Mental Health Flashcards

Question

Dystonia

Answer 1

may occur after single dose or several days involuntary muscle contractions of head and neck (hoarseness, laryngeal spasms) may involve torso and extremities (torticollis, opisthotonons) Tx with anticholinergics or antiparkison meds

Answer 2

after single dose or several weeks later with increase slow pill-rolling movement of hands, cogwheel rigidity, shuffling gait, loss of arm swing "rabbit syndrome": tremor of lips with constant chewing Tx with anticholinergics

Answer 3

Months to years after involuntary rapid movement of face, torso, or extremities. lip smaking Tx: eval q 3-6 months, anticholinergics, antiparkison, remove agent

Answer 4

loxapine chlorpromazine photosensitivity, need CBC, TFTs and urine

Answer 5

``` clozapine Olanzapine Quetiapine Risperidone weight gain common with these ```

Answer 6

``` anorexia bulemia unspecified 3 times higher in women ashamed, embarrassed and guilty ```

Answer 7

biggest risk is that they die suddenly from starvation, cardiac or suicide may have co-morbid mental probs need inpt tx

Answer 8

Bipolar I Bipolar II Cyclothymia

Answer 9

``` can affect occupation men and women equal onset in early childhood up until 40s-50s, not older genetic degree substance abuse 25-50% lifetime suicide risk ```

Answer 10

triggered by adverse event or stressor manic followed by depression tx most often seek with depression can have episodes lasting 3-6 months

Answer 11

manic or mixed episode with one or more depressive episodes

Answer 12

one hypomanic episode, no manic | hx of one or more depressive

Answer 13

numerous episodes of depressed mood, do not meet full criteria for major depression and episodes of hypomania over 2 years

Answer 14

``` D: distractibility I: insomnia G: gradiosity F: flight of ideas A: activities S: pressure speech T: thoughtlessness - spending sprees ```

Answer 15

elevated or irritable mood lasting at least 1 week psychotic features marked impairment in occupational or social fx

Answer 16

distinct period of elevated, expansive or irritable mood lasting at least 4 days similar to manic episodes not severe enough to cause occupation trouble no psychotic features

Answer 17

nearly every day for 1 week criteria for manic episode and major depressive episode met simultaneously severe occupation dysfx sx not attributed to underlying cause

Answer 18

``` score 7 or more is a mod to severe prob assess cognitive (distracted, racing thoughts, increased talking) and behavior ( less sleep, impulsive) ```

Answer 19

``` Lithium + antipsychotic Valporic + antipsychotic Gabapentin Topiramate Benzo ```

Answer 20

``` not normal more common in LTC 80% tx in primary care depression can precede medical issues lead to alcohol and med use ```

Answer 21

PHQ-9 or GDS | during the past month have you felt down or depressed? have you dropped any activities or interests

Answer 22

``` sleep interest guilt energy concentration appetite psychomotor suicide ```

Answer 23

``` insomnia low energy anorexia anhedonia guilt ```

Answer 24

anhedonia or lack of interest and pleasure

Answer 25

``` short duration cog loss or dysfx communication of distress memory gaps for specific events attention and concentration preserved little effort for tasks highlights failures loss of social skills mood changes ```

Answer 26

``` gradual progressive few complaints of cog. loss unconcerned with changes memory gap attention and concentration faulty struggle with tasks delights in trivial accomplishments social skills retained shallow affect ```

Answer 27

grief less likely than depression to be associated wit loss of self-esteem symptoms should lessen in 6 months hospice care = less depression for surviving spouse

Answer 28

frontal lobe disease apathy, lack of motivation can be seen in Alzheimers

Answer 29

chronic disorder of depressive symptoms most days for 2 years but not meeting MDD "Eyore" disorder high risk for developing MDD

Answer 30

more common in older adults delusions/paranoia common hallucination are rare more likely to have dementia sx

Answer 31

white men high risk take seriously asses frequently provider does not put ideas in the minds of others

Answer 32

therapy bright light tx ECT therapy

Answer 33

trial of 4-6 weeks if SSRI's check lab for hyponatremia SSRIs first line (sertaline, citalopram) avoid TCA's (amytriptaline)

Answer 34

Alcohol use | CAGE

Answer 35

Type of dementia progressive and fatal brain disease 7th leading cause of death severe enough to cause probs in every day life

Answer 36

cortex (frontal)- thinking, planning, remembering | hippocampus- formation of memory

Answer 37

