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
