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Exam 1 Flashcards

1
Q

A cognitive disorder in which the patient’s reality is skewed or has an abnormal interpretation of reality

A

Paranoid Schizophrenia

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2
Q

What are the initial onset of symptoms for schizophrenia?

A

Lack of motivation, inability to pay attention, social isolation

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3
Q

What is the age range for paranoid schizophrenia?

A

18-30

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4
Q

What are the common signs and symptoms of schizophrenia?

A 
Hallucination/delusions -seeing hearing or tasting things that others do not
Socializing less often with friends
Trouble sleeping
Irritability  
Suspicious of others intentions
Difficulty thinking clearly
Decline in self-care
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5
Q

4 Medical interventions for schizophrenia

A

Physical exam-rule out
Tests and screenings- screen for drugs, order imaging
Psychiatric eval- discussion with family?
Diagnostic criteria

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6
Q

Treatment for schizophrenia

A

Medications**
-antipsychotic meds (1st gen more side effects) Chloropromazine, haloperidol
-2nd gen less effects abilify, saphris, rexulti
Psychosocial therapy
Side effects will decrease compliance

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7
Q

PT interventions

A 
Subjective- government implantation
Men>women 18-35
Suicide 4.9-22.3%
Mild childhood head injuries
Psychological stress 
Chronic LBP 
Anosognosia - adherence an issue (diff. Self awareness)
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8
Q

When do negative symptoms of schizophrenia occur?

A

Prodromal or onset

Active=positive

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9
Q

What % of schizophrenia patients have diabetes?

A

6%

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10
Q

Aerobic exercise can have what 3 impacts on schizophrenia?

A

Reduces psychiatric symptoms
Potentially improves mental and physical QOL
Reduces metabolic risk and wt gain

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11
Q

Adjusting needs of schizophrenic patient

A

+/- symptoms
Barriers: anxiety, loneliness,pain, feeling of judgement, depression, misunderstanding of exercise
Visual actualization
Do not crowd/overwhelm them, explain!

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12
Q

A condition in which a pt develops blindness, paralysis, or other neurological symptoms that can’t be explained

A

Conversion disorder “hysteria” “functional neurological symptom disorder

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13
Q

S&S of conversion disorder

A 
Vision issues
Loss of smell or speech
Muscle weak or paralysis
Numbness or abnormal sensation
Hearing problems or deafness
LOB
LOC or seizures
Unresponsiveness 
Uncontrolled Movements
 Difficulty swallowing
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14
Q

Diagnosis of Conversion disorder

A

Symptoms affect your movement or senses
Can be related to a stressful event
You’re not faking
Can’t be explained by another condition of medication
Symptoms can cause stress in social or work settings

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15
Q

medical interventions for conversion disorder

A

Hypnosis-little success
Psychotherapy-emotional basis of symptoms.
Speech therapy
Medication-haloperidol, tricyclics antidepressants, electroconvulsive therapy
PT/OT
Stress reduction and distraction technique
Treating underlying conditions
Education and reassurance they don’t have a serious med cond.

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16
Q

Interventions for conversion disorder

A

Psychiatric assistance- one disorder found in 89.5% of patients during follow-up
Prevent reinforcement of sickness
Treatment progression-rapport, WB, gait
Improve endurance, balance, posture, flexibility, strength

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17
Q

PT watch in conversion

A

Reintegration into society

  • develop rapport
  • pregnant activities
  • community reintegration
  • general mobility
  • supported gait activities
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18
Q

This theory states that consequences govern human behavior

A

Skinerian learning theory
If positive behavior enforced will continue
quality not quantity

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19
Q

Criteria for dx in conversion disorder

A
  1. 1 or more symptoms are present that either affect voluntary motor or sensory fxn LOC
  2. Found not to be medical cond. or affects of substance or culture behavior/ experience
  3. 1 or more diagnostic features are present that provide internal inconsistency or incongruity with recognized neuro disorder
  4. Symptom causes clinically significant distress of impairment in social, occupational, or other important area (med eval)
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20
Q

This disorder is characterized by the presence of 2 or more distinct personality states

A

Dissociative identity disorder

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21
Q

What % of the pop. Has DID?

A

1-3% US

6% make it obvious on ongoing basis

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22
Q

Cause of DID?

A

Childhood trauma -form of coping

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23
Q

S&S of DID

A

Memory loss of certain periods or info
Sense of being detached from self/emotions
Depression
Anxiety
Suicidal thoughts
Blurred sense of identity
Inabilityto cope with emotional stress
Perception of ppl around you is distorted
Significant stress in relationships and work

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24
Q

Medical interventions for DID

A

Hypnosis
New way to cope with stress
Cognitive behavioral therapy
Help identities become aware of one another and resolve conflicts
Meds may be antidepressants, anti-anxiety, antipsychotics

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25
Q

What should a PT watch for in DID?

