NU625 Test 1 Trial 2

Question 1

What is? The basic cellular unit of the nervous system, the microprocessor of the brain responsible for conducting impulses from one part of the body to another

Answer 1

The Neuron (“Nerve Cells”)

Question 2

What is? Also known as soma; made up of the nucleus and cytoplasm within cell membrane

Answer 2

Cell body

Question 3

What is? Transmits signals away from the neuron’s cell body to connect with other neurons and cells

Answer 3

Stem or axon

Question 4

What is? Collect incoming signals from other neurons and send the signal toward the neuron’s cell body

Answer 4

Dendrites

Question 5

What is? Composed of two separate, interconnected divisions. What are they called?

Answer 5

Nervous system: Central Nervous system and Peripheral nervous system

Question 6

What is? Composed of the spinal cord and the brain

Answer 6

Central Nervous system

Question 7

What is? Composed of the peripheral nerves that connect the CNS to receptors, muscles, and glands. Includes the cranial nerves just outside the brain stem. Comprises the somatic nervous system and the autonomic nervous system.

Answer 7

Peripheral nervous system

Question 8

What is? Conveys information from the CNS to skeletal muscles; responsible for voluntary movement

Answer 8

Somatic nervous system

Question 9

What is? Regulates internal body functions to maintain homeostasis; conveys information form the CNS to smooth muscles, cardiac muscle, and glands; responsible for involuntary movement.

Answer 9

Autonomic nervous system

Question 10

What is? Divided into the sympathetic nervous system and the parasympathetic nervous system.

Answer 10

Autonomic nervous system

Question 11

What is? The excitatory division ; prepares the body for stress (fight or flight); stimulates or increases activity of organs

Answer 11

Sympathetic nervous system

Question 12

What is? Maintains or restores energy; inhibits or decreases activity of organs.

Answer 12

Parasympathetic nervous system

Question 13

What is? Either categorized as white or gray matter?

Answer 13

Brain tissue

Question 14

What is? composed of nerve cell bodies and dendrites; it is the working area of the brain and contains the synapses, the area of neuronal connection

Answer 14

Gray matter

Question 15

What is? the myelinated axons of neurons

Answer 15

White matter

Question 16

What is? Structured to contain grooves and dips of corrugated wrinkles within the brain tissue that provide anatomic landmarks or reference points.

Answer 16

Outermost surface of the brain

Question 17

What is? Small shallow grooves in the outermost surface of the brain

Answer 17

Sulci

Question 18

What is? Deeper groves extending into the brain

Answer 18

Fissures

Question 19

What is? The raised tissue areas of the outermost surface of the brain

Answer 19

Gyri

Question 20

What is? The brain subdivided into

Answer 20

Cerebrum and the brainstem

Question 21

What is? The largest part of the brain, which is divided into two halves, the right and left hemispheres.

Answer 21

Cerebrum

Question 22

What is? This hemisphere of the cerebrum is dominant in most people

Answer 22

Left hemisphere

Question 23

What is? This hemisphere of the cerebrum controls the left sided body functions

Answer 23

Right hemisphere

Question 24

What is? Both hemispheres connected by a large bundle of white matter, an area of sensorimotor information exchange between the two hemispheres

Answer 24

Corpus callosum

Question 25

Each hemisphere of the cerebrum is divided into how many lobes?

Answer 25

four

Question 26

What is? Largest and most developed lobe of the cerebrum

Answer 26

frontal lobe

Question 27

What is? Frontal lobe location that is Responsible for controlling voluntary motor activity of specific muscles

Answer 27

motor function

Question 28

What is? Frontal lobe location that Coordinates movement of multiple muscles

Answer 28

premotor area

Question 29

What is? Frontal lobe location that Allows for multimodel sensory input to trigger memory and lead to decision-making

Answer 29

Association cortex

Question 30

What is? Frontal lobe location of Working memory, reasoning, planning, prioritizing, sequencing behavior, insight, flexibility, judgment, impulse control, behavioral cueing, intelligence, abstraction

Answer 30

Seat of executive functions

Question 31

What is? Frontal lobe location for Expressive speech

Answer 31

Language (broca’s area)

Question 32

What is? Frontal lobe location of the most focal area for personality development

Answer 32

Personality variables

Question 33

What is? Problems in this lobe of the cerebrum can lead to personality changes, emotional, and intellectual changes

Answer 33

Frontal lobe

Question 34

What is? Blank Lobe, functions include:Language (Wernicke’s area): Receptive speech or language comprehensionPrimary auditory areaMemoryEmotionIntegration of vision with sensory informationProblems in this lobe can lead to visual or auditory hallucinations, aphasia, and amnesia

Answer 34

Temporal lobe

Question 35

What is? Blank lobe, functions include:Primary visual cortexIntegration area: Integrates vision with other sensory informationProblems in this lobe can lead to visual field defects, blindness, and visual hallucinations

Answer 35

Occipital lobe

Question 36

What is? Blank lobe, functions include:Primary sensory areatasteReading and writingProblems in this lobe can lead to sensory-perceptual disturbances and agnosia

Answer 36

Parietal lobe

Question 37

What is? This brain area includes the cerebral cortex, limbic system, thalamus, hypothalamus, and basal ganglia

Answer 37

Cerebrum

Question 38

What is? Controls wide array of behaviorsControls the contralateral side of the body Sensory information is relayed from the thalamus and then processed and integrated in the cortexResponsible for much of the behavior that makes us human: speech, cognition, judgement, perception, and motor function

Answer 38

Cerebral cortex

Question 39

What is? Essential system for the regulation and modulation of emotions and memoryComposed of the hypothalamus, thalamus, hippocampus, and the amygdala

Answer 39

Limbic system

Question 40

What is? Plays key roles in various regulatory functions such as appetite, sensations of hunger and thirst, water balance, circadian rhythms, body temperature, libido, and hormonal regulation

Answer 40

Hypothalamus

Question 41

What is? Sensory relay station except for smell; modulates flow of sensory information to prevent overwhelming the cortex; regulates emotions, memory, and related affective behaviors

Answer 41

Thalamus

Question 42

What is? Regulates memory and converts short term memory into long term memory

Answer 42

Hippocampus

Question 43

What is? Responsible for mediating mood, fear, emotion, and aggression; also responsible for connecting sensory smell information with emotions

Answer 43

Amygdala

Question 44

What is? Also known as the corpus striatumServes as a complex feedback system to modulate and stabilize somatic motor activity (information conveyed from the CNS to skeletal muscles)Plays a role in movement initiation; complex motor functions with association connectionsFunctions in learning and automatic actions such as walking or driving a car

Answer 44

Basal ganglia

Question 45

What is? Contains extrapyramidal motor system or nerve tractFunctions in involuntary motor activity (e.g., muscle tone, posture, coordination of muscle movement and common reflexes)Many psychotropic medications can affect the extrapyramidal motor nerve track, causing involuntary movement side effectsContains both the caudate and the putamenProblems in this brain area can lead to bradykinesia, hyperkinesia, and dystonia.

Answer 45

Basal ganglia

Question 46

What is? Made up of cells that produce neurotransmittersIncludes the midbrain, pons, medulla, cerebellum, and reticular formation

Answer 46

Brainstem

Question 47

What is? Houses the ventral tegmental area and the substantia nigra (areas of dopamine synthesis)

Answer 47

Midbrain

Question 48

What is? Houses the locus ceruleus (area of norepinephrine synthesis)

Answer 48

Pons

Question 49

What is? Together with the pons, contains autonomic control centers that regulate internal body functions

Answer 49

Medulla

Question 50

What is? Responsible for maintaining equilibrium; acts as a gross movement control center (e.g. control movement, balance, posture)

Answer 50

Cerebellum

Question 51

What is? Each hemisphere of this has ipsolateral control (same side of body)Problems with this can lead to ataxia (uncoordinated and inaccurate movements).Romberg test is important for detecting deficiencies in cerebellar functioning.

Answer 51

Cerebellum

Question 52

What is? The primitive brainInnervates thalamus, hypothalamus, and cortexRegulation functions include: Involuntary movement, reflex, muscle tone, vital sign control, blood pressure, respiratory rate, critical to consciousness and ability to mentally focus, to be alert and pay attention to environmental stimuli

Answer 52

Reticular formation system

Question 53

What are the two classes of cells in the nervous system?

Answer 53

Glia and neurons

Question 54

What is? Structures that form the myelin sheath around axons and provide protection and support

Answer 54

Gila

Question 55

What is? Nerve cells responsible for conducting impulses from on part of the body to another

Answer 55

Neurons

Question 56

Components of this include:Cell bodyDendritesAxons

Answer 56

Neuron

Question 57

What is? Also known as soma; made up of the nucleus and cytoplasm within the cell membrane

Answer 57

Cell body

Question 58

What is? Receives information to conduct impulse toward the cell body

Answer 58

Dendrites

Question 59

Sends or conducts information away from the cell body

Answer 59

Axon

Question 60

What is? The connection site and area of communication between neurons where neurotransmitters are released

Answer 60

Synapse or synaptic cleft

Question 61

The spirit of motivational interviewing is characterized by what?

Answer 61

Acceptance, partnership,evocation, compassion

Question 62

The four processes of motivational interviewing are?

Answer 62

Engage, focus, evoked, plan

Question 63

The enhanced national standards for culturally and linguisticallyappropriate services and health and healthcare from the office of minority health at the US Department of Health and Human Services are composed of 15 standards that provide individuals and organizations with the blueprint for successively implementing and maintaining culturally and linguisticallyappropriate services. Culturally and linguistically appropriate healthcare and services, broadly defined his care and services that are respectful of and responsive to the cultural and linguistic needs of all individuals, are increasingly seen as essential to reducing disparities and improving healthcare quality

Answer 63

C LAS standards

Question 64

The purpose of this is to provide a blueprint for health and healthcare organizations to implement culturally and linguistically appropriate services that will advance health equity, improve quality, and help eliminate healthcare disparities

Answer 64

C LAS purpose

Question 65

Standard one: provide effective, equitable, understandable, and respectful quality care and services.standard two: advance and sustain governance and leadership that promotes C LAS and health equity.Standard three: recruit, promote, and support a diverse governance, leadership, and workforce.Standard four: educate and train governance, leadership, and workforce and see LAS.Standard five: offer communication and language assistance.

