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Human Behavior > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What is the most prevalent mental illness?

A

anxiety disorders

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2
Q

What is the 10th leading cause of death overall in the US?

A

suicide

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3
Q

What race has the highest prevalence of living with a mental health condition?

A

AI/AN followed by asian

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4
Q

What are the components of the psych interview?

A 
establish relationship with patient
assess risk
formulate ddx and management plan
negotiate and initiate tx plan
produce standard record
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5
Q

What is the biopsychosocial model?

A

holistic approach that examines disease/illness beyond the pathophysiological construct

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6
Q

What facilitates working alliance?

A

attentive listening, empathy, respect and communication

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7
Q

What is content and process?

A

what is being said and how its being said

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8
Q

What are 3 psych interview techniques?

A

normalization
continuation
redirection

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9
Q

Normalization

A

helps reduce shame/stigma, being judges

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10
Q

Continuation

A

acknowledges patient, engages, nonverbal cues

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11
Q

Redirection

A

helps guide and focus interview

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12
Q

How long should you allow the pt to talk freely without interruption?

A

at least 3-4 minutes

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13
Q

What is SIGECAPS?

A 
sleep
interest
guilt
energy
concentration
appetite
psychomotor agitation
slowing or suicidality
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14
Q

What is the goal of past psych hx?

A

obtain information about psych illnesses and their course over pts lifetime including sx and tx

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15
Q

What is the goal of social development hx?

A

establish pts development and social hx across various stages of pts life

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16
Q

How far apart should clinician and patient be seated?

A

4-6 feet

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17
Q

What is WHODAS?

A

world health organization disability assessment schedule

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18
Q

What are the 6 domains of WHODAS?

A 
cognition
mobility
self-care
getting along
life activities
participation
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19
Q

What are the 4 Ps?

A

predisposing factors
precipitating factors
perpetuation factors
protective factors

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20
Q

What is MAPPS-CO?

A 
mood
anxiety
psychosis
personality
substance/addiction
somatic
cognitive
obsessions/compulsions
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21
Q

What is the purpose of the MSE?

A

evaluate, qualitatively and qualitatively a range of mental functions and behaviors at a specific point in and provide impt info for diagnosis

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22
Q

What are the components of MSE?

A 
general appearance and attitude
motor activity/behavior
orientation/level of consciousness
mood and affect
speech
thought form and content
perception
memory and cognition
judgement and insight
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23
Q

What is psychomotor retardation and what does it signify?

A

slowing of physical and emotional rxns

may signify depression or negative sx of schizophrenia

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24
Q

What is psychomotor agitation and when may it occur?

A

excessive motor and cognitive activity may occur with anxiety or mania

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25
Q

Tics

A

sudden repetitive, jerky movements of eyes, vocal organs, face, extremities or trunk

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26
Q

Compulsion

A

repetitive and ritualized behavior which the person feels compeleld to perform

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27
Q

Echopraxia

A

involuntary repetition or imitation of another persons actions typically seen with Tourette’s or autism

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28
Q

Akathisia

A

movement disorder characterized by feeling of inner restlessness and compelling need to be in constant
SE of APS

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29
Q

Catalepsy

A

person can be molded into position that is then maintained for prolonged period of time
seen in catatonic schizophrenia

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30
Q

Catatonia

A

severe disturbance of motor fn usually manifested by markedly decreased activity but may involve hyperactivity with alteration btwn these states

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31
Q

Dystonia

A

involuntary muscle contractions that cause slow repetitive potentially painful movements or abnormal postures
Drug induced

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32
Q

Dyskinesia

A

difficulty or distortion in performing voluntary mvts

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33
Q

How do you check orientation?

A

time
place
person
situation

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34
Q

obtunded

A

slowed response to stimulation

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35
Q

stuporous

A

awakening in response to pain

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36
Q

comatose

A

unresponsive

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37
Q

Affect

A

patients observed expression of emotion

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38
Q

Circumstantiality

A

over inclusion of trivial or irrelevant details that impede sense of getting to the point

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39
Q

clanging

A

thought associated with sound of word rather than by their meaning

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40
Q

derailment

A

breakdown in both logical connection between ideas and overall sense of goal directness

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41
Q

flight of ideas

A

succession of multiple associations so that thought seem to abruptly move from idea to idea often expressed though rapid pressured speech

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42
Q

neologism

A

invention of new words or phrases

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43
Q

preservation

A

persistent repetition of specific words or concepts despite absence or cessation of stimulus

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44
Q

tangentiality

A

pt gives reply thats appropriate to general topic without actually answering the question

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45
Q

thought blocking

A

sudden disruption of thought or break in flow of ideas

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46
Q

word salad/incoherence

A

speech makes no sense at all

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47
Q

pressured speech

A

fast and difficult to interrupt

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48
Q

distractible speech

A

patient changes subject in response to something unrelated in environment

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49
Q

obsessions

A

intrusive and unwanted ideas which intrude into consciousness despite efforts to suppress them

