | Males>females
28
S&S ADHD
Behavioral: aggression, excitability, fidgeting, lack of restraint, hyperactivity, impulsivity, persistent rep of words, talk excessively Cognitive: absent-minded, diff. Focus, forgetful, problem pay attention, short attention span Mood: anger, anxiety, boredom, excitement, mood swings depression and learning disability is common
29
Treatment for ADHD
Preschool- behavioral therapy, methylphenidate if behavior does not improve Elementary- meds and behavior therapy-stimulants (atomoxetine, extended release guanfacine, extended release clonidine)
30
Comorbidities with ADHD
Stroke Cardiovascular disease Diabetes
31
Symptoms causing problems during treatment of ADHD
Forgetfulness Difficulty focusing Mood disorders: anxiety, aggression, mood swing Aerobically fit-less succumbed to helplessness
32
Treatment for kids and adults
``` Kids -help creat and learn a schedule Encourage movement and exercise Help organize everyday items Improve movement performance Adults -relaxation technique Stress management Enhance self-esteem Change negative thought patterns ```
33
This disorder presents with inflated sense of importance, deep need for excessive attention, admiration, praise, lack of empathy, troubled relationships
Narcissistic personality disorder
34
What cluster is narcissistic personality disorder and when does it begin?
B early adulthood
35
Other complications with narcissism?
Difficulty with relationships, workplace and school problems | Depression and anxiety, physical health problems, drug abuse, suicidal thoughts
36
Medical interventions for narcissism
``` Psychotherapy Medications Cognitive behavioral therapy Psychodynamic therapy Family therapy ```
37
PT watch for in narcissism?
Difficulty extracting desired info during eval and treat Disturbances in gym One-on-one Aggravated if therapy not what they wanted Intolerance to criticism
38
Interventions PT for narcissism
Educate pt on how to manage symptoms Motivational interviewing Exercise to improve mood Worksheet for triggers
39
The level of care in the health care system that consists of emergency tx and critical care
Acute or secondary care
40
Anemia in the presence of CAD may result in what?
Angina particularly with exertion lead to heart failure
41
What is he primary cause of gastrointestinal bleeding and what population?
Anemia older
42
Low and high critical values hemoglobin
Low 5-7 | High 20+
43
WBC counts
5-10 Upward leukocytosis 11+ infection, cancer drugs or large meals/stress Downward leukopenia <4 Very low neutropenia <1.5 medications for bone marrow cancer psychotics folic Early morn low afternoon high
44
Platelet norms
140-400 Trend upward thrombocytosis >450 venous thromboembolism Down thrombocytopenia <150 severe <20
45
What systems regulate acids?
Rental and pulmonary
46
What does the renal system regulate?
Base bicarbonate
47
PaI2 declines with age secondary to?
Reduction in elasticity of msk system
48
PaO2 levels range from ___ to ___ in childhood and decreases by how much after 60?
80-100 1/ year
49
PaCO2 if it goes up and pH goes down then respiratory condition Opposite If numbers are equal go in same direction= metabolic disorder
ROME
50
What nutrient is the primary determinant of extracellular fluid volume?
Sodium levels? 134-142 Hypernatremia? >145 impaired cognition seizures Hyponatremia <130 impaired cognition hypotension
51
What is potassium important for?
Excitable cells of nerves muscles and heart 3.7-5.1 Hyperkalemia >5.5 cardiac issues weakness Hypokalemia <3.5
52
This electrolyte is important for bone formation, cell division and growth, blood coagulation, muscle contraction and release of nt
Calcium 8.6-10.3 Hypocalcemia imputed cognition
53
What risks for electrolyte imbalance In older patients
``` Malnutrition Dehydration aDR Infection Cancer Organ fxn decline ```
54
The endocrine system measures what nutrient? Normal levels?
Glucose m70-100 >126 diabetes plasma glucose >200 >250 or less than 70 glucose cannot be used as energy
55
How many people die each year due to suicide?
1 every 13 min
56
Men are how much more likely that women to commit suicide?
4
57
What perecwnt of college student feel depressed?
30
58
How many adults had 1 major depressive disorder in 2012?
16 million
59
Suicide kills how many more deaths than homiciide?
