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Exam 2 Flashcards

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1
Q

Altered perception, cognition, and/or impaired ability to determine what is real:

A

psychosis

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2
Q

delusional disorder:

A

false thoughts or beliefs that have lasted 1 month or longer. Usually not severe enough to impair functioning

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3
Q

Schizophrenia is often preceded by this phase…

A

prodromal phase

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4
Q

Milder symptoms of schizophrenia–can last months or years before the full disorder manifests:

A

prodromal phase

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5
Q

Comorbidities for schizophrenia:

A

substance use disorders
anxiety
depression
suicide
physical illness - CVD and metabolic syndrome contribute to premature death
polydipsia - a contributing factor is antipsychotics that cause dry mouth

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6
Q

Risk factors for developing schizophrenia:

A

-genetic
-neurobiological - use of amphetamines and cocaine enhance dopamine activity which can induce psychosis and precipitate schizophrenia
-brain structure abnormalities
-prenatal stressors
-environmental factors

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7
Q

Acute Phase of Schizophrenia:

A

hallucinations, delusions, apathy, social withdrawal, anhedonia, impaired judgment and cognition, difficulty coping; symptoms become apparent to others.
–can last several months even with treatment

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8
Q

Stabilization Phase of Schizophrenia:

A

movement toward previous functioning
-continued outpatient or partial hospitalization may be required
-can last several months

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9
Q

Maintenance or Residual Phase of Schizophrenia:

A

a new baseline may be established
-positive symptoms are diminished or absent
-negative symptoms continue to be a concern

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10
Q

Positive Symptoms:

A

presence of symptoms that SHOULD NOT be present:
hallucinations
delusions
paranoia
disorganized/bizarre thoughts, behavior and/or speech

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11
Q

Negative Symptoms:

A

ABSENCE of qualities that SHOULD BE present
-anhedonia
-social discomfort
-lack of goal directed behavior
-avolition
-alogia

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12
Q

Cognitive Symptoms:

A

subtle or obvious impairment in memory, attention, thinking, problem solving, impulse control

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13
Q

Affective Symptoms:

A

symptoms involving emotions and their expression

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14
Q

Automatic and unconscious process by which we determine what is and is not real…

A

reality testing
-this is an example of a positive symptom of schizophrenia

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15
Q

false beliefs that are held despite a lack of evidence to support them:

A

delusions

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16
Q

common delusions:

A

persecutory, grandiose, religious

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17
Q

Term for unusual speech pattern that results from haphazard and illogical thinking where concentration is poor and thoughts are loosely connected:

A

associative looseness

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18
Q

Most extreme form of associative looseness which is a jumble of words that is meaningless to the listener:

A

word salad

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19
Q

Choosing words based on their sound rather than meaning (often rhyming, for example):

A

clang association

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20
Q

words that have meaning for the patient but a different or nonexistent meaning for others:

A

neologisms

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21
Q

poverty of thought:

A

alogia

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22
Q

loss of motivation

A

avolition

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23
Q

inability to experience pleasure or joy

A

anhedonia

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24
Q

pathological repetition of another’s words

A

echolalia

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25
Q

conversations including unnecessary and often tedious details but eventually reaching the point

A

circumstantiality

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26
Q

wandering off topic or going on on tangents and never reaching the point

A

tangentiality

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27
Q

generalized slowing and thinking; difficulty finishing thoughts

A

cognitive retardation

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28
Q

urgent or intense speech; reluctance to allow comments from others

A

pressured speech

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29
Q

moving rapidly from one thought to the next

A

flight of ideas

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30
Q

reduction or stoppage of thought; cognitive disorganization or interruption of thought can cause this

A

thought blocking

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31
Q

often uncomfortable belief that someone else has inserted thoughts into the patient’s brain

A

thought insertion

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32
Q

a belief that thoughts have been taken or are missing

A

thought deletion

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33
Q

believing that reality can be changed simply by thoughts or unrelated actions

A

magical thinking

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34
Q

irrational fear from mild to profound; may result in dangerous defensive actions

A

paranoia

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35
Q

alterations in perception (can include all five senses)

A

hallucinations

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36
Q

a feeling of being unreal or having lost an element of one’s person or identity

A

depersonalization

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37
Q

a feeling that the environment has changed and everything appears strange and unfamiliar

A

derealization

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38
Q

pronounced increase or decrease in the rate and amount of movement

A

catatonia

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39
Q

muscular rigidity

A

catalepsy
-may be very severe and lead to exhaustion, pneumonia, blood clotting, malnutrition, dehydration