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50
Q

grandiose

A

delusions of grandeur

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51
Q

persecution

A

belief that someone wants to cause them harm

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52
Q

erotomanic

A

belief that someone famous is in love with them

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53
Q

nihilistic

A

belief that self or part of self, others or the world does not exist

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54
Q

ideas of reference

A

belief that everything refers to pt

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55
Q

ideas of influence

A

beliefs about another person or force controlling some aspect of ones behavior

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56
Q

illusions

A

misperception or misinterpretation of REAL external sensory stimuli

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57
Q

dissociation

A

lack of connection in a persons thoughts, memory or sense of ID

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58
Q

depersonalization

A

sense that one is outside his/herself

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59
Q

derealization

A

subjective sense that the environment is strange of unreal

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60
Q

hallucinations

A

abnormal perceptions in which pt hears, sees, tastes, smells or feels something others cannot

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61
Q

When do illusions typically occur?

A

delirium and psychosis

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62
Q

When do hallucinations typically occur?

A

psychosis

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63
Q

When do auditory hallucinations typically occur?

A

schizophrenia

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64
Q

When do visual hallucinations typically occur?

A

organic conditions

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65
Q

when do tactile hallucinations typically occur?

A

alcohol or benzo withdrawal

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66
Q

How do you test attention?

A

spell world backwards

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67
Q

How do you test concentration?

A

serial 7s

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68
Q

What is patients insight?

A

patients ability to understand and acknowledge factors that influence a situation such as his/her illness

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69
Q

What is ASEPTIC?

A 
appearance
speech
emotion
perceptions
thought content and process
insight and judgement
cognition
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70
Q

What is ddx for MDD?

A 
secondary depression
bipolar disorder
anxiety disorder
greif/loss
personality disorder
dysthymia
adjustment disorder
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71
Q

Dysthymia

A

persistent long term depression

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72
Q

What are the most common comorbid psych disorders associated with MDD?

A

anxiety
substance use
personality disorders

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73
Q

MDD etiology

A

early environment shapes neuronal connectivity and current environment unmasks vulnerabilities to trigger depression via release of cortisol

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74
Q

What is the stress diathesis model?

A

predisposed due to genetics and brain structure/abnormalities and neurotransmitters but triggered by stressors to develop psych disorders

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75
Q

What neurotransmitters are involved in pathophysiology of depression?

A

serotonin, NE, dopamine

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76
Q

Neocortex

A

concentration

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77
Q

Striatum

A

sluggish movement

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78
Q

Central striatum

A

anxiety

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79
Q

Hypothalamus

A

sleep and appetite

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80
Q

Hippocampus

A

memory

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81
Q

Risk factors for recurrence

A

multiple lifetime episodes
incomplete response to treatment
absence of acute stress when episode beings
severity of episode

82
Q

Danger signs of suicide

A 
talking about it
hopelessness/helpless/worthlessness
preoccupation with death
making arrangements
giving things away
anxiety
83
Q

MDD epidemiology

A

2x MC women

84
Q

MDD general tx

A

tricyclics, SSRI, SNRI, MAOI

85
Q

NeuroStar TMS

A

transcranial magnetic stimulation for MDD with no improvement from meds

86
Q

ECT

A

100 volt shock for MDD pt who don’t respond to drugs

87
Q

Epidemiology of DMDD

A

MC males

88
Q

Positive symptoms

A

delusions, hallucinations, disorders of thought, agitation/aggression

89
Q

Negative symptoms

A

affect flattening, apathy, anergia, asociality, alogia, diminished emotional expression, attentional impairment

90
Q

cognitive sx

A

working memory
executive fn
attention
learning

91
Q

mood sx

A

depression
anxiety
suicide

92
Q

Brain pathways affected by schizophrenia

A

hyperactive mesolimbic pathway causing positive sx

hypoactive mesocortical pathway causing negative, cognitive and mood sx

93
Q

What is the effect of blocking nigrostriatal D2?

A

EPS

94
Q

How does glutamate regulate dopamine?

A

directly-fibers progect to brainstem neurons

indirectly-fibers direct to GABA to brake

95
Q

How does PCP induce schizophrenia like effects?

A

Blocking brain NMDA receptors

96
Q

Pathyphys od schizophrenia

A

synaptic pruning
lateral and third ventricles are enlarged
reduction of blood flow to left globus pallidus
thinner temporal love
smaller anterior hypothalamus

97
Q

Precipitating factors of schizophrenia

A

brain damage, birth trauma, viral infections, nutritional dissues

98
Q

risk factors for schizophrenia

A 
FH
urban areas
northern hemi
winter month birth
pregnancy complications
loss of parent during childhood
lower socioeconomic status
99
Q

What percentage of schizophrenia patients commit suicide?

