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NP > Adult - Psychosocial > Flashcards

Adult - Psychosocial Flashcards

1
Q

dysthymia defined

A

depression of long term standing

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2
Q

Three areas of causality for depression?

A

psychodynamic - anger directed inward
cognitive - negative belief system
biochemical

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3
Q

Depression mnemonic

A

IN SAD CAGES

INterest

Sleep disturbance
Appetite change
Depressed mood

Concentration difficulties
Activity alteration - hypo hyper
Guilty feelings
Energy loss
Suicidal ideaion
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4
Q

Important lab to order to rule out significant differential for depression:

A

TSH - R/O hypothyroid

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5
Q

Categories of feelings

A 
mad
sad
glad
afraid
ashamed
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6
Q

Stages of grief

A

DABDA

denial
anger
bargaining
depression
acceptance
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7
Q

Most commonly prescribed antidepressant class

A

SSRIs

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8
Q

SSRI examples

A 
paroxetine (Paxil)
fluoxetine (Prozac)
sertraline (Zoloft)
citalopram (Celexa)
flovoxamine (Luvox)
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9
Q

What are the advantages of SSRIs?

A

low overdose danger
fast symptom response
no postural hypotension

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10
Q

Risk of SSRI?

A

seratonin syndrome

high fever

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11
Q

Major concerns of tricylic antidepressant?

A

anticholinergic
suicide
prolonged QT

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12
Q

Examples of tricyclic antidepressants

A

amitriptyline (Elavil)
imipramine (Tofranil)
doxepin (Sinequan)

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13
Q

Dietary concerns with MAOi

A

wine + cheese = hypertensive crisis

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14
Q

Examples of MAOi

A

phenelzine (Nardil, Nardelzine)

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15
Q

Antianxiety medication classes

A 
benzodiazepines
antihistamines
beta blockers
tricyclics and MAOi
buspirone (Buspar)
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16
Q

First rule out in anxiety

A

TSH to r/o hyperthyroid

17
Q

What is the only anti-anxiety that is not classified as a tranquilizer?

A

buspirone (Buspar)

18
Q

Groups in which suicide risk is particularly high?

A

adolescents and early adulthood
white males > 45 years
those > 65 years

19
Q

Suicide mnemonic

A

SUICIDAL

Sex (men more successful if attempted)
Unsuccessful attempts
Identified family members with suicide attempts
CI chronic Illness
Depression, drug abuse, drinking
Age of patient
Lethal method available
20
Q

Alcoholism mnemonic

A

CAGE

ever felt the need to Cut down?
have people Annoyed you by criticizing your drinking?
have you ever felt Guilty about your drinking?
have you ever had an Eye-opener drink in the morning to steady your nerves or get rid of a hangover?

21
Q

What is the focus of the mental status assessment?

A

cerebral function

22
Q

Mini-mental status exam mnemonic

A

ORAL 23 RWD

Orientation
Recognition
Attention
Recall
Language

2 - names of 2 objects
3 - follow 3 step command

Reading
Writing
Drawing

23
Q

sudden, transient onset of clouded sensorium

A

delirium

“they’ll be back”

24
Q

Common causes of delerium

A 
toxins
alcohol
anesthesia
trauma
poor nutrition
25
Q

gradual memory loss with decreased intellectual functioning

A

dementia

“they will not be back”

26
Q

Common cause of dementia

A

Alzheimer’s

27
Q

Dementia rule out mnemonic

A

DEMENTIA

Drug reactions
Emotional disorders
Metabolic / endocrine disorders
Eye and ear disorders
Nutritional problems
Tumors
Infection
Arteriosclerosis
28
Q

Dementia – Development of multiple cognitive defects characterized by both memory impairment and one or more of what?

A

aphasia
apraxia
agnosia
inability to plan, organize, sequence

29
Q

Aphasia

A

difficulty with speech

30
Q

Apraxia

A

inability to perform previously learned task

no idea how to brush teeth or tie shoes; prompting them to do so does not help

31
Q

Agnosia

A

inability to recognize an object

as tested by STEREOGNOSIS test (eyes closed, object in palm)

“O in agnOsia, Object, and stereOgnosis”

32
Q

What is the underlying cause of Alzheimer’s?

A

acetylcholine deficiency

33
Q

Mainstay of medications used in Alzheimer’s?

A

acetylcholinesterase inhibitors

donepezil (Aricept)
galantamine (Razadyne)
rivastigmine (Exelon)

34
Q

What is an adjunt medication used in Alzheimer’s?

A

NMDA blockers

memantine (Namenda)

35
Q

What is the cerebellum responsible for?

A

balance and coordination

36
Q

What are three techniques for assessing cerebellar function?

A

Romberg
Finger to Nose test
Heel to Shin test

NP (76 decks)

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