Exam #3 Flashcards
1
Q
what are positive symptoms of schizophrenia?
A
delusions, hallucinations, disorganized speech, grossly disorganized(hyperactive)
2
Q
does schizophrenia have periods of remission?
A
yes
3
Q
what is the symptom criteria for schizophrenia?
A
must have delusions, hallucinations, disorganized speech, with catatonic, disorganized, and negative symptoms for at least one month
4
Q
what are the stages of schizophrenia?
A
premorbid, prodromal, active psychotic, and residual phase
5
Q
what happens during the premorbid phase?
A
symptoms like shy, withdrawn, antisocial, poor school performance
hard to diagnose in this stage
6
Q
what happens during the prodromal stage?
A
psychotic symptoms are frank, functional impairment, deterioration in role, social withdraw, sleep disturbance, anxiety, irritability, depression, fatigue, and poor concentration
7
Q
what happens during the active psychotic phase?
A
positive and negative symptoms will be present…..delusions, hallucinations, disorganized speech, catatonic behavior….in this stage the patient should be admitted into the psychiatric unit
8
Q
what are predisposing factors for schizophrenia?
A
genetics, biochem, viral infections, anatomical abnormalities in the brain, psychological factors, environmental influences, and theoretical integration
9
Q
how can viral infections cause schizophrenia?
A
pre natal exposure to the flu virus
10
Q
how can biochem cause schizophrenia?
A
too much dopamine activity
11
Q
what anatomical abnormalities can cause schizophrenia?
A
reduction in the gray matter and size of hippocampus
12
Q
what psychological factors can cause schizophrenia?
A
childhood trauma
13
Q
what environmental factors can cause schizophrenia?
A
sociocultural factors, stressful life events, cannabis use in patients who are predisposed
14
Q
what are the schizophrenic delusional disorders?
A
grandiose, jealous, persecutory, somatic, and mixed
15
Q
what does the delusional disorder grandiose mean?
A
irrational ideas regarding worth, talent, knowledge, and power
16
Q
what does the delusional disorder jealous mean?
A
irrational idea that their partner is unfaithful
17
Q
what does the delusional disorder persecutory mean?
A
that they are being mistreated or spied on
18
Q
what does the delusional disorder somatic mean?
A
irrational belief that he or she has some physical defect, disorder, or disease
19
Q
what does the delusional disorder mixed mean?
A
it follows no single theme
20
Q
what is brief psychotic disorder?
A
sudden onset of psychotic symptoms that last less than one month
21
Q
what can cause brief psychotic disorder?
A
sudden psychosocial stressor or traumatic even
22
Q
what is the treatment for brief psychotic disorder?
A
antipsychotics
23
Q
what is substance and medication induced psychotic behavior?
A
prominent hallucination and delusions that can attributed to the effects of a drug
24
Q
what do you to treat substance and medication induced psychotic behavior?
A
drug screen, give them fluids, and sedate
25
what is psychotic disorder due to another medical condition?
prominent hallucination and delusions that can attributed to a medical condition
26
what is the most common population to get medication induced psychotic disorder?
elderly
27
what can cause medication induced psychotic disorder?
labs being off or UTI
28
what is schizophreniform disorder?
same symptoms as schizophrenia and lasts between 1 and 6 montsh
29
what is schizoaffective disorder?
schizophrenia disorder accompanied with a mood disorder like mania, depression, bipolar
30
what are positive symptoms?
delusions, hallucinations, disorganized thought/speech, and bizarre behaviors
31
do atypicals treat positive or negative symptoms?
positive symptoms and negative
32
do typicals treat positive or negative symptoms?
negative symptoms
33
what are negative symptoms?
flat affect, reduced social interaction, anhedonia, avolition, alogia, catatonia
34
what are some examples of alterations in thought?
ideas of thought, persecution, grandeur, somatic delusions, jealousy, being controlled, thought broadcasting, thought withdrawal, religiosity, and magical thinking
35
what does alterations in ideas of thought mean?
misconstrues trivial events and attaches personal significance to them
36
what does alterations in persecution mean?
feels singled out for harm by others
37
what does alterations in grandiosity mean?
thinks they are powerful and important
38
what does alterations in somatic delusions mean?
thinks that their body is changing in an abnormal way.....growing a third arm
39
what does alterations in jealousy mean?
thinks that their partner is sexually involved with someone
40
what does alterations in being controlled mean?
