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ANCC Boards > DSM Dx/Criteria > Flashcards

DSM Dx/Criteria Flashcards

1
Q

DSM IV Axes

A

I psychiatric dx
II personality d/o, MR, developmental delays
III medical conditions
IV psychosocial/environmental px affecting tx
V global clinician rating GAF

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2
Q

GAF scale

A

100 -91
Superior functioning in a wide range of
activities, life’s problems never seem to
get out of hand, is sought out by others because of his or her many positive
qualities. No symptoms.
90-81
Absent or minimal symptoms
(e.g., mild anxiety before an exam
), good
functioning in all areas, interested and involved in a wide range of activities.
socially effective, generally satisfied with life, no more than everyday problems
or concerns
(e.g. an occasional argument with family members).
80 - 71
If symptoms are present, they are transient and expectable reactions to
psychosocial stressors
(e.g., difficulty concentrat
ing after family argument);
no more than slight impairment in social, occupational or school functioning
(e.g.,
temporarily failing behind in schoolwork).
70 - 61
Some mild symptoms
(e.g. depressed mood and mild insomnia)
OR some difficulty in social, occupational, or school functioning
(e.g., occasional
truancy, or theft within the household)
, but generally functioning pretty well, has
some meaningful interpersonal relationships.
60 - 51
Moderate symptoms
(e.g., flat affect and circumstantial speech, occasional panic
attacks)
OR moderate difficulty in social, occupational, or school functioning
(e.g.. few
friends, conflicts with
peers or co-workers).
50 - 41
Serious symptoms
(e.g.. suicidal ideation, severe obsessional rituals, frequent
shoplifting)
OR any serious impairment in social
, occupational, or school functioning
(e.g.,
no friends, unable to keep a job).
40 - 31
Some impairment in realit
y testing or communication
(e.g., speech is at times
illogical, obscure, or irrelevant)
OR major impairment in several areas, such as work or school, family relations,
judgment, thinking, or mood
(e.g., depressed man avoids friends, neglects family,
and is unable to work; child frequently beats
up younger children, is defiant at home,
and is failing at school).
30 - 21
Behavior is considerably influenced by delusions or hallucinations
OR serious impairment in communication or judgment
(e.g., sometimes
incoherent, acts grossly inappropriat
ely, suicidal preoccupation)
OR inability to function in almost all areas
(e.g., stays in bed all day; no job, home,
or friends).
20 - 11
Some danger of hurting self or others
(e.g., suicide attempts without clear
expectation of death; frequently violent; manic excitement)
OR occasionally fails to maintain minimal personal hygiene
(e.g., smears feces)
OR gross impairment in communication
(e.g., largely incoherent or mute).
10 - 1
Persistent danger of severely hurting self or others
(e.g., recurrent violence)
OR persistent inability to main
tain minimal personal hygiene
OR serious suicidal act with clear expectation of death.
0
Inadequate information.

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3
Q

Time criteria for MDD

A

sx last at least 2 weeks

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4
Q

time criteria for dysthymic d/o

A

depressive mood for atleast 2 years

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5
Q

time criteria for bipolar 1 d/o

A

(mania) persistently elevated, expansive or irritable mood lasting at least 1 week
* does not have to have depressive episode

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6
Q

criteria for bipolar II d/o

A

*depressive episode at least 1
*hypomanic episode at least 1
hypomanic has to last for at least 4 days
*never have psychotic sx or manic or mixed episode

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7
Q

criteria for cyclothymic d/o

A

hypomanic and depressive sx that don’t meet criteria for MDD or bipolar
*sx last at least 2 years and not with out sx for longer than 2 months

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8
Q

criteria for panic d/o

A

period of intense fear/discomfort
*4 sx phys/behav and reach peak within 10min
1 month or mor of at least having a concern about future attacks or worry of attacks or change in behavior r/t attacks

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9
Q

criteria for social phobia/social anxiety d/o

A

persistent fear of 1 or more social/performance situations

*if under 18 must last at least 6 months

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10
Q

criteria for OCD

A

marked distress, time consuming (more than 1 hour per day)

can have obsession=thoughts or compulsions=behaviors

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11
Q

criteria for PTSD

A

sx last greater than 1 month and exposed to traumatic event or threatened
acute-less than 3 months
chronic-great than 3 months