Answer 65

CLA standards

Question 66

Standard six: inform individuals of the availability of language assistance.Standard seven: ensure the competence of individuals providing language assistance.Standard eight provide easy to understand materials and signage.Standard nine: infuse CLA’s goals, policies, and management accountabilities out the organizations planning and operations.Standard 10: conduct organizational assessments.Standard 11: collect and maintain demographic data.Standard 12: conduct assessments of community health assets and needs.Standard 13 partner with the community.Standard 14: create conflict and grievance resolution processes.Standard 15: communicate the organization’s progress in implementing and sustaining

Answer 66

C LAS standards

Question 67

The synapse converts an electrical signal blank from the presynaptic neuron into a chemical signal blank that is transferred to the postsynaptic neuron

Answer 67

Action potential and neuron transmitter

Question 68

Blank is released at the synaptic cleft as a result of electrical activity known as action potential

Answer 68

Neurotransmitters

Question 69

The two phases of an action potential are?

Answer 69

Depolarization and repolarization

Question 70

What is the initial phase of the action potential (an excitatory response)when sodium and calcium ions flow into the cells

Answer 70

Depolarization

Question 71

What is the restoration phase (an inhibitory response), when potassium leaves the cell or chloride enters the cell.

Answer 71

Repolarization

Question 72

Problem in either the structure or chemistry of this blank interrupts normal flow of impulses and stimuli, which then contribute to symptoms commonly seen in psychiatric disorders.

Answer 72

Synapse

Question 73

Chemical synthesized from dietary substrates that communicate information from one cell to another

Answer 73

Neurotransmitters

Question 74

The neurotransmitter will be released from the blank across the synapse and then bind to a specific receptor on the blank.

Answer 74

Presynaptic neuron and Postsynaptic neuron

Question 75

1. Neurotransmitter must be present in the nerve terminal.
2. Simulation of neuron must cause release of neurotransmitter in sufficient quantities to cause an action to occur at postsynaptic membrane.
3. Effects of exogenous transmitter on postsynaptic membrane must be similar to those caused by stimulation of presynaptic neuron.
4. A mechanism for inactivation or metabolism of the neurotransmitter must exist in the area of the synapse
5. Exogenous drugs should alter the dose, response curve of the neurotransmitter in a manner similar to the naturally occurring synaptic potential.

Answer 75

Classification requirements for neurotransmitters

Question 76

Monoamines, amino acids, cholinergics, neuropeptides

Answer 76

Categories of neurotransmitters

Question 77

Dopamine, norepinephrine, epinephrine, serotonin all belong to the class of this neurotransmitter

Answer 77

Monoamines

Question 78

Known as a catecholamine; produced in the substantia nigra and the ventral tegmental area; precursor is tyrosine; removed from the synaptic cleft by monoamine oxidase enzymatic action

Answer 78

Dopamine

Question 79

This monoamine is produced in these four pathways: mesocortical, mesolimibic, nigrostriatal, tuberoinfundibular

Answer 79

Dopamine

Question 80

Also known as a catecholamine; produced in the locus ceruleus of the pons; precursor is tyrosine; removed from the synaptic cleft and retuned to storage via an active reuptake process; major neurotransmitter implicated in mood, anxiety, and concentration disorders

Answer 80

Norepinephrine

Question 81

Also known as a catecholamine; produced by the adrenal glands; and also referred to as the adrenergic system

Answer 81

Epinephrine

Question 82

Known as an indole; produced in the raphe nuclei of the brainstem; precursor is tryptophan; removed from the synaptic cleft and returned to storage via an active reuptake process; major neurotransmitter implicated in mood and anxiety disorders

Answer 82

Serotonin

Question 83

Glutamate, aspartate, GABA, and glycine make up this category of neurotransmitters

Answer 83

Amino acids

Question 84

What is the universal excitatory neurotransmitter; major neurotransmitter involved in process of kindling, which is implicated in seizure disorders and possibly bipolar disorders; balance implicated in mood disorders and schizophrenia

Answer 84

Glutamate

Question 85

What is Another excitatory neurotransmitter; works with glutamate

Answer 85

Aspartate

Question 86

Universal inhibitory neurotransmitter; site of action of benzodiazepines, alcohol, barbiturates and other CNS depressants

Answer 86

GABA

Question 87

What is Another inhibitory neurotransmitter; works with GABA

Answer 87

Glycine

Question 88

acetylcholine belongs to this category of neurotransmitters

Answer 88

Cholinergics

Question 89

Synthesized by the basal nucleus of Meynert; precursors are acetylcoenzyme A and choline

Answer 89

Acetylcholine

Question 90

Non-opioid type and opioid type belong to this category

Answer 90

Neuropeptides

Question 91

This category of neurotransmitter modulates pain; decreased amount of this category of neurotransmitter is thought to cause substance abuse

Answer 91

Neuropeptides

Question 92

Decrease acetylcholine causes?

Answer 92

Alzheimer’s disease and impaired memory

Question 93

Increased acetylcholine causes?

Answer 93

Parkinsonian symptoms

Question 94

Increase Dopamine causes?

Answer 94

Schizophrenia and psychosis

Question 95

Decrease Dopamine causes?

Answer 95

Substance abuse, Anhedonia (inability to feel pleasure), Parkinson’s disease

Question 96

Decreased norepinephrine causes?

Answer 96

Depression

Question 97

Increase in norepinephrine causes what mental health condition?

Answer 97

Anxiety

Question 98

Decreased serotonin causes?

Answer 98

Depression, obsessive-compulsive disorder, anxiety disorders, and schizophrenia

Question 99

Decrease GABA causes?

Answer 99

Anxiety disorder

Question 100

Glutamate increase causes?

Answer 100

Bipolar affective disorder, psychosis from escape mixed neurotoxicity or excessive pruning

Question 101

Glutamate decrease causes?

Answer 101

Memory and learning difficulty, negative symptoms of schizophrenia

Question 102

Opioid neuropeptides decreases causes?

Answer 102

Substance abuse

Question 103

Serotonin 5-HT 1A

Answer 103

Regulation of sleep

Question 104

Serotonin 5-HT1D

Answer 104

Pain perception

Question 105

Serotonin 5-HT2

Answer 105

Mood states

Question 106

Serotonin 5-HT2A

Answer 106

Temperature

Question 107

Serotonin 5-HT3

Answer 107

Regulation/facilitation of aggression

Question 108

Serotonin 5-HT4

Answer 108

Libido

Question 109

Disadvantages of this lack sensitivity, cannot differentiate white matter from gray matter, cannot view structures close to the bone tissues, under estimation of brain atrophy, inability to image sagittal and Cornel views

Answer 109

CT

Question 110

Autosomal dominant conditions may be present in more than one generation and up to what percent of offspring when one parent is affected such as Marfan syndrome

Answer 110

50%

Question 111

Testing for presence of HLA-B 1502 allele, an inherited variant of HLA-B gene, is required by the FDA in people of blank descent prior to prescribing the anticonvulsant carbamazepine due to the risk of Stevens-Johnson syndrome and toxic epidermal necrolysis

Answer 111

Asian

Question 112

Painful stick neck and thick tongue are indicated of of what medical term

Answer 112

Dystonia: is a movement disorder in which a person’s muscles contract uncontrollably can result in repetitive movements or abnormal posture

Question 113

CNS dopamine and acetylcholine have a blank relationship. As dopamine receptors are antagonized by antipsychotic medications, acetylcholine levels increase, giving rise to what?

Answer 113

Reciprocal, extrapyramidal side effects

Question 114

A positive Babinski or fanning of toes and dorsiflexion of the great toe is normal in infants up to age what

Answer 114

Two years

Question 115

On old Olympus towering top a fin and German viewed some hops

Answer 115

Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Acoustic, Glossopharyngeal, Vagus, Spinal Accessory, Hypoglossal

Question 116

What cranial nerve ? Test sense of smell and ensure patency of the nasal passages, have the client close eyes and test each nostril separately while others is occluded, asking the client to identify familiar odors

Answer 116

Olfactory

Question 117

What cranial nerve? Test vision using Snellen chart or other suitable chart depending on the client’s acuity and ability to cooperate. Examine the inner aspect of the eyes with the ophthalmoscope. Test peripheral vision using the confrontation test.

Answer 117

Optic

Question 118

What cranial nerve? This is the motor nerve to the five extrinsic eye muscles. Test together with cranial nerve for an cranial nerve six. Test the extraocular movements. Check the equality of pupils, the reaction to light, and their ability to accommodate. Test the corneal light reflex, when shining a light at the bridge of the nose, the light should appear symmetrical in both eyes.

Answer 118

Oculomotor

Question 119

What cranial nerve? Use the same processes cranial nerve three and cranial nerve six.

Answer 119

Trochlear

Question 120

What cranial nerve? Palpate the messenger muscles with the fingertips while the client clenches his or her teeth. Look for disparity and tension between the two muscles, which can indicate paralysis on the weak side. Look for tremor of the lips, involuntary chewing movements, and spasm of the masticatory muscles.

Answer 120

Trigeminal motor division

Question 121

What cranial nerve? Test tactical perception of the facial skin by touching with a wisp of cotton. Test superficial pain of the skin and mucosa with pinpricks. Test the sense of touch in the oral mucosa.

Answer 121

Trigeminal sensory division

Question 122

What cranial nerve? Use the same processes for cranial nerve three and four.

Answer 122

Abducens

Question 123

What cranial nerve? Inspect the face in repose for evidence of flaccid paralysis. Test by asking the client to elevate eyebrows, wrinkled forehead, close eyes, frown, smile, and puffed cheeks.

Answer 123

Facial motor division

Question 124

What cranial nerve? Test taste for sugar, vinegar, and salt

Answer 124

Facial sensory division

Question 125

What cranial nerve? Check hearing with the audiometer or by the whisper test. Check for hearing loss using the Weber and the Rinne tests.

