Exam 3 Flashcards by Ella Coleman

How long do schizophrenia sx have to last to be dx with it?

1 month

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Name the disorder:
Severe mental condition in which there is disorganization of the personality, deterioration in social functioning, and loss of contact with, or distortion of reality

Involves hallucinations and delusion

Can occur with or without the presence of organic impairment

Psychosis

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Name the disorder:
Disabling psychological disorder

Involves: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative sx

Result in a severe deterioration of social and occupational functioning

Schizophrenia

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What are the 4 A’s of schizophrenia?

-Affect –> Emotions
-Associative looseness –> Thinking
-Autism –> Reality perception
-Ambivalence –> Vacillation

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What are the biochemical factors influencing psychosis?

-Excess dopamine production
-Can also involve other NTs like norepi, serotonin, acetylcholine, GABA, prostaglandins, and endorphins

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What prenatal exposures can lead to schizophrenia?

-Influenza
-Ventricular enlargement
-Neural circuit dysfunctions

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What are the comorbidities of schizophrenia?

-Substance use disorders
-Nicotine dependence
-Anxiety, depression, suicide
-Physical health or illness
-Polydipsia-psychosis-induced thirst

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Name the disorder:
Presence of delusions for at least 1 month
Subtypes of this disorder = erotomanic, grandiose, jealous, persecutory

Delusional disorder

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Name the disorder:
Sudden onset of psychotic sx that may or may not be preceded by a severe psychosocial stressor, sx last at least one day but < a month, evidence of impaired reality

Brief Psychotic Disorder

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What are 1st gen antipsychotics?

1) Thorazine
2) Prolixine
3) Haldol

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What do 1st gen antipsychotics tx?

Positive sx

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What are extrapyramidal SEs?

1) Pseudoparkinsonism
2) Acute dystonia
3) Akathisia
4) Tardive Dyskinesia

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Name the disorder:
Hallucinations and delusions are attributed to usage of substance, exposure to a substance, or withdrawal from a substance

Substance-Medication Induced Psychotic Disorder

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Name the Disorder:
Prominent hallucinations and delusions attributed to another medical condition

Psychotic Disorder d/t another medical condition

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What is catatonia?

Motor disturbances from stupor (no motor activity) to excessive motor activity or agitation

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Name the disorder:
Sx are identical to schizophrenia, but has only had the condition for < 6 months

Schizophreniform disorder

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When does schizophreniform turn into schizophrenia?

When sx persist for > 6 months

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Name the disorder:
Schizophrenia in addition to depression or mania

Schizoaffective disorder

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What are the 2nd gen antipsychotics?

1) Clozaril
2) Risperidal
3) Zyprexa
4) Seroquel
5) Geodon

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What kind of sx do 2nd gen antipsychotics tx?

Positive and negative sx

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What is the main side effect of 2nd gen antipsychotics?

Weight gain

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True or False:
2nd gen antipsychotics do not cause extrapyrimidal effects

True

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What are the phases of schizophrenia?

1) Premorbid
2) Prodromal
3) Active psychotic phase
4) Residual phase

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What characteristics are associated with the premorbid phase of schizophrenia?

1) Shy
2) Withdrawn
3) Poor peer relationships
4) Poor performance in school
5) Asocial behavior

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What characteristics are associated with the prodromal phase of schizophrenia?

1) Lasts weeks to months, sometimes 2-5 years 2) Significant deterioration in function 3) Depressive sx, signs of cognitive impairment, social withdrawal, sudden onset of OCD behaviors

What characteristics are associated with the active phase of schizophrenia?

-Acute episode where sx are more pronounced -Psychotic sx are more prominent

What characteristics are associated with the residual phase of schizophrenia?

-Improvement in positive sx but negative sx remain -Flat affect; impairment in role functioning

What are positive sx of schizophrenia?

1) Delusions 2) Hallucinations 3) Disorganized Thinking 4) Grossly disorganized of abnormal motor behavior

What are negative sx of schizophrenia?

1) Lack of emotional expression 2) Avolition 3) Alogia 4) Associality 5) Diminished ability for abstract thinking 6) Apathy 7) Anergia 8) Anhedonia

Name the vocab: Decreased or lack of motivation to complete purposeful acitivities

Avolition

Name the vocab: Decreased verbal communication

Alogia

Name the vocab: Decreased interest in social interaction and relationship

Associality

Name the vocab: "The FBI is after me" Paranoid

Persecutory

Name the vocab: People on the TV or radio are talking about them Environmental cues

Referential

Name the vocab: A celebrity loves them or "I am Jesus Christ" Power and greatness

Grandiose

Name the vocab: Thinks something is wrong with an organ or that they are pregnant, centered on personal body function

Somatic

Name the vocab: Someone of higher status is in love with them

Erotomanic

Name the vocab: The doctor gave me and shot and now I can communicate with the FBI Objects/people control them

Control/influence

Name the vocab: Self/others/world do not exist

Nihilistic

What are positive sx: thought disturbances?

