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Clinical Medicine Final Exam > Mental Health > Flashcards

Flashcards in Mental Health Deck (78)
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1

t/f: Mild changes in memory with age are
NORMAL

t

2

define dementia.

a decline in cognition
that interferes with daily life function

3

name 3 types of dementia.

Alzheimer disease (60-80%)
– Vascular/multi-infarct dementia
– Parkinson disease with dementia

4

Dementia is generally __________

progressive

5

Most causes of dementia are
_____________, and thus ____________

neurodegenerative
progressive

6

Vascular dementia is ________________

non-neurodegenerative

7

t/f: Vascular dementia is not reversible

f: – Maybe reversible if the underlying cause is identified
and treated

8

Dementia occurs mostly in:

older age (rate increase)

9

t/f: dementia patients usually don’t state that
they have memory loss

t

10

dementia early stage:

Forgetfulness
altered mood
abnormal thoughts
gets lost easily

11

dementia late stage:

Can’t recognize family, can’t feed self, etc

12

Diagnosis of dementia is mostly based on ________

symptoms

13

Diagnostic and Statistical Manual of Mental
Disorders (DSM)-5:
– Significant cognitive impairment in at least 1 area:

Learning and memory
• Language (aphasia)
• Executive function
• Complex attention
• Perceptual-motor function
• Social cognition

14

Examples of abnormal cognitive function + define.

• Learning and memory:
– trouble remembering events and people

• Language
– Trouble with word finding

• Executive function: Reasoning
– unable to cope with unexpected events

• Complex attention: Handling complex tasks
– Difficulty balancing a checkbook

• Perceptual-motor function: Spatial ability and orientation
– getting lost in familiar places

• Social cognition: Behavior issues
– Socially inappropriate behavior

15

Screening survey can help identify abnormalities (name 2)

Mini-Mental State Examination (MMSE)

Montreal Cognitive Assessment (MoCA)

16

t/f: Diagnostic tests are important to
rule out specific causes of dementia

t

17

Rule out medical conditions that could cause
secondary dementia
(such as ________)

tumor

18

is an MRI or CT preferred for dementia diagnosis?

MRI > CT– controversial, not sufficiently specific

19

Some abnormalities on imaging in dementia include:

• Cerebral atrophy
• Ventricular enlargement
• Ischemic changes/microhemorrhages
*** Can be found in other diseases, eg, CVA

20

Dementia is a cause of ________

death

21

what is the first step in managing dementia?

FIRST, recognize and treat the underlying disease
if present

22

what are non-pharmacologic treatments for dementia?

- Cognitive therapy, occupational therapy
– Lifestyle: healthy diet, exercise
– Avoid alcohol

23

what are pharmacologic treatments for dementia?

• Cholinesterase inhibitors:
– Aid in early/moderate dementia to improve
memory

- N-methyl-D-aspartate (NMDA) receptor
antagonist: – Better in moderate/severe dementia

24

________ disease is the most
common form of dementia

Alzheimer disease is the most
common form of dementia

25

Alzheimer disease is definitively diagnosed ________

post-mortem

26

what is the pathophysiology of Alzheimers?

inflammatory neural plaques- composed of amyloid-beta protein + neurofibrillary tangles (tau)

accumulate in the cortex and cerebral blood
vessels (injury)

27

where do neuronal injuries first occur in Alzheimer's

higher cortical function
areas:

28

higher cortical function
areas are responsible for:

memory,
speech,
executive function
(eg, complex thinking, multitasking, social behavior, insight into behavior)

29

_______ and _______functions are preserved
until later in alzheimers disease

Sensory + motor

30

t/f: Alzheimer can be genetic, but
usually isn’t

t

31

Advanced Alzheimer causes
significant:

alterations in
cognition and bodily functions

32

Alzheimer Sp:

Can’t recognize faces
• Can’t perform daily
activities (trouble combing
hair, feeding self, etc)
• Neuropsychiatric symptoms
(apathy, social
disengagement,
disinhibition)

33

Alzheimer Si:

• Seizures
• Chronic dehydration
• Infection
• Malnutrition

34

t/f: Management of Alzheimer is the same as management
for dementia from other
causes

t

35

name 5 types of depression.