that their thoughts are being controlled by someone else
41
what does thought broadcasting mean?
thinks that their ideas can be heard by others
42
what does thought withdrawal mean?
thinks their thoughts have been removed from their brain
43
what does religiosity mean?
obsessed with religious beliefs
44
what does magical thinking mean?
thinks that their actions can control a situation...wearing a hat makes them invisible
45
what is associative looseness?
inability to concentrate on a single though
46
what is noelogisms?
make up words
47
what is echolalia?
the client repeats specific words that they have heard
48
what is clang association?
meaningless rhyming of words
49
what is tangentiality?
inability to get to the point of communication due to the introduction of many new topics
50
what is word salad?
words jumbled together with little meaning or significance to the listener
51
what are auditory hallucinations?
hallucinations you can hear
52
what are visual hallucinations?
hallucinations that you can see
53
what are tactile hallucinations?
hallucinations that you can feel
54
what are gustatory hallucinations?
hallucinations that you can tast
55
what are olfactory hallucinations?
hallucinations that you can smell
56
illusions???
57
what is echopraxia?
copying what they observe
58
what is depersonalization?
feelings of unreality....lost identity
59
what is derealization?
perception that the environment has changed
60
what is identification and limitation?
taking on the form of behavior that they observed someone doing....copy cat
61
what does apathy mean?
lack of interest in their environment
61
what alteration in behavior do schizophrenics experience?
flat affect, apathy, agitation, pacing, robot like, stupor, catatonia, impaired impulse control, avolition, anhedonia, and deteriorated apperance
62
what does stupor mean?
motionless coma-like state
63
what does catatonia mean?
inability to move normal
64
what does avolition mean?
inability to initiate a plan to reach a goal
65
what does anhedonia mean?
inability to experience pleasure
66
how are some things schizophrenics do socially?
isolate, withdraw, not trust
67
what do you do when your patient is experiencing hallucinations/dellusions?
be accepting but orient back to reality
68
in regard to violence, what interventions can do for schizophrenics?
low stimulus, removing dangerous objects, intervene when signs appear
69
in general, what are some goals for schizophrenic patients?`
decrease anxiety, build trust, define reality, interact with others, safety, hygiene, and adaptive family coping
70
what are SMART goals
Specific, measurable, attainable, realistic, and have a time``
71
what type of therapies might schizophrenics attend?
individual, group and behavioral
72
what training might schizophrenics be apart of to help them socially?
social skills training, family therapy, and assertive community treatment
73
what is social skills training?
use of role play to help the patient understand eye contact, personal space, voice notation, posture etc
74
what is family therapy for schizophrenics?
helps family members cope and understand the illenss
75
what is assertive community treatment for schizophrenics?
care team comes to the patient home and does treatment there
76
what medications are used to treat schizophrenia?
antipsychotics
77
what are the two kinds of antipsychotics?
typical and atypical
78
what type of symptoms do typicals treat?
positive symptoms
79
do typicals or atypicals have more eps symptoms?
typicals
80
do typicals or atypicals increase the risk of seizures?
typicals
81
what type of symptoms do atypicals treat?
positive and negative
82
do typical or atypicals make you gain weight?
atypicals due to the change in your metabolic rate
83
do typicals or atypicals have a sedative effect?
atypicals
84
what must you assess before starting your patient on antipsychotics?
NSAIDs, dietary supplement, drug use, smoking, drinking, prescription med
85
what are the symptoms of antipsychotics? VERIFY
N/V, diarrhea, rash, photosensitivity, orthostatic hypotension, hormone changes, ECG changes, anticholinergic, seizures, hypersalivation, hyperglycemia,
86
what is agranulocytosis?
failure of bone marrow to produce adequate white blood cells
87
what medication can cause agranulocytosis?
clozapine
88
what is the worst outcome of agranulocytosis?
death
89
what should you do when you notice that your patient has agranulocytosis?
stop the medication and treat the symptoms
90
what are the symptoms of agranulocytosis?
fever, malaise, sore throat
91
what is done for patients with agranulocytosis other than stopping the medication?
lab work to monitor wbc
92
what is the dystonic reaction?
muscle spasms particularly in the neck, eyes, and tongue
93
what does the patient experience with the dystonic reaction?
pain, fear, dysphagia, and compromised airway
94
what should be given to a patient with a dystonic reaction?