Answer 125

Acoustic

Question 126

What cranial nerve? Test together with cranial nerve 10

Answer 126

Glossopharyngeal

Question 127

What cranial nerve? Tester elevation of the uvula by having the client open his or her mouth and say “ah”. Test the gag reflex by touching the back of the throat with the tongue blade.

Answer 127

Vagus

Question 128

What cranial nerve? Test the strength of the sternocleidomastoid and trapezius muscles against resistance of your hands.

Answer 128

Accessory spinal

Question 129

What cranial nerve? Look for tremors and other involuntary movement when the client protrudes his or her tongue.

Answer 129

Hypoglossal

Question 130

Have the client stand up straight with feet together, arms by sides, and eyes closed. Only slight swaying would be normal, and the client will be able to sustain this post for approximately five seconds. More than slight swing suggests cerebellar ataxia or vestibular dysfunction

Answer 130

Equilibrium by administering the Romberg test

Question 131

Ability to perform rapid alternating movements such as patting knees alternating palm and back of hands, touching thumb to each finger. The client should be able to smoothly execute these movements and maintain the rhythm.

Answer 131

Diadochokinesia

Question 132

Inability to discriminate between objects based on touch alone; results of a lesion in the parietal lobe

Answer 132

Astereognsosis

Question 133

Movement disorder in which a person’s muscles contract uncontrollably. Contraction causes the affected body part the twist involuntary, resulting in repetitive movements or abnormal postures.

Answer 133

Dystonia

Question 134

Repetitive and rapid, jerky, involuntary movement that appears to be well coordinated; often seen in Huntington’s disease

Answer 134

Choreiform

Question 135

Inability to recognize letters or numbers drawn on the clients hand with a pointed object

Answer 135

Agraphesthesia

Question 136

Is movement disorder characterized by subjective feeling of inner restlessness accompanied by mental distress and an inability to sit still.

Answer 136

Akathisia

Question 137

Greater than blank percentile for body mass index places the child at increased risk for being overweight

Answer 137

85th

Question 138

The client is presenting with elevated temperature and also is taking psychotropic meds such as Tegretol or clozaril be alert for what

Answer 138

Agranulocytosis

Question 139

What antipsychotic can cause cataracts

Answer 139

Quetiapine (Seroquel)

Question 140

Is a milky nipple discharge unrelated to the normal milk production of breast-feeding.

Answer 140

Galactorrhea

Question 141

Be aware that lithium and anorexia nervosa can cause what

Answer 141

Peripheral edema

Question 142

Function of what gland is to take iodine from the circulating blood, combine it with amino acid tyrosine, and convert it to the thyroid hormones’ T3 and T4

Answer 142

Thyroid

Question 143

The thyroid gland also stores T3 and T4 until they are released into the bloodstream under the influence of thyroid stimulating hormone released from what gland?

Answer 143

Pituitary

Question 144

When T4 and T3 are high, TSH secretion does what?

Answer 144

TSH secretion decreases

Question 145

When T4 and T3 levels are low, TSH secretion does what?

Answer 145

TSH secretion increases

Question 146

This cation for the structure of bones and teeth is mediated by interactions among three hormones’: parathyroid, hormone, vitamin D, and calcitonin

Answer 146

CA

Question 147

Confusion, decreased libido, importance, decreased appetite, memory loss, lethargy, constipation, headaches, slow or clumsy movements, syncope, weight gain, fluid retention, muscle aching and stiffness, slowed reflexes, somatic discomfort, slowed speech and thinking, sensory disturbances, cerebellar ataxia, loss of amplitude and ECG, mimics symptoms of unipolar mood disorders

Answer 147

Systemic effects of hypothyroidism

Question 148

Mimics symptoms of bipolar affective disorder, motor restlessness, emotional lability, short attention span, compulsive movement, fatigue, tremor, insomnia, importance, weight loss, increase in appetite, abdominal pain, excessive sweating, flushing, elevated upper eyelid leading to decreased blinking, staring, fine tremor of eyelid, tachycardia, dysrhythmias

Answer 148

Systemic effects of hyperthyroidism

Question 149

Calcium normal values

Answer 149

8.8 to 10.5mg/dl

Question 150

Free T4 normal values

Answer 150

0.8 to 2.8ng/dl

Question 151

Normal thyroid stimulating hormone

Answer 151

2 to 10 mU/l

Question 152

Increased levels of what can cause: acidosis, hyperparathyroidism, cancers, vitamin D intoxication, Addison’s disease, and hyperthyroidism

Answer 152

Calcium

Question 153

Decreased levels of what can cause alkalosis, hyperparathyroidism, renal failure, pancreatitis

Answer 153

Calcium

Question 154

Systemic effects of what causes: increase in neuromuscular excitability, confusion, Paris thesis around the mouth and in the digits, muscle spasms in the hands and feet, hyperreflexia, convulsions, tetany, continuous severe muscle spasm, prolonged QT interval, intestinal cramping, and hyperactive bowel sounds

Answer 154

Hypocalcemia less then 8.5

Question 155

Systemic effects of what causes: fatigue, weakness, lethargy, anorexia, nausea, constipation, behavioral changes, impaired renal function, shortened QT interval, depressed T waves, bradycardia, and heart block

Answer 155

Hypercalcemia Greater then 12

Question 156

Normal sodium values

Answer 156

135 to 148mEq/l

Question 157

Increased levels of what can cause: hypovolemia, dehydration, diabetes insipidus, excessive salt ingestion, gastroenteritis

Answer 157

Increase levels of sodium

Question 158

Decreased levels of what can cause: Addison’s disease, renal disorder, G.I. fluid loss from vomiting, diarrhea, nasogastric suction, alias, diuresis

Answer 158

Decreased levels of sodium

Question 159

Systemic effects of what causes: lethargic, headache, confusion, apprehension, seizures, coma, hypotension, tachycardia, decreased urine output, weight gain, edema, ascites, jugular vein distention.

Answer 159

Hyponatremia less than 135mEq/l

Question 160

Systemic effects of what causes: convulsions, pulmonary edema, thirst, fever, dry mucous membranes, hypertension, tachycardia, low jugular venous pressure, restlessness

Answer 160

Hypernatremia greater than 147mEq/l

Question 161

Normal values for magnesium

Answer 161

1.3 at the 2.1mEq/l

Question 162

Increase levels of what can cause: Addison’s disease, adrenalectomy, renal failure, diabetic ketoacidosis, dehydration, hypothyroidism, hyperthyroidism

Answer 162

Magnesium

Question 163

Decreased levels of what can cause: hyperaldosteronism, hypokalemia, diabetic ketoacidosis, malnutrition, alcoholism, acute pancreatitis, GA loss from vomiting, diarrhea, nasogastric suction, and for Sheila, malabsorption syndrome, pregnancy induced hypertension.

Answer 163

Magnesium

Question 164

Systemic effects of what causes: depression, confusion, irritability, increased reflexes, muscle weakness, ataxia, nystagmus, tetany, convulsions

Answer 164

Hypomagnesemia less then 1.5

Question 165

Systemic effects of what causes: nausea and vomiting, muscle weakness, hypertension, bradycardia, respiratory depression, depressed skeletal muscle contraction, and depressed nerve function

Answer 165

Hypermagnesemia greater than 2.5mEq/l

Question 166

Normal chloride values

Answer 166

98 to 106mEq/L

Question 167

Increased levels are caused by: acidosis, hyperkalemia, hyponatremia, dehydration, renal failure, Cushing’s syndrome, hyperventilation, and anemia

Answer 167

Chloride

Question 168

Decreased levels are caused by: alkalosis, hypokalemia, hyponatremia, G.I. loss from vomiting, diarrhea, nasogastric suction, and fistula, diuresis, over hydration, Addison’s disease, burns

Answer 168

Chloride

Question 169

Potassium normal value range

Answer 169

3.5 to 5.1 mEq/l

Question 170

Increased levels are caused by: acidosis, insulin deficiency, Addison’s disease, acute renal failure, hypoaldosteronism, infection, dehydration

Answer 170

Potassium

Question 171

Decreased levels are caused by: alkalosis excessive insulin, G.I. loss, laxative abuse, burns, trauma, surgery, Cushing’s syndrome, Hyperaldosteronism, thyrotoxicosis, anorexia nervosa, diet deficient in meat and vegetables

Answer 171

Potassium

Question 172

Systemic effects of what causes: muscle weakness, paralysis, tingling of lips and fingers, restlessness, intestinal cramping, diarrhea, narrow and taller T waves, shorten QT interval, depressed ST segment, prolonged PR interval, widened QRS complex leading to cardiac arrest.

Answer 172

Hyperkalemia greater than 5.5mEq/l

Question 173

Systemic effects of what causes: impaired carbohydrate metabolism, impaired renal function, polyurea, polydipsia, skeletal muscle weakness, and smooth muscle atony, cardiac dysrhythmias, paralysis, and respiratory arrest

Answer 173

Hypokalemia levels less than 3.5mEq/l

Question 174

Normal values of ALT

Answer 174

5 to 35 U/I

Question 175

Normal values of AST

Answer 175

5 to 40 U/I, AST has less in skeletal muscles, kidneys, pancreas, brain

Question 176

GGT normal values

Answer 176

10 to 38 IU/I

Question 177

How many stages in girls breast development

Answer 177

Stage one prepubertal
stage II breast Bud stage with elevation of breast and papillary; enlargement of areola
stage III further enlargement of breast and aerial; no separation of their contour
stage IV Areola and papilla form a secondary mound above level of breast
stage V mature stage projection of papilla only related to recession of a areola

Question 178

How many stages in boys development of external genitalia

Answer 178

Stage I prepubertal
stage II enlargement of scrotum and testes; scrotum skin reddens and changes and texture
stage III enlargement of penis; further growth of testes
stage IV increase in size of penis with growth and breadth and development of glans; testes and scrotum larger, scrotum skin darker
stage V adult genitalia

Question 179

How many stages and Boys and Girls Club care

Answer 179

Stage I prepubertal
stage II sparse growth of long, slightly pigmented hair, straight or curled, at base of penis or long labia
stage III darker, coarser, and curly hair, spreading sparsely or junction a few
stage IV adult type pair, but covering smaller area than an adult, no spread to medial surface of thighs
stage V adult type and quantity with horizontal distribution

Question 180

Plan an exercise routine that last at least blank minutes, and perform the work out at least blank to blank days a week.