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40
Q

pronounced slowing of movement

A

motor retardation

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41
Q

excited behavior, such as running or pacing - can put patient at risk

A

motor agitation

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42
Q

mimicking of movements of another

A

echopraxia

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43
Q

tendency to resist or oppose the requests or wishes of others

A

negativism

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44
Q

assuming illogical expressions, posture, or positions

A

gesturing/posturing

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45
Q

impaired ability to sense where one’s body ends and another’s begins

A

boundary impairment

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46
Q

decreased desire for social interaction

A

asociality

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47
Q

reduced or constricted affect

A

affective blunting

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48
Q

Typically affects of schizophrenia:

A

flat
blunted
constricted
inappropriate - incongruent with actual emotional state
bizarre

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49
Q

impaired ability to think abstractly

A

concrete thinking

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50
Q

inability to realize one is ill (caused by the illness itself)

A

anosognosia

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51
Q

What does the recovery model focus on?

A

hope
living a full and productive life
recovery rather than focusing on controlling symptoms and adapting to disability

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52
Q

What is the overall goal of the acute phase of schizophrenia?

A

patient safety and stabilization

Also, that patient consistently labels hallucinations as “not real and a symptom of illness”

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53
Q

First-gen antipsychotics are _____ antagonists.

A

dopamine

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54
Q

Examples of first-gen antipsychotics:

A

haloperidol
chlorpromazine

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55
Q

First-gen antipsychotics work primarily by reducing _____ symptoms but have little effect on _____ symptoms.

A

positive; negative

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56
Q

Benefits of second-gen antipsychotics:

A

-treat positive symptoms and help negative symptoms
-fewer and better-tolerated side-effects

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57
Q

atypical antipsychotics are ____ and ____ antagonists.

A

serotonin; dopamine

58
Q

Examples of atypical antipsychotics:

A

clozapine
risperidone

59
Q

Side effects of first-gen antipsychotics:

A

-extrapyramidal side effects
–acute dystonia
–akathisia
–pseudoparkinsonism
–tardive dyskinesia

-anticholinergic side effects - dry mouth, blurred vision, constipation, urinary retention, tachycardia

Other: sedation, orthostatic hypotension, lowered seizure threshold, photosensitivity

60
Q

sudden, sustained contraction of one or several muscle groups, usually of the head and neck

A

acute dystonia

61
Q

motor restlessness that causes pacing and/or an inability to stay still

A

akathisia

62
Q

temporary group of symptoms that resemble Parkinson disease

A

pseudoparkinsonism

63
Q

persistent EPS involving involuntary rhythmic movements

A

tardive dyskinesia
(smoking, alcohol, and stimulate use increase risk)

64
Q

Serious side effects of antipsychotic medications:

A

neuroleptic malignant syndrome, severe neutropenia, anticholinergic toxicity

65
Q

Metabolic Syndrome

A

weight gain, abnormal lipid levels, increased insulin resistance which leads to increased risk of CVD, diabetes, etc.

66
Q

Comorbidities of Bipolar I:

A

-migraines
-metabolic syndrome
-ADHD
-substance use disorder
-anxiety disorders

67
Q

Comorbidities of Bipolar II:

A

-anxiety disorders
-eating disorders
-substance use disorders

68
Q

Some people with bipolar I or II will experience _____________ and may have at least four mood episodes in a 12 month period.

A

rapid cycling

69
Q

Risk factors of Bipolar Disorder:

A

-genetic
-neurobiological
-brain structure and function - particularly in the prefrontal cortex, hippocampus, and amygdala
-neuroendocrine - hypothyroidism
-peripheral inflammation - both manic and depressive states increase peripheral inflammation
-cognitive factors
-environmental factors

70
Q

Mania may cause these disorganized thoughts and speech patterns:

A

pressured speech
circumstantial speech
tangential speech
loose association
flight of ideas
clang associations

71
Q

Thought content related to mania:

A

grandiose delusions
persecutory delusions

72
Q

Therapeutic level of lithium:

A

0.8-1.2mEq/L (target range for a 12-hr serum trough)

73
Q

When should you draw the first lithium level?

A

every 2-3 days after beginning and after any dosage change until the therapeutic level has been reached. Then every 3-6 months.

74
Q

What blood work should you check before starting lithium?

A

renal and thyroid status

75
Q

What is valproate and valproic acid used for?