``` mild cognitive impairment vascular dementia mixed dementia Lewy Body dementia Parkinson's disease dementia frontotemporal dementia creutzfeldt-jacob disease pressure hydropcephalous Hunningtons Wernicke-Korsakoff ```

Answer 38

``` Age 85 or older family history apolipoprotien E-e4 (APOE-e4) pos = 50% head injury or recent fall CVD ```

Answer 39

``` memory loss affecting job difficulty with familiar tasks language problems not oriented to time or place poor or decreased judgement prob with abstract thinking misplacing things changes in mood or behavior changes in personality loss of initiative ```

Answer 40

``` Have you observed decline in..... remember things that happened recently use the phone travel handle finances take care of personal hygiene ```

Answer 41

``` 2 or more = dementia problems with judgment reduced interest in hobbies/activities repeats self trouble learning to use something forgets month and year difficulty with finances difficulty remembering appointments ```

Answer 42

``` thyroid disease alcohol drug adverse effects vision hearing loss Vit B def. head injury parkinson's disease ```

Answer 43

MMSE Clock test Mini-cog Montreal Cog test

Answer 44

``` takes about 10 minutes and score 0-30 dementia with score 23-24/30 Orientation 10 points Registration 3 pts Attention/calculation 5 points Recall 3 pts Language 9 pts no score diagnostic just suggestive ```

Answer 45

test cognitive such as: comprehension, planning, visual memory, visuopatial ability, motor programing and concentration could be affected by impairment with vision/writing

Answer 46

``` Memory and thinking test give 3 words to remember draw a clock put numbers on the clock set the time recall those 3 words ```

Answer 47

name as many animals in 1 min (18) alternate between letters and numbers executive function= working memory, problem solving, sequencing, resisting distractions

Answer 48

Neuro tests lab tests CT and MRI

Answer 49

``` cranial nerves motor strength tremor/myoclonus reflexes babinski sensory finger to nose praxis (show me how to...comb hair, cut bread) ```

Answer 50

``` BP supine and standing CHF PVD heart rate A fib Carotid bruits ```

Answer 51

``` short steps shuffle lack of arm swing stooped posture small steps wide-based poor tandem ```

Answer 52

``` CBC CMP B12 TSH RPR UA ```

Answer 53

``` Under 60 recent head trauma/seizure NPH normal pressure hydronephrosis Hx cancer or bleeding disorder atypical presentation sudden onset or rapid progression focal neuro signs ```

Answer 54

memory impairment (learn new or recall old) and 1 or more cognitive disturbances significant impairment in social fx gradual onset and continuing decline

Answer 55

Aphasia- language Apraxia - motor activities Agnosia - can't identify objects Executive fx - planning, organizing, sequencing

Answer 56

memory problems noticeable but not compromising independence | continue to eval for AD

Answer 57

history of CVA or TIA stepwise decline localizing neuro signs

Answer 58

``` visual hallucinations fluctuating LOC Parkinsonian motor symptoms falls executive fx worse than memory ```

Answer 59

``` personality changes impulsivity disinhibition self neglect social inappropriate lower ages normally ```

Answer 60

motor symptoms first then dementia

Answer 61

rapid onset and decline | myclonus

Answer 62

wet/wobbly/wacky | gait/balance disturbance, falls, incontinence

Answer 63

1-7 (mild to very severe)