Answer 180

30 minutes, 3 to 5 days

Question 181

The target heart rate during physical activity should be blank to blank of the maximum heart rate

Answer 181

60 the 90%

Question 182

Physical activity at blank to blank of the maximum heart rate is considered moderate intensity exercise

Answer 182

60 to 70%

Question 183

CDC recommends blank minutes or more of physical activity each day for children and adolescents

Answer 183

60 minutes

Question 184

CDC recommends blank minutes of moderate intensity aerobic activity every week and muscle strengthening activities blank or more days a week for adults

Answer 184

Hundred and 50 minutes and two

Question 185

All SSRIs and some other antidepressants have been implicated in blank. Owing to diminished renal function and frequent polypharmacy, blank is more common in the elderly. Water pills could make it worse.

Answer 185

Hyponatremia

Question 186

In this condition clients can show up feeling tired, foggy, severe headache owing to cerebral edema

Answer 186

Hyponatremia

Question 187

What client teaching should be included in preparation for beginning lithium?

Answer 187

The client should be taught about the potential risks and benefits of taking lithium. Women of childbearing age should be educated about the risk of birth defects, including Ebstein’s anomaly. Consideration of lithium dose and maintenance blood level should be included in discussing the relative risk. The client should be taught about the signs and symptoms of lithium toxicity.

Question 188

What test should be ordered before starting lithium

Answer 188

Baseline labs consisting of a metabolic panel, TSH, and CBC women of childbearing age should have a pregnancy test.

Question 189

In the elderly what additional test should be ordered before treating with lithium?

Answer 189

Those with heart disease are over the age of 65 should first have a baseline ECG

Question 190

Patient started on lithium to follow up with the fire G, constipation, and bradycardia what should the provider consider his etiology?

Answer 190

Hypothyroidism or hypercalcemia both of which can because by lithium

Question 191

What is time needed to clear 50% of the drug from the plasma

Answer 191

Half-life

Question 192

What is the point at which the amount of drug eliminated between doses is approximately equal to the dose administered

Answer 192

Steady state

Question 193

It takes how many half-lives to achieve a steady state and how many half-lives to completely eliminate a drug

Answer 193

Five

Question 194

Approximately 10% of Caucasians are poor metabolizers of this P4 50 enzyme

Answer 194

2 D6 enzyme

Question 195

Approximately 20% of Asians may have reduced activity of this P4 50 enzyme

Answer 195

2C 19 enzyme

Question 196

First pass metabolism increase activity of P4 50 enzymes on 2C9, 2C19, 2D6, and 3A4 are common in what age group

Answer 196

Young children

Question 197

The P4 50 enzyme1A2 pathway is delayed in what age group

Answer 197

Young children

Question 198

Enzyme inducers can what to the serum level of other drugs that are substrates of that enzyme, thus possibly causing sub therapeutic drug levels

Answer 198

Decrease

Question 199

Inhibitors or inducers? Bupropion, Clomipramine

Answer 199

Inhibitors

Question 200

Inhibitors or inducers? Cimetidine and Clairthromycin

Answer 200

Inhibitor

Question 201

Inhibitors or inducers? Fluoroquinolones and Grapefruit

Answer 201

Inhibitors

Question 202

Inhibitors or inducers? Ketoconazole and Nefazodon

Answer 202

Inhibitors

Question 203

Inhibitors or inducers? SSRIs

Answer 203

Inhibitors

Question 204

Inhibitors or inducers? Carbamazepine

Answer 204

Inducer

Question 205

Inhibitors or inducers? Hypericum (St. John’s Wort)

Answer 205

Inducer

Question 206

Inhibitors or inducers? Phenytoin

Answer 206

Inducers

Question 207

Inhibitors or inducers? Phenobarbital and tobacco

Answer 207

Inducers

Question 208

Enzyme inhibitors can do what to the serum level of other drugs that are substrates of that enzyme, thus possibly causing toxic levels

Answer 208

Increase

Question 209

Liver disease will affect liver enzyme activity and first pass metabolism, possibly resulting in what plasma drug levels

Answer 209

Toxic

Question 210

Kidney disease or drugs that reduce renal clearance, such as NSAIDs, may what to serum concentration of drugs that are excreted by the kidneys such as lithium. Older adults are more sensitive to psychotropics because of their decreased intracellular water, protein binding, low muscle mass, decreased metabolism, and increased body fat concentration.

Answer 210

Increase

Question 211

Most psychotropics are highly protein bound and older adults have more body fat and less protein they are more likely to develop what as a result of taking medications

Answer 211

Toxicity

Question 212

What effect? Drug binds to receptors and activates a biological response

Answer 212

Agonist affect

Question 213

What effect? Drug causes the opposite effect of agonist; binds to same receptor

Answer 213

Inverse agonist affect

Question 214

What effect? Drug does not fully activate the receptors

Answer 214

Partial agonists affect

Question 215

What effect? Drug binds to the receptor but does not activate a biological response

Answer 215

Antagonist affect

Question 216

What kind of response? Depolarization; involves the opening of sodium and calcium channels so these ions go into the cell

Answer 216

Excitatory response

Question 217

What kind of response? Repolarization; involves the opening of chloride channel so chloride goes into the cell, potassium leaves, or both

Answer 217

Inhibitory response

Question 218

Another site for drug actions are enzymes, which are important for drug metabolism and play an important role in the chemical alteration of the drug. Some drugs such as what inhibit the actions of a particular enzyme, thus increasing the availability of the neurotransmitter.

Answer 218

MAOIs monoamine oxidase inhibitors

Question 219

Another site for drug action is carrier proteins or reuptake pumps, which transport neurotransmitters out of the synapse and back into the presynaptic neuron to be recycled or reused. Some drugs, such as what, will inhibit reuptake pumps, thus increasing the synaptic availability of the neurotransmitter

Answer 219

SSRIs

Question 220

What is the relative dose required to achieve certain effects?

Answer 220

Potency

Question 221

What is the relative measure of the toxicity or safety of a drug; ratio of the median toxic dose to the median effective dose

Answer 221

Therapeutic index

Question 222

Drugs with what kind of therapeutic index have a high margin of safety; that is, the therapeutic dose and the toxic dose are far apart.

Answer 222

High therapeutic index

Question 223

Have a low margin of safety; that is, the therapeutic dose and toxic dose are close together.

Answer 223

Low therapeutic index

Question 224

What is the process of becoming less responsive to particular drug over time

Answer 224

Tolerance

Question 225

An acute decrease in the therapeutic response

Answer 225

tachyphylaxis

Question 226

What schedule of medication? I abuse potential, used for research purposes only, not legally available by prescription, examples include heroin and marijuana

Answer 226

Schedule one

Question 227

What schedule of medication? Medicinal drugs in current use, high potential for abuse and dependency, written prescription only, no telephone orders allowed, no refills allowed on prescriptions examples include morphine, codeine, methadone Dilaudid oxycodone hydrocodone amphetamine salts, methylphenidate

Answer 227

Scheduled two

Question 228

What schedule of medications? Medicinal drugs with less abuse potential than schedule two drugs, still greater potential for abuse and schedule for drugs, telephone orders if followed by written prescription, prescription must be renewed every six months, refills limited to five, examples include testosterone, Suboxone, appetite suppressant’s

Answer 228

Schedule three

Question 229

What scheduled medications? Medicinal drugs with less abuse potential than schedule three drugs. Examples include benzodiazepines

Answer 229

Schedule four

Question 230

What scheduled medications? Medicinal drugs with the lowest abuse potential includes buprenorphine, codeine, Phenergan and, the Lomotil

Answer 230

Schedule five

Question 231

Beta blockers, steroids, interferon, accutane, retroviral drugs, antineoplastic, benzodiazepines, and progesterone can induce what medical conditions?

Answer 231

Depression

Question 232

Steroids, Antabuse, INH, and antidepressants in persons with bipolar disorder can induce what medical condition?

Answer 232

Mania

Question 233

These drugs can cause a false positive for what: stimulants, Wellbutrin, Prozac, trazodone, ranitidine, nefazodone, nasal decongestants, pseudoephedrine

Answer 233

Amphetamines

Question 234

This drug can cause a false positive for what: valium

Answer 234

Alcohol

Question 235

This drug can cause a false positive for what: zoloft

Answer 235

Benzodiazepines

Question 236

This drug can cause a false positive for what: amoxicillin, most antibiotics, NSAIDs

Answer 236

Cocaine

Question 237

This drug can cause a false positive for what: quinolones, rifampin, codeine, poppy seeds

Answer 237

Heroin or morphine

Question 238

This drug can cause a false positive for what: over the counter cough medicines such as nyquil dextromethorphan

Answer 238

Methadone or PCP

Question 239

Attack of nerves is a syndrome among individuals of Latino descent, characterized by symptoms of intense emotional upset, including acute anxiety, anger or grief; screaming and shouting uncontrollably; attacks of crying; trembling; heat in the chest rising into the head; and becoming verbally and physically aggressive.

Answer 239

Ataque de nervios

Question 240

Is a term that was going to in South Asia with little more than half a century ago to account for common clinical presentations of young male patients who attributed their various symptoms to semen loss

Answer 240

Dhat syndrome

Question 241

Wind attacks or a syndrome found among Cambodians in the United States and Cambodia. Common symptoms include those of panic attacks, such as dizziness, palpitations, shortness of breath, and cold extremities, as well as other symptoms of anxiety and autonomic arousal.

Answer 241

Khyal cap

Question 242

Thinking too much or rumination or upsetting thoughts term used by Zimbabwe

Answer 242

Kufungisisa

Question 243

Humanly caused illness or sent to sickness is a cultural explanation in Haitian communities for diverse medical and psychiatric disorders.