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12
Q

criteria for acute stress d/o (ASD)

A

sx last at least 2 days but not longer than 4 wks or 1 month

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13
Q

criteria for GAD

A

excessive worry/anxiety for at least 6 months

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14
Q

criteria for dementia

A

2 or more of: Aphasia (language), Apraxia (motor), Agnosia (recognizing objects), and executive functioning px

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15
Q

criteria for schizophrenia

A

hallucinations, delusions, disorganized thoughts and speech and behavior and negative sx (need 2 or more for at least 1 month unless bizarre delusions or hallucinations consisting of voice keeping running commentary or 2 or more voices conversing with each other)
*continuous s/s persistis at least 6 months

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16
Q

criteria for schizoaffective d/o

A

have schizophrenia along with depressive episode or manic or mixed episode
delusions or hallucinations in absence of mood issue have to last for at least 2 weeks and mood sx present for substantial portion of total duration of active and residual periods
*have mood in between + sx

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17
Q

criteria for schizophreniform d/o

A

criteria met for schizophrenia except that the s/s have been present for at least 1 month but less than 6 months

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18
Q

criteria for brief psychotic d/o

A

have 1 or more (delusion, hallucination, disorganized speech and behavior) lasting 1 day but less than 1 month with full return to premorbid funcitoning

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19
Q

criteria for delusional d/o

A

non bizarre delusions for at least 1 month
subtypes: erotomanic (believes another is in love with them); grandiose, jealous, persecutory, somatic, mixed, unspecified type

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20
Q

alcohol withdrawal

A 
tremulousness 68 hours after cessation
psychotic and perceptual 8-12 hours
seizures 12-24 hours 
DT's any first 72 hours
delerium can occu in 1 week after cessation

sx: autonomic hyperactivity, increased hand tremor, insomnia, n/v, transient hallucinations/illusions, psychomotor agitation, anxiety, grand mal seizures

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21
Q

CIWA scoring

A

0-9 absent or minimal w/drawal
10-19 mild to mod
> or equal to 20 severe w/ drawal
tx often BZDs

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22
Q

acute intoxication of opiods

criteria

A

apathy/sedation, disinhibition, psychomotor retardation, impaired attention and judgment;
atleast 1 of the following (drowsy, slurred speech, pupillary constriction, decreased LOC)

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23
Q

opioid w/drawal

A

n/v, runny nose or lacrimation, pupillary dilation, piloerection, diaphroesis, diarrhea, yawning, fever, insomnia

