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MQW U3 > Behavioral > Flashcards

Behavioral Flashcards

1
Q

What is APGAR?

A 
A - appearance (color)
P - pulse 
G - grimace (reflex irritability)
A - Activity (muscle tone)
R - Respiration

Used to predict likelihood of immediate survival (of neonates)
Normal = 8-9

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2
Q

Post Partum Major Depression occurs in ___ of new mothers, within ___ of child birth, and can persist ___

A

10%
1 month
1 year

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3
Q

Criterion for premature and very premature birth

A

Premature: 37 Weeks

Very premature: 32 Weeks

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4
Q

4 Necessary infant reflexes necessary for survival

A
  1. Rooting: touch cheek –> turn toward nipple
  2. Palmar Grasp: grip any object put in palm
  3. Moro: limb extended when child is startled
  4. Babinski: dorsiflexion of toes when sole is stroked
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5
Q

3 Spheres of Development:

A
  • Motor
  • Social
  • Verbal/Cognitive
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6
Q

How does development tend to occur (progress)? From ___ to ___

A
  • Cephalad to caudal
  • Central to peripheral
  • From self to others
  • From understanding to expressing
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7
Q

Stranger anxiety starts at ___

A

9 months

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8
Q

Social smile starts at ___

A

12 weeks

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9
Q

Separation anxiety starts at age ___
But ____always comes first
Separation Anxiety Disorder Starts at age ___

A

Late in first year
Object permanence comes first
7 years: school phobia/refusal

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10
Q

Babinski reflex disappears at ___

A

1 year

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11
Q

What milestone at age 2?

A

Say “No!”

Terrible Twos

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12
Q

Gender identify by age ___

A

3 years

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13
Q

Play progression:

Cooperative by age ___

A

Solitary –> parallel –> associative –> cooperative

4 years

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14
Q

Year 6 Milestones

A
  • “Superego”
  • Morality
  • Empathy
  • Lying is wrong
  • Finality of death
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15
Q

Rett’s Disorder Characteristics:

A
  • 4 Years of normal functioning
  • Hand wringing
  • Breathing problems
  • Intellectual impairment
  • Ataxia
  • Motor and social declines,
  • X-linked
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16
Q

Universality of death by age ___

Morality by age ___

A

9 years

12 years

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17
Q

Body image and popularity ideas by age ___

A

15 years

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18
Q

3 Predisposing factors for teen pregnancy

A
  1. Depression
  2. Poor school achievement
  3. Divorced parents
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19
Q

Selective Mutisum usually starts at age ___

A

6 years

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20
Q

Phonological vs Articulation disorders

A

Phonological: leaves out or misplaces speech sounds

Articulation: unable to make necessary motor movements for accurate speech. ex: lisp

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21
Q

Separation Anxiety Disorder Characteristics

A
  • School phobia or refusal

- Starts at 7 years/stressful life event/anxious family

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22
Q

Autism Spectrum Disorder Findings:

A
  • Seen before age 3
  • No finger pointing (theory of mind)
  • Larger head circumference (overgrowth during first year)
  • More common in boys
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23
Q

5 Stages of Dying:

A 
Denial
Anger
Bargaining
Depression
Acceptance
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24
Q

Bereavement (normal grief) vs. Complicated Bereavement (abnormal)

A
  • Both have initial shock and denial
  • Both include sadness and crying
  • Abnormal involves suicidal thinking or hallucinations
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25
Q

Schizophrenia definition:

A

“Split Mind”

Behavior vs. thought content divergence

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26
Q

Hallmark symptom of schizophrenia:

A

Psychosis: impairment in reality testing

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27
Q

List 12 Symptoms of Psychosis

A
  1. Illusion
  2. Hallucination
  3. Ideas of reference
  4. Delusions
  5. Loss of ego boundaries
  6. Alogia
  7. Echolalia
  8. Thought Blocking
  9. Neologisms
  10. Circumstantiality
  11. Tangentiality
  12. Loose associations
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28
Q

Difference between Illusion vs Hallucinations

A

Illusion: misinterpretation of real external stimuli

Hallucinations: sensory perceptions not generated by external stimuli

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29
Q

What is false conviction that one is subject of attention by other people?