benztropine and diphenhydramine
95
what is akathisia?
inability to sit still
96
what will a patient with akathisia look like?
restless, pacing, fidgeting, leg shaking etc
97
when does akathasia typically present?
when antipsychotics are started or increased
98
what should be administered when the patient has akathisia?
benztropine and diphenhydramine
99
what is pseudoparkinsonism?
shuffling gait, muscle stiffness, mask expression, drooling
100
can pseudoparkinsonism be fixed?
yes
101
what should be administered for patients with pseudoparkionism?
benztropine and diphenahydramine
102
what is tardive dyskinesia?
abnormal involuntary movements typically seen on the face
103
what is the patient at risk for socially with tardive dyskinesia?
social isolation
104
is tardive dyskinesia permanent?
yes
105
what is used to screen for TD?
aims
106
what should you do if your patient gets TD?
stop the medication
107
what is neuroleptic malignant syndrome?
characterized be 104-105 temp
108
what is the patient at risk for if they get malignant syndrome?
death
109
what medication is administered for malignant syndrome?
dantrolene
110
what are the antiparkinsonian agents?
xxxxxx
111
what are the indications for antiparkinsonian agents?
treatment of all forms of parkinsonism and for the relief of drug-induced extrapyramidal reactions.
112
what is the MOA of antiparkinsonian agents
restores the natural balance of ACH and dopamine
113
what precautions should taken when give antiparkinsonian agents?
glaucoma, obstructions, BPH, myasthenia gravis
114
what are the side effects of antiparkinsonian agents?
anticholinergic effects, Neausa, Gi upset, sedation, dizzines, exacerbation of psychosis, orthostatic hypotension, sedation,
115
what should patients do when going outdoors if on antiparkinsonian agents?
wear sunscreen
116
what should patients taking antiparkinsonian agents not consume?
alcohol or other medications without dr knowledge
117
what might the patient need to do weekly when taking antiparkinsonian agents?
lab draw
118
is anxiety normal?
yes it prepares you for threats and gives motivation
119
what is GABA?
a neurotransmitter that is responsible for calming you down
120
is GABA high or low in patients with GAD?
low
121
what are risk factors for GAD?
genetics, environment, depression, substance abuse
122
what are some symptoms of GAD?
restless, on edge, easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance
123
how many symptoms and for how long must a patient experience symptoms in order to be diagnosed with GAD?
3 symptoms for 6 months
124
how can regular anxiety lead to panic attacks?
if your day to day anxiety is not controlled this leads to GAD and if GAD is uncontrolled this can lead to panic attack
125
do panic attacks have a trigger or is it random?
specific triggering event
126
does panic disorder have a trigger or is it random?
random
127
what are the symptoms of a panic attack?
chest pain, feeling of choking, paresthesia, fear of dying, shaking, sweating, trembling, hyperventilation, depersonalization, derealization, increased HR, and sob
128
what are the symptoms of anxiety?
irritability, disturbed sleep, muscle tension, increased HR, SOB,
129
what is hyperventilation?
occurs when a patient has a panic attack...characterized by having too high of respirations
130
what are the symptoms of hyperventilation?
lightheaded, tachycardia, SOB, numbness, tingling, syncope
131
what is the patient blowing off too much of during hyperventilation?
too much CO2
132
what should be done if a patient is hyperventilating?
have them breathe into a paper bag
133
should you give a patient who is hyperventilating oxygen?
no
134
does a patient who is hyperventilating go into respiratory acidosis or alkalosis?
respiratory alkalosis
135
what might the patient receive if they have an active hyperventilation episode?
benzo
136
what is panic disorder?
a recurrent panic attack that is unpredictable
136
what medications are administered for panic disorder patients?