– Unipolar/Major/Clinical **
– Bipolar
– “Pseudodementia”
– Postpartum
– Psychotic

36

The cause of unipolar depression
is ________

unknown

37

what are depression internal factors?

genetics, personality, history

38

what are depression external factors?

substance use, conduct

39

define depression

Depression is associated with many neurobiological changes; however, it is not clear if
these changes represent etiologic causes,
sequelae, both, or neither

40

t/f: males are diagnosed with depression twice as often as females

Female >> males by 2 times

41

Depression causes a variety of
symptoms: 9

• Depressed mood most of the day
• Decreased interest
• Appetite change/weight change
• Sleep disturbances
• Agitation
• Fatigue or low energy
• Poor concentration
• Thoughts of worthlessness
• Thoughts of death or suicidal ideation

42

Signs of depression are based on

observation of affect

43

Affect =

how we evaluate someone's mood in the exam

44

name 3 signs of depression.

– "Flat" affect = minimal expressions
– Sad
– Irritated

45

t/f: Depression is difficult to confirm

t

46

The biggest risk of
depression is ________

suicide

47

what can be useful to help diagnose depression

screening tools

48

what are 4 management options for depression?

* Manage underlying cause (if present)
• Medication
• Cognitive behavior therapy
• Exercise

49

Medication for depression is
extremely common: 6

- (SSRIs)
- Dopamine/Norepinephrine-Reuptake Inhibitor
- (SNRIs)
- serotonin modulators
- TCAs
Monoamine oxidase inhibitors

50

Bipolar disorder is characterized by

multiple mood types

51

name 4 bipolar mood types.

• Mania: unusually good, euphoric, or high mood with
disinhibitions

• Hypomania: Less severe mania

• Major depression

• Psychosis can occur during mania or depression
(not hypomania)
– Delusions of grandeur or hallucinations

52

Bipolar can result in societal issues: 4

• Suicide
• Violence
• Social isolation
• Legal issues

53

Bipolar has ______ + ______
treatments

acute and chronic

54

bipolar pharmacological treatment:

– Antimanic
– Anticonvulsants
– Antipsychotics
– Anti-depressants

55

what is one of the most common mental health disorders?

anxiety

56

t/f: anxiety is potentially chronic

t

57

Anxiety is also more common in ______

women

58

______+ _______ are often comorbid

Anxiety and depression

59

Anxiety is characterized by

excessive worry

60

name 4 symptoms of anxiety.

Restlessness
• Irritability
• Fatigue and sleep disturbances
• Muscle tension

61

what can be helpful in diagnosing anxiety?

screening tools, but diagnosis is based on symptoms

62

Some patients with anxiety also have secondary mental health disorders: 2

• Social phobia
• Panic disorder

63

Treatment of anxiety is similar to depression: 4

• Cognitive behavioral therapy

• Medications
– [SSRI], [SNRI])

• Benzodiazepines are unique for anxiety

• Other treatments are also helpful, such as
herbs and other therapy

64

t/f: adhd is more common in boys

t

65

what is one of the most common conditions of childhood?

ADHD

66

name two si/sp of children?

Hyperactivity:
– Fidgetiness/Restlessness
– Excessive talking/interruptions
• Inattention

67

name two si/sp of adults?

• Less hyperactivity, more inattention
• Deficits in executive function
• Emotional dysregulation

68

how is adhd managed?

Manage underlying cause (if present)
• Medication
• Behavioral intervention (mostly for kids)
– Home and school

69

define delirium.

Delirium has an acute onset but may last hours to weeks

Difficulty with attention and concentration
• Changes in level of consciousness

– Poor concentration - confusion - stupor

• Fluctuation in signs

70

Delirium is usually secondary to other causes, such as:

Medical conditions
• Medications adverse effects
• Substance abuse

71

t/f: Delirium is often misdiagnosed

t: Delirium is classified as altered consciousness,
but it's often misdiagnosed as memory
loss/dementia

72

how is Schizophrenia characterized? what can it lead to?

Characterized by psychosis
• Can lead to suicide

73

t/f: Schizophrenia is a syndrome that has many different
psychopathologies

t

74

Schizophrenia + symptoms:

Hallucinations, delusions, disorganization

75

Schizophrenia - symptoms:

– Flat affect, catatonia

76

t/f: Schizophrenia can have cognition impairments

t

77

what is the first-line treatment for Schizophrenia

Antipsychotic medication

78

Ocular side effects of anticholinergic medications

* Dry eye
– Visual disturbances
– Mydriasis
– Paralysis of accommodation