3rd year semester 2 final Flashcards
Serotonin
inhibitory
Sleep, mood, eating behavior
The pleasure neurotransmitter
mood disorders, anxiety and violence
norepinephrine
Excitatory
Arousal, wakefulness, learning
anxiety and addiction
GABA
gamma-amino butric acid
inhibitory
Anxiety states
Acetylcholine
excitatory
Arousal, attention, movement
Dopamine
inhibitory
Fine movement & emotional behaviour
most prevalent mental health disorder in Canada
anxiety
Major Mental Disorders – Canada
- Anxiety 12%
- Mood disorder 8.3%
- Personality disorder 7%
- Substance addiction 3.4%
- Self-harm 2%
- Schizophrenia 1%
Generalized Anxiety Disorder (GAD) definition
• Increased levels of anxiety that affect functioning in 2 or more areas of life, for six months or longer
o social, occupational, or other important functioning
what is Acrophobia
fear of heights
what is Brontophobia
fear of thunderstorms
treatments for PTSD
Cognitive Processing Therapy (CPT) Prolonged Exposure Eye Movement Desensitization & Reprocessing (EMDR) Antidepressants antianxiety agents
what is the drug to treat nightmares PTSD?
Prazosin
examples of dissociative symptoms
subjective sense of numbing; absence of emotional responsiveness; dissociative amnesia
what are positive symptoms (*schizophrenia)
*presence of something that is not normally present
Delusions; Hallucinations; Disorganized thinking; Abnormal motor behaviour
what are negative symptoms (*schizophrenia)
*absence of something that should be present but is not
Alogia - Poverty of speech; flattened affect; anhedonia - inability to experience pleasure; asociality; Avolition - lack of initiative or motivation; apathy; anergia - lack of energy
what does the term circumstantiality mean in relation to alteration of speech?
inclusion of unnecessary & tedious details
what does the term Neologisms mean in relation to alteration of speech?
made up words or using existing words that have meaning only for the client
what does the term Echolalia mean in relation to alteration of speech?
pathological repeating of another’s words
what is the cornerstone treatment of schizophrenia?
antipsychotics
Block dopamine receptors
Take 2-6 weeks for effect
Some clients who are not medication compliant are given depot (long-acting) injection (1-2 x month)
Extrapyramidal Side Effects (EPS) of antipsychotics
Tardive Dyskinesia Pseudoparkinsonism Dystonia Cogwheel rigidity Opisthotonos Oculogyric crisis Akathisia
LEAP approach
Listen - with compassion and genuineness
Empathize - conveying understanding of what client is feeling
Agree - to support client’s goals & refrain from judgement
Partner - provide a respectful, collaborative environment
Schizophreniform disorder
similar to schizophrenia, but duration of illness is < 6 months
Schizoaffective disorder
major depressive, manic, or mixed mood episode presenting concurrently with symptoms of schizophrenia
Brief Psychotic disorder
sudden onset of psychosis lasting < 1 month, often precipitated by extreme stressors
highest mortality rate of all psychiatric illnesses
anorexia 10%
when does bulimia first occur?
early teens to mid-20’s
rarely seen under 12
when does anorexia first occur?
b/t 7 and 12
what is russel’s sign & what is it a sign of?
scarred knuckles, self-induced vomiting, bulimia
Schizoid personality disorder
characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle
Schizotypal personality disorder
characterized by a need for social isolation, anxiety in social situations, odd behaviour and thinking, and often unconventional beliefs
Histrionic personality disorder
characterized by a long-standing pattern of attention seeking behaviour and extreme emotionality
Common signs of Autism
impaired social interaction
may be unresponsive to people or focus intently on one item to the exclusion of others for long periods of time
fail to respond to their names and often avoid eye contact
Difficulty understanding social cues
Repetitive movements
speak later than others
may refer to self by name
what is the concept of neurodiversity?
suggesting that neurological differences be recognized and respected as a social category on a par with gender, ethnicity, class, or disability
Viewed as a variation of human wiring, rather than disease
definition of ADHD
before age 7, continue for at least 6 months
create a real handicap 2 or more areas
what’s the first thing you should think of when an elderly patient is confused?
Infection!