Benzo, SSRI, Betablockers, Anxiolytics, and SNRI
137
what benzo is given to panic disorder patients?
alprazolam
138
what patient ed is given to patients taking benzo?
they are addictive, has to be tapered off, no caffeine, no smoking, no alcohol, PRN only
139
what SSRI is given to panic disorder patients?
paroxetine
140
what patient ed is given to patients taking SSRI?
increased SI, sexual dysfunction, weight gain
141
what beta blocker is given to panic disorder patients
propranolol
142
what anxiolytic is given to panic disorder patients?
buspirone
143
what does anxiolytics mimic?
benzo effect without the symptoms
144
can you take buspirone daily?
yes
145
what SNRI do panic disorder patients take?
venlafaxine
146
what teaching can be given to panic disorder patients to decrease the amount of occurrences?
notice when your symptoms begin, breating, imagery,yoga, sleep, exercise, journaling
147
what are phobias?
an irrational fear of something
148
what are risk factors for phobias?
learned behavior or traumatic event
149
what is agoraphobia?
fear of being vulnerable or unable to escape
150
what is social phobia?
fear of doing something embarrassing
151
what are the interventions for phobias?
safety, explore their perception of fear, discuss reality of avoiding
152
what medications groups are used to treat phobias?
benzo, ssri, betablocker, snri
153
what benzo is used to treat phobias?
alprazolam
154
What SSRI is used to treat phobias?
paroxetine
155
what beta-blocker is used to treat phobias?
propanolol
156
what snri is used to treat phobias?
venlafaxine
157
what medications are used to treat OCD?
ssri...Fluoxetine
Paroxetine
Sertraline
Fluvoxamine
158
what is OCD?
an obsession with something that is relieved by compulsions
159
what is an obsession?
intrusive thoughts that give anxiety
160
what is a compulsion?
something that is done to relive anxiety around the obsession
161
what is the OCD cycle?
obsession, anxiety, compulsion, relief
162
what are interventions for patients with OCD
identify triggers, allow compulsion but slowly limit, replace compulsion with coping skill
163
what are ocd patients at risk for?
substance abuse
164
what are the typical antipsychotics?
chlorpromazine, haloperidol, Fluphenazine,
165
what are the atypical antipsychotics?
Olanzapine, Risperidone, Aripiprazole, Ziprasidone, clozapine
166
what are the predisposing factors to PTSD?
the experience, the individual, and recovery
167
what in the experience predisposed someone to getting PTSD?
severity, duration, anticipation, death, control of reoccurrence, location
168
what individual attributes predisposed someone to get PTSD?
ego strength, coping, MH condition, previous trauma, temperament, demographic
168
what in the recovery stage might predispose someone to getting PTSD?
social support, close family, societal attitudes, culture
168
what are potential causes for PTSD?
DV, war, abuse, disasters, accidents, bullying, surgery, robbery, death of a loved one, adoption, separation
169
how long must you have symptoms after an experience to have PTSD?
1 month
170
what are the intrusion symptoms of PTSD?
recurrent memories, nightmares, flashbacks, prolonged distress
171
what are the avoidance symptoms of PTSD?
avoiding trauma related to.....thoughts, feelings, people. places, conversations, activities, objects, situations
172
what are cognition symptoms of PTSD?
cant recall specific events, negative toward self, survivor guilt, distorted blame, lack of interest, inability to feel positive emotions
173
what are the dissociative symptoms of PTSD?
altered sense of reality
174
what are the arousal and reactivity symptoms of PTSD?
irritable, aggression, self destruction, hypervigilance, exaggerated startle, problems sleeping and concentrating
175
what are co morb for PTSD?
depression, anxiety, and substance abuse
176
what are the interventions for PTSD?
stay with them, build trust, encourage verbalization, coping skills
177
what medications are used for PTSD?
SSRI, betablocker, anxiolytics, Benzo
178
what SSRI is used to treat PTSD?
paroxetine and sertraline
179
what betablocker is used to treat PTSD?
propranolol
180
what anxiolytic is used to treat PTSD?
buspirone
181
what benzo is used to treat PTSD?
alprazolam
182
what therapies are used for PTSD?
group CBT, exposure therapy, EMDR, digital therapeutics
183
what is EDMR?
patients talks about an event while their eyes follow a swinging object
184
who do you not do EDMR with?
active SI, substance abuse, psychosis, and seizure disorder
185
what is adjustment disorder?
a response to a stressor that lasts 3-6 months
186
what are the symptoms of adjustment disorder?
depressed mood, anxiety, disturbance of conduct, mixed disturbance???
187
what black box warning is associated with antipsychotics?
Increased risk of MORTALITY in ELDERLY patients with dementia-related psychosis.
188
189
what are the negative symptoms of schizophrenia?
flat affect, anhedonia, alogia, avolition, asociality, catatonia
190
what does anhedonia mean?
inability to experience pleasure
191
what does alogia mean?
lack of speech
192
what does avolition mean?
inability to reach gaols
193
