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Flashcards in Test 1 Deck (211):
1

s/s of generalized anxiety disorder

excessive worry, restlessness, irritability for at least 6 months

2

benzos work by increasing

GABA activity

3

typical pharm trx for GAD

antidepressant & benzo

4

risks of benzos

dependence, rebound insomnia

5

common side effects of antidepressants

weight gain and sexual dysfunction

6

complications of antidepressants in elderly

hyponatremia, hypercoagulation, osteoporosis, serotonin syndrome

7

buspirone is only approved for treatment of

generalized anxiety disorder

8

TCAs are not first line for generalized anxiety disorder because

high risk of cardiac dysrhythmias and lethal overdose

9

s/s of anxiety in children

diminished interest, social withdrawal

10

s/s of anxiety in adolescents

anger & obedience

11

characteristics of panic disorder

palpitations, shaking, sweating, SOB that peak in 10 minutes and then go away

12

characterized by excessive fears of scrutiny, embarrassment and humiliation in social or performance situations, leading to significant distress and/or impairment in functioning

social phobia

13

treatment for phobias

CBT, desensitization

14

A diagnosis of PTSD is made only after

a month has passed since traumatic event

15

treatment for OCD

CBT & SSRI

16

progressive cognitive decline mostly seen in those > 65

alzheimer's dementia

17

dementia correlated with CVA

vascular dementia

18

dementia with fluctuating cognition associated with parkinsonism, hallucinations and delusions, gait difficulties, and falls.

Lewy body dementia

19

dementia with language difficulties, personality changes, and behavioral disturbances

frontotemporal dementia

20

these is no evidence that these prevent the onset of dementia

statins

21

rule these out when diagnosing alzheimer's dementia

thyroid disease, vit B12 deficiency, depression

22

treatment for mild dementia

cholinesterase inhibitors

23

cholinesterase inhibitors

donepezil (Aricept) and rivastigmine (Exelon)

24

treatment for moderate to severe dementia

cholinesterase inhibitors, Namenda, or antipsychotics

25

Acute neurologic complication of illness and/or medication, especially common in older patients, manifested by new confusion and impaired attention.

delirium

26

difference between delirium and dementia

delirium is acute, dementia is chronic and progressive

27

characteristics of autism

ineffective social skills, inability to sustain conversation, repetitive behaviors

28

environmental need for autistic child

structured educational program with a routine.

29

early signs of autism are present by

18 months of age

30

red flags for autism are

don't respond to name being called by 1 year old, no single word by 16 months

31

screen for autism in ALL children at

18-24 months of age

32

stages of grief

denial, anger, bargaining, depression, acceptance

33

low levels of this neurotransmitter is associated with depression

serotonin

34

dosage for escitalopram (Lexapro)

5-20 mg

35

dosage for citalopram (celexa)

10-40 mg

36

dosage for sertraline (zoloft)

50-200 mg

37

dosing for paroxetine (paxil)

20-60 mg

38

dosing for fluoxetine (prozac)

10-80 mg

39

SNRIs

venlaxafine (Effexor) and duloxetine (Cymbalta)

40

dosing for venlaxafine (Effexor)

75-373 mg

41

dosing for duloxetine (Cymbalta)

20-60 mg

42

dosing for buproprion (Wellbutrin)

200-450 mg

43

antidepressants should be continued for

6-9 months

44

lifelong trx of antidepressants are needed if

more than 3 depressive episodes

45

s/s of serotonin syndrome

confusion, hyperreflexia, fever, myoclonus

46

differences between depression and dementia

dementia has a slower decline in function; depression occurs more rapidly with a fluctuating course

47

suicide screening

o Thoughts of suicide
o Plan to commit suicide
o Means to complete the plan
o Intention to follow through with the plan