*Infection such as a UTI or pneumonia may be present in the elderly with no signs except for a CHANGE IN MENTAL STATUS
what is the most common, reversible cause of delirium?
medications
Atypical Cognitive Changes aging
- short-term memory loss
- Disorientation, confusion
- Repetition of ideas
- going on tangents
- Impaired judgement
- Lack of insight
- Changes in personality
what percentages of dementia are neurodegenerative & ischemic?
80% neurodegenerative
20% ischemic
what are the 1st and 2nd most commone types of dementa
1st - Alzheimer’s
2nd - vascular dementia
what is Apraxia ?
impaired ability to carry out motor activities despite intact motor function
what is Agnosia ?
failure to recognize or identify objects despite intact sensory function
what is Pick’s disease?
Frontotemporal Dementia
-Brain shrinkage and reduced function
Age of onset 50-60 years
what is Anomia ?
difficulty remembering words
what is Hyperorality?
taste/chew everything
what is Hypermetamorphosis?
touching everything in sight
Medications for early to moderate stages of Alzheimer’s
Cholinesterase inhibitors
- prevent the breakdown of acetylcholine
- May delay worsening of symptoms for 6 to 12 months, on average, for about half the people who take them
what are the names of Cholinesterase inhibitor drugs?
Donepezil - all stages of AD
Rivastigmine - mild to moderate AD
Reminyl - mild to moderate AD
Medication for moderate to severe stages of Alzheimer’s
Memantine
- activity of glutamate
- To improve memory, attention, reason, language and ability to perform simple tasks
definition of major depression
• Depressed mood or diminished interest/pleasure in activities most of the day, nearly every day FOR 2 WEEKS
what does vegetative mean and what are the vegetative signs of depression?
Nutrition - anorexia
Sleep - insomnia
Self-care deficits
Elimination - Constipation
what is the most severe type of bipolar disorder?
Bipolar I Disorder
manic or mixed episodes that last at least 7 days
what is distinctive about bipolar II?
manic episodes are hypomanic
whereas bipolar I goes all the way to hypermanic
what is cyclothymic disorder
mild form of bipolar
-Episodes of hypomania as well as mild depression for at least 2 years
what is rapid cycling?
4 or more mood episodes in a 12 month period
what is the first line treatment of bipolar?
lithium
o Need good kidney function and adequate daily fluid intake and monitor salt intake
how does suicide rank in terms of leading causes of death in Canada?
9th
what is the suicide rate in Nunavut?
27.8 per 100 000
ISPATHWARM what is this acronym used for & what does each letter mean?
warning signs of suicide
ideation; substance use; purposelessness; anxiety or agitation; trapped; hopelessness or helplessness; withdrawal; anger; recklessness; mood change
SADPERSONS what is this acronym used for & what does each letter mean?
triage in ER re: suicidal Sex (male) Age (<19 or >45) Depression Previous suicide attempt Ethanol abuse Rational thinking loss Social supports lacking Organized plan No spouse Sickness (chronic, debilitating disease)
1 point for each
<2 = discharge with outpatient psych eval
3-6 = consider hospitalization or very close f/u
7 or more = hospitalization
Date PAD was legalized
June 6th, 2016, legalized in Canada
What is existential distress?
- The experience of life with little or no meaning
- It is defined as a state of powerlessness that arises from one’s confrontation with one’s own mortality and results in the consequent feelings of disappointment, futility and remorse that disrupt one’s engagement with and purpose in life
Rigor mortis
o Stiffening of the body
-d/t lack of adenosine triphosphate (ATP)
o Rigor begins 2-4 hrs after death and ceases at about 96 hr after death
o Nurses role: to have deceased appear natural (for family viewing), close eyes & mouth, position body in good alignment, and put in dentures
Algor mortis
o Gradual decrease of body temperature after death
o Body temp falls 1º C per hour until it reaches room temperature
o The skin loses its elasticity and can be damaged easily
o Nurses role: handle body carefully, gently remove any dressings or tape
Livor mortis
o After blood circulation has ceased, the red blood cells break down, releasing hemoglobin, which discolours surrounding tissues
o This discolouration appears in the lowermost/dependent areas of the body
normal BMI
18.5-24.9
severely underweight BMI
under 16
morbid obesity BMI
either 40
or
35 or greater + 1 obesity-related health condition