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mental health exam 3
| Question | Answer |
|---|---|
| neurodevelopmental disorders | -communication disorder -learning disorder -motor disorders -intellectual developmental disorder -autism spectrum disorder -attention deficit hyperactivity disorder |
| speech disorder | -difficulty making sounds |
| language disorder | -difficulty using or understanding words |
| social communication disorder | -difficulty using nonverbal and verbal means of communicating with others |
| stereotypic movement disorder | -hand waving, rocking, head banging, nail biting |
| autism-social communication and interaction | -deficits in social-emotional reciprocity (back and forth conversation) -deficits in nonverbal communicative behaviors used in interactions (verbal and nonverbal) -deficits in developing, maintaining and understanding relationships |
| autism- restricted repetitive behaviors | -repetitive motor movements -insistence on sameness -highly restricted and fixated interests that are abnormal in intensity -hyper- or hypoactivity to sensory input – pain/temperature, sounds, smells/odors |
| treatment for autism disorders | -ritalin – ADHD type behaviors -atypical antipsychotics – irritability, self-injurious and/or aggressive behaviors -antidepressants – anxiety, mood lability |
| ADHD specifiers | -combined presentation -predominantly inattentive presentation -predominantly hyperactive/impulsive presentation |
| stimulants for ADHD | -methylphenidate -dextroamphetamine and amphetamine salt preparations -dexmethylphenidate preparations -dextroamphetamine preparations |
| non-stimulants for ADHD | -atomoxetine HCL (Strattera) -bupropion (Wellbutrin) -α-adrenergic agonists (Clonidine – Norepinephrine Agonist, Guanfacine (Tenex)) |
| oppositional defiant disorder | -least severe of the impulse disorders -primarily in childhood -angry and irritable mood -defiant and vindictive behaviors -arguing with authority figures -seeks revenge |
| intermittent explosive disorder | -adults 18 years of older -inability to control aggressive impulses -aggression can be toward person, animals, property, self -typically inappropriate aggressive reaction to a situation |
| phases of intermittent explosive disorder | -tension/arousal -explosive behavior/outburst -sense of relief/release -remorse/regret |
| conduct disorder | -child or adolescent onset -invading the rights of others -aggressive behavior and usually destruction of property -initiate physical fights, bully others -coercion – sexual -may lack emotion or empathy for others -pyromania -kleptomania |
| treatment of oppositional defiant disorder | -no meds, treat comorbid conditions |
| treatment of intermittent explosive disorder | -SSRI -mood stabilizer -antipsychotic |
| treatment of conduct disorder | -antipsychotics |
| social anxiety disorder | -fear or anxiety in social situations, lasting for more than 6 months -fear of being negatively evaluated (this is the primary focus) -giving a speech, being observed eating/drinking, meeting unfamiliar people |
| panic disorder | -recurrent unexpected panic attacks -abrupt surge of intense fear for no real reason -reaches peak within minutes |
| OCD | -presence of obsessions, compulsions, or both -obsessions – thoughts, urges or images – intrusive -compulsions – repetitive behaviors -the obsessions and compulsions are time consuming |
| disruptive mood dysregulation disorder | -severe recurrent temper outbursts that are out of proportion -outbursts are inconsistent with development -outbursts occur 3 or more times per week -mood is persistently irritable or angry when outbursts are not occurring |
| rumination disorder | -repeated regurgitation of food |
| enuresis | -bed wetting or voiding in clothes -over age of 5 -rule out urinary dysfunction -toilet training -treat with mipramine (Tofranil) and desmopressin (antidiuretic compound) |
| encopresis | -defecating in inappropriate places -over age of 4 -assess bowel function -daily laxative and mineral oil |
| clinical criteria of anorexia nervosa | -refusal to maintain body weight – less than 85% of that expected -fear of gaining weight or becoming fat -disturbance in the experiences of one’s body weight or shape -absence of at least three consecutive menstrual cycles |
| clinical criteria of bulimia nervosa | -binge eating – within a discrete period of time -recurrent compensatory behavior – self-induced vomiting, misuse of laxatives, diuretics, enemas, medications, fasting, excessive exercise -behaviors occur at least twice a week for 3 months |
| complications of eating disorders | -growth retardation -pubertal delay or arrest -impaired acquisition of bone mass -structural brain changes -dehydration -electrolyte imbalance- osteopenia |
| cluster A personality disorders | -paranoid -schizoid -schizotypal |
| cluster B personality disorders | -antisocial -borderline -histrionic -narcissistic |
| cluster C personality disorders | -dependent -obsessive-compulsive -avoidant |