Answer 243

Maladi moun

Question 244

Is a common idiom of distress among Latinos in United States and Latin America refers to a general state of vulnerability to stressful life experiences and the difficult life circumstances

Answer 244

Nervios

Question 245

Is a cultural syndrome that integrates conceptual categories of traditional medicine with the Western diagnosis. Syndrome composed of 3/5 nonhierarchical symptoms cluster weakness, emotions, excitement, nervous pain, sleep, irritability

Answer 245

Shenjing shuairuo

Question 246

Is a cultural explanation for distress and misfortune prevailing among some Latinos in the United States and among people in Mexico, Central America, and South America. It is not recognized as an illness category among Latinos from the Caribbean. His illness attributed to a frightening event that causes the soul to leave the body and result in unhappiness and sickness, as well as difficulties functioning’s and key social roles.

Answer 246

Susto

Question 247

Is a cultural syndrome characterized by an anxiety about an avoidance of interpersonal situations due to the thought, feeling, or conviction that one’s appearance and actions in social interactions are inadequate or offensive to others.

Answer 247

Taijin Kyofusho

Question 248

Absolute neutrophil count is calculated how?

Answer 248

White blood cell count times percentage of neutrophils or segmented neutrophils plus band neutrophils times the white blood cell count

Question 249

Benign ethnic neutropenia is what?

Answer 249

Condition observed in certain ethnic groups whose average ANC’s are lower than other populations.

Question 250

General population absolute neutrophil count is?

Answer 250

Greater than 1500

Question 251

When initiating Clozapine how often do you check a CBC for the first six months, 6 to 12 months, and after 12 months.

Answer 251

First six months weekly, six months to 12 months biweekly, and monthly after 12 months

Question 252

What is mild neutropenia and is this considered normal for people in the Ben population?

Answer 252

Mild neutropenia is considered 1000 1499 is considered normal for Ben population the general population you continue treatment but check CBC three times weekly until absolute neutrophil count is over 1500

Question 253

What is moderate neutropenia and is this considered normal for people in the ben population?

Answer 253

500 to 999. In the general population hematology consult, interrupt treatment, resume treatment once absolute neutrophil count is over 1000 check CBC daily once over a thousand then check CBC three times weekly once over 1500 check CBC weekly for four weeks then returned to patient’s last normal range and see monitoring interval
for Ben population check CBC three times weekly until ANC is over a thousand. Once ANC is back over a thousand check weekly for four weeks then returned to patient’s last monitoring interval. Continue treatment and recommend hematology consult

Question 254

Severe neutropenia in the general population and in the ben population is considered what?

Answer 254

ANC less than 500. General population hematology consult. Stop medication. Do not re-challenge unless prescriber determines benefits outweigh risks. Daily CBC until ANC is greater than 1000 than three times weekly until ANC is greater than 1500. If restarting treat patient as new patient.
Ben population check CBC until ANC is greater than 500 daily. Then check CBC three times weekly until ANC is greater than 1000. If patient stays on med treat as if a new patient.

Question 255

Blank is typically caused by acute illness or drug toxicity and is often reversible. Blank is typically caused by anatomic changes in the brain, has slower onset, and is generally irreversible.

Answer 255

Delirium and dementia

Question 256

With blank you may feel very restless or tense and have a constant desire to move. This might show up as physical discomfort, agitation, anxiety, or general irritability. Pacing shaking of legs rocking of feats or rubbing your face.

Answer 256

Akathisia

Question 257

Blank reactions are involuntary muscle contractions. These movements are often repetitive and might include eye spasms were blinking, twisting head, recruiting tongue, and extended neck. Movements may be very brief but they could also affect posture or stiffen muscles for a period of time. They most often affect the head and neck so they can occur in other parts of the body. Blank can cause painful muscle stiffness and other discomfort. Can choker have trouble breathing.

Answer 257

Acute dystonia

Question 258

Length describe symptoms that resemble those of rigid muscles in the limbs. Could also cause tremor, increase elevation, slow movements, or changes in posture and gait

Answer 258

Parkinsonism

Question 259

Generally the first signs are rigid muscles and fever, then drowsiness or confusion. Sometimes seizures in the Tacoma, renal failure, death.

Answer 259

Neuroleptic management syndrome

Question 260

A late onset symptom involves repetitive, involuntary facial movements, tongue twisting, chewing motions and lipsmacking, cheek puffing, and grimacing. Changes in gait, jerky limb movements, or shrugging usually after six months of taking the medication agent diabetes can increase the risk more typical with first generation antipsychotics

Answer 260

Tardive dyskinesia

Question 261

The National Institutes of Health guidelines define what as having three or more of the following traits, including traits you’re taking medication to control:

Large waist — A waistline that measures at least 35 inches (89 centimeters) for women and 40 inches (102 centimeters) for men
High triglyceride level — 150 milligrams per deciliter (mg/dL)
Reduced “good” or HDL cholesterol — Less than 40 mg/dL (1.04 mmol/L) in men or less than 50 mg/dL (1.3 mmol/L) in women of high-density lipoprotein (HDL) cholesterol
Increased blood pressure — 130/85 millimeters of mercury (mm Hg) or higher
Elevated fasting blood sugar — 100 mg/dL (5.6 mmol/L) or higher

Answer 261

Metabolic Syndrome

Question 262

Fear triggers the amygdala that activates the sympathetic nervous system and the Blank.

Answer 262

What is the hypothalamic pituitary adrenal axis (HPA Axis).

Question 263

The HPA axis releases Blank, activating secretion of Blank, causing secretion of cortisol.

Answer 263

What is the Corticotropin releasing factor (CRF) and Adrenocorticotropic hormone (ACTH). Board Vitals PMHNP Review Questions

Question 264

In situations of chronic stress, excessive blank release may eventually cause hippocampal atrophy. The hippocampus inhibits the HPA axis, atrophy in this region may lead to chronic activation of the HPA axis, likely increasing risk of developing psychiatric illnesses

Answer 264

What is Glucocorticoid/Cortisol Release.

Question 265

Neurons from what two areas of the brain normally suppress the hypothalamic-pituitary-adrenal axis?

Answer 265

What is the hippocampal area and amygdala

Question 266

While proper functioning of the HPA axis is essential for dealing with stress, when the HPA axis is stimulated too much it can lead to what physical and psychiatric problems?

Answer 266

What is Type 2 diabetes, obesity, CVS disease, anxiety, depression, mood disorders, and cognition.

Question 267

P450 enzyme pathways inhibited will raise or lower substrates (medications)?

Answer 267

What is raises.

Question 268

P450 enzymes pathways induced by medications will raise or lower other substrates (medications)?

Answer 268

What is lower.

Question 269

Caffeine is an inducer of what Cytochrome P450 enzyme pathway?

Answer 269

What is CYP 1A2.

Question 270

Cytochrome P450 1A2 enzyme can be induced, or increased in activity, by what legal substance? Often requiring a higher antipsychotic drug dose outpatient then what they would need inpatient.

Answer 270

What is Cigarettes.

Question 271

This anticonvulsant/mood stabilizer’s induction and autoinduction by the hepatic enzyme CYP450 (3A4) pathway occurs in 2 to 3 weeks; slightly higher doses may be needed or tolerated at that time.

Answer 271

What is Carbamazepine

Question 272

This Cytochrome enzyme pathway metabolizes several psychotropic drugs as well as several of the statins for treating high cholesterol. Potentially increasing risk of muscle damage and rhabdomyolysis.

Answer 272

What is CYP 3A4

Question 273

Fluvoxamine (SSRI, FDA approved for OCD) is an inhibitor for these two common Cytochrome P450 enzyme pathways (1A2, 2D6, 2C9, 2C19, or 3A4)?

Answer 273

What is 1A2 and 3A4

Question 274

This anticonvulsant/mood stabilizer’s induction of the Cytochrome P450 3A4 pathway when added to patients previously stable on clozapine, iloperidone, lurasidone, or zotepine does what to their medication concentration? requiring a dose increase or decrease?

Answer 274

Carbamazepine, reduces them, increase

Question 275

Excitatory neurotransmitter that is being implicated more and more in schizophrenia. In excess, may be responsible for kindling and apoptosis.

Answer 275

Glutamate

Question 276

The brain releases this neurotransmitter during pleasurable activities. Too much is associated with schizophrenia. Too little is associate with depression, muscular rigidity and Parkinson’s disease.

Answer 276

Dopamine

Question 277

Excitatory neurotransmitter that elevates mood, modulates attention and fatigue. Too much is linked to anxiety and hyperactivity. Too little is linked to depression, low energy, and fatigue.

Answer 277

Norepinephrine

Question 278

Projections from this neurotransmitter affect mood, depression, movement, obsessions, compulsions, appetite, sleep, and sexual response. Too little is linked to depression. Too much can be potentially fatal.

Answer 278

Serotonin

Question 279

This neurotransmitter is involved in voluntary movement, learning, memory & sleep. Too much is associated with depression. Too little has been associated with dementia.

Answer 279

Acetylcholine

Question 280

All antagonize H1 receptors. Often used to treat movement disorders associated with neuroleptics. Also used for sleep and anxiety.

Answer 280

Antihistamines

Question 281

Dopamine and serotonin antagonist used to treat both positive & negative symptoms in schizophrenia. Associated with lower risk of EPS and higher risk of metabolic side effects.

Answer 281

Atypical, Second Generation Antipsychotics

Question 282

Used to treat depression. Also used for anxiety disorders, PMDD, and eating disorders.

Answer 282

Selective Serotonin Reuptake Inhibitors (SSRIs)

Question 283

Used to speed up the central nervous system to increase neural activity in the brain. Acts by increasing NE and DA in the prefrontal cortex. Balances tonic versus phasic firing. Used for ADHD and Narcolepsy. Used as an adjunct for depression, obesity, chronic fatigue.

Answer 283

Stimulants

Question 284

Reduce inactivation of acetylcholine and potentiate neurotransmission. Indicated for mild to moderate Alzheimer’s disease. Often combined with Memantine (Namenda).

Answer 284

Cholinesterase Inhibitors

Question 285

“One sick _______ in a neuronal circuit can affect the whole circuit, from the GABA interneuron and the glutamate neurons it innervates, to downstream dopamine neurons and beyond.”