A

Amnesia
Answering questions while interacting with multiple personalities
Presence of other mental health issues
Differing biological responses

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26
Q

Interventions for DID

A

Treat comorbidities with exercise
Treat patient as WHOLE identity (don’t treat personalities separately)
Do not neglect knowledge meant of other personalities
Avoid triggers of past traumatic events

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27
Q

What % of the population is diagnosed with ADHD?

A

8.4% kids 2.5% adults

Males>females

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28
Q

S&S ADHD

A

Behavioral: aggression, excitability, fidgeting, lack of restraint, hyperactivity, impulsivity, persistent rep of words, talk excessively
Cognitive: absent-minded, diff. Focus, forgetful, problem pay attention, short attention span
Mood: anger, anxiety, boredom, excitement, mood swings
depression and learning disability is common

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29
Q

Treatment for ADHD

A

Preschool- behavioral therapy, methylphenidate if behavior does not improve
Elementary- meds and behavior therapy-stimulants (atomoxetine, extended release guanfacine, extended release clonidine)

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30
Q

Comorbidities with ADHD

A

Stroke
Cardiovascular disease
Diabetes

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31
Q

Symptoms causing problems during treatment of ADHD

A

Forgetfulness
Difficulty focusing
Mood disorders: anxiety, aggression, mood swing
Aerobically fit-less succumbed to helplessness

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32
Q

Treatment for kids and adults

A 
Kids
-help creat and learn a schedule
Encourage movement and exercise
Help organize everyday items
Improve movement performance
Adults
-relaxation technique
Stress management
Enhance self-esteem
Change negative thought patterns
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33
Q

This disorder presents with inflated sense of importance, deep need for excessive attention, admiration, praise, lack of empathy, troubled relationships

A

Narcissistic personality disorder

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34
Q

What cluster is narcissistic personality disorder and when does it begin?

A

B early adulthood

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35
Q

Other complications with narcissism?

A

Difficulty with relationships, workplace and school problems

Depression and anxiety, physical health problems, drug abuse, suicidal thoughts

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36
Q

Medical interventions for narcissism

A 
Psychotherapy
Medications
Cognitive behavioral therapy
Psychodynamic therapy
Family therapy
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37
Q

PT watch for in narcissism?

A

Difficulty extracting desired info during eval and treat
Disturbances in gym
One-on-one
Aggravated if therapy not what they wanted
Intolerance to criticism

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38
Q

Interventions PT for narcissism

A

Educate pt on how to manage symptoms
Motivational interviewing
Exercise to improve mood
Worksheet for triggers

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39
Q

The level of care in the health care system that consists of emergency tx and critical care

A

Acute or secondary care

40
Q

Anemia in the presence of CAD may result in what?

A

Angina particularly with exertion lead to heart failure

41
Q

What is he primary cause of gastrointestinal bleeding and what population?

A

Anemia older

42
Q

Low and high critical values hemoglobin

A

Low 5-7

High 20+

43
Q

WBC counts

A

5-10
Upward leukocytosis 11+ infection, cancer drugs or large meals/stress
Downward leukopenia <4
Very low neutropenia <1.5 medications for bone marrow cancer psychotics folic
Early morn low afternoon high

44
Q

Platelet norms

A

140-400
Trend upward thrombocytosis >450 venous thromboembolism
Down thrombocytopenia <150 severe <20

45
Q

What systems regulate acids?

A

Rental and pulmonary

46
Q

What does the renal system regulate?

A

Base bicarbonate

47
Q

PaI2 declines with age secondary to?

A

Reduction in elasticity of msk system

48
Q

PaO2 levels range from ___ to ___ in childhood and decreases by how much after 60?

A

80-100 1/ year

49
Q

PaCO2 if it goes up and pH goes down then respiratory condition
Opposite
If numbers are equal go in same direction= metabolic disorder

A

ROME

50
Q

What nutrient is the primary determinant of extracellular fluid volume?

A

Sodium levels? 134-142
Hypernatremia? >145 impaired cognition seizures
Hyponatremia <130 impaired cognition hypotension

51
Q

What is potassium important for?

A

Excitable cells of nerves muscles and heart
3.7-5.1
Hyperkalemia >5.5 cardiac issues weakness
Hypokalemia <3.5

52
Q

This electrolyte is important for bone formation, cell division and growth, blood coagulation, muscle contraction and release of nt

A

Calcium
8.6-10.3
Hypocalcemia imputed cognition

53
Q

What risks for electrolyte imbalance In older patients

A 
Malnutrition
Dehydration
aDR
Infection
Cancer
Organ fxn decline
54
Q

The endocrine system measures what nutrient? Normal levels?

A

Glucose m70-100
>126 diabetes plasma glucose >200
>250 or less than 70 glucose cannot be used as energy

55
Q

How many people die each year due to suicide?

A

1 every 13 min

56
Q

Men are how much more likely that women to commit suicide?