Double
60
Medical cost for depression?
80 billion
61
What are the high risk groups for suicide?
Military Rural LGBTQ American indiana and Alaskan
62
What are the characteristics of bipolar or manic depressive disorder?
Major atypical shifts in mood | Episodes of euphoria followed by depression
63
What med is commonly used to treat bipolar?
Lithium
64
What percent of adults experience anxiety?
18%
65
This is the hyperactixation of the sympathetic nervous system
Generalized anxiety disorder
66
What are the symptoms for generalized anxiety disorder?
``` Increased bp and hr Nausea Chest pain SOB dizzy Perspiration ```
67
This is the fear of crowds and open spaces
Agoraphobia
68
What are the symptoms of panic disorder?
Panic attacks with no triggers Unpredictability if attacks Fear of having another attack at any time
69
4 things about rituals of OCD
Significantly interrupt daily life Behaviors cannot be controlled or stopped At least 1 hour per day is spent performing rituals Rituals do not bring pleasure or happiness
70
What parts of the brain show a change in OCD?
Frontal cortex and subcritical areas
71
Top 4 reasons for men and women cause PTSD
Rape combat exposure childhood neglect childhood physical abuse Rape physical attack sexual molestation being threatened with a weapon
72
PTSD must have what following post traumatic event?
At least 1 reexperiencing symptom At least 1 avoidanc 2 arousak or reactivity symptoms 2 cognition and mood symptoms
73
What are examples of cognition and mood symptoms in PTSD?
Trouble remembering key features of traumatic event Distorted feelings like guilt or blame Loss of interest in enjoyable activities Negative thoughts about oneself or world
74
What % of the population suffers from PTSD?
2.2% 7.7 mik
75
What percent of Iraq war veterans?
11-20% 300,000
76
Are women or men more likely? And what % will experience PTSD sometime during life?
Women 7-8%
77
What was the number one cause of death in 2012 for Us Tripp’s?
Suicide
78
Slowing if response time and motor movements aka psychomotor retardation is common in what?
Untreated depression and treatment with benzodiazepines for anxiety
79
Exercise can alter what?
Biochemical components in brain
80
Relapse of depression is drecreased with what compared to what?
Exercise pharmaceuticals
81
What are the minimum exercise requirements for depression?
2 days per week flexibility and muscle strength 10 step ups or flight of stairs 8 sit to stand Chair sit and reach R and L 8 arm curls with minimum 2 recommend 4 kg
82
What happens to serotonin with exercise?
Synthesis increases but so does metabolism
83
What length of time should you exercise for alleviation of anxiety?
30 min
84
The reason or reasons one has for acting or behaving in a particular way
Motivation
85
Age changes in motivation
Increased capacity to self-regulate Stronger adherence to behavior Imitation to change slower Positive self concept New approaches to activities more motivating More engaged in PT to function as caregiver Requires less info to make a decision
86
What are the 5 components of motivation
``` Beliefs Unpleasant physical sensation Individualized care Social support Goal identification ```
87
Behaviorist orientation
Stimulus/ response design and environment produces desired response. No creativity or problem solving
88
Cognitive orientation
Involvement thinking, problem solving and formation of concepts. Simplex yo complex
89
Humanist orientation
Based on human potential for growth. Emphasis on individual freedom and responsibility as well as experiential perceptions which enable environment
90
A system based on imitation for modeling
Social learning theory
91
Adult learning theory is based on what 4 concepts?
Changes in self concept are function of growth and maturity Rolled experience inolder adults provides substantial foundation to build new experiences Readiness to learn concept of transitioning Fromm external to internal stimulus Orientation to learn refers to older adults purpose for learning. Immediate applicable intervention
92
The trans theoretical model is based on what 5 strategies
``` Preconremplation Action Maintenance Preparation Contemplation ```
93
Cure model is what while care model is?
Authoritative collaborative
94
This theory states that human motivation and action are regulated by forethought
Social cognitive theory - a belief system that exercise may increase pain has potential decrease motivation
95
Social cognitive theory is based on what 2 expectations
Individuals beliefs and capabilities in performing course of action to attain desired outcome Belief that a certain consequence will be produced by personal action

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