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AGNP AANC Boards > Mental Health > Flashcards

Mental Health Flashcards

1
Q

normal M and W alcohol intake per day

A

M : 2 drinks a day

W: 1 drink a day

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2
Q

what lab value could indicate alcohol abuse

A

elevated Gamma Glutamyl Transaminases w/ or w/o ALT AST elevation

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3
Q

With chronic alcohol abuse what labs would you see elevated

A

> 100 MCV due to def in folate
Hypertriglyceremia
Thrombocytopenia - increased risk of bleeding

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4
Q

what can you tx DT’s from alchol with

A

benzos ( librium and valium)

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5
Q

Wernicke- Korsakoffs Dementia

A

permanent damage to the brain and spinal cord due to chronic alchol and VITAMIN def of thiamine and B1

tx: give high doses of thiamine and B vitamins

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6
Q

CAGE test

A

evaluation to see if someoone may have a alcohol problem two or more is a +

Cut down
Annoyed
Gulity
Early in AM

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7
Q

DX of Anorexia

A

restriction of energy intake resulting in low body weight w/intense fear of gaining weight/ being fat. Low body weight BMI < 18.5

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8
Q

Complications of eating disorders

A

osteoporosis, stress fractures, bradycardia, CHF, arythmias from vit K depletion, sz

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9
Q

What is the tx plan for ADHD

A
  1. behavioral therapy

2. Amphetemines

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10
Q

side affects of amphetamines

A

anorexia, insominia, poor growth, tics

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11
Q

What is atomoxetine

A

non-stimulent for ADHD, check LFT’s and there is an increase risk of SI

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12
Q

who is most at risk for SI

A

older men with multiple comordities

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13
Q

major depression dx

A

presence for two weeks: sad mood, diminished interest, ( anhedomia), PLUS presence of at least 5 of the following

  • decreased energy
  • poor self image
  • poor cognition
  • sleep too much or too little
  • change in appitiete
  • weight change
  • diminshed interest
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14
Q

minor depression

A

Presence of 2-4 symtpoms of depression ( including depressed mood or loss of pleasure)

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15
Q

what do you need to do when dx depression

A
  1. labs to r/o other causes
  2. assess current SI risk
  3. first line SSRI’s
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16
Q

What are examples of SSRI’s

A

Fluoxetine, Paroxetine, Escitalopram, Citopram, Sertraline

17
Q

Fluoxetine

A

Prozac , longest half life, dont need to wean off

18
Q

Paroxetine

A

Paxil. shortest half life, wean off slowly, high risk of erticle dysfunction

19
Q

Indications for SSRI’s , s/e, follow up,

A

depression. OCD, GAD, SAD, Panic

insomina, sexual dysfunction, anorexia

follow up 2 weeks after start

20
Q

what are the contraindications for SSRI’s

A

MAOI w/thin 2 weeks, triptans, TCA’s, Eldeprl

21
Q

What is the FDA black box warning on the SSRI’s

A

increase risk of SI in people up to 23

22
Q

What is the best depression medication for the elderly

A

SSRI’s Celexa (citalopram), Lexapro (ecitalopram), Zoloft (sertaline)

23
Q

What interactions do MAOI’s have

A

food interactions ( aged-cheese, red wine, beer, fermnated foods)

24
Q

why are TCA’s not first line for depression

A

increased risk of successful SI from an overdose ( fatal arrythmias

25
Q

Atypical Antidepressants indications and contraindiactions

A

Wellbutrin
depression, smoking cessation, seasonal effective disorder

avoid w. hx of sz and head injuries

26
Q

What two medications for smoking cessation?

A

Zyban and Chantix

pt can still smoke w/ med but needs to be less

follow up in 2 weeks

27
Q

SNRI’s names, indication, contraindication,

A

For depression and GAD
Cymbalta, Effexor, Chantix

dont use w/ people with HTN or glaucoma

28
Q

what is an anti-anxiety medication?

A

buspar must be taken daily

29
Q

What is short term insomnia or transient

A

adjustment, stress related,
sympt < 3 months,
expect when the stressor resolves it will too

30
Q

Sleep Terms :

sleep-onset and early awakening

chronic insomia

A

s: difficulty initiaing sleep
e: wakes up after an hour or too
chronic: sympts occur at least 3 x week for 3 months or longer

31
Q

Primary insomonia

A

not drug related related to stress, travel, shift work

32
Q

Secondarcy insomonia

A

related to medication or disease

33
Q

What is the first line therapy for insomonia

A

Sleep hygiene

34
Q

Meds for insomonia

A

antihistamines - benedrly
Kava kava, melatonin

perscription Restoril

35
Q

What are signs of abuse

A
  1. delay in seeking tx
  2. Pattern of injuries not consistent
  3. Injurues on trunk vs extremities
  4. preg and elderly ( if new onset STD)
36
Q

Type 1 Bipolar vs Type 2

A
  1. full blown manic episodes

2. hypomanic (milder symptoms)

37
Q

Bipolar TX

A

Lithem, depakote ( check TSH as it can cause hypothyroidism )

38
Q

PTSD TX

A
  1. pyschotherapy
  2. Meds ( Zoloft and Paxil) SSRI
  3. Eye movement desensitiation and reprocessing)

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