48

one or more manic or mixed episodes during a patient’s lifetime

bipolar I

49

at least one major depressive episode are met in addition to at least one hypomanic episode

bipolar II

50

the onset of bipolar is at ages ____ with initial episodes of _____

15-30; depression

51

manic episode lasts usually

one week

52

people with bipolar have a high risk of

substance abuse and suicide

53

antidepressants in a bipolar patient can

cause them to switch from a depressed to manic mood

54

mood stabilizers for bipolar

lithium, lamotrigine, valproate

55

baseline lab before starting lithium

TSH and calcium

56

lamotrigine for bipolar has a high risk of developing

skin rash and SJS

57

complications of anorexia

hypotension, bradycardia, hypothermia, amenorrhea

58

heart complication d/t anorexia

mitral valve prolapse

59

ECG findings in anorexic patients

usually normal except for bradycardia

60

xerosis is seen in

anorexia (dry, scaly skin)

61

lab results in anorexia

leukopenia, high BUN, high cholesterol, low estrogen

62

med for anorexia

olanzapine

63

first line trx for anorexia

nutritional rehab and psychotherapy

64

complications of anorexia

high LFT, superior mesenteric artery syndrome, acute pancreatitis

65

anorexia has a ____ body weight and bulimia has a ____ body weight

low; normal

66

in anorexia, the HR is ____, in bulimia the HR is _____.

low; high

67

bulimia is characterized as binge-eating and compensatory behaviors at least

once a week for 3 months

68

s/s of bulimia

tachycardia, hypotension, parotid gland swelling, and dental erosion

69

bulimia has a high risk for

diabetes

70

first line therapy for bulimia

fluoxetine

71

this is contraindicated in both anorexia and bulimia as it can cause seizures

buproprion (wellbutrin)

72

mandatory reporting for

elder and child abuse/neglect`

73

Regardless of the gender identity of the patient, physical exams should be based on

the organs present.

74

In transgender patients, it is important to assess and treat for

cardiovascular disorders d/t hormone intake

75

annual screening should be done in men who have sex with men

HIV, syphilis, chlamydia, gonorrhea

76

treatment for those with hypoactive sexual disorder

testosterone patch for buproprion

77

meds that can cause erectile dysfunction

antihypertensives, antidepressants

78

PDE-5 inhibitors for ED are contraindicated in those

taking nitrates

79

PDE5 inhibitors

sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis)

80

teaching for sildenafil (Viagra) and vardenafil (Levitra)

effective for short periods and have to be taken on an empty stomach

81

patients with dysparenuria should have

a pelvic exam and pap

82

characterized by excessive daytime sleepiness and inappropriate manifestations of REM sleep.

narcolepsy

83

undesirable physical events or experiences that occur during entry in sleep.

parasomnias

84

one type of REM sleep parasomnia

REM sleep behavior disorder

85

when patient physically act out vivid, often unpleasant dreams with vocal sounds and sudden, often violent arm and leg movements during REM sleep

REM sleep behavior disorder

86

REM sleep behavior disorder occurs in

men greater than 50

87

inhalants cause

drowsiness, dizziness, slurred speech

88

major hazard of nitrous oxide inhalation is

anoxia

89

cocaine properties

CNS stimulant

90

cocaine dependence can cause

seizures and arrythmias

91

and increase in GABA causes

sedation

92

intoxication is a BAC

greater than 0.10%

93

DTs develop within ____hour of the last drink

24-72

94

benzos facilitate the action of

GABA

95

causes of carotid sinus syncope

tight collars, shaving, head turning

96

causes of situational syncope

micturition, coughing, swallowing

97

meds that can cause syncope

ACEI, beta blockers, sulfa, quinolones

98

positive orthostatics if

more than 20 mmHg change in systolic, 10 mmHg change in diastolic, or more than 20 bpm in HR

99

how to stabilize after syncope

place supine, loosen clothing, turn patient's head to the side

100

peripheral disorders that can cause dizziness

labryinthitis, benign positional vertigo, Meniere's disease, any inner ear disorder