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24
Q

cluster A personality d/o

A

paranoid, schizotypal, schizoid
can be very defensive
bizare, eccentric, loners

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25
cluster B personality d/o
antisocial, BPD, histrionic, narcissistic | dramatic, erratic, egocentric
26
cluster C personality d/o
OCPD, dependent, avoidant | avoidant, anxious, fearful
27
general dx criteria for personality d/o
2 or more effected (cognition, affectivity, interpersonal fx, impulse control) pattern is stable and of long duration
28
criteria for conduct d/o
formal dx: 7-18 y/o before 10 childhood onset after 10 adolescent onset greater than 18 meet criteria for ASPD
29
criteria for ODD
precursors: 3-7 y/o d/o: 8 y/o
30
criteria for autism
lack awareness of other; may tx them like objects abnormal communication repetitive behaviors stereotypical movements
31
criteria for Rett's d/o
``` *affects only females normal development until 5months; onset 1 year old -they cease to gain developmental milestones -loss of skills already required sterotypic hand movements seizures, scoliosis and hypertonicity ```
32
criteria for asperger's d/o
like autism but *speech is not affected
33
criteria for ADHD
px in at least 2 settings | age criteria of 7 y/o
34
criteria for MR
``` code on axis II IQ less than 70 mild 50-17 IQ mod 35-50 severe 20-35 profound below 20 onset before 18 y/o ```
35
Fetal Alcohol Syndrome characterizations | not coded in DSM IV
Physical signs: skin folds in corner of eyes low nasal bridge short nose **indistinct philantrum (groove between nose and upper lip) **thin upper lip small head circumference small midface
36
What age populations most at risk for suicide?
Teens and older adults
37
What is the number one cause of suicide in teens?
depression | adolescents have a irritable mood more often than a sad mood
38
Assessing cluster A
pervasive distrust, suspiciousness, with odd unusual behaviors, Paranoid personality, schizoid, schizoidtypal
39
Assessing cluster B
pervasive problems with relationships and affect/mood borderline, histrionic, antisocial, narscistic
40
Assessing cluster C
pervasive anxiety, fear avoidant, dependent, obsessive
41
what is personality
emotional, cognitive and behavioral attributes of a person - enduring pattern of precieving reality and thinking about things - ingrained and developed early but can be altered
42
what is egosyntronic
consistent with personality; it is behavior based on personality that is comfortable
43
what is egodystonic
incosistent with personality; it is behavior based on personality that is uncomfortable
44
When does abstract thinking develop
greater than age 12
45
Time frame for oppositional defiant disorder
6 months and greater
46
childhood onset for CD is...
before age 10 is childhood | after age 10 is adolescent
47
Neurotransmitters in ADHD
DA and NE
48
brain region in ADHD
PFC, basal ganglia, and RAS (reticular activating system)
49
Substance abuse
has to maladaptive has to cause problems and they still use the substance has to be 12 months
50
substance dependence
cognitive, behavioral, physiological sx
51
addiction
has to be 12 months
52
Delerium Tremens
first 24-72 hours (1-3 days) | n/v, sweats, tremors, tactile distrubances, anxiety, agitation, visual and auditory disturbances, HA, altered sensorium
53
CIWA scores
mild w/drawal 0-8 mod 9-15 severe greater than 15 max score 67
54
substance abuse | drugs used for cravings
naltrexone acomporosate ondansetron buprenophrine
55
Aversive treatment in substance abuse
disulfram (Antabuse) * need to be alcohol free for at least 12 hours and anything with alcohol in like mouthwash for up to 2 weeks after stoping med * monitor liver * can induce mania
56
etiology of substance related disorders | reinforcement
brain based on changes to structure and fx - positive rewards result in social rewards commonly associated with drug use such as euphoria and is mediated by DA pathways - negative rewards are aversive such as anxiety and depression mediated by GABA pathways - reinforcement occurs in the ventral demential area in nucleus accumbent (reward center) - DA relased and further release of neuropeptides this enhances pleasure experience and with repeated use DA system becomes sensitized and eventually associated with stimuli (like pics of the drug)
57
Neuroadaptation related to substance abuse
this is how tolerance and withdrawal occur. changes can be enduring for years causing increased risks for relapse. it explains how you can pick up a drink after years of sobriety and have same level of tolerance and physical impact.
58