| paranoid (cluster A) | -suspicious that others are going to harm -unjustified doubts about the loyalty of others -perceived attacks on character that are not apparent from others -suspicious of spouse or sexual partner |
| schizoid (cluster A) | -detachment from social relationships -little interest in sexual experiences -lacks close friends other than first-degree relatives -emotional coldness or detachment -pleasure in few (if any) activities |
| schizotypal (cluster A) | -behavior that is odd or eccentric -pattern of social and interpersonal deficits -discomfort with close relationships -appearance that is odd or eccentric -no close friends other than relatives -excessive social anxiety even in familiar settings |
| antisocial (cluster B) | -disregard for the rights of others -failure to conform to social norms in terms of lawful behaviors -failure to plan ahead -lack of remorse -reckless disregard of the safety and well-being of others -repeated physical fights or assaults |
| borderline (cluster B) | -instability of relationships -frantic efforts to avoid abandonment -unstable self-image -impulsivity in: spending, sex, substance abuse, driving, binge eating -chronic feelings of emptiness -inappropriate intense anger -recurrent suicidal intent |
| narcissistic (cluster B) | -need for admiration -self importance -fantasizes about unlimited success, power, brilliance, beauty -exploitative of others -unable to recognize the needs of others -arrogant and haughty behaviors |
| histrionic (cluster B) | -excessive attention seeking -sexually seductive/provocative behaviors -uses physical appearance to draw attention to self -self-dramatization, theatrical, exaggerated expressions of emotion –easily influenced by others -rapid shifting of emotions |
| dependent (cluster C) | -need to be taken care of -difficulty making everyday decisions -difficulty expressing disagreements with others -feels helpless when alone -immediately seeks a relationship when another ends -fears being left to take care of self |
| obsessive-compulsive (cluster C) | -preoccupied with rules and details -perfectionism -holds onto worn objects with no value -excessively devoted to work -inflexible -miserly spending style toward self and others -rigid and stubborn |
| avoidant (cluster C) | -avoids occupational activities where there is interaction with others -restraint with intimate relationships -preoccupied with being criticized or rejected -views self of inept -doesn’t take personal risks |
| characteristics of alcohol withdrawal syndrome | -shakiness (tremors) -anxiety (irritability) -rapid heart rate -reduced ability to perform ADL -slight confusion -last drink taken several hours ago -history of long-term drinking |
| meds for alcohol withdrawal | -benzos (valium, diazepam) -antiseizure meds (carbamezapine) -meds for delirium tremens (IV antianxiety meds, lidocane) |
| delirium characteristics | -rapid onset -secondary to physical insult -reversible -impaired short-term memory -fluctuating LOC -thought content matches LOC -may have slurred speech -visual and/or tactile hallucinations -anxious, fearful, bewildered |
| dementia characteristics | -insidious onset -slow, progressive development -usually a primary disorder -impaired short-term memory -LOC unchanged -thought content normal initially -eventual loss of ability to abstract -misidentification, delusions affect matches mood |
| mild Alzheimer's | -decreased short-term memory -word-finding difficulties -decreased decision making, concentration, reasoning, judgment -difficulty performing usual activities -denial -getting lost -repetitive questioning |
| moderate Alzheimer's | -apraxia, agnosia, aphasia, poor comprehension -disorientation -blunted affect -misidentification -sleep disturbance -delusions -needs help with ADL's, supervision with meals -emotional lability -wanders -urinary incontinence |
| severe Alzheimer's | -gait disturbance -unable to feed self -urinary and bowel incontinence -bedridden -swallowing difficulty -24-Hour supervision |
| four A's of Alzheimer's | -agnosia -aphasia -amnesia -apraxia |
| meds for mild to moderate Alzheimers | -acetylcholinesterase inhibitors: -tacrine (Cognex) -donepezil (Aricept) -rivastigmine (Exelon) -galantamine (Razadyne) -memantine (Namenda)—for moderate to severe disease |
| Alzheimer's preventative agents | -NSAIDs -statins -estrogen -B and E vitamins |
| extrapyramidal side effects | -akathisia -akinesia -dystonia -drug induced Parkinsonism -tardive dyskinesia |
| neuroleptic malignant syndrome | -potentially lethal -hyperthermia: 101° F to 103° F to 108° F -rigidity -autonomic dysfunction |
| treatment of NMS | -dantrolene (Dantrium) muscle relaxant -bromocriptine (Parlodel) centrally acting dopaminergic |
| treatment for EPSE | -anticholinergics |
| other treatment options for EPSE | -dopamine agonist: amantadine (Symmetrel) -beta blocker: propranolol (Inderal) -benzodiazepine: diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin) -vitamins E and B may diminish symptoms associated with Tardive dyskinesia (TD) |