Answer 285

What is a synapse

Question 286

I am the circuit considered to be the “final common pathway of reward.”

Answer 286

What is the mesolimbic dopamine circuit

Question 287

This circuit can create fear and panic leading to phobias.

Answer 287

What is the amygdala-centered circuit

Question 288

Ascending serotonergic projections in the brain regulate these 3 things.

Answer 288

What are mood, anxiety, & sleep

Question 289

This circuit is considered the “worry loop” and can lead to problems with anxiety/obsessions.

Answer 289

What is the cortico-striato-thalmo-cortico loop

Question 290

This can be the outcome when an exogenous substance is introduced to the mesolimbic dopamine pathway.

Answer 290

What is addiction

Question 291

These two pathways are considered as the cause of schizophrenic symptoms.

Answer 291

What are the dopamine pathways and the glutamate pathways

Question 292

There are 4 main circuits which are “out of tune.” These include the ACC, dorsolateral PFC, the prefrontal motor cortex, and the orbital prefrontal cortex. I am the mental illness caused by abnormal firing in these areas.

Answer 292

What is ADHD

Question 293

Underactivity of this system leads to negative, cognitive, and affective symptoms of schizophrenia.

Answer 293

What is the mesocortical dopamine system

Question 294

Blocking the action of the natural neurotransmitter agonist. The substance is by itself inactive.

Answer 294

What is an antagonist

Question 295

These are found at opposite ends of the agonist spectrum

Answer 295

What are agonists and inverse agonists

Question 296

This causes partially enhanced signal transduction

Answer 296

What is a partial agonist

Question 297

A conformational change in the G-protein linked receptor that turns on the synthesis of a second messenger to the greatest extent possible

Answer 297

What is the action of a full agonist

Question 298

This happens when neurotransmitter inactivation mechanisms are blocked by a drug

Answer 298

What is indirect full agonism

Question 299

Antacids reduce bioavailability of this anticonvulsant/CNS depressant

Answer 299

What is gabapentin (Neurotin)

Question 300

Drugs that should be given with caution when a patient is on lithium

Answer 300

What are NSAID’s, ACEI’s, and ARB’s

Question 301

What are NSAID’s, ACEI’s, and ARB’s?

Answer 301

What are St. John’s wort, ginseng, and nutmeg?

Question 302

Constipation caused by this atypical antipsychotic may cause reduced if administered at the same time as these

Answer 302

What is clozapine and: bulk laxatives, magnesium-based antacids, lactulose

Question 303

These meds used to treat migraines can cause serotonin syndrome if combined with SSRI’s

Answer 303

What are triptans- [sumatriptan (Imitrex), almotriptan, naratriptan (Amerge)], carbamazepine (Tegretol), and valproic acid (Depakene)

Question 304

In the case of G protein link systems, the second messenger is a blank, but in the case of an ion channel link system the second messenger can be a blank such as calcium.

Answer 304

Chemical and ion

Question 305

G-protein linked systems, ion channel linked systems, hormone linked systems, and neurotrophic linked systems what are these?

Answer 305

These are the four important signal transduction cascades in the brain

Question 306

How many states of ligand-gated ion channels?

Answer 306

Five: channel in resting state, channel open, channel closed, channel desensitized, channel inactivated.

Question 307

There are two major classes of ion channels what are they?

Answer 307

Ligand-gated ion channels and voltage sensitive ion channels

Question 308

The opening of ligand-gated ion channels is regulated by what?

Answer 308

Neurotransmitters

Question 309

Voltage sensitive ion channels is regulated by the blank across the membrane in which they reside

Answer 309

Charge, numerous anticonvulsants bind various sites on these channels and may exert their anticonvulsant action by this mechanism as well as their actions as mood stabilizers, treatments for chronic pain, anxiety, and sleep medications.

Question 310

Agonists do what to the channel?

Answer 310

They open it. Partial agonists open it but not as much as a full agonist. The antagonist can cause the channel to go back to its resting state which is the same state the channel is in prior to the presence of the agonist.

Question 311

What does the inverse agonists due to the channel?

Answer 311

The inverse agonist binds to the channel and causes it the close

Question 312

The normal stress response involves activation of the hypothalamus and the resultant increase in what, which in turn stimulates the release of what from the pituitary. This then causes what to be released from the adrenal gland, which feeds back to the hypothalamus and inhibits what release, terminating the stress response

Answer 312

corticotropin releasing factor, adrenocorticotropic hormone, glucocorticoid, corticotropin

Question 313

Is it neuroleptic malignant syndrome or serotonin syndrome?
Serotonergic agents
Abrupt onset
HTN, Tachycardia, tachypnea, hyperthermia
Course is rapidly resolving
Skin Diaphoretic
Muscles increased tone, tremors, choreathetoid movements
Reflexes hyperreflexia, clonus (uncontrolled flexion)
Pupils mydriasis (dilation of the pupil of the eye)
Bowel sounds hyperactive

Answer 313

Serotonin Syndrome

Question 314

Is it neuroleptic malignant syndrome or serotonin syndrome?
Dopamine antagonists
Gradual
HTN, Tachycardia, tachypnea, hyperthermia
Prolonged course
diaphoretic
defuse rigidity "lead pipe"
decreased reflexes
normal pupils
bowel sounds normal to decrease

Answer 314

neuroleptic malignant syndrome

Question 315

The neurotransmitters acetylcholine, histamine, and epinephrine are involved in _______ pathways that can influence _______ in mood disorders?

Answer 315

What are arousal pathways and cortical arousal?

Question 316

The mesocortical pathway is a dopaminergic pathway that connects the ventral tegmentum to the blank.

Answer 316

prefrontal cortex

Question 317

The mesolimbic pathway, sometimes referred to as the blank, is a dopaminergic pathway in the brain. The pathway connects the ventral tegmental area in the midbrain to the ventral striatum of the blank in the forebrain

Answer 317

reward pathway, basal ganglia

Question 318

The nigrostriatal pathway is a bilateral dopaminergic pathway in the brain that connects the substantia nigra pars compacta in the midbrain with the blank in the forebrain

Answer 318

dorsal striatum (caudate nucleus and putamen)

Question 319

the tuberoinfundibular pathway refers to a population of dopamine neurons that project from the arcuate nucleus in the tuberal region of the hypothalamus to the blank. It is one of the four major dopamine pathways in the brain.

Answer 319

median eminence

Question 320

Blank is the major excitatory neurotransmitter in the nervous system…..Blank is the chief inhibitory neurotransmitter in the brain. The major difference between the two is the latter is synthesized from the former

Answer 320

Glutamate and GABA

Question 321

Chapter 8
what are the most blank for individual therapy: losses, interpersonal conflicts, symptomatic presentations such as panic, phobias, negativity, unfulfilled expectations at life transitions, characterological issues such as narcissism or aggressiveness.

Answer 321

Individual therapy

Question 322

What can be broken when there is an increased potential for self harm or harm to others; abuse of children, older adult, or person with disabilities; when the therapist determines that the person needs hospitalization; and when clients request that their information be released to 3rd party.

Answer 322

Confidentiality

Question 323

What therapists believe that behavior is determined by unconscious motivations and instinctual drives. Promotes change by the development of greater insight and awareness of maladaptive defenses. Attends to pass developmental and psychodynamic factors, which shape present behaviors.

Answer 323

Sigmund Freud

Question 324

What is? Suggests that external events do not cause anxiety or maladaptive responses. States that a person expectations, perceptions, and interpretations of events cause anxiety. Allows clients to view reality more clearly through an examination of their central distorted cognitions. Goals the change clients irrational belief, faulty conceptions, and negative cognitive distortions.

Answer 324

Cognitive therapy

Question 325

Who is? Credited with conception of the cognitive therapy

Answer 325

Aaron Beck

Question 326

What is? Focuses on changing maladaptive behaviors by participating in active behavioral techniques such as exposure, relaxation, problem-solving, and role-playing

Answer 326

behavioral therapy

Question 327

who is, the originator of behavioral therapy?

Answer 327

Arnold Lazarus

Question 328

What is? Commonly used with people with borderline personality disorder. Focuses on emotional regulation, tolerance for distress, self-management skills, interpersonal effectiveness, and mindfulness, with an emphasis on treating therapy interfering behaviors.

Answer 328

Dialectical behavioral therapy

Question 329

Who is, the originator of dialectical behavioral therapy

Answer 329

Marsha Linehan

Question 330

What therapy goals fits this kind of therapy? Decreases suicidal behaviors, decreases therapy interfering behaviors, decreases emotional reactivity, decreases self invalidation, decreases crisis generating behaviors, decrease passivity, increase realistic decision-making, increase accurate communication of emotions and competencies.

Answer 330

Dialectical behavioral therapy

Question 331

What type of therapy? A philosophical approach in which reflection on life and self confrontation is encouraged. If this is accepting freedom in making responsible choices. States that a basic dimension of humans including finding meaning and purpose in life. Such as why am I here? What is my purpose? Goals are to live authentically and to focus on the present and on personal responsibility.

Answer 331

Existential therapy

Question 332

Who is credited with Existential therapy

Answer 332

Viktor Frankl

Question 333

What therapy? Also known as person centered therapy. Concepts include self-directed growth and self actualization; people are born with the capacity to direct themselves toward self-actualization. Each person has potential to actualize and find meaning.

Answer 333

Humanistic therapy

Question 334

Who is credited with humanistic therapy?

Answer 334

Carl Rogers

Question 335

What therapy? Evidence-based therapy with focus on interpersonal issues that are creating distress. Time-limited, active, focused on the present and on interpersonal distress. Developed to treat aspects of depression and is effective for adults and adolescents. Has been applied to treat interpersonal distress related to other disorders, including bipolar, substance use, and eating disorders.

Answer 335

Interpersonal therapy

Question 336

Who is credited with interpersonal therapy?

Answer 336

Gerald L Klerman

Question 337

What therapy? A form of behavioral and exposure therapy. Involves use of bilateral stimulation in other words moving the ice back and forth, alternating tapping on hands or knee, or sounds and ear. Most commonly used in posttraumatic stress disorder. Goals to achieve adaptive resolution.