1) Percusatory 2) Grandiose 3) Reference 4) Control/influence 5) Somatic 6) Nihilistic 7) Erotomatic 8) Jealous

What are positive sx: Perceptual disturbances?

1) Hallucinations (5 senses) 2) Illusions 3) Echopraxia

What is echopraxia?

Imitating movement of others

What are the positive sx: disorganized thinking?

1) Loose associations 2) Neologisms 3) Clang associations 4) Word salad 5) Circumstantiality 6) Tangentiality 7) Perseveration 8) Echolalia

Name the type of disorganized thinking: Shift of one idea to another without connection of ideas "The sky is blue and the shoes are worn out"

Loose association

Name the type of disorganized thinking: Newly invented words that are meaningless to other "I got a ride on a new telemotor"

Neologisms

Name the type of disorganized thinking: Using words in a sentence that rhyme

Clang associations

Name the type of disorganized thinking: Words that are put together without meaning

Word salad

Name the type of disorganized thinking: Unable to express point of topic d/t unnecessary or tedious details

Tangentiality

Name the type of disorganized thinking: Speaking same word or idea in response to different questions The person gets stuck on a particular thought

Perseveration

Name the type of disorganized thinking: Repeating words or phrases spoken by another

Echolalia

Name the vocab: Indifference or disinterest in the environment

Apathy

Name the vocab: Inability to feel/express pleasure; can increase risk for suicide

Anhedonia

Name the phase of planning and implementation of schizophrenia: -Sx stabilization -Safety -Medication -Communication -Limit-setting

Phase 1

Name the phase of planning and implementation for phase 1 of schizophrenia: -Milieu Management (set boundaries and expectations)** -Activities and groups -Safety -Counseling -Communication techniques -Associative loosness -Health teaching/health promotion

Phase II & III

What are contraindications of using antipsychotics?

1) Coma 2) Parkinsons 3) Severe hypotension 4) Older adults with dementia

Name the vocab: Subjective-- Emotion that may have a major influence on a person's perception of the world "I'm happy" or "I'm irritated"

Mood

Name the vocab: Objective-- the emotional reaction associated with an experience (how you view a person-- can tell if they are happy/sad)

Affect

What are the RFs for Depressive Disorders?

1) Hereditary 2) Over 65 3) NT deficiencies 4) Medical illness 5) PP 6) Trauma 7) Stressful life events

What are the phases of depressive disorders?

1) acute phase 2) Continuation phase 3) Maintenance face

Name the phase of depressive disorders: Severe clinical findings, tx 6-12 wks, may need hospitalization, reduction of depressive manifestations is the goal, assess suicide risk and implement safety precautions

Acute phase

Name the phase of depressive disorders: -Increased ability to function -Tx 4-9 mos -Relapse prevention -Med therapy/education -Psychotherapy

Continuation phase

Name the phase of depressive disorders: -Remission of manifestations -Can last for years -Prevention of future depressive episodes is the tx goal

Maintenance phase

Name the depressive disorder: frequent temper outbursts that last at least 12 months- and chronic irritability. Not bipolar; dx between ages 6-10 years old

Disruptive mood dysregulation disorder

Name the depressive disorder: depressed mood, loss of interest for at least 2 weeks. May be “recurrent with a seasonal pattern, seasonal affective disorder (SAD). Must occur almost every day for at least 2 weeks, sleep pattern disturbances, suicidal ideation, anhedonia, weight loss or gain, depressed mood.

MDD

Name the depressive disorder: more mild form of depression, usually has an early onset, persistent symptoms for 2 years for adults and at least 1 year for children

Persistent depressive disorder

Name the depressive disorder: occurs in the luteal phase of the menstrual cycle (after ovulation before menstruation)Mood swings, depression, anxiety, overeating, anergic, aching, bloating, weight gain, breast tenderness, excess sleep or insomnia

Premenstrual dysphoric disorder

What other medical conditions can contribute to depressive disorders?

-Electrolyte imbalances -Thyroid issues -Vitamin deficiencies

What are the etiology theories of depressive disorders?

1) Serotonin deficiency**** (also low norepi & dopamine) 2) Genetics 3) Predisposition & STRESS

What are the main assessment tools for adults to dx depressive disorders?

Hamilton & Beck

What is the most common depression assessment tool used in adults?

Geriatric

What med types are the 1st line tx for MDD?

SSRI/SNRIs

True or False: TCAs work faster to tx MDD than SSRIs/SNRIs

Flase- SSRIs/SNRIs work faster than TCAs

What kind of effects do you need to watch out for when a pt is taking TCAs?

