Need to learn now Flashcards

Pass NP Certification

1
Q

Bipolar Disorder - DSM IV TR Criteria

A

a period of abnormally & persistently elevated, expansive or irritable mood lasting ≥ 1 wk or any duration if hosp. is necessary.
≥3 present during mood disturbance to a significant degree. DIGFAST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Screening clock for dementia

A
3 points for # 12 in correct position
1 point for all 12 #s
1 point for 2 distinct hands ALWAYS ask the pt to place hands at eleven ten 
1 point for correct designated time
score of < 4 is + for impairment.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hamilton Depression Rating Scale

A
>23 = very severe depression
19-22 = severe depression
14-18 = moderate depression
8-13 = mild depression
0-7 = no depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Other common screening tools

A

BPRS = Brief Psychiatric Rating Scale - assess psychosis
PANSS = Positive & Negative Syndrome Scale - assesses schizophrenia
Mood disorder questionnaire screens for bipolar
PHQ-9 Patient Health Questionnaire; screens for depression in primary care & populations w/ co-morbid medical illness (Endorsed by APA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

GAF & Scoring

A

Global Assessment Functioning.
0-40 or 50 = require hospitalization
71-80 minimal psychopathology
depending ≥40 can be opt.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

AIMS & Scoring

A

Abnormal Involuntary Movement Scale
1-4 oral facial movements
5-6 extremity movements
7 trunk movement
8-10 global judgement related to sx present
11-12 dental & denture status that may influence score.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lithium labs

A
Thyroid indices
Creatinine Clearance
Sodium
Lithium levels 0.6 - 1.2 Tx acute mania
                     0.8 - 1.0 Maintenance Tx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Neuro-imaging

A

PET scan - primarily experimental brain mapping
MRI - Gross structure of the brain, new onset psychosis or dementia, delineate gray & white matter. Structural, metabolic & functional imaging
EEG - measures electrical activity of the brain. New onset of seizures, esp. in children, evaluate brain tumors & abscesses, subdural hematomas, CVA’s, intracranial hemorrhage
CT - Brain Mapping, specific or minute brain abnormalities are enhanced, areas of ischemia, areas in states of dementia, tumors. Used for migraines, trauma, vertigo & dizziness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cranial Nerves CNI

A

Cranial Nerve I - S

olfactory - smell test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CNII

A

Cranial Nerve II - S

Optic - Visual Acuity, confrontation method to assess visual fields

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CNIII

A

Cranial Nerve III - M
Oculomotor
eye movement, six eye positions individually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CNIV

A

Cranial Nerve IV - M
Trochlear
eye movement, same tests as oculomotor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CNV

A

Cranial Nerve V
Trigeminal - B
superficial & deep structures of head & face
corneal reflex, show teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CNVI

A

Cranial Nerve VI - M
Abducens
Specific eye movements, same as oculomotor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

CNVII

A

Cranial Nerve VII
Facial - B
Facial movements - corneal reflex, raise eyebrows, puff cheeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

CNVIII

A

Cranial Nerve VIII - S
Acoustic
Hearing, whisper, tuning fork w/ Rinne positive as normal, air conduction persists twice as long as bone conduction

17
Q

CNIX

A

Cranial Nerve IX - B
Glossopharyngeal,
swallow, check for deviation of uvula to unaffected side.

18
Q

CNX

A

Cranial Nerve X - B
Vagus
Swallow, elevation of uvula, check gag reflex

19
Q

CNXI

A

Cranial Nerve XI
Accessory - M
Innervates the trapezius & sternocleidomastoid, have shrug shoulders & turn head against resistance

20
Q

CNXII

A

Cranial Nerve XII
Hypoglossal - M
have patient stick tongue out, push against the side of the cheek, check for fasciculation.

21
Q

3 levels of prevention

A

Primary Prevention - to promote health prior to any illness, (healthy diet, no tobacco)
Secondary prevention - early identification & tx of existing problems, screenings, etc.
Tertiary Prevention - Rehabilitation & restoration of health.

22
Q

DM Screening

A

Impaired Glucose Tolerance - >100 126 on 2 separate occasions
DM - Random Blood Glucose >200 w/ s/s
DM - oral glucose tolerance test >200

23
Q

Cholesterol Testing

A

Total 40 men & >50 women

Triglycerides <150

24
Q

HTN Classifications

A

Normal 160 or >100

25
Q

Thyroid

A

Thyroxine (T4) is main thyroid hormone & is converted to T3 to have effect
Anterior Pituitary controls regulation of TSH or Thyroid Stimulating Hormone which convertes T4 to T3. TSH & T4 communicate & regulate each other. Most T4 is protein bound so to check Free T4 w/ TSH is important in determining Thyroid Function.
TSH 0.35-5.5
Ft4 11.7-31.2
T31.1-2.7

26
Q

Hyperthyroidism

A
Mania
surgery or medication
TSH low, elevated or normal Ft4
T3 is elevated
nervousness, anxiety, irritability, weight loss, sweating, insomnia
27
Q

Hypothyroidism

A

Depression
Thyroid Medication
TSH elevated,
Low FT4 and Low TSH indicates dz state that involves the pituitary gland.
fatigue, unexplained weight gain, depression, muscle & joint pain.

28
Q

Freud

A

Id - Locus of instinctual drives, pleasure principal, unconscious.
Ego - Rational self, maintains balance between id, reality, superego
Superego - perfection principle, internalizes values & moral sets, forms the conscious.

29
Q

Defense Mechanisms

A

Denial - the refusal to accept reality or fact, acting as if a painful event, thought or feeling did not exist.
Projection - misattribution of a person’s undesired thoughts, feelings or impulses onto another person who does not have those thoughts, feelings or impulses. Projection is often the result of a lack of insight and acknowledgement of one’s own motivations and feelings.
Rationalization - putting something into a different light or offering a different explanation for one’s perceptions or behaviors in the face of a changing reality
Sublimation - consciously unacceptable instinctual drives are expressed in personally and socially acceptable channels.

30
Q

Interpersonal Theory (Sullivan)

A

Anxiety & self-esteem, interpersonal therapy,
focus-interpersonal relationships & social supports
non-judgmental stance
Issues - withdrawal, attachment models
Techniques - highly directive interventions

31
Q

Transactional Analysis (Berne)

A

focuses on past & current decisions the client has made.

Interpersonal security, chief disruptive force in interpersonal relations., “strokes”, rackets, life scripts,

32
Q

Gestalt Therapy (Perls)

A

Must accept personal responsibility, feelings, awareness of moment, avoidance, body messages, reversals.

33
Q

Person Centered Therapy (Rogers)

A

Unconditional positive regard, greater trust in self

34
Q

Behavioral Therapy (Pavlov, Skinner)

A

operant conditioning, variables that create consequence & affect behaviors, change cognition. Techniques - Problem Identification & assessment. requires detailed information to understand the client’s presenting problems, based on initial onset, severity & frequency. COGNITIVE RESTRUCTURING, assertiveness & social skills training.

35
Q

Rational-Emotive Therapy (Ellis)

A

neurosis is irrational thinking & behaving, emotional disturbances rooted in childhood, belief system is cause of emotional problems, examine validity of beliefs,
Goal - eliminate self-defeating outlook on life.
disputing irrational beliefs

36
Q

CBT - Cognitive Behavioral Therapy (Beck)

A

cognitive distortions, cognitive reframing, reformulate thought processes, examine where thoughts have become illogical.

37
Q

Trauma Informed Care

A

CBT - EMDR