A

treating acute mania

76
Q

common side effects of valproic acid:

A

nausea, weakness, somnolence, indigestion, diarrhea, dizziness, vomiting

77
Q

black box warnings for valproate:

A

monitor LFTs, platelets (thrombocytopenia), pancreatitis

78
Q

What anticonvulsants pose a risk of Stevens-Johnson Syndrome and patients should report any rash immediately to the HCP?

A

carbamazepine
lamotrigine

79
Q

This is diagnosed when low level depression occurs most of the day, for the majority of days and last at least two years in adults. May experience decreased appetite/overeating, insomnia/hypersomnia, low energy, poor self esteem, hopelessness:

A

persistent depressive disorder

80
Q

substance/medication-induced depressive disorder:

A

-prolonged use of/withdrawal from drugs and alcohol
-depressive symptoms are not experienced in the absence of drugs/alcohol
-symptoms appear within one month of use

81
Q

Major depressive disorder:

A

-persistently depressed mood lasting for a minimum of two weeks
-depressive episode may last 5-6 months

82
Q

Term for not diagnosing a person with depression in the first two months following a significant loss:

A

bereavement exclusion

83
Q

What model of depression considers the interplay between genetic and biological predisposition toward depression and life events?

A

diathesis-stress model

84
Q

What theory holds the underlying assumption that a person’s thoughts will result in emotions and people with depression process information in negative ways and tend to ignore positive aspects of their lives?

A

cognitive theory

85
Q

What is the most dangerous aspect of major depressive disorder?

A

preoccupation with death

–always evaluate for SI

86
Q

alterations in those activities necessary to support physical life and growth (eating, elimination, sleeping, sex):

A

vegetative signs of depression

87
Q

normal mood

A

euthymic

88
Q

overly happy

A

euphoric

89
Q

inability to feel pleasure in aspects of life that once made a person happy

A

anhedonia

90
Q

How long in advance should a patient discontinue all SSRIs before starting an MAOI?

A

2-5 weeks

91
Q

hyperpyrexia

A

fever

92
Q

Executive functioning

A

planning, decision making, problem solving, abstract thinking

93
Q

social cognition

A

processing, storing, and applying information about other people and social situations

94
Q

Key points about delirium:

A

–affects lower level functioning
–acute
–often reversible
–disorientation, anxiety, agitation, poor memory, delusional thinking, visual hallucinations

95
Q

Delirium is always _______

A

a medical emergency

96
Q

Errors in the perception of sensory stimuli:

A

illusions - unlike delusions or hallucinations, you can explain and clarify illusions for the individual

97
Q

agnosia

A

inability to identify familiar objects or people

98
Q

creation of stories or answers in place of actual memories to maintain self-esteem

A

confabulation

99
Q

persistent repetition of a word, phrase, or gesture that continues after the original stimulus has stopped

A

perseveration

100
Q

Only occurs in AD: diminished ability and eventual inability to read or write

A

agraphia

101
Q

loss of language ability

A

aphasia

102
Q

loss of purposeful movement in the absence of motor or sensory impairment (ex: unable to put on clothes properly)

A

apraxia

103
Q

tendency to put everything in the mouth to taste and chew

A

hyperorality

104
Q

tendency for an individual’s mood to deteriorate and agitation to increase in the later part of the day

A

sundowning

105
Q

Cluster A: behaviors described as odd or eccentric

A

paranoid personality disorder
schizoid personality disorder
schizotypal personality disorder

106
Q

Cluster B: behaviors described as dramatic, emotional, erratic

A

borderline personality disorder
narcissistic personality disorder
histrionic personality disorder
antisocial personality disorder

107
Q

Cluster C: behaviors described as anxious or fearful

A

avoidant
dependent
obsessive-compulsive

108
Q

long-standing distrust and suspiciousness of others based on the belief, unsupported by evidence, that other want to exploit, harm, or deceive the person.

A

paranoid personality disorder

109
Q

This person exhibits a lifelong pattern of social withdrawal. They are somewhat expressionless and have a restricted range of emotional expression. Others view them as odd or eccentric because of their discomfort for social interaction.

A

schizoid personality disorder

110
Q

What is the prominent feature of schizoid personality disorder?

A

emotional detachment

111
Q

This person does not blend in with the crow. Their symptoms are strange and unusual. Magical thinking, odd beliefs, strange speech patterns, inappropriate affect.

A

schizotypal personality disorder

112
Q

This person has severe social and interpersonal deficits and experience extreme anxiety in social situation. Tend to ramble with overly detailed and abstract content and are overly suspicious. This disorder is also the first of the schizophrenia spectrum disorders.

