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PMHNP > items from lecture for 8003 final > Flashcards

items from lecture for 8003 final Flashcards

1
Q

serotonin is made and synthesized in the

A

raphe nuclei and axon terminal

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2
Q

precursor to serotonin is

A

tryptophan

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3
Q

classic conditioning

A

results from the repeated pairing of a neutral (conditioned) stimulus with one that evokes a response (unconditioned) stimulus ( pavlovs dogs rang bell and conditioned dogs to salivate when thinking they will be fed).
Ultimately neutral stimulus evokes a response- think Pavlov’s dogs

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4
Q

operant conditioning

A

BF Skinner
Learning occurs as a result of an action

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5
Q

Social learning theory

A

Bandura
o Combine operant and classical conditioning theories
o Reciprocal determinism: behavior results from interaction between cognitive and environmental factors
o Self-efficacy: capacity to adapt to threatening situations as well as normal everyday activities
o Modeling behavior

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6
Q

cognitive dissonance

A

inconsistency among a person’s beliefs, knowledge, and behavior

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7
Q

attribution theory

A

: focus on how persons perceive the causes of behavior

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8
Q

Neurophysiology of learning: Hull

A

drive reduction theory of learning

contributions:

homeostasis,

humans are drawn to behaviors that can help them achieve physical and mental equilibrium.

motivation comes from your biological need.

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9
Q

neurophysiology of learning: Kandel

A

nobel for habituation and sensitization significant contributions

led to changes in sensory pathways and the changes parallel memory process

gave rise to thinking about memory storage

connections have a definite plan but can be altered by experience

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10
Q

neurophysiology of learning: Habituation

A

think desensitization

loss of behavioral response

become non threatening

simplest type of learning

NMDA receptors

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11
Q

Memory: Foundations for learning is in the

A

hippocampus cortex and cerebellum

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12
Q

Memory: Learning starts when the

A

sense take in a stimulus from the environment

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13
Q

Memory: Stimulus transformed into

A

memory trace or memory link

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14
Q

Memory: Electrical impulse passes through a neuron allows

A

expression, thought, movement, and behavior towards a stimulus

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15
Q

Memory: all of this results when

A

Connections between synapses are formed continuously in our brains.

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16
Q

Somatic symptoms:

  1. Neurological
A

head traum

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17
Q

Somatic symptoms:

  1. Endocrine:
A

hypothyroid

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18
Q

Somatic symptoms:

  1. Metabolic and systemic:
A

uremia

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19
Q

Somatic symptoms:

  1. Toxic:
A

intoxication

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20
Q

Somatic symptoms:

  1. Nutritional:
A

vitamin b12 deficiency

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21
Q

Somatic symptoms:
6. Infectious:

A

viral hepatitis

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22
Q

Somatic symptoms:
Autoimmune:

A

SLE

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23
Q

Somatic symptoms:

  1. Neoplastic:
A

endocrine tumors

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24
Q

Bleuler 4 As

A

● Association (looseness of)
○ Thoughts are not organized well. No good stream of conscious thought
● Affective disturbances - flat affect
● Autism
○ Social awkwardness - inability to read or give appropriate social cues
● Ambivalence
○ General emotional neutrality about matters

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25
Q

The neuropathological basis for schizophrenia involves the

A

limbic systeml

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26
Q

limbic system always refers to

A

to primitive and basic functions of the brain

think hallucinations (positive symptoms)

and basal ganglia

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27
Q

Schizophrenia induces abnormalities in the

A

cerebral cortex, thalamus, and brainstem

28
Q

schizophrenia is a

A

disease of the brain

a thought disorder

29
Q

early onset risk factors for schizophrenia

A

● Having a family history of schizophrenia
● Increased immune system activation, such as from inflammation
● Older age of the father
● Some pregnancy and birth complications, such as malnutrition or exposure to toxins or viruses that may impact brain development
● Taking mind-altering (psychoactive) drugs during teen years

30
Q

Schizophrenia dx
Two or more of the following each present for significant portion during 1 month period ( or less if successfully treated) at least one of these should be 1-3

A
  1. Delusions
  2. Hallucinations
  3. Disorganized speech
  4. Grossly abnormal psychomotor behavior such as catatonia
  5. Negative symptoms (restricted affect or avolition/asociality)
31
Q

Schizophrenia
onset in children is:
often are:
Often do:

A

-schizophrenia onset is insidious (slow and gradual)
-Children often socially rejected and have limited social skills
-Some do poorly in school despite normal intelligence

32
Q

Schizophrenia good prognosis factors

A

-late and acute onset- if after age 30 generally brief and good prognosis may not return
-married
-Good support system
-positive symptoms ( seeing things or hearing things)

33
Q

Schizophrenia poor prognosis factors

A

young onset
insidious onset: slow/gradual

34
Q

boys vs girls depression prevalence

A

Depression is significantly more common in boys under the age of 10. But by age 16, girls have a greater incidence of depression.