| has high risk for developing EPSE | -woman -older adult -first episode of schizophrenia -has affective symptoms |
| criterion A- impaired control | -uses in larger amounts or over a longer period than original intended -expresses persistent desire too cut down or regulate....but with multiple unsuccessful attempts -individual’s daily activities revolve around the substance -intense cravings |
| criterion A- social impairment | -use results in failure to fulfill major role obligations -the individual may continue use despite having persistent or recurrent social problems -important activities are given up |
| criterion A- risky use | -recurrent use in situation which it is physically hazardous -continues to use despite knowledge of having a persistent or recurrent physical or psychological problem likely cause or worsened by substance |
| diagnostic markers of alcoholism | -concentration of 150mg of ethanol with out signs of intoxication (.15 BAL) -gamma-glutamyltransferase (GGT) 70% of people with high GGT are persistent heavy drinkers -higher sensitivity and specificity |
| substance abuse screening tools | -CAGE -Audit -SBIRT |
| meds for alcohol abuse | -naltrexone -acamprosate -disulfiram -topiramate |
| alcohol withdrawal syndrome | -hangover-tremor, headache, mydriasis, GI symptoms, sweating, tachycardia mild hypertension-6-8 hours post cessation -alcoholic hallucinosis- 8-12 hours post cessation -generalized seizures-12-24 hours post cessation -delirium tremens |
| delirium tremens | -high fever -failure of all ego functions -violence -convulsions -death |
| amnestic disorders associated with alcohol abuse | -blackouts—dehydration –can occur early in drinking hx. -Korsokoff’s psychosis—thiamine deficiency- irreversible brain damage -Wernecke’s encephalopathy-ataxia damage to 6th cranial nerve-reversible with thiamine Rx |
| physical effects of chronic drinking | -peripheral neuropathy -alcoholic cardiomiopathy -esophagitis -gastritis -pancreatitis -hepatitis -cirrhosis -leukopenia -thrombocytopenia |
| CNS stimulant intoxication | -euphoria, impaired judgment, anxiety -nausea, vomiting, psychomotor agitation -muscle weakness -confusion, seizures, death -nicotine—restlessness and insomnia |
| symptoms of CNS withdrawal | -dysphoria, fatigue, sleep disturbance -headache, fatigue, anxiety, nausea and vomiting -nicotine- restlessness, increased appetite, -irritability |
| opioid intoxication | -drowsy, euphoria -respiratory depression -coma -death |
| opioid withdrawal | -6-12 hours after last dose -nausea vomiting diarrhea -lacrimation -rhinorrhea -pupillary dilation, sweating, fever |
| recreational therapy | -assist patients to find activities to balance work and play |
| occupational therapy | -functional abilities of patients, their capacity to work and perform tasks of daily living |
| psychoeducation | -educating patients and families regarding symptom recognition and management -provide social support -share information to assist adaptation to living with a chronic illness -prepare for discharge |
| group therapy | -an opportunity to get input from others, can work with large number of patients, and is economical -gain new insight, knowledge, and perspective -feeling of acceptance and belonging -accountable to group of people with similar struggles |
| spirituality groups | -instilling hope and encouraging patients to look at faith or spirituality as resources for their recovery -run by chaplain or mental health treatment team professional -focus on forgiveness, grief, meaning in life |
| community meetings | -addressing daily needs associated with community living -inpatient or community setting |
| intensive/acute care units | -24-hour structured inpatient locked unit -emphasis on short-term, intense therapeutic interventions -PT is a danger to self or others or gravely disabled -voluntary or involuntary -high severity illness, requiring close supervision and intervention |
| conditions on intensive/acute care units | -acute and persistent mental illness -organic brain syndrome- ex: dementia, delirium -detoxification from alcohol or drugs -acute situational or emotional distress -suicide threats or attempts -medication adjustment |
| child/adolescent unit | -offers comprehensive psychiatric assessment, stabilization, and short-stay intensive treatment |
| common conditions on child/adolescent units | -severe depression -bipolar disorders -impulse-control disorders -phobias, and other anxiety disorders -schizophrenia and other psychotic disorders -eating disorders |
| substance abuse unit | -detoxification -acute inpatient medical and psychiatric stabilization and treatment |
| dual diagnosis unit | -focuses on co-occurring disorders of substance abuse and mental illness in a psychiatric hospital setting. -resolution of medical and psychological crises -detoxification -psychotherapy and group activities |
