Domain 3 Flashcards
what is the first line medication to use for nightmares for PTSD?
Prazosin
What receptors are used with the medication Prazosin?
Alpha 1 adrenergic receptor antagonist and decreases nightmares due to decreasing/blocking effects of norepinephrine.
Are nightmares caused by what neurotransmitter?
norepinephrine
what is the time frame for diagnoses of GAD?
3 months
what si the time frame for MDD?
at least two weeks of symptoms
what is the time frame for acute distress syndrome?
3 days to 4 weeks
what is the time frame for PTSD?
1 months of symptoms
TD/Tourette’s syndrome/Tourette’s disorder
vocal and motor TICs
which neurotransmitter abnormality is thought to be involved in the pathophysiology of Tourette Disorder, contributing to the development of motor and vocal tics?
Excess dopamine activity
imbalances in the dopamine function, particularly in the cortico-striatal-thalamo-cortical (CSTC) circuit, may contribute to the development of motor and vocal tics.
This theory is supported by the effectiveness of dopamine-blocking medications (antipsychotics) in reducing tics.
how long does schizophreniform disorder need symptoms present? what is the time frame?
1-6 months
what is the difference between schizoaffective disorder and schizophrenia?
schizoaffective disorder includes symptoms of a mood disorder in addition to psychotic symptoms.
what are positive symptoms of schizophrenia?
hallucinations (auditory and visual), hearing voices, delusions (false beliefs), and disorganized behavior and speech.
what are negative symptoms of schizophrenia?
affective flattening (restricted range and intensity of emotional expression/diminishment of normal emotional responses), avolition (lack of motivation and ability to initiate and sustain purposeful activities/decrease in normal functioning and motivation), and poverty of speech (alogia/reduction in the amount of productivity of speech/decrease in verbal output).
what is the definition of anhedonia?
inability to experience pleasure
definition of affective flattening
restricted range and intensity of emotional expression
what is the definition of alogia?
poverty of speech
what is the definition of poverty of speech
Reduction in the amount and productivity of speech.
what are these examples of: auditory hallucinations and delusions of persecution, impaired concentration and excessive motor activity, and grandiose delusions and disorganized thinking?
positive symptoms of schizophrenia
which of neurobiological defects have been consistently associated with schizophrenia?
Overactivity of the dopamine system, mesolimbic pathway= positive symptoms of schizophrenia
Serotonin is associated with what?
mood regulation/depression mood disorder
what neurotransmitter is inhibitory?
gaba/gabaergic system/gamma-aminobutyric acid
what neurotransmitter is associated with anxiety and epilepsy?
GABA
GABA can help reduce anxiety by calming the brain, slowing down the central nervous system, and reducing anxiety signals. This is done by clocking or inhibiting certain nerve transmission.
which neurobiological defects are most consistently associated with schizophrenia?
dysregulation of dopamine and glutamate systems in various brain regions.
dopamine dysfunction is linked to positive
what structural brain abnormalities is most consistently linked to schizophrenia
enlargement of the lateral ventricles and reduction in hippocampal volume
what structural abnormality is associated with mood and anxiety disorder?
amygdala and prefrontal cortex
what structural abnormalities are associated with motor control and movement disorders?
shrinkage of the cerebellum and enlargement of the basal ganglia
what actions is most appropriate to address the patients physical health and assess pts risk of metabolic side effects?
checking pts body mass index and waist to hip ratio
checking BMI and WHR is crucial preventive care measure for pts taking antipsychotic medications.
antipsychotics are associated with what?
weight gain and metabolic syndrome, monitoring these helps identify pts at risk for these side effects.
which antipsychotic is least likely to gain weight?
aripiprazole (Abilify)
others after aripiprazole are quetiapine.
what mood stabilizer is associated with least weight gain for BD?
lamotrigine (Lamictal)
what is the least sedating medication associated with schizophrenia?
aripiprazole ( atypical antipsychotic)
what medication/antidepressant medication would be least sedative aide effects?
Escitalopram (Lexapro) is the least sedating SSRI while maintaining daytime alertness.
what mood stabilizer is appropriate to prescribe during pregnancy?
lamotrigine
Lithium is associated with what contraindication during pregnancy?
heart defects, when used during the first trimester.
Valporic Acid (Depakote) is associated with what birth defects?
neural tube defects and cognitive impairments
Carbamazepine (Tegretol) is associated with what birth defects?
neural tube defects
what medications are known to be associated with the risk of QT prolongation?
ziprasidone (Geodon{MOST LIKELY}), RISPERIDONE (RISPERDAL), haloperidol, and quetiapine
what herbal or OTC is associated with liver toxicity?
KAVA
Fetal alcohol syndrome (FAS)
LEAD TO GROWTH RETARDATION, MICROCEPHALY, INTELLECTUAL DISABILITY, AND DISTINCTIVE FACIAL FEATURES (small eyes, exceptionally this upper lip, a short, upturned nose, and a smooth philtrum) deformities of joints, limbs, and fingers.
Down syndrome
intellectual disability and facial features (epicanthal folds and a flattened facial profile), decreased or poor muscle tone, short neck with excess skin at the back of the neck, flattened facial profile and nose, small head, ears, and mouth, upword slanting eyes, often with a skin fold that comes out from the upper eyelid and covers the inner corner of the eye.
fragile X syndrome
elongated face, large head, large ears, flexible joints, flat feet, and a prominent forehead and jaw.
SCALES
1.
2.
3
4
5
6
7
8
9
- slumm 0-20
- mmse 10-20
- PHQ9 10- 14
4.GAD7 10- 14
5.HAMD 14- 18
6.HAMA 18 - 24
7.COWS 13 - 24 buprenorphine/naloxone
8.CIWA 16 - 20 lorazepam (for liver disease pt)/diazepam/Librium
9.BECK 20-28
Erikson’s psychosocial stages
1
2
3
4
5
6
7
8
- 0-1 hope trust VS mistrust
- 1-3 will autonomy VS shame
- 4-6 purpose Guilt VS Initiative
- 7-11 Competency inferiority VS Industry
- 12-19 fidelity CONFUSION VS identity
- 20-25 love intimacy VS isolation
- 26-64 care stagnation VS generativity
- > =65 wisdom Despair VS integrity
Freud’s
1.
2.
3.
4.
5.
Old Age People Like Grapes
1. 0-1.5yo (18m)= oral
2. 18m(1.5yo)- 36m (3yo)= anal
3. 3yo-6yo= Phallic
4. 7yo-puberty(12yo)= Latency
5. 12yo - < = Genital
Piaget’s
1.
2.
3.
4.
Some People Can Fly
1. 0-2 = sensorimotor= object permanence
2. 3-7 = Pre-operational = magical play
3. 8-11 = concrete operational= math
4. 12-< = formal operational = abstract logic/science fair
lithium levels
0.6-1.2
Carbamazepine normal values
4-12
Thyroid stimulating hormone (TSH) normal values
2-10
Sodium normal values
135-145
ALT/AST (liver disease) normal values
ALT (5-35)/ AST (5-40)
valproic acid normal values
50-100
> =+4 proteins in urine=
nephrotoxic (kidney damage)
Which neurotransmitter systems are most likely implicated in the pathophysiology of this mood disorder, recurrent episodes of depression and anxiety. the patient describes periods of low mood, fatigue, excessive guilt, and poor concentration. additionally, the patient experiences episodes of heightened anxiety, restlessness, and racing thoughts?
serotonin and norepinephrine
both are implicated in mood regulation and are commonly associated with mood disorders. low levels of serotonin are linked to depressive symptoms, while imbalances in norepinephrine can contribute to anxiety symptoms.