Answer 337

Eye movement desensitization and reprocessing

Question 338

What phase of EMDR? The client visualizes the trauma, verbalizes the negative thoughts or maladaptive beliefs, every maze and attentive to physical sensations. This process occurs for limited time what the client maintains rhythmic eye movements. He or she is then instructed to block out negative thoughts; to breathe deeply; and then to verbalize what he or she is thinking, feeling, or imaging.

Answer 338

Desensitization phase

Question 339

What phase of EMDR? The client installs and increases the strength of the positive thought that he or she has declared as a replacement of the original negative thought.

Answer 339

Installation phase

Question 340

What phase of EMDR? The client visualizes the trauma along with the positive thought and then scans his or her body mentally to identify any tension within.

Answer 340

Body Scan

Question 341

Benefits of this kind of therapy? Increases insight about oneself. Increases social skills. It is cost-effective. Develop sense of community.

Answer 341

Group therapy

Question 342

What are? Installation of hope, universality, altruism, increased development of socialization skills, imitative behaviors, interpersonal learning, group cohesiveness, catharsis, existential factors, and corrective refocusing

Answer 342

10 therapeutic factors that differentiate group therapy from individual therapy

Question 343

Participants develop hope for creating a different life. Members are at different levels of growth; thus, they gain hope from others that change is possible.

Answer 343

Installation of hope

Question 344

Participants discover that others have similar problems, thoughts, or feelings and that they are not alone.

Answer 344

Universality

Question 345

This results from sharing oneself with another in helping another

Answer 345

Altruism

Question 346

New social skills are learned, and maladaptive social behaviors are corrected. The group can provide a natural laboratory.

Answer 346

Increase development of socialization skills

Question 347

Participants are able to increase their skills by imitating the behaviors of others

Answer 347

Imitative behaviors

Question 348

Interacting with others increases adaptive interpersonal relationships

Answer 348

Interpersonal learning

Question 349

Participants developed an attraction to the group and other members as well as a sense of belonging.

Answer 349

Group cohesiveness

Question 350

Participants experience catharsis as they openly express their feelings, which were previously suppressed

Answer 350

Catharsis

Question 351

Groups enable participants to deal with the meaning of their own existence

Answer 351

Existential factors

Question 352

Participants reexperience family conflicts in the group, which allows them to recognize and change behaviors that may be problematic

Answer 352

Corrective refocusing

Question 353

What phase? The leader considers the direction and framework of the group. Purpose, goals, membership criteria, membership size, pre-group interview, informed consent.

Answer 353

Pre-group phase

Question 354

What phase? Members are concerned about self-disclosure and being rejected. Goals and expectations are identified, and boundaries are established. The development of trust or rapport is very important.

Answer 354

Forming phase

Question 355

What phase? Members are resistant and may begin to use testing behaviors. Issues related to inclusion, control, and affection begin to surface. Leaders tasks are to allow expression of both positive and negative feelings, assist the group in understanding the underlying conflict, and it examine nonproductive behaviors.

Answer 355

Storming phase

Question 356

What phase? Resistance to the group is overcome by members. A strong attraction to the group and others emerge. Open and spontaneous communication occurs, and the group norms are established.

Answer 356

Norming phase

Question 357

What phase? The group’s work becomes more focused. Creative problem-solving and solutions begin to emerge. Experiential learning takes place. Group energy is directed towards completion of goals.

Answer 357

Performing phase

Question 358

Preparation is made to in the group. Remember that the work of termination begins during the first stage of the group. Both members and leaders express their feelings about each other and termination. A discussion and overview of what is been learned as well as what issues still need to be worked on, takes place.

Answer 358

Adjoining face

Question 359

What kind of therapy? Characterized by progressive return of memories of past experiences. Used with older adults. Enables participants to search for meaning in their lives and strive for some resolution of past interpersonal and intrapsychic conflicts.

Answer 359

Reminiscence therapy

Question 360

What kind of therapy? The system is any unit structured on feedback. The process by which all members operate together. Based on the idea that one could not understand any part without understanding how all parts operate together. Operates based on a set of rules that may be overt or covert.

Answer 360

Family system theory or concepts

Question 361

What is? Protect and enhance the functional integrity of families, individuals, and subsystems. Can be physical or psychological.

Answer 361

Boundaries

Question 362

What type of boundary? Maintain person separateness while emphasizing belongingness

Answer 362

Clearly defined boundaries

Question 363

What type of boundary? May lead to distant relationships into disengagement

Answer 363

Rigid or inflexible boundaries

Question 364

What type of boundary? Blurred and indistinct boundaries; lead to enmeshment

Answer 364

Diffuse boundaries

Question 365

What is? An ongoing feedback loop; a series of actions and reactions that maintain a problem. Individuals and emotional problems are best understood when the context of relationships and through assessing interactions within entire family

Answer 365

Circular causality

Question 366

What is? Tendency of families to resist change and to maintain a steady state

Answer 366

Family homeostasis

Question 367

What is? A family’s tendency to adapt to change when changes are necessary

Answer 367

Morphogensesis

Question 368

What is? A family tendency to remain stable in the midst of change

Answer 368

Morphostasis

Question 369

Originated by Murray Bowen who believe that a person’s problematic behavior may serve the function or purpose for the family or be a symptom of dysfunctional patterns. Focus is on chronic anxiety within families. Treatment goals are to increase the family’s awareness of each member’s function within the family and to increase levels of self differentiation.

Answer 369

Family systems therapy

Question 370

What is? The level at which one’s self of self worth is not dependent on external relationships, circumstances, or occurrences.

Answer 370

Self differentiation

Question 371

What is? Dyads that form triads to decrease stress; the lower the level of family adaptation, the more likely a blank will develop.

Answer 371

Triangle

Question 372

What is? Level of differentiation of the parents is usually equal to the level of differentiation for the entire family.

Answer 372

Nuclear family emotional system

Question 373

What is? Dysfunction present over several generations

Answer 373

Multigenerational transmission process

Question 374

What is? Parents transmitting their own level of differentiation on the most susceptible child

Answer 374

Family projection process

Question 375

What is? Attempting to break contract with the family of origin

Answer 375

Emotional cutoffs

Question 376

What is? Influences interactions and personality characteristics

Answer 376

Sibling position

Question 377

What type of therapy? Originated by Salvador Minuchin who placed emphasis on how when and to whom family members relate in order to understand and then change the family structure. A person symptoms are rooted in the context of family transaction patterns. The symptom is a function of the health of the whole family and is maintained by structural problems in the system. The main treatment goal is to produce a structural change in the family organization to more effectively manage problems, changing transitional patterns, and family structure.

Answer 377

Structural family therapy

Question 378

What is? An invisible set of functional demands that organize the way members interact of each other, made up of subsystems, coalitions, and boundaries.

Answer 378

Family structure

Question 379

What is? Mapping relationships using symbols to represent overinvolvement, conflict, coalitions, and so forth

Answer 379

Structural mapping

Question 380

What is? Distribution of power

Answer 380

Hierarchies

Question 381

What therapy? Originated by Virginia Satir. Behavior is determined by personal experience and not by external reality. Focuses on being authentic, on freedom of choice, on human validation, and on experiencing the moment. Treatment goals are to develop authentic, nurturing communication and increased self-worth of each family member; overall goal is growth rather than symptom reduction alone. It does not focus on particular techniques.

Answer 381

Experiential therapy

Question 382

What therapy? Originated by Jay Haley. Symptoms are viewed as metaphors and reflect problems in the hierarchal structure. Symptoms are a way to communicate metaphorically with the family. Treatment goals to help family members behave in ways that will not perpetuate the problem behavior. Interventions are problem focused. This therapy is more symptom focus than structural therapy. Therapist are concerned mainly with those techniques that change the sequence of interactions that is maintaining the problem. Techniques are straightforward directives, paradoxical directives, and reframing belief systems.

Answer 382

Strategic therapy

Question 383

What is? Tasks that are designed in expectation of the family member compliance

Answer 383

Straightforward directives

Question 384

What is? Negative task that is assigned when family members are resistant to change the member is expected to be noncompliant.

Answer 384

Paradoxical directives

Question 385

What is? Problematic behaviors are relabeled to have more positive meaning in other words jealousy reframed to caring.

Answer 385

Reframing belief systems

Question 386

What therapy? Originated by Steve deShazer, Bill O’Hanlon, and Insoo berg. Focus is to rework for the present situation solutions that have worked previously. Treatment goal effective resolution of problems through cognitive problem-solving and use of personal resources and strengths. Techniques include the use of miracle questions, exceptional finding questions, and scaling questions.

Answer 386

Solution focused therapy

Question 387

What is? If a miracle were to happen tonight while you were asleep, and tomorrow morning you woke to find that the problem no longer existed, what would be different? How would you know the miracle took place? How would others know?

Answer 387

Miracle questions

Question 388

What is? Directing clients to a time in their lives when the problem did not exist, which helps them move toward solutions by assisting them in searching for any exceptions to the pattern. Was there a time when the problem did not occur?

Answer 388

Exception finding questions

Question 389

What is? On a scale of 1 to 10, with 10 being very anxious and depressed, how would you rate how you are feeling now? This is useful for highlighting small increments of change.

Answer 389

Scaling questions

Question 390

What kind of therapy? Deal with the connection between the mind of the body and are viewed as holistic healthcare.

Answer 390

Complementarity and alternative therapies

Question 391

What is? Used in addition to traditional medical practices.

Answer 391

Complementarity therapies.

Question 392

What is? Used in place of traditional medical practices.

Answer 392

Alternative therapies

Question 393

What is? Recent term used to describe the use of traditional complementarity therapies

Answer 393

Integrative therapies

Question 394

White people use this kind of therapy? Desire for more control over decision-making, decreased insurance coverage for traditional medical therapies, therefore making the use of this therapy cheaper, preference for natural rather than synthetic medications, increase cost of prescriptions and services, failure of conventional medications.