101

central disorders that can cause dizziness

TIA/CVA, multiple sclerosis, tumor

102

hallmarks of a peripheral lesion r/t dizziness

nausea, normal neurologic exam, position related

103

hallmarks of a central lesion r/t dizziness

abnormal neurologic exam

104

clinical test for positional vertigo

HallPike-Dix

105

caution with anticholinergics as it can cause

drowsiness, urinary retention, and confusion in elderly

106

POUND with migraine

pulsating or throbbing
one day duration 4-72 hours
unilateral
nausea
disturbance in everyday activities

107

alleviating factors in migraine with/without aura

quiet room with eyes closed

108

triggers to migraines

stress, weather, cheese, chocolate, alcohol, hormonal changes

109

prodrome phase of migraines

irritability, fatigue, food cravings

110

______ is common with migrainers

fibromyalgia

111

when further investigation is needed for HA

age greater than 50, decreased DTR, personality change

112

preventative therapy for migraines

anticonvulsant, CCB, beta blocker, antidepressant

113

abortive therapy for migraines

triptans, NSAIDs, corticosteroids

114

meds for abortive therapy for migraines should be limited to

use of 2 days or less as it can cause rebound headache.

115

tension headache is described as

tight band around the head

116

cluster headache characteristics

reaches intensity in 15 minutes, patient cannot sit still, severe pain

117

those with cluster headaches have a high risk of

suicide

118

other features that can occur with cluster headaches

ipsilateral conjunctival injection, lacrimation, rhinorrhea

119

preventative therapy for cluster headaches

verapamil and lithium

120

abortive therapy for cluster headaches

oxygen at 7L/min, triptans

121

vasculitis of large and medium vessels

temporal arteritis

122

risk factor for temporal arteritis

age greater than 50

123

s/s of temporal arteritis

fever, weight loss, temporal headache, jaw pain, visual changes

124

diagnostics for temporal arteritis

CRP and ESR

125

treatment for temporal arteritis

glucocorticoids, baby ASA

126

benign, chronic tremor of the upper extremities or head. The legs are NOT involved

essential tremor

127

when the tremor is accentuated as the hand approaches a given target

essential tremor

128

in essential tremor, the tremor disappears during

sleep or when drinking alochol

129

trx for essential tremor

propranolol

130

complication of essential tremor

alcoholism

131

most common cause of resting tremor

parkinson's

132

resting tremor disappears when

movement is voluntary

133

intention tremor is caused by

multiple sclerosis and stroke

134

in intention tremor, the tremor increases as

it moves hand closer to target

135

physical exam of tremor includes

when it’s fully supported at rest, when the limb is elevated against gravity, and during goal-directed movements.

136

Wilson's disease is

autosomal recessive

137

Wilson's disease is an impairment of

copper

138

Wilson's disease tremor

asymmetrical tremor

139

partial seizures involve

only a portion of the brain

140

when the patient has deja vu, hallucination, or activity of an arm or leg that doesn't cause a loss of consciousness

simple partial seizure

141

when the patient stares into space and either remains motionless or engages in repetitive behaviors (lip smacking, chewing, etc).

complex partial seizure

142

generalized seizures involve

both hemispheres of the brain

143

nonconvulsive generalized seizure

absence (petit mal)
atonic (drop attacks)

144

convulsive generalized seizure

myoclonic
tonic-clonic

145

caution with antiepileptic drugs as they have interactions with

warfarin, antibiotics, and oral contraceptives

146

education with antiepileptics

- don't switch between brand name and generic
- can increase suicide thougts

147

Most common neuro disorders in children with a systemic viral or bacterial infection.

febrile seizure

148

risk factor for febrile seizure

age, viral infection, recent immunization

149

simple febrile seizure

last less than 15 min once in a 24-hour period

150

complex febrile seizure

last more than 15 min more than once in 24 hours

151

Lumbar puncture in children with febrile seizures

unnecessary if the child returns to baseline

152

Do not treat patients with febrile seizures with

antiepilectic drugs

153

to obtain a driver's license, there is no evidence of clinical seizures in a

3 month period prior to medical review

154

is the doctor held liable for their recommendation on the patient for obtaining driver's license?