Anticholinergic effects

What tips can you give to pts experiencing anticholinergic effects?

1) Increase H2O 2) Increase fiber 3) Sugarless gum 4) Eye drops 5) Walking/exercising

What can happen if someone on MAOIs has high tyramine levels?

Can cause a hypertensive crisis

What are foods with tyramine?

1) Aged cheese 2) Dried meats 3) Chocolate 4) Smoked sausage/fish 5) Cough medicine 6) Wine

What are examples of complementary therapies for depressive disorders?

1) ECT 2) Vagal nerve stimulator 3) Light therapy 4) Transcranial magnetic stimulation 5) Exercise (3-5 days/wk) 6) CBT

Name the complementary therapy: Inducing a grand maul seizure for patients experiencing severe depression **NOT 1st line

ECT

Name the complementary therapy for depressive disorders: Wired thread under the skin that sends stimulating signals to the brainstem & then sends signals to different areas of the brain

Vagal nerve stimulator

Name the complementary therapy of depressive disorder: Client stares at a light causing retina stimulation that triggers a release of melatonin & increases serotonin Effective in those that have SAD

Light therapy

What NT does exercise release?

Serotonin

What does CBT do?

Changes negative behaviors and thought patterns

Name the suicidal cue: "I'm going to kill myself"

Overt -- obvious

Name the suicidal cue: "I don't know how much more I can take"

Covert -- beating around the bush

Name the type of loss: Part of life cycle

Necessary

Name the type of loss: A loss of a valued person or item

Actual

Name the type of loss: A loss defined by the client that may not be obvious to others (Ex: loss of a job)

Perceived

Name the type of loss: Losses d/t developmental processes of life

Maturational

Name the type of loss: Unanticipated loss caused by an external event (Ex: car accident or hurricane)

Situational

What is normal grieving?

Incomplicated/achieved by 6 months May experience somatic sx like: chest/back/stomach pain or HA

Name the type of complicated grief: Does not demonstrate normal behaviors of loss, can remain in denial stage for months Ex: Parent w/ child that passed away states "He's coming home soon"

Delayed or inhibited gried

Name the type of complicated grief: Someone w/ somatic sx in addition to grief -- can be exaggerated

Distorted or exaggerated grief

Name the type of complicated grief: Clients remain in denial stage and unable to accept the loss, can result in decreased function to complete ADLs

Prolonged or chronic grief

Name the type of complicated grief: Grief that cannot be shared publicaly or socially Ex: Suicide, abortion

Disenfranchised

Name the type of BPD: -The client has at least 1 episode of mania altering with major depression- more common in men Climb all the way to the top of the mountain and come right back down

BPD I

Name the type of BPD: -the client has 1 or more hypomanic episodes alternating with major depressive episodes- more common in women Get halfway to the top of the mountain and come right back down

BPD II

Name the type of BPD: -the client has at least 2 years of repeated hypomanic manifestations that do not meet the criteria for hypomanic episodes alternating with minor depressive episodes not an extreme manic state but above baseline

Cyclothymia

What are the comorbidities of BPD?

1) Substance use 2) Anxiety 3) Borderline personality disorder 4) ODD 5) Social phobias 6) SAD 7) ADHD 8) Migraines 9) Metabolic syndromes

What are the characteristics of mania?

1) Labile mood with euphoria (major mood fluctuations) 2) Restlessness 3) Can't take criticism 4) Increased talking/activity 5) Flight of ideas 6) Grandiose views 7) Impulsive, demanding, manipulative 8) Attention-seeking behaviors 9) Decreased sleep, ability to do ADLs, visual impairements, denial of illness

What stage of mania: -Hospitalization may be required -Reduction of sx & safety is goal -Risk for harm to self or others -May need 1:1 supervision

Acute

What stage of mania: -Tx 4-9 mos -Relapse prevention through education -Med adherence & psychotherapy = goal

Continuation

Name the stage of mania: -Tx generally continues through pt's life -Prevention of future manic episodes = goal

Maintenance

What are toxic lithium levels?

1.5 - 2.0 (could be lethal > 3.5)

What are signs of lithium toxicity?

1) V/D 2) Slurred speech 3) Weakness 4) Stupor 5) Coma 6) Tremor 7) Seizires

What are therapeutic lithium levels for acute mania?

1.0 - 1.5

What are therapeutic lithium levels for maintence?

0.6 - 1.2

What are the anticonvulsants meds?

1) Valproate (seizures & BPD) 2) Carbamazepine (seizures & BPD) 3) Lamotrigine (depression, but not mania)

What med is used a lot in BPD II that needs to be watched for rashes as a sign of allergic rxn?

Lamotrigine

What benzos are used in BPD?

Clonzaepam Lorazepam

What 2nd gen atypical antipsychotics are used in BPD?

Zyprexa Risperidal

Exam 3 Flashcards

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