A

Ideas of reference

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30
Q

Delusions:

Most common type?

A
  • False beliefs
  • Not correctable by logic or reason
  • Delusions of persecution most common
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31
Q

Loss of ego boundaries:

A

Not knowing where one’s mind and body end and those of others begin

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32
Q

Alogia:

A
  • Lack informative content in speech

- Mute or speaks few words

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33
Q

“I’m very sure I’ve got the cure and I’m not pure”

A

Echolalia:

  • Repeating statements of others
  • Associating words by their sounds, not meanings
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34
Q

“I have to take my…..”

Often because of ___

A

Thought blocking

hallucinations

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35
Q

“I’m fatigloo”

A

Neologisms

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36
Q

Circumstantiality vs Tangentiality

A

Circumstantiality: responds to questions, but presenting voluminous details

Tangentiality: beginning logically, getting further from the point, fail to answer question

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37
Q

“I drive a brown car. So i like brown snickers and the sun is really nice today.”

A

Loose associations

  • Loss of logical meaning
  • No linked associations
  • Illogically jumps from one subject to another
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38
Q

Differentiate Schizophrenia vs Medical Delirium

A

Schizophrenia= no clounding of consciousness: alert, oriented

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39
Q

Schizophrenia DSM-5 Criteria

A

A. Characteristic Symptoms (2+)
B. Social/Occupational dysfunction: at least 1 of work, interpersonal, self care
C. Duration: at least 6 months w/ 1 month of symptoms
D. Schizoaffective and Mood Disorder exclusion
E. Substance/general medical condition exclusion

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40
Q

5 Schizophrenia characteristic symptoms:

A
  1. Delusions
  2. Hallucinations
  3. Grossly disorganized or catatonic behavior
  4. Negative symptoms
  5. Disorganized speech
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41
Q

3 Phases of Schizophrenia:

A
  1. Prodromal: prior to 1st psychotic break
  2. Psychogic/Active: loss of touch w/ reality
  3. Residual: period between psychotic episodes, in touch w/ reality, but doesn’t behave normally
42
Q

Schizophrenia age of onset in men vs women

A

Men: 15-25

Women 25-35

43
Q

Enlargement of what brain structure(s) in Schizophrenia?

A

Lateral and third ventricle

44
Q

Brain density change in what brain structure(s) in Schizophrenia?

A

Lower density –> smaller

Hippocampus, amygdala, parahippocampal gyrus

45
Q

What happens in frontal lobe in Schizophrenia?

A

Hypofrontality: decreased use of glucose

46
Q

Dopamine Hypothesis of Schizophrenia:

Glutamate Hypothesis of Schizophrenia

A
  • Excessive DA activity in MESOLIMBIC tract

- Hypoactivity of NDMA receptor in brain

47
Q

2 Neuronal Pathways in Schizophrenia (positive/negative symptoms)

A

Positive: Glu-GABA-Glu-DA
Pathology: high DA in mesolimbic

Negative: Glu-GABA-Glu-GABA-DA
Pathology: low DA in mesocortical

48
Q

Brief Psychotic Disorder

A

Schizophrenia symptoms

1-29 days LESS than 1 month

49
Q

Schizophreniform Disorder

A

1-6 Months of Schizophrenia symptoms

50
Q

Schizoaffective Disorder

A

Schizophrenia + mania and/or depression

51
Q

All effective antipsychotics for Schizophrenia block ___ receptors in ___ DA pathway