A

4

57
Q

What perecwnt of college student feel depressed?

A

30

58
Q

How many adults had 1 major depressive disorder in 2012?

A

16 million

59
Q

Suicide kills how many more deaths than homiciide?

A

Double

60
Q

Medical cost for depression?

A

80 billion

61
Q

What are the high risk groups for suicide?

A

Military
Rural
LGBTQ
American indiana and Alaskan

62
Q

What are the characteristics of bipolar or manic depressive disorder?

A

Major atypical shifts in mood

Episodes of euphoria followed by depression

63
Q

What med is commonly used to treat bipolar?

A

Lithium

64
Q

What percent of adults experience anxiety?

A

18%

65
Q

This is the hyperactixation of the sympathetic nervous system

A

Generalized anxiety disorder

66
Q

What are the symptoms for generalized anxiety disorder?

A 
Increased bp and hr
Nausea
Chest pain
SOB
dizzy
Perspiration
67
Q

This is the fear of crowds and open spaces

A

Agoraphobia

68
Q

What are the symptoms of panic disorder?

A

Panic attacks with no triggers
Unpredictability if attacks
Fear of having another attack at any time

69
Q

4 things about rituals of OCD

A

Significantly interrupt daily life
Behaviors cannot be controlled or stopped
At least 1 hour per day is spent performing rituals
Rituals do not bring pleasure or happiness

70
Q

What parts of the brain show a change in OCD?

A

Frontal cortex and subcritical areas

71
Q

Top 4 reasons for men and women cause PTSD

A

Rape combat exposure childhood neglect childhood physical abuse

Rape physical attack sexual molestation being threatened with a weapon

72
Q

PTSD must have what following post traumatic event?

A

At least 1 reexperiencing symptom
At least 1 avoidanc
2 arousak or reactivity symptoms
2 cognition and mood symptoms

73
Q

What are examples of cognition and mood symptoms in PTSD?

A

Trouble remembering key features of traumatic event
Distorted feelings like guilt or blame
Loss of interest in enjoyable activities
Negative thoughts about oneself or world

74
Q

What % of the population suffers from PTSD?

A

2.2% 7.7 mik

75
Q

What percent of Iraq war veterans?

A

11-20% 300,000

76
Q

Are women or men more likely? And what % will experience PTSD sometime during life?

A

Women 7-8%

77
Q

What was the number one cause of death in 2012 for Us Tripp’s?

A

Suicide

78
Q

Slowing if response time and motor movements aka psychomotor retardation is common in what?

A

Untreated depression and treatment with benzodiazepines for anxiety

79
Q

Exercise can alter what?

A

Biochemical components in brain

80
Q

Relapse of depression is drecreased with what compared to what?

A

Exercise pharmaceuticals

81
Q

What are the minimum exercise requirements for depression?

A

2 days per week flexibility and muscle strength
10 step ups or flight of stairs
8 sit to stand
Chair sit and reach R and L
8 arm curls with minimum 2 recommend 4 kg

82
Q

What happens to serotonin with exercise?

A

Synthesis increases but so does metabolism

83
Q

What length of time should you exercise for alleviation of anxiety?

A

30 min

84
Q

The reason or reasons one has for acting or behaving in a particular way

A

Motivation

85
Q

Age changes in motivation

A

Increased capacity to self-regulate
Stronger adherence to behavior
Imitation to change slower
Positive self concept
New approaches to activities more motivating
More engaged in PT to function as caregiver
Requires less info to make a decision

86
Q

What are the 5 components of motivation

A 
Beliefs
Unpleasant physical sensation
Individualized care
Social support
Goal identification
87
Q

Behaviorist orientation

A

Stimulus/ response design and environment produces desired response. No creativity or problem solving

88
Q

Cognitive orientation

A

Involvement thinking, problem solving and formation of concepts. Simplex yo complex

89
Q

Humanist orientation

A

Based on human potential for growth. Emphasis on individual freedom and responsibility as well as experiential perceptions which enable environment

90
Q

A system based on imitation for modeling

A

Social learning theory

91
Q

Adult learning theory is based on what 4 concepts?

A

Changes in self concept are function of growth and maturity
Rolled experience inolder adults provides substantial foundation to build new experiences
Readiness to learn concept of transitioning Fromm external to internal stimulus
Orientation to learn refers to older adults purpose for learning. Immediate applicable intervention

92
Q

The trans theoretical model is based on what 5 strategies

A 
Preconremplation
Action
Maintenance
Preparation
Contemplation
93
Q

Cure model is what while care model is?

A

Authoritative collaborative

94
Q

This theory states that human motivation and action are regulated by forethought

A

Social cognitive theory - a belief system that exercise may increase pain has potential decrease motivation

95
Q

Social cognitive theory is based on what 2 expectations

A

Individuals beliefs and capabilities in performing course of action to attain desired outcome
Belief that a certain consequence will be produced by personal action

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