Ch. 36: Care of Medically Compromised Persons

Question 1

What is most common underlying type of chronic pain?

Answer 1

Neuropathic pain
*Can lead to: 
hyperalgia - increased sensation of pain
allodynia - lowered pain threshold
hyperesthesia - increased nociceptor sensitivity

Question 2

What are the 4 steps in treatment of pain management?

Answer 2

1. Analgesics & NSAIDS
2. Antidepressants, TENS, & psychosocial support
3. Adrenergic agents, TENS, & psychosocial support
4. Psychotherapy, neuroblockade, spinal cord stimulation (TENS)

Question 3

What is HIV-1 associated cognitive-motor complex?

Answer 3

Manifestations of HIV include impaired cognitive & motor functions – known as HIV-1 associated cognitive-motor complex.

Question 4

What are the most common initial S&S of the AIDS-dementia complex?

Answer 4

changes in mentation & personality, –delirium, dementia, organic mood disorder & organic delusional disorder

Question 5

What are behavioural responses & psychological consequences from stress response related to physiologic trauma?

Answer 5

Behavioural responses: 
-Hypervigilance
-Fear & anxiety
Psychological sequelae: 
-social isolation
-agitation
-personality disorders
-PTSD
-depression
-dissociative identity disorder

Question 6

What is neurologic impairment most often related to? And what are the primary causes?

Answer 6

Neurologic impairment is most often related to brain cell (neurone destruction).
Primary causes of neuronal damage are:
-Traumatic injury
-ischemia
-infarction (CVA)
- brain tumour
-metabolic poisoning assoc. with systemic disease
*Brain cell loss may also be result of degenerative processes (Alzheimers or Parkinson’s)

Question 7

What psychiatric illnesses occur most commonly with chronic medical illnesses?

Answer 7

Substance use disorder
Anxiety - phobias most common
Depressive disorder

Question 8

A psychiatric disorder may be 1st manifestation of a primary disease. For example. depressive symptoms (comorbid depression) are an intrinsic part of what disorders?

Answer 8

endocrine disorders, metabolic disturbances, malignancies, viral infections, inflammatory disorders, & cardiopulmonary conditions