A

schizotypal personality disorder

113
Q

This person is excitable and dramatic yet they are also high functioning.

A

histrionic personality disorder

114
Q

This person has intense feelings of entitlement, exaggerated belief in one’s own importance, and a lack of empathy. They also suffer from weak self-esteem and hypersensitivity to criticism.

A

narcissistic personality disorder

115
Q

This person is extremely sensitive to rejection, feels inadequate, and are socially inhibited - they avoid interpersonal contact owing to fears of rejection or criticism.

A

avoidant personality disorder

116
Q

Characterized by a pattern of submissive and clinging behavior related to an overwhelming need to be cared for.

A

dependent personality disorder

117
Q

This person exhibits limited emotional expression, stubbornness, perseverance, indecisiveness, and has a preoccupation with orderliness, perfectionism, and control.

A

obsessive-compulsive personality disorder

118
Q

Characterized by severe impairments in functioning: instability, impulsivity, identity or self-image distortions, unstable mood, unstable interpersonal relationships.
–emotional dysregulation
–emotional lability
–impulsivity

A

borderline personality disorder

119
Q

What personality disorder suffers from chronic SI and self-destructive behaviors?

A

borderline personality disorder

120
Q

“splitting” is a primary defense mechanism of what personality disorder?

A

borderline

121
Q

Term for the inability to view both positive and negative aspects of others as part of a whole which results in viewing someone as either a wonderful or horrible person.

A

splitting

122
Q

This person displays a pattern of disregard for the rights of others and their frequent violation.
–antagonistic behaviors: being deceitful and manipulative for personal gain or hostile if one’s needs are blocked.
–risk taking
–disregard for responsibility and impulsivity
–most concerned with gaining personal power and pleasure

A

antisocial personality disorder
–often referred to as sociopaths

123
Q

What is an ego-syntonic disorder?

A

an example is anorexia nervosa–the patient knows their actions are potentially harmful, but they believe that the benefits outweigh the harm

124
Q

term for fine, downy hair on the face and back sometimes seen in patients with anorexia nervosa:

A

lanugo

125
Q

Term for the potentially lethal syndrome that may occur in severely malnourished patients with anorexia nervosa as nutrients are restored:

A

refeeding syndrome - abnormalities in fluid balance and glucose metabolism

126
Q

bulimia nervosa

A

repeated episodes of binge eating (1500-5000 calories within any 2-hr period) followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics, fasting, excessive exercise

127
Q

What is the only FDA approved medication for bulimia nervosa?

A

fluoxetine

128
Q

The patient with this disorder engages in episodes of increased intake that occur beyond the point of satiety and cause distress afterward. They do not regularly use compensatory behaviors - they may be of normal weight but repeated binge eating causes obesity.

A

binge-eating disorder

129
Q

When a person is in the process of using a substance to excess:

A

Intoxication

130
Q

When a person no longer responds to the drug in the way that the person initially responded:

A

Tolerance

131
Q

Cannabis withdrawal symptoms

A

Irritability, anger, aggression, anxiety, restlessness, depressed mood

132
Q

Physical symptoms of cannabis withdrawal:

A

Abdominal pain, shakiness, sweating, fever, chills, headache

133
Q

Hallucinogens

A

Classic: LSD
Dissociative drugs: PCP and ketamine

134
Q

What hallucinogen intoxication is a medical emergency?

A

PCP
—benzo may be administered IM or IV and mechanical cooling may be necessary for severe hyperthermia

135
Q

Opioid withdrawal symptoms:

A

Mood dysphoria
Nausea, vomiting
Diarrhea
Muscle aches
Fever
Insomnia
Pupillary dilation
Yawning

136
Q

When does opioid withdrawal syndrome begin for morphine, heroin, and methadone?

A

6-8 hours after the last dose following a period of at least one week of use

137
Q

When does meperidine withdrawal begin?

A

8-12 hours from abstinence

138
Q

What medication is useful for treating tremulousness and mild to moderate agitation due to alcohol withdrawal?

A

Chlordiazepoxide (Librium)

139
Q

What is the common IV treatment for alcohol withdrawal seizures?

A

Diazepam (Valium)

140
Q

Term for alcohol withdrawal delirium?

A

Delirium tremens - medical emergency - may happen any time within the first 72 hours

141
Q

Side effects of buspirone:

A

Dizziness
Nausea
Headache
Nervousness
Lightheadedness
Excitement

Psych Exam 2 (1 decks)

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