the most commonly abuse illegal drug
marijuana
59
the most commonly abuse legal drug
alcohol
60
CAGE scoring
2 or more indicate clinically significant and risk for dependency
61
Psychotropics
are lipophilic, extensively metabolized in liver though phase of oxidative reactions phase II glucuronide conjugation and evolve changes in CYP450 monooxygenases
62
CYP system
- superfamily of isoenzymes located in endoplasmic reticulum mainly in liver - isoenzymes responsible for oxidized metabolism and exonbiotics as well as endogenous compounds like prostaglandins, fatty acids, steroids - CYP enzymes classified by amino acid sequence - the # is "family" which over 4j0% identify with family members and # is equal to individual isoenzyme - major CYP enzymes in metabolism of drugs: families 1 2 3 with the isoforms CYP1A2, 2C9, 2C19, 2D6, 3A4 - each CYP isoform is specific gene product-family genetics but effected by environment
63
Delirium
is a syndrome not disease subtypes (hyperactive, hypoactive, mixed/cycles) screening tool CAM confusion assessment method
64
Hallmark s/s of AD
amyloid plaques, neurofibillary tangles genetically autosomal dominant decrease in Ach and NE
65
Hallmark s/s of VD
carotid bruits, fundoscopic abnormalities, enlarged cardiac chambers
66
Hallmark s/s of HIV dementia
parenchymal abnormalities on MRI | *caution with drug interactions between Antivirals and Antipsychotics
67
Hallmark s/s of frontotemporal dementia
gliosis, picks bodies | *changes in personality
68
Hallmark s/s of Creutzfeldt-Jakob dementia
fatal, rapid
69
Hallmark s/s Huntington's dementia
subcortical and mostly motor abnormalities
70
Hallmark s/s Lewy body
lew inclusion bodies in cortex (protein bodies) * recurrent visual hallucinations * adversely react to antipsychs
71
amaurosis fugax
unilateral vision loss, curtain over eye
72
Namenda
10-20mg N-methyl-D-aspartate glutamate receptor antagonist *prevents over excitation of glutamate and promotes synaptic plascticity
73
cholinesterase inhibitors
for mild to mod dementia aricept 5-10 mg rivastigmine (exelon) 1.5-6mg BID for AD and PD transdermal 9.5 daily
74
what does psychotic mean
inability to test reality
75
mesolimbic
limbic system info processing **Where positive sx arise in schizo
76
mesocortical
frontal cortex attention, concentration, executive fx **where negative sx arise/cognitive sx in schizo
77
catatonia
motor sx immobility-catalepsy OR excessive purposeless movement
78
soft signs of schizo
1. astenognosis (loose ability to judge the shape of object by touch) 2. twichtes, tics, rapid eye blinking 3. dysdiadochokinesia (impairment of ability to perform rapidly alternating movements 4. impaired find motor movement, left-right confused 5. mirroring
79
astenognosis
loose ability to judge shape of object by touch | parietal lobe px
80
dysdiadochokinesia
impairment to perform rapidly alternating movements | cerebellum px
81
Hard signs in schizo
1. weakness | 2. decreased reflexes
82
How anti psychos work on DA pathways
mesolimibic - decrease positive signs by blocking DA mesocortical - decrease negative signs by increasing DA nigrostriatla - block 5HT which causes DA to increase and Ach to decrease and prevent or decrease chance of EPS tuberoinfundibular - DA inhibit prolactin
83
The higher the potency of blocking DA....
the increased risk of EPS | DA and Ach are inversely related...so decreasing DA will increase Ach
84
The lower the potency of blocking DA...
the less risk of EPS | decrease DA you increase Ach; inversely related
85
What does caffeine and nicotine do to antipsychotics?
they decrease the concentration/effects of the antipsychotic meds
86
neuroleptic malignant syndrome labs
increase CPK, WBC, LFT
87
treatment for neuroleptic malignant syndrome
``` dantrolene bromocriptine *stops the blocking of DA antipyretic for hyperthermia or cooling blanket hydration BZD for catatonic sx ```
88
What is the black box warning on antipsychotics in older adults?
they can increase risk of mortality in older adults with dementia
89
schizophrenia time frame
greater than 6 months
90
schizophreniform time frame
less than 6 months and may not have impairments in fx
91
erotomanic
delusion focused on false belief that another is in love with them usually spiritual or famous usually stalking
92
brief psychotic d/o lasts...
1 day and less than 1 month
93
theories in anxiety d/o
freud-psychodynamic: anxiety initially from experiences from birth; conflict with id and superego; increase use of defense mechanisms sullivan-interpersonal: px between interpersonal relationships and self becomes identified by our we perceive others to view us neurobiological: px with limbic, midbrain, and areas of cortex; HPA axis, autonomic response; decrease levels of GABA, (GABA and 5HT suppress HPA axis)