A

10%

100
Q

Poor prognostic factors of schizophrenia

A 
early age of onset
male
more neg sx
more brain abnormalities
lower level of fn prior to onset
substance abuse
disorganized subtype
101
Q

Fluphenazine

A

high potency APS for schizophrenia

102
Q

Trifuoperazine

A

High potency APS for schizophrenia

103
Q

thiothixine

A

High potency APS for schizophrenia

104
Q

haloperidol

A

High potency APS for schizophrenia

105
Q

thioridazine

A

low potency APS for schizo

106
Q

chlorpromazine

A

low potency APS for schizo

107
Q

Effect of anti-H1

A

sedation and weight gain

108
Q

effect of anti alpha 1

A

orthostasis and reflex tachycardia

109
Q

anti-M1

A

blurry vision, dry mouth, constipation, urinary retention, tachy, memory problems, delerium

110
Q

effects of high potency APS

A

more EPS but less anti H1, anti alpha 1 and anti M1

111
Q

What are EPS?

A

acute dystonia, akathisia, drug induced parkonsonism and tardive dyskinesia

112
Q

Drug induced parkonsonism

A

bradykinesia, rigidity, tremors

113
Q

Acute dystonia

A

sudden sustained forceful muscle contractions

114
Q

akathisia

A

motor restless or discomfort relieved by movement

115
Q

tx for dystonia

A

benztropine

116
Q

tx for parkonsonism

A

reduce APS or benztropine

117
Q

tx for akathisia

A

reduce APS, use propanolol or benzodiazepine (valium)

118
Q

tx for tardive dyskinesia

A

cease APS if possible

119
Q

clozapine

A

atypical APS

120
Q

risperidone

A

atypical APS

121
Q

olanzapine

A

atypical APS

122
Q

quetiapine

A

atypical APS

123
Q

ziprasidone

A

atypical APS

124
Q

aripiperazole

A

atypical APS

125
Q

paliperidone

A

atypical APS

126
Q

iloperidone

A

atypical APS

127
Q

SE of atypical APS

A

weight gain, inc blood glucose, increased triglycerides, possible sedation, QT prolongation

128
Q

panic disorder

A

anticipatory anxiety, misinterpretation of bodily sensations, belief that avoidance is protective

129
Q

social phobia

A

negative social expectations, fear of humiliation or judgement,

130
Q

PTSD

A

overestimation of risk of repetition of traumatic experiences

131
Q

Physiological response to stres

A

cortisol, monoamines (5-HT and NE), central NY (gaba and glutamate)

132
Q

sympathetic

A

fight or flight

133
Q

parasympathetic

A

rest and digest

134
Q

agoraphobia

A

fear of places and situations that cause panic

135
Q

How does avoidance sustain dysfunction?

A

rewarded by reduction in unplesant arousal

136
Q

Anxiety treatments

A

benzos, SSRI, SNRI, tricyclic antidepressants, Buspar, anticonvulsants, cognitive behavior therapy

137
Q

How are addictive behaviors reinforced?

A

dopamine is released in nucleus accumbens and DA will increase with anticipation of reward

138
Q

sensitization

A

repeated administration of stimulus results in amplification of response

139
Q

tolerance

A

need more to get desired effect

140
Q

What is CAGE

A

2 yeses indicated possible substance use disorder

cut back
annoyed
guilty
eye opener

141
Q

What is the most commonly abused drug?

A

marijuana followed by prescription drugs

142
Q

Nicotine MOA

A

agoist at nicotinic receptors causing inc NE

143
Q

Nicotine route of administration

A

inhaled, oral

144
Q

Nicotine intoxication

A

relaxation, increased concentration, anorexia, increased BP

145
Q

Nicotine withdrawal

A

beings 1 hr after last cigarette, peaks in 24 rs, irritability, increased appetite, craving

146
Q

Nicotine use d/o tx

A

bupropion, varenicline, replacement therapies, aovid cues, stress management, exercise

147
Q

What is the most effective tx for nicotine use disorder

A

combo nicotine replacement and pharmacotherapty

148
Q

alcohol use d/o MOA

A

GABA

149
Q

alcohol use d/o intoxication

A

slurred speech, confusion, disinhibition, seizures

150
Q

alcohol use d/o withdrawal

A

elevate BP, elevate puse, diaphoresis, confusion, seizures

151
Q

alcohol use d/o adverse effects

A

cirrhosis, GI cancer, esophageal varices

152
Q

alcohol use d/o minor withdrawal sx

A

insomnia, tremulousness, mild anxiety, GI upset, HA, palpitations, anorexia (6-12 hrs)

153
Q

When are alcoholic hallucinations seen?

A

12-24 hours

154
Q

When are alcoholic withdrawal seizures seen?