no

155

seizure free restriction of ____ months is needed to drive in Texas

6 months

156

Chronic progressive inflammatory and neurodegenerative disease affecting the CNS.

multiple sclerosis

157

s/s of multiple sclerosis

paresthesia, limb weakness, increased DTR, unsteady gait, nystagmus

158

diagnostic of multiple sclerosis

MRI

159

trx for multiple sclerosis

disease modifying therapy: interferons

160

prognosis for multiple sclerosis

capable of living a regular life for 15-20 years

161

clinical features of parkinson's

resting tremor, bradykinesia, rigidity, postural instability

162

parkinson's is caused by

low dopamine

163

the goal of trx for parkinson's is to

maximize functional ability. you cannot slow the progression of the disease

164

complications of parkinson's

psychosis, dementia, depression

165

TIAs are

acute ischemic deficits that last less than 24 hours

166

most common causes of meningitis in adults and children

N. meningitides and Strep pneumoniae

167

presentation of meningitis

fever, headache, stiff neck

168

is present if the patient resists passive knee extension when the hip is fully flexed.

kernig sign

169

present if a patient actively flexes the hips when the neck is passively flexed.

Brudzinski sign

170

LP in meningitis shows

very high WBC and protein, high glucose, and positive gram stain

171

encephalitis is caused by

herpes virus, west nile, adenovirus, enterovirus, mumps/measles

172

difference b/t meningitis and encephalitis

normal mental status in meningitis; encephalitis has altered mental status

173

LP in encephalitis

high WBC and protein, normal glucose, neg gram stain

174

this has been effective in lowering in the meningitis rate

Hib vaccine

175

when meningitis vaccine is given

11-12 and college freshman

176

acute inflammation of the facial nerve

bell's palsy

177

goal of bell's palsy trx

protection of the eye

178

higher risk of bell's palsy in

pregnancy

179

bell's palsy affects CN

VII

180

trigeminal neuralgia affects CN

V

181

trigeminal neuralgia characterisitscs

burning, sharp pain to one side of the face

182

trigeminal neuralgia can be exacerbated by

chewing, talking, facial movement, weather

183

trigeminal neuralgia trx

anticonvulsant

184

Characterized by rapid, progressive, and symmetric loss of motor function

GBS

185

causes of GBS

occurs 1-4 weeks after a URI and GI infection.

186

characteristics of GBS

numbness/tingling in lower limbs that works up.

187

complication of GBS

decline in respiratory status

188

initial diagnostics for GBS

peak flow meter and pulse ox.

189

hydrocele in an infant resolves at

1 year of age

190

characteristics of muscle dystrophy

muscle weakness, normal intellect

191

age when toddler should walk independently

12-14 months

192

risk factors for hydrocephaly

prematurity, meningitis, intrauterine infection

193

what child should do at 6-8 months

wave bye, sit up without support

194

newborn jaundice that occurs less than 12 hours old indicates

ABO incompatibility

195

how long should child remain in "time out"

1 min for each year of life

196

should a 2 year old with asthma receive the Flu-mist vaccine?

no

197

a child should not delay immunizations when

they are being treated with atbx

198

anterior fontanel closes at

9-14 months

199

the posterior fontanel closes at

4 months

200

age to use "time out" as a discipline method

18 month-2 years

201

a childhood immunization that is likely to cause a fever

pneumococcal

202

at what age should a child be to ride a tricycle?

3 years old

203

children should not receive tetracycline before

9 years of age

204

when should children be able to tie their shoes?

6-7 years

205

when should children be able to voice that they are hungry, cold, tired, etc

4 years old

206

a newborn loses up to ___% of birth weight in the first week of life

10

207

Fluoroquinolones should be not be given before

18 years of age

208

sulfa drugs should not be prescribed before

2 months of age

209

Wernicke encephalopathy is caused by

thiamine deficiency

210

rotten teeth is associated with

methamphetamines

211

alcohol withdrawal is associated with

clonidine