94
cyclothymic d/o
similar to bipolar but less severe - hypomania and dysthymia sx - risk developing BP disorder
95
depolarization
initial phase, excitatory, Na and Ca in
96
repolarization
restore phase, inhibitory, K leaves
97
potency
dose required to cause effect
98
therapeutic index
level where desired effect is achieved and below level of toxicity * margin of safety with high index * low index low safety margin
99
tachyphylaxis
acute decline in therapeutic response
100
Ch level
98-106
101
k level
3.5-5.1
102
thyroid fx
t3 t4 bind small amount to protein *free T4 0.8-2.8 normal used to evaluate hypo or hyper (can be increase in methadone and decreased in propranolol) TSH-evaluate hypo; values can be increased with lithium -hypo: decreased T4 increased TSH -hyper mimics bipolar d/o
103
Ca level
8. 8-10.5 - increased in children that are growing - increased by lithium, it D, thiazides, antacids - decreased in anticonvulsants, steroids, oral contraceptives - increase excite and decrease depress
104
Na level
135-148 | imbalance-water distribution, seizures, heart and bp rate, HA LOC changes
105
Mg level
1.3-2.1 decrease depress, irritable, weakness increase n/v weakness
106
ALT
5-35 acts as catalyst in amino acid production with liver damage level may rise as much as 50x normal (1750) pronounced >300 disease and damage mod 100-300 muscle injury (trauma, seizures, infection, injections), biliary obstruction, CHF, MI, burns Drugs: tylenol, carbamazepine can increase
107
AST
5-40 most are in skeletal muscles increased with tissue damage pronounced >5x normal (200) acute liver damage, MI, shock, acute pancreatitis, mono mod 3-5x normal (120) biliary, cardiac, CHF, liver tumor, chronic hepatitis slight 2-3 x normal (80) pulmonary infarct, DT's, CVA, cirrhosis
108
GGT
10-38 isoenzyme of alkaline phosphatase monitor level with alcohol abuse mod increase in cirrhosis, pancreatitis, renal disease
109
theories in MDD
psychodynamic: object loss (early losses in childhood effect us later) aggression turned inward (Frued): loss in childhood causes anger and turns inward to decrease self esteem and cause guilt learned helplessness-hopelessness: lack of control biological theory: genetic predisposition endocrine dysfx: HPA axis-neurovegatitive sx; increase cortisol results in changes in brain; abnormal transmitors or decrease in tryptophan/5HT; decrease volume of hippocampus, PFC, limbic
110
Bereavement
occurs if depression sx are within 3 months of major loss/death self esteem usually preserved
111
How do you treat HTN related to MAOI ?
give phyntolamine which binds to NE receptor sites and blocks NE
112
What personalities are associated with dysthymic d/o
cluster B | antisocial, BPD, NPD, dependent, histrionic
113
Theories in bipolar
biological: GABA dysregulation, increase NE/adrenergic, voltage gate px kindling: brain becomes sensitive to electrical stimuli misfiring
114
Lithium level SE toxicity
0.5-1.2 SE: wt gain, thyroid and parathyroid dxfx, hand tremors, GI upset, acne, edema, tubular changes, leukocytosis Toxicity: slurred sjpeech, confusion, severe GI effect -monitor kidneys, NSAIDS and ACEI can increase levels *gold standard for mania, depression and SI response 1-2 wks routine lab: CBC, Renal, thyroid, lithium levels *want to ask about pregnancy (Epstein bar)
115
depakote
gold standard for rapid cycling labs routine (CBC, liver, depakote levels) *ask about pregnancy (spina bifida)
116
black cohosh
good in menapuase sx and prementraul sx
117
belladonna
anxiety
118
catnip
sedation
119
chamomile
sedation, anxiety
120
ginkgo
delerium, dementia, sexual dysfx caused by SSRI
121
ginseng
depression, fatigue
122
valerian
sedation
123
Yalom
group therapy
124
10 concepts of group therapy
``` install hope alturism socializaiton interpersonal learning catharsis corrective refocusing universality imitative behavior group cohesiveness existential factors ```
125
group phases
``` forming storming (resistance) norming performing adjourning ```
126
family system concepts
system-units/structure all operate together need to understand all parts
127
Bowen
family systems therapy
128
Minuchin
structural family therapy how px are created with relationships of others px/sx are rated in family patterns structural mapping/genogram
129
Satir
experiental therapy | px determined by personal experience
130
deShazer and OHanlon and Berg
solution focused therapy miracle questions exception finding sclaing
131
omega 3
ADHD, dementia, MCI, | interacts with warfarin and increases its effects