35
Q

depression etiology

A

Biological factors
-monoamine neurotransmitters- norepinephrine, dopamine, serotonin, and histamine

36
Q

Prognosis of SSD somatic symptom disorder:

A

prognosis of SSD varies.

chronic

relapsing disorder that usually doesnt remit (wax and wane)

80% chance of being dx again 5 yrs laster with same type of presentation

37
Q

SSD in DSM

A

new dx

multiple current somatic symptoms disrupting daily life or are distressing

one severe sx: pain

38
Q

etiology of OCD

A

environmental: negative events in childhood

genetic dysfunction in orbitofrontal cortex, anterior cingulate cortex, and striatum implicated

39
Q

gender and ocd characteristic

A

males more likely to have comorbid tic disorder with OCD

40
Q

obsession vs compulsion

A

obsession we do with our minds (thoughts)

compulsion we do with our body (behaviors)

41
Q

recognizing ocd is about

A

control and acceptance

42
Q

12 mo prevalence of GAD in US

A

0.9% adolescents and 2.9% adults

43
Q

gender and GAD

A

female 2x male

44
Q

GAD most often coexists with

A

another mental disorder, phobia, or depressive disorder

45
Q

HPA affects disorders

A

mood disorders
PTSD
dementia
SUD

46
Q

panic disorder sx

A

derealization
feelings of unreality
depersonalization being detached from ones self

47
Q

most children ouotgrow separation anxiety by

A

3

48
Q

selective mutism usually starts

A

before 5yo

49
Q

2 major amino acid neurotransmitters

A

GABA and glutamate

50
Q

Cluster B personality. Most common in outpatient (4)

A

Antisocial PD
Borderline PD
Histrionic PD
Narcissistic PD

51
Q

Antisocial PD

A

Prison
general disregard and violation of rights of others

very transactional relationships

52
Q

Borderline PD

A

often see self harm or suicide

great insecurity and fear of abandonment

strong boundaries

53
Q

Histrionic PD

A

major drama all the time

amplified more drama than BPD

center of attention

54
Q

Narcissistic PD

A

Trump

extreme negative reactions to criticism

elevated sense of self importance

difficulty showing empathy or remorse

reality is an extremity insecure person reacting

55
Q

cluster b onset must

A

onset in adolescents or early adulthood

sx stable over time and lead to distress

56
Q

PD and comorbidity

A

50% who meet criteria for one will meet criteria for another

can be paired with at least one other disorder
Bipolar
SUD
Eating

57
Q

differentiate lewy body from other dementia

A

acting out dreams in sleep and known for visual hallucinations

58
Q

best known questionnaire for informant for dementia

A

IQCODE

59
Q

differentiate delirium from dementia

A

delerium :
rapid onset
fluctuates throughout the day

60
Q

PTSD major criterion for dx

A

A: stressor
B: intrusion sx
C: avoidance
D: negative alterations in cognitions and mood
E: alterations in arousal and reactivity
F: Duration more than 1 mo
G: functional significance (distress/impair)
H: Exclusion

61
Q

PTSD 2 specifications

A

Dissociative: criteria met but also high level of depersonalization or derealization

Delayed (full criteria not met til at least 6 mo)

62
Q

4 main structures of limbic system

A

amygdala, hippocampus, regions of the limbic cortex, septal area

primitive

63
Q

cluster A PD broad description

A

street personality

odd weird people

often misdiagnosed as autism

Paranoid, Schizoid, Schizotypal

64
Q

cluster B PD broad description

A

most common in outpatient

Antisocial, borderline, histrionic, narcissistic

65
Q

labs for carbamazepine (tegretol) or Depakote

A

annual LFT with serum drug level

66
Q

Tourette dx

A

2+ motor tics
sx for 1+ yr
onset before 18

67
Q

areas that play a significant role in depression

A

amygdala, the thalamus, and the hippocampus

PMHNP (24 decks)

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