PSYCHOSOCIAL DISORDERS Flashcards Preview

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Flashcards in PSYCHOSOCIAL DISORDERS Deck (45):
1

Dysthymia define

chronic form of depression lasting at least 2, and frequently more, years

2

example of stable causality

"it will always be this way"
cognitive cause of depression

3

example of global thinking

"everything is ruined"
cognitive cause of depression

4

What is the DSM5 criteria for depression

person must have 5 or more of the following symptoms for the same 2 weeks period and represent a change in previous functioning

5

What must be present in depression

depressed mood most of the day, nearly every day AND/OR
Markedly diminished interest or pleasure in almost all activities (anhedonia)

6

What is anhedonia

markedly diminished interest or pleasure in almost all activities

7

In sad cages of depression

sleep disturbances
appetite changes
depressed mood
concentration difficulty
activity: agitation/ retardation
Guilt feelings or low self esteem
energy loss
suicidal ideation

8

Initial tests in depression

TSH, BMP, CBC, LFTs, U/A, VDRL, B12, ect.)

9

What are some SSRIs (selective serotonin reuptake inhibitors)

most common:
Paroxetine (paxil)
Fluoxetine (prozac)
Sertraline (Zoloft)
Citalopram (celexa)
Fluvoxamine (Luvox)

10

What are some reasons SSRIs are preferred

low overdose danger, fast symptom response, no postural hypotension

11

concerns of tricyclic antidepressants

anticholingergic effects such as dry mouth and constipation and QT prolongation

12

Concerns with MAOIs

wine and cheese= hypertensive crisis

13

Common RXd TCAs

amitriptyline
Nortriptyline (pamelor)
imipramine (tofranil)

14

common RXd MAOIs

rasagiline (azilect)
phenelizine (nardil)

15

Generalized anxiety disorder

excessive worry/ anxiety about life circumstances

16

Panic disorder

morbid dread of seemingly harmless object/ situation; may lead to agoraphobia

17

Obsessive compulsive disorder

repetitive thoughts (obsession) that a person is unable to control and/or urge to perform an act that cannot be resisted without great difficulty (compulsion) which interferes with normal ADLs

18

PTSD

Having anxiety for at least 6 months after a severe trauma/ event perceived as a threat to ones integrity-characterized by flashbacks, nightmares and intrusive thoughts

19

Antianxiety medications

benzodiazepines: ativan 1mg HS
Antihistamines: For those with COPD or potential for abuse
Bet blockers: To reduce tachycardia, palpitations, and breathlessness
tricyclics and MAOIs: May be beneficial for panic attacks but less efficacious for generalized anxiety
Buspirone (buspar) only anti anxiety medication not classified as a tranquilizer, takes 3 to 4 weeks to reach full therapeutic effects (SE nausea, sweating)

20

What do you RX for psychosis

antipsychotics
typical: haloperidol
atypical: risperidone, quetiapine (seroquel), olanzapine (zyprexa) aripiprazole (abilify)

21

what should you expect with atypical antipsychotics

significant weight gain

22

What might be the major reasons for suicide in the elderly that should be targeted in tx

loneliness and medical disability

23

What screening test for alcoholism?

CAGE screening. If 2 or more is a positive

24

What are the components of the cage screening?

C: Have you ever felt the need to cut down on your drinking?
A: Have people annoyed you by criticizing your drinking?
G: Have you ever felt guilty about your drinking?
E: Have you ever had a drink first thing in the morning to steady your nerves or her rid of a hangover?

25

Mini mental status exam components

orientation to time and place
recognition (repeat 3 objects)
attention (serial 7 counting backwards)
Recall (ask to recall 3 objects 5 minutes later)
language
Identify names of 2 objects
follow 3 step command
Reading
writing
drawing

26

What does the mental status assessment test for (mini-mental status)?

Cerebral function

27

What is the cerebral function?

senses and functioning

28

What is the scoring of the mental status exam (cerebral function)

Maximum:30
no cognitive impairment: 24-30
Delirium/dementia: 18-23 (mild impairment), 0-7 (severe impairment)

29

What is impaired in delirium/ dementia?

cerebral functioning

30

Define delirium

SUDDEN, TRANSIENT onset of clouded sensorium, may occur at any age. Associated with a physical stressor
REVERSABLE

31

Define dementia

Neurocognitive disorder. GRADUAL memory loss with decreased intellectual functioning usually occurring over the age of 60

32

Causes of delirium

toxins, ETOH or drugs, trauma, impactions in the elderly, poor nutrition, electrolyte imbalances, anesthesia

33

causes of dementia

Atherosclerosis
neurotransmitter deficits
cortical atrophy
ventricular dilation
loss of brain cells
possible viral causes
alz disease

34

DEMENTIA to rule out other diseases indicative of dementia

D: Drug reactions/ interactions
E: emotional disorders
M: metabolic/ endocrine disorders
E: eye and ear disorders
N: nutritional problems
T: tumors
I: infection
A: arteriosclerosis

35

define alzheimers disease

the development of multiple cognitive defects characterized by both memory impairment (impaired ability to learn new information and recall previously learned information) and one or more of the following:
Aphasia, apraxia, agnosia, inability to plan, organize, sequence, and make abstract differences

36

aphasia

difficulty with speech

37

apraxia

inability to perform a previously learned task

38

agnosia

inability to recognize an object

39

What kind of deficiency in ALZ

acetylcholine

40

Management of ALZ

neuro consult
medications to increase availability of acetylecholine

41

medications to increase the availability of acetylcholine

acetylcholinesterase inhibitors
Donepezil (aricept)
Galantamine (Razadyne)
Rivastigmine (exelon)
OFTEN RX with NMDA receptor antagonist such as memantine (named) to improve thinking and ADLs

42

What is the cerebellum responsible for?

balance and coordination

43

Assessment for cerebellar functioning

Romberg test, finger to nose test, heel-to-shin test

44

Romberg test

evaluates proprioception and cerebellar function
ask patient to stand FEET TOGETHER, EYES CLOSED, and ARMS AT THE SIDE
Positive romberg if the patient has a loss in balance

45

what feeling might differentiate a tic disorder from an anxiety disorder OCD?

feelings of dread