132
sam e
depression, OA, liver disease | may cause hypomania, hyperactive muscles and possible seratonin syndrome
133
vitamin e
immune system, neuro d/o | can increase effects of warfarin and anti platelet drugs and increase statins
134
melatonin
insomnia, jet lag, shift work, CA ASA, NSAIDS, beta blockers, steoids alcohol interacitons can inhibit ovulation in large doses
135
fish oil
BP, HTN | warfarin ASA, NSAIDS, ginkgo, garlic, may alter glucose regulation
136
psychoanylytical
frued | for gaining insight
137
cognitive
Aaron Beck | events don't cause anxiety ppl perceptions cause anxiety
138
behavioral
Lazarus | change behavior through exposure, relaxation, px solving, role playing
139
DBT
Linehan | BPD
140
existential
Frankl person centered self directed growth self actualization
141
interpersonal
Kleman Weissman | focus on present
142
EMDR
Shapiro form of behavior therapy bilateral stimulation
143
Schedule 1 drugs
non medicinal substances high abuse potential research
144
schedule II drugs
``` high potential abuse drugs in current use NO telephone orders and NO refills (Morphine, codeine, fentanyl, methadone, oxy) ADHD meds/stimulants ```
145
schedule III drugs
``` potential for abuse telephone order IF followed by written must be renewed every 6 months refill limited to 5 testosterone, butalbital ```
146
schedule IV drugs
darvon, tawlin, BZD | can only be refilled up to 5 x or after 6 months
147
schedule V drugs
with lowest potential for abuse | handled same as non schedule drugs
148
Pregnancy category
``` A-controlled studies show no risk B-no evidence of human risk C-risk cannot be ruled out D-positive evidence of risk X-C/I in pregnancy ```
149
teratogenic: depakote
spina bifida
150
teratogenic: lithium
epstein anomaly
151
teratogenic: carbamazepine
neural tube defects
152
teratogenic: BZD
floppy baby syndrome, cleft palate
153
agraphesthesia
unable to recognize letters drawn on hand
154
physical assessment | romber
testing equillibrium | px with cerebellum or vestibular dysfx
155
epidemiology
study at distribution, inclusion, and prevalence and duration of disease
156
incidence rate
number of cases occurring over specified time (usually 1 year)
157
prevalence rate
number of existing cases at a specified time
158
structural and functional imaging
functional MRI, 3D MRI, | mostly used for research
159
functional imaging
``` assess bold flow and may use radioactive to cross blood brain barrier used in research EEG and evoked potential testing MEG SPECT ```
160
structural imaging
gives evidence of size and shape of anatomy structures CT (3D view) -easy, inexpensive, see structures based on density, but cannot view structures close to bone, underestimate brain atrophy MRI (2D image) -view structures close to bone, separate white and gray matter, readily available but expensive, and many CI like pacemaker, implants and ventilators
161
monoamines/catecholamines
DA, NE
162
locus creels of pons | precursor tyrosine
NE
163
adrenal glands
EPI
164
substatia nigra and ventral tegmental area | precursor tyrosine
DA
165
raphe nuclei | precursor tryptophan
SE
166
Amino acids | excitatory
glutamate | aspartate
167
amino acids | inhibitory
GABA | Glycine
168
amino acids Ach cholinergic produced....
produced by basal nucleus of meynert | precursor acetylcoenzyme A and choline
169
neuropeptides non-opiod like substance P, somatostatin opiod like endorphins, enkephalins, dynorphins modulate...
modulate pain, | a decreased amt thought to cause substance abuse
170
Sullivan
interpersonal theory once concept is on drives what drives us (sex drives, security, satisfaction)
171
Maslow
hierarchy of needs
172
psychoanylytical | all behavior has meaning
Frued
173
behavior of determinism
Frued | it is activated by unconcious or mental content
174
oral phase
0-18months
175
anal phase
18m-3 yr
176
phallic
3y-6 yr
177
latency (social/relationships)
6 yr-puberty
178
genetial puberty
puberty and beyond
179
Bandura
social learning self efficacy ppl learn from observing/role modeling bobo doll
180
Leininger
theory of cultural care | nursing theory
181
Peplau
based on sullivan interpersonal theory phases of nurse relationship: orientation, working, termination
182
Watson
caring theory | nursing theory
183
transtheroetical model of change
precontemplation- no intention to change contemplation- thinking about change preparation- ready to change action-they change maintenance- engage in change and prevent relapse
184
Piaget
cognitive theory human development is from cognitive, learning and comprehending stages: sensorimotor, preoperational, concrete
185
Piaget | sensorimotor
birth-2 | object permanence