A

24-48 hours

155
Q

When are alcoholic delirium tremens seen?

A

48-72 hours

156
Q

Wernicke’s enphalopathy triad

A

confusion, ataxia, abnormal eye movements

157
Q

Korsakoff syndrome/psychosis

A

amnesai, confabulation, hallucinations

158
Q

What causes wernicke-korkoff syndrome?

A

thiamine deficiency

159
Q

Tx for acute alcohol withdrawal

A 
Lorazepam
Alprazolam
Clonazepam
Diazepam
Chlordiazepoxide
160
Q

alcohol use disorder tx

A

acamprosate
naltrexone
disulfiram

161
Q

Caffeine MOA

A

dopamine

162
Q

caffeine intoxication

A

palpitations, anxiety, irritability, insomnia

163
Q

caffeine withdrawal

A

HA, lethargy, irritability, depressed mood

164
Q

Opiates MOA

A

mu, kappa, delta

165
Q

Opiate types

A

heroin, morphine, oxycotin

166
Q

Opiates intoxication

A

euphoria, sedation, miosis, respirtory depression, constipation

167
Q

Opiates withdrawal

A

dysphoria, myalgias, rhinorrhea, diarrhea, lacrimation, dilated pupils

168
Q

Opiates adverse effects

A

HIV, hepatitis, endocarditis, self neglect, OD, death

169
Q

Opiate OD tx

A

Naloxone (Narcan)

170
Q

Tx for opioid use d/o

A

methadone
buprenorphine
clonidine
naltrexone

171
Q

Stimulants

A

coaine, methamphetamine, amphetamines, methylphenidate

172
Q

stimulants MOA

A

cocaine inhibits DA reuptake (increased DA in synapse)

173
Q

stimulants intoxication

A

euphoria, increasde vigilance, anorexia, mydriasis, tachycardia, hypertension, arrhythmias, auditory and tactile hallucinations, psychosis, agitation

174
Q

stimulants withdrawal

A

resemble MDD and suicidal ideation and attempts, dysphoria, hypersomnia, increased appetite, irritability, craving

175
Q

stimulants adverse effects

A

necorsis of soft tissues, cyanosis, cardiovascular, stroke

176
Q

tx for stimulant use d/o

A

symptomatic and behavioral

177
Q

marijuana MOA

A

cannabinoid receptor is GPCR and inhbits adenylate cyclase

178
Q

marijuana intoxication

A

perceptual disturbances, anxiety, paranoia, conjunctival injection, tachycardia, dry mouth, increased appetite

179
Q

marijuana withdrawal

A

irritability, depression, restlessness, anorexia, cravings

180
Q

marijuana adverse effects

A

amotivations syndrome, psychosis

181
Q

PCP MOA

A

NMDA antagonist

182
Q

PCP intoxication

A

RED DANES

183
Q

REDDANES

A

rage, erythema, dialted pupils, delusions, amnesia, nystagmus, excitation, skin dryness

184
Q

PCP withdrawal

A

lack of energy and depression

185
Q

PCP adverse effects

A

memory loss, liver fn problems, depression, psychosis

186
Q

hallucinogens MOA

A

serotonin agonist

187
Q

hallucinogens effects

A

pupil dilation, wakefulness, hallucinations, visual disturbances

188
Q

MDMA MOA

A

release monoamines

189
Q

MDMA effects

A

euphoria, intimacy, diminished fear, improved self-confidence

190
Q

MDMA withdrawal sx

A

depressed, paranoid, feeling cold, confused, nauseated, dizzy

191
Q

What is perceptual distortions a symptom of?

A

delerium termens

192
Q

mental illness

A

condition that affects pesons thinking, feeling or mood

193
Q

mental disease

A

interruption, cessation or disorder of bodily functions, systems or organs with recognizable etiologic agent, identifiable set of signs/sx and or consistent anatomic alterations

194
Q

mental disorder

A

clinically significant disturbance in individuals cognition, emotion, regulation or behavior

195
Q

psychoanalytic theory

A

personality development and unconscious motivations

196
Q

attachment theory

A

role of early caregive and child relations

197
Q

Jealosy

A

belief that everynoe wants what they have

198
Q

alogia

A

impoverished thinking and cognition assessed by patients speech

199
Q

Anhedonia-asociality

A

difficulties in experiencing interest or pleasure and lack of involvement in social relationship

200
Q

What is “depression is worth studiously memorizing extremely grueling criteria. sorry.”

A 
Depressed mood
loss of Interest
Weight loss or gain
inSomina
psychoMotor agitation
loss of Energy
inappropriate Guilt
decreased Concentration
Suicidal ideations
201
Q

Suicide risk factors

A 
M>F
Older men
Depression
Previous Attempt
Ethanol Abuse
Rational thinking loss
Lack of social support
organized plan
no spouse
sickness

Human Behavior (5 decks)

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