Answer 64

no impairment

Answer 65

very mild decline

Answer 66

mild decline

Answer 67

moderate decline

Answer 68

very severe

Answer 69

should be done every 6 months address caregiver burden assess fx capacity

Answer 70

cholinesterase inhibitors: Aricept, Exelon, Razadyne | NMDA antagonists: Namenda

Answer 71

Donepezil daily dosing 5mg daily x 4-6wks then 10mg daily ODT available at 23 mg for long term dosing S/E: n/diarrhea, vivid dreams, HA, syncope could take in the AM to decrease dreams

Answer 72

``` Rivastigmine 1.5-6mg 2x/day with food transdermal path avail 4.6-9.5mg S/E: n/diarrhea, GI upset, dizziness transdermal patch could have fewer GI sx but mild dermatitis often with PD and LB dementias ```

Answer 73

``` Galantamine 4mg-12mg 2x day ER 8mg daily S/E: n/v/d titrate every 4 weeks take with meals with renal disease 16mg/d is the max ```

Answer 74

Memantine titrate from 5mg-10mg 2x day over 4 weeks indicated for mod to severe AD S/E: dizziness, confusion, constipation give with a-cholinesterase inhibitor to limit GI effects

Answer 75

poor hygiene and grooming difficulty with walking difficulty with visual tasks difficulty with attention, memory and comprehension

Answer 76

give prescription for DO NOT DRIVE point out price of gas have a plan for alt transportation refer to DMV for driver evaluation

Answer 77

``` control risk factors of CVD, hyperlipidemia, DM exercise mental exercise treat depression heart healthy diet ```

Answer 78

often overlooked places a person at risk for other cog. impairment often in ICUs, long term care

Answer 79

disturbed consciousness cognitive changes rapid onset

Answer 80

Hyperactive - agitated/combative Hypoactive - lethargic/confused Mixed

Answer 81

dementia advanced age comorbid condition

Answer 82

``` Meds Infection - UTI, pneumonia, menningitis Metabolic probs - dehydration CV - CHF Neuro - seizure, bleed Renal - retention Endocrine - hyperthyroid, DM fecal impaction, sleep deprivation, postoperative, pain ```

Answer 83

``` Antiparkinsons (carbadopa) Steroids urinary incont meds (detrol) Theophylline antihistamines (benadryl) NSAIDS Narcotics muscle relaxants seizure meds ENT meds - meclizine Abx - quinolones H2 blockers CV meds (dig) ```

Answer 84

growing problems with meds below citalopram for depression then oxybutynin for urinary incont and then cyclobenzaprine major anticholinergic effect

Answer 85

``` CBC BNP LFTs Renal fx albumin glucose TSH ammonia UA O2 sat CT ECG ```

Answer 86

safety family help as sitters remove meds tx underlying causes

Answer 87

P: protocol for sleep, back massage, warm milk R: replenish fluids E: ear aids V: visual aids E: exercise/ambulation N: name person place and time for orientation T: taper or d/c unneeded meds

Answer 88

``` Haldol 0.5-1mg PO reeval in 1-2 hours IM dose would act faster 20-40 min reeval 30-60 min double dose if initial ineffective calculate total effective dose in 24 hours and divide by 1/2 give that dose BID but not if sedated QT prolongation possible ```

Answer 89

Lorazepam .5-2mg IV or PO 1-2 hrs | Add Thiamine 100mg/day IM, IV or PO if due to alcohol

Answer 90

60 and older

Answer 91

Korea and WWII

Answer 92

Agent orange Hep C Malaria PTST

Answer 93

``` blast injuries embedded fragments TBI - traumatic brain amputations loss of vision ```

Answer 94

``` PTSD Depression Suicide High risk behavior substance abuse ```

Answer 95

isolation separation from family continued exposure to injured and life threatening conditions hopelessness

Mental Health Flashcards

(123 cards)