186
piaget | preoperational
2-7 yr | symbolism, magical thinking
187
piaget | concrete operations
7-12 yr concepts reversibility (ice to water) conservation (shape may change but still same: clay)
188
Id
primary drives, | unconscious
189
ego
external reality, rational | defense mechanisms
190
super ego
right vs wrong guilt vs shame develop by age 6
191
reaction formation
overcompensate, display opposite feelings
192
undoing
try to make up for behavior
193
sublimation
unconscious | substitute acceptable behavior for strong unacceptable behavior
194
Erickson | infancy
0-1 yr | trust vs mistrust
195
erickson | early child
1-3 yr | autonomy vs shame and doubt
196
erickson | late child
3-6 yr | initiative vs guilt
197
erickson | school age
6-12 yr | industry vs inferiority
198
erickson | adolescents
12-20 | identity vs role confusion
199
erickson | early adult
20-35 | intamancy vs isolation
200
erickson | middle adult
35-65 | generativity vs self absorption or stagnation
201
erickson | late adult
>65 | integrity vs despair
202
probability
likelihood of event occuring
203
pvalue
level of significance probability of particular result occurring by chance alone (if p=.01 there is 1% probability of obtaining a result by chance alone)
204
t test
assess means of 2 groups to see if they are different
205
analysis of variance ANOVA
test 3 or more groups to see if they are different
206
pearson r
see the relationship between two groups
207
variance
how values are dispersed around mean
208
standard deviation
indication of possible deviation from mean
209
external validity
ability to generalize
210
internal validity
the extent you can say no other variables except the one you are studying caused the result
211
the highest level of evidence
systematic, meta analysis
212
lowest level of evidence
opinions, authorities or expert committees
213
hierarchy of evidence
``` highest -systematic, meta analysis -evidence from clinical practice guidelines -one or more RCT -controlled trials -systematic review from qualitative and describtive study -single descriptive or qualitative -opinion, expert committees lowest ```
214
justice
doing what is fiar
215
beneficience
promoting well being
216
nonmalfeasance
doing no harm
217
fidelity
being true and loyal
218
autonomy
do for self
219
veracity
tell truth
220
respect
treat you with equal respect
221
deontological theory
action judged as good or bad regardless consequences
222
teleological theory
action good or bad based on consequences
223
virtue ethics
actions chosen based on moral virtues or character of person making decision
224
duty
NP had duty to exercise reasonable care=standard
225
breach of duty
violated standard of care
226
proximate cause
causal relationship between breach of duty and pts injuries
227
damages
permenant substantial damage as result of breach in duty
228
primary prevention
prevent dx
229
secondary prevention
decrease prevalence of mental d/o, early case finding, screening, prompt, effective tx
230
tertiary prevention
decrease disabilities associated with mental d/o | rehab, tx programs
231
asperger
No delay in language delay in motor sometimes sustained px in social repetitive movements, behaivors
232
rett syndrome
develop specifid deficits after a normal developmental period primarily in girls can have decelerated head growth between 5months and 48 months loose previously acquired skills 5-30months lose social, poor coordination, stereotypal movements, motor slowing
233
ASD
marked impairment in social, cognitive by age 3 communication delay, unable to sustain or initiate convo, repetitive behaviors, inflexible, short attention, app and sleep px, self injurous behavior, no imaginary plan, no peer play,
234
russel's sign
callouses on hands from purging
235
FDA approved drug for bulimia
fluoxetine
236
MR | onset
less than 18 yrs | IQ less than 70
237
mild MR
50-70 | 6th grade level
238
mod MR
35-55 | 2nd grade level
239
severe MR
20-40 | poor motor, little or no speech
240
profound MR
less than 20 minimal sensorimotor fx poor cognitive social often no speech
241
stage I of sleep
NREM transition from wake to sleep 5% of cycle
242
state II of sleep
NREM 50% of cycle
243
state III and IV of sleep
NREM slow wave deepest level 20-25% of cycle occur in first 1/3 or 1/2 cycle
244
REM cycle sleep
cyclical throughout night alternating with NREM ever 80-100min usually
245
insomnia
inability to get enough sleep needed to fx during day
246
transient insomnia
jet leg, stress, hotels
247
short term insomnia
bereavement, stress | may last up to 3 weeks
248
long term insomnia
greater than 3 weeks

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