A

D2

mesolimbic

52
Q

DSM-5 Criteria for Neurodevelopmental Disorder

A

New name for ADHD

  • Start before age 12
  • Symptoms in multiple (2+) settings
  • Must cause social disability
  • 6+/9 Symptoms (inattention or hyperactive/impulsive)
  • 6 Months
53
Q

Versions of ADHD

A
  • Combined
  • Inattentive
  • Hyperactive/impulsive
  • Other specified, or unspecified
54
Q

2 neurotransmitter genes most commonly associated w/ ADHD

A

Dopamine system

Noradrinergic system

55
Q

ADHD __ symptoms tend to persist greater than ___ symptoms

A

Inattentive > hyperactivity/impulsivity

56
Q

High dopamine/noradrinergic activity leads to ___

Very high leads to ___

A

Hypervigilant

Very high –> Psychosis

57
Q

Low dopamine/noradrinergic activity leads to ___

Very low leads to ___

A

ADHD

Very low –> Schizophrenia (-) symptoms

58
Q

In ADHD brains, selective pruning happens (earlier/later)

59
Q

3 Nonaddictive ADHD Drugs:

Side effects?

A

Atomoxetine (NRI)
Guanfancine ER a2 agonist
Clonidine ER a2 agonist

Less efficacy than stimulants
Often sedating
May lower BP

60
Q

Class of ADHD drugs that has greatest efficacy is ___

Adverse effects?

A

Stimulant class

Risk of addiction
Too much –> paranoia
Stunt growth, weight loss (low appetite)

61
Q

1st line ADHD treatment for preschool, children and adolescents, and adults

A

Preschool: behavioral therapy

Children and adolescents: Slow release Methylphenidate (MPH)

Adults: Nonaddictive (Atomoxetine, Modafinil, Ganfacine ER, Clonidine ER)

62
Q

a2 Agonist mechanism of action for ADHD

A

Norepi a2 receptor: increase signal strength –> increase signal to noise ratio –>make glutamate function more efficient

63
Q

Most common co-occuring disorder with ADHD:

64
Q

Functional MRI finding in ADHD

A

Hypoactive Anterior Cingulate

65
Q

3 Spheres of functioning:

A
  1. Social
  2. Academic
  3. Occupational
66
Q

Personality traits are [immutable/circumstantial/modifiable] risk for suicide

67
Q

Risk traid for suicide includes

A

Ideation
Intention
Plan

68
Q

What religions are at increased risk for suicide?

A
  • Jewish or protestant

- Highest in protestant

69
Q

Highest risk demographic for suicide:

A

Middle aged
White/Caucasian
Male

70
Q

Top 3 leading causes of death for adolescents 15-19

A
  1. Accidents
  2. Homocide
  3. Suicide
71
Q

Age and gender pattern for suicide risk

A
  • Increases substantially after 55
  • Decrease for old women
  • Increase for old men
  • Men ALWAYS higher risk than women
72
Q

Top suicide method in US vs. elsewhere

A

US: firearms
Elsewhere: hanging

73
Q

[Short/long] allele for serotonin transporter gene (SERT) associated with increased MDD and suicide risk

A

Short allele (ss) –>highest risk

Long allele (l/l) –> protective

74
Q

Antidepressents [raise/lower] risk of suicide for what group of people?

A

Raise

24 or younger

75
Q

Why increased suicide risk initially after being put on antidepressants?

A

-Increased energy and clear thinking improve before lifting of depressed mood –> More energy to act on suicidal thoughts

76
Q

Greatest predictor of suicide risk:

A

Past violence

77
Q

DSM-5 Major Depressive Disorder Criteria:

A
  1. 5+/9 Symptoms during 2-week period (at least 1 is depressed mood or loss of interest/pleasure)
  2. Symptoms cause distress or impairment in functioning
  3. Not attributable to physiological effects
78
Q

SIG E CAPS

A 
Sleep disturbance
Interest/pleasure reduction
Guilt, worthlessness
Energy loss, fatigue
Concentration/attention impairment
Appetite changes
Psychomotor symptoms
Suicide Ideation
79
Q

How to differentiate normal sadness vs. depression?

