Unit 2 - Cognition, Mood, Affect

Question 1

include disorders with a deficit in cognition or memory that causes a significant change from a previous level of functioning

Answer 1

Neurocognitive Disorders (NCD’s)

Question 2

Mild NCD is also called…

Answer 2

mild cognitive impairment

Question 3

Major NCD was previously described as _____ in the DSM 4-TR

Answer 3

Dementia

Question 4

NCD due to _____ is the most common

Answer 4

Alzheimer’s

Question 5

How does NCD differ from Delirium?

Answer 5

NCD: chronic & permanent
Delirium: Acute & can be treated though it can cause NCD

Question 6

Characterized by a disturbance of attention and awareness and a change in cognition that develops over a short period

Answer 6

Delirium

Question 7

Delirium can have a slower onset if underlying etiology is…

Answer 7

systemic illness or metabolic imbalance

Question 8

_____ subsides completely upon recovery from underlying determinant

Answer 8

Delirium

Question 9

The patient is very distractible and has to be repeatedly reminded to focus attention. Disorganized thinking prevails as evidenced by rambling, incoherent speech.

Answer 9

Delirium

Question 10

5 S/S of Delirium

Answer 10

Autonomic Manifestations:

• tachycardia
• elevated BP
• dilated pupils
• sweating
• flushed face

Question 11

Delirium vs Dementia:

• Onset
• Course
• Duration
• Consciousness
• Attention
• Psychomotor changes
• Revercibility

Answer 11

• acute, insidious
• fluctuating, progressive
• days to weeks, months to year
• altered, clear
• impaired, normal (except with severe)
• increased or decreased, normal
• usually, rarely

Question 12

_____ Delirium:

• agitation
• restlessness
• attempts to remove tubes & lines

Answer 12

hyperactive

Question 13

_____ Delirium:

• withdrawal
• flat affect
• apathy
• lethargy
• decreased responsiveness

Answer 13

hypoactive

Question 14

_____ Delirium

- patients fluctuate between hyper and hypo

Answer 14

mixed

Question 15

characterized by a state of generalized cognitive deficits in which there is a deterioration of previously acquired intellectual abilities.

Answer 15

Dementia

Question 16

was created in 1990, and it was intended to be a bedside assessment tool usable by non-psychiatrists by Dr. Sharon Inouye to assess for delirium.

Answer 16

CAM (Confusion Assessment Method)

Question 17

Delirium is defined in terms of four diagnostic features, and is deemed positive when

Answer 17

Feature 1 + Feature 2 + Feature 3 or 4

Question 18

When to use benzodiazepines for Delirium

Answer 18

when etiology is substance withdrawal

Question 19

Are antipsychotics recommended to treat NCD

Answer 19

NOOO!!! Black Box Warning for First Gen antipsychotics because there is an increase risk for death in elderly pt’s

Question 20

Side effects of antipsychotics

Answer 20

• Extrapyramidal: jitterness & tremors

- anticholinergic: dry mouth, blurred vision, constipation, urinary retention

Question 21

Contraindications for antipsychotics

Answer 21

• hypersensitive
• CNS depression/comatose
• blood dyscrasias
• Parkinson’s
• Narrow Angle Glaucoma
• Liver, Renal, or Cardiac Insufficiency

Question 22

• In assessing NCD, CT’s of the brain will show the…
• An LP will show…
• PET scans show the…

Answer 22

• size and shape
• CNS infection
• metabolic activity of the brain

Question 23

_____ include psychological disorders characterized by the elevation or lowering of a person’s mood

Answer 23

Mood DIsorders

Question 24

It causes highs and lows, but isn’t as extreme as bipolar

Answer 24

Cyclothymeia

Question 25

(or persistent depressive disorder) is in-between normal mood and mild depression.

Answer 25

Dysthymia

Question 26

a low mood that has occurred for at least 2 years and with at least 2 other symptoms of depression.

Answer 26

Dysthymia

Question 27

- Depressed mood or loss of interest or pleasure in usual activities - Social and occupational functioning impaired for at least 2 weeks - No history of manic behavior - Cannot be attributed to use of substances or a general medical condition - The patient must meet 5 or more of 9 symptoms

Answer 27

Major Depressive Disorder

Question 28

_____ is similar to MDD, but milder

Answer 28

Dysthymia

Question 29

- Characterized by mood swings from profound depression to extreme euphoria (mania), with intervening periods of normalcy - Delusions or hallucinations may or may not be part of clinical picture - Onset of symptoms may reflect seasonal pattern

Answer 29

Bipolar Disorder

Question 30

age of onset for bipolar disorder

Answer 30

early 20's

Question 31

- 1 or more manic or mixed episodes leading to: serious problems, hospitalization, psychotic features

Answer 31

Bipolar 1

Question 32

- 1 or more hypomanic episodes (4 days or more), and no mania - 1 or more major depressive episodes (2 weeks or more)

Answer 32

Bipolar II

Question 33

- altering between hypomanic symptoms and mild or moderate depressive moods like Bipolar II - less severe, higher functioning

Answer 33

Cyclothymia

Question 34

What does ECT treat

Answer 34

Mania