| medical-psychiatric unit | -provides care for individuals with mental illness and coexisting medical problems in need of hospitalization |
| geropsychiatric unit | -provides care to patients who have a psychiatric disorder, one or more acute or chronic health conditions, and normal age-related physical changes -alzheimer’s disease -schizophrenia -fall prevention |
| psychiatric hospitals | -long-term treatment of severely psychotic patients and forensic individuals -highly restrictive -treatment malls -skills-based relapse prevention programs -cognitive-behavioral programs to reduce symptom severity -psychoeducational meetings |
| forensic psychiatric hospitals | -patient convicted of a criminal offense and has a diagnosed mental illness -most restrictive -PTs charged with criminal offense and too dangerous to reside in community -strict rules and regulations -correctional officers |
| group homes | -6- to 12-bed program located in a neighborhood setting staffed with nonclinical paraprofessionals -structured program -children and adolescents -adults -sychoeducation, individual and group therapy, and medication management |
| partial hospitalization | -short-term, for patients transitioning from acute psychiatric inpatient unit -successful integration into community -full day psychiatric rehabilitation services -psychoeducation -psychiatric medication evaluation -individual and group therapy |
| day treatment | -patient stabilization, rehabilitation, and recovery in a community outpatient setting -maintain or enhance current level of functioning -maintain community living -develop self-awareness -scheduled activities -recovery model |
| day treatment for dual diagnoses | -day treatment setting for comorbidity of mental disorder and substance addiction disorder -receive intensive, coordinated community-based mental health and substance abuse treatment -group sessions -develop coping skills -relapse prevention, AA, NA |
| types of crises | -maturational -situational -adventitious |
| maturational crisis | -marriage -birth of child |
| situational crisis | -external, extraordinary, unanticipated, but part of everyday life -ex: job loss, death of a loved one, abortion |
| adventitious crisis | -not part of everyday life -ex: natural disaster, rape, crime of violence |
| phases of a crisis | -confronted by conflict: problem solving techniques are attempted -anxiety continues to rise: this occurs when usual defense and problem solving techniques fail -severe anxiety & panic -debilitating state: depression, violence, suicidal behaviors |
| stages of violence | -impact -recoil -reorganization |
| impact stage of violence | -lasts minutes to days -common responses: shock, denial, anger, shame, helplessness, physiologic responses, disturbed sleeping and eating -delayed reactions possible -occasionally, dissociative symptoms, intrusive memories, severe anxiety |
| recoil stage of violence | -lasts weeks to months -struggle to adapt -periods of acting “normal” -latter portion of phase—desire to talk about details of and feelings about trauma -need for support and temporary dependence -gradual awareness of full impact |
| reorganization stage of violence | -lasts months to years -gradual decrease in emotions -begins with reviewing and organizing what happened and why -regain sense of control and self-protection -resolution of grief -without resolution symptoms remaining qualify as PTSD |
| rape trauma syndrome | -sleep disturbances, nightmares -anorexia, amotivation -fears, anxiety, phobias, suspicion -relationship disruptions -self-blame, guilt, shame -lowered self-esteem -somatic symptoms (occur to an individual but no medical justification) |
| manifestations of childhood sexual abuse | -disturbed G&D -denial of experience -sleep, eating disturbances -anxiety, depression, aggression -active fantasy life, masturbation -poor impulse control, somatization -fear, shame, self-blame, self-destructive behavior -running away |
| manifestations of adolescent sexual abuse | -overt dysfunctional coping -impulsive acting out -self-destructive behaviors, self-mutilation -suicide attempts -sleep, eating, substance abuse disorders -running away, truancy, delinquency -prostitution, early marriage |
| manifestations of adult sexual abuse | -memory disturbances -anxiety -relationship issues -addiction -body symptoms -other issues: detachment, control, self-punishment, anger, sexual identity |
| responses to terminal illness | -Denial -anger -bargaining -depression -acceptance |
| anticipatory grief | -mourning in advance of a loss -form of finalizing the loss for some (spending time together, life review, saying ‘goodbye’) |
| grief | -normal reactions -ex: depressed mood, anxiety, insomnia, guilt |
| bereavement | -period of grieving following a death |
| mourning | -things people do to cope with a death (funerals) |
| types of grief | -maladaptive -chronic grief -delayed grief -exaggerated grief -disenfranchised Grief – grief that cannot be openly expressed |
Created by:
bkpittman1