A 
S.W.A.G
Have at least one of the following in depression:
Suicidality
Weight loss
Anhedonia
Guilt
80
Q

Atypical Depression likely findings:

A
  • Weight gain, hypersomnia

- Leaden paraysis, carb cravings, rejection sensitivity

81
Q

Medical conditions that mimic depression:

A
  • Hypothyroidism –>tired
  • Cushing’s
  • Anemia –>tired
  • Vitamin deficiency (B12, Folate)
  • Obstructive sleep apnea –> poor brain perfusion at night
82
Q

2 Biological Theories of Depression:

A
  • Monoamine deficinecy
  • Monoamine receptor excess

-Reality= combination of both

83
Q

(Genetic/Environmental) factors more important in depression

A

Environmental

84
Q

Functional Neuroanatomy in MDD:

A
  • Hypoactive dorsolateral prefontral cortex

- Hyperactive amygdala

85
Q

Gender difference in MDD

A
  • Lifetime prevalence: women > men

- Women more likely to seek help

86
Q

2 Common comorbidities of MDD:

A
  • Substance abuse

- Generalized anxiety

87
Q

3 Frontline treatment classes of MDD:

A

SSRI
SNRI
NDRI

Less severe side effects than MAOIs and TCAs

88
Q

Increasing cortisol in brain does what to make depression more likely?

A

Decrease brain neurotrophic factors

89
Q

What is Delay of Reinforcement Gradient?

A
  • Individuals w/ ADHD are MORE sensitive to IMMEDIATE reinforcement
  • LESS sensitive to DISTAL reinforcement
  • Compared to normally developing individuals
90
Q

Oppositional Defiant Disorder (ODD) Criteria:

How to define severity?

A
  • 4+ Symptoms (3 groups: Angry/Irritable, Argumentative/Defiant, Vindictive) for 6+ Months
  • Negative Impact
  • Not during course of other disease (psychotic, depressive)
  • Severity based on number of settings (1, 2, 3+)
91
Q

Conduct Disorder (CD) Criteria:

A

Violate norms or rights of others

  • 3+ symptoms for 12+ months (agression, destruction, deceit/theft, violate rules)
  • Functional impairment
  • If 18+, criteria not met for Antisocial personality disorder
92
Q

Limited prosocial emotions is:

A

Specific manifestation of Conduct Disorder
-2+ findings for 12+ months in multiple relationship/ssettings
Symptoms:
1. no remorse/guilt
2. no empathy
3. unconcerned about performance
4. shallow/deficient affect

93
Q

Development impairment characteristics of Autism (4)

A
  1. No babble or coo by 12 months
  2. No gesture (point, wave, grasp) by 12 months
  3. Doesn’t say single words by 16 months or 2-word phrases by 24 months
  4. Loss of language or social skills at any age
94
Q

Asperger’s Syndrom is Autism with high ___

95
Q

Diagnosis of Autism based on:

A
  • Autism Diagnostic Interview-R (ADI-R)

- Observation (home, school, video analysis)

96
Q

3 Criteria for Intellectual Disability Diagnosis:

97
Q

Academic level achievement in Mild vs Moderate ID:

A

Mild: 6th grade, minimal supervision

Moderate: 2nd grade, under supervision

98
Q

Examples of “essential” vs “associated” feature of Autism:

A

Essential: repetitive behavior, flapping, body rocking

Associated: self-injury, aggression, pica

99
Q

3 Diagnostic criteria for Pica

A
  1. > 1 month eating non-nutritive substancces
  2. Eating is inappropriate for developmental level
  3. eating is not culturally sanctioned
100
Q

Medication use in Autism

A

~27% of children take >1 med

Increase use of meds with age

CAM treatment decreases w/ age

MQW U3 (11 decks)

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