Answer 394

Complementary and alternative therapies

Question 395

What are these kind of interventions, guided imagery, meditation, yoga, biofeedback

Answer 395

Mind-body interventions

Question 396

What type of therapies? Herbal products, vitamins, supplements, aromatherapy

Answer 396

Biologically based therapies

Question 397

What type of therapies? Utilizes acupressure and acupuncture, massage, reflexology

Answer 397

Manipulatives and body-based therapies

Question 398

What is? Based on the basic tenets of Chinese medicine that vital energy Chi flows along specific pathways that of many points of access and that manipulating these points, by either hands or needles, corrects imbalances by stimulating or removing blockages to energy flow. Thought to produce effects by regulating the nervous system and aiding the activity of endorphins and immune system cells at different sites in the body. Also thought to alter brain chemistry by changing the release of neural hormones and neurotransmitters.

Answer 398

Acupressure and acupuncture

Question 399

What is? A process providing a person with visual or auditory information about the autonomic physiologic functions of his or her body, such as blood pressure, muscle tension, and brainwave activity. The person learns to consciously control these processes which were previously regarded as involuntary. Uses and stress related symptoms, pain, insomnia, neuromuscular problems, neurobehavioral disorders, enhancement of healing, athletic and work performance.

Answer 399

Biofeedback

Question 400

What is? Therapeutic use of plants or oils to obtain many therapeutic effects, such as analgesic, psychological, and antimicrobial benefits. In psychiatry, olfactory stimulation used to elicit feelings or memories during psychotherapy.

Answer 400

Aromatherapy

Question 401

What is? Practice of herbal medicine originated in China and is the oldest system of medicine. Relies on plant secure illnesses and maintain health. Similar to prescription medications, many plants contain active compounds that produce physiological effects. FDA approval is not required thus no uniform standards ensure quality control or potency.

Answer 401

Herbal products and supplements

Question 402

What is? Used for attention deficit hyperactivity disorder, dyslexia, cognitive impairment, dementia, cardiovascular disease, asthma, lupus, and rheumatoid arthritis. Interacts with warfarin, increases anticoagulant effect.

Answer 402

Omega-3 fatty acids

Question 403

What is? Use for depression, osteoarthritis, and liver disease. May cause hypomania, hyperactive muscle movements, and possible serotonin syndrome

Answer 403

Sam-e

Question 404

What is? Used for depression, obesity, insomnia, headaches, and fibromyalgia. Found in high concentrations in Turkey. Increased risk of serotonin syndrome with use of selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, and St. John’s wort.

Answer 404

Tryptophan

Question 405

What is? Used for enhancing the immune system in protecting cells against the effects of free radicals. Use for neurological disorders, diabetes, and premenstrual syndrome. Interacts with warfarin, increasing coagulate affect, antiplatelet drugs, and statins, increasing additive effect and risk of rhabdomyolysis

Answer 405

vitamin E

Question 406

What is? Use for insomnia, jet lag, shiftwork, and cancer. Set timing of circadian rhythms and regulate seasonal responses. Interacts with aspirin, nonsteroidal anti-inflammatory drugs, beta-blockers, corticosteroids, valerian, kava kava, and alcohol. Can inhibit ovulation in large doses.

Answer 406

melatonin

Question 407

What is? Use for bipolar disorder, hypertension, lowering triglycerides, and decreasing blood clotting. Interacts with warfarin, aspirin, NSAIDs, garlic, and ginkgo. May alter glucose regulation.

Answer 407

What is fish oil

Question 408

What herbal? Menopausal symptoms, premenstrual syndrome, dysmenorrhea

Answer 408

Black cohosh

Question 409

What herbal? For anxiety

Answer 409

Belladonna

Question 410

What herbal? For sedation

Answer 410

Catnip

Question 411

What herbal? Sedation and anxiety

Answer 411

Chamomile

Question 412

What herbal? Delirium, dementia, sexual dysfunction caused by SSRIs

Answer 412

Ginkgo

Question 413

What herbal? Depression and fatigue

Answer 413

Ginseng

Question 414

What herbal? For sedation

Answer 414

Valerian

Question 415

What is? Believed to increase blood circulation, improve lymph flow, improve musculoskeletal tone, and have a relaxing effect on the mind

Answer 415

Massage

Question 416

What is? Consciously directing one’s attention to alter one state of consciousness. Produces physiological effects such as decreased heart rate, blood pressure, and respiratory rate; decreased anxiety; and increased alpha brain waves

Answer 416

Meditation

Question 417

What is? Stimulates the body’s natural healing power through massaging the feet, hands, and years. It alleviates tension by cleaning crystalline deposits under the skin that may interfere with the natural flow of the body’s energy. Based on the mapping of body parts on the souls inside the feet, hands, and ears. Treats disorders related to the represented body parts by application of pressure. Use for back pain, migraine, infertility, sleep disorders, digestive disorders, and stress related conditions.

Answer 417

Reflexology

Question 418

What is? Foods classified as yin and yang. Goals to keep the dietary yin and yang in balance and attempt to live in harmony with nature.

Answer 418

Macrobiotics

Question 419

What is? Originated in Indian religious practices. Combines mind and body connection. Uses breathing, physical movements, and meditation.

Answer 419

Yoga

Question 420

What is? A 21 item self reporting questionnaire for evaluating the severity of depression in normal and psychiatric populations.

Answer 420

Beck Depression inventory

Question 421

What is? It assesses which of the early maladaptive characteristics of patient probably has

Answer 421

Schema questionnaire

Question 422

What is this an example of? This three question technique example 1. Evidence for her negative belief. 2. How else can she interpret the situation? 3. If it is true, what are the implications?

Answer 422

Cognitive behavioral therapy

Question 423

Chapter 9

Blank disorders of the most common of all psychiatric illnesses.

Answer 423

Mood disorders

Question 424

These type of disorders have high degree of somatic symptomology that accompanies these disorders.

Answer 424

Mood disorders

Question 425

What is? What are the most common human emotions, exists on a continuum ranging from the absence of depression at one into pathological levels that produce significant symptoms of psychiatric disorder called major depression at the other.

Answer 425

Sadness

Question 426

What is? Can be a healthy reaction to life stressors that motivates a person to deal with events and emotions.

Answer 426

Mild depression

Question 427

Blank can be pathological if: it is disproportionate to events and sustained over significant time. It significantly impairs normal social functioning. It significantly impairs normal somatic functioning. It is apparently unrelated to any identifiable event or situation in a person’s life

Answer 427

Sadness

Question 428

What is? one of the most common psychiatric disorders; the primary unipolar affective disorder. A complex brain-based illness with a primary characteristic of a persistent disturbance in mood. An excessive or distorted degree of sadness that manifests with behavioral, affective, cognitive, and somatic symptoms. May have a known precipitating event, situation, or concern but often occurs without any precipitating stressor identified. Significantly interferes with daily functioning and goal attainment. Has complex genetic, biochemical, and environmental etiological factors.

Answer 428

Major Depressive Disorder

Question 429

What theory? This theory assumes that early psychological development issues lay the foundation for depressive responses and later in life; that the accomplishment of the first stage of development in which the child is able to form relationships is normal; that during the second stage of development, the child experiences the loss of significant mothering person. Loss can be a real or imagined and is unexpected and overwhelming. The loss may be related to maternal death, illness, or emotional lack of availability or the birth of new sibling in the child’s perception of losing undivided, individualized attention from the mother. The child’s initial reaction is anger; however, the child feels unsafe to express his anger openly and directly. This may relate to the child’s fearing for their loss if he or she responds with anger or his or her subjective perception that anger is unacceptable. The child uses defense mechanisms to deal with conflict created by desire for the love object by co-occurring with anger for the love object. Instead of anger being express outward at the maternal figure, it turns inward because it is more acceptable and safer to be angry at oneself and at the mother. Anger at oneself is rationalized that the child assumes that loss of the mother was related to something bad that he or she did rather than to the caregivers action. Excessive guilt becomes a manifestation of the process of dealing with aggression experience with the loss of the mother’s attention. A similar emotional reaction such as low self-esteem, excessive guilt, and ability to cope with anger, self-destructive impulses occurs as an adult whenever a loss is experienced.

Answer 429

Aggressive turned inward theory Sigmund Freud

Question 430

What theory? This theory represents a diathesis stress model in which developmental experiences sensitize a person to respond to stressful life events in a depressed manner. This theory assumes that people with a tendency to be depressed think about the world differently than nondepressed people in that depressed people are more negative and believe that bad things are going to happen to them because of their own personal shortcomings and inadequacies. This thinking promotes low self-esteem and beliefs that the person deserves to have bad things happen to him or her and promotes pessimistic perceptions about the world at large and about his or her future, as well as globalize the negativity to all events, situations, and people in his or her life. When confronted by stressful events, these people tend to appraise them and the potential consequence in a negative, hopeless manner and therefore more depressed than people of different styles.

Answer 430

Cognitive theory by Aaron Beck

Question 431

What theory? This theory is a modified aspect of cognitive theory, which assumes that a person becomes depressed due to perceptions of lack of control over life events and experiences. These perceptions are learned over time, especially as the person perceives other seeing him or her as inadequate. Perceptions of lack of control lead to the person not adapting or coping. The person’s behavior becomes passive and nonreactive because the self-perceptions of personal characteristics of being helpless, hopeless, and powerless.

Answer 431

Learned helplessness and hopelessness. Martin Seligman

Question 432

What is a genetic predisposition termed SNP?

Answer 432

Single nucleotide polymorphism disorder a clear genetic predisposition to depressive disorder

Question 433

Having a depressed blank is the single strongest predictor of depression?

Answer 433

Parent

Question 434

Children of depressed parents are how many times more likely to experience MDD in their lifetime? Have a blank chance of having a depressed episode before age 18

Answer 434

3. 40%

The earlier the age of onset for MDD and the more severe the symptoms, the more likely it is that a person has a strong genetic predisposition for depression.

Question 435

Neurovegetative symptoms commonly seen in major depressive disorder are related to functions of what two glands?

Answer 435

hypothalamus and pituitary

Question 436

Dysphoria is often triggered by changes in levels of blank that occur during the menstrual cycle.

Answer 436

sex steroids

Question 437

In response to stress, the hypothalamus releases blank, which then stimulates the pituitary to release blank. This then stimulates the adrenals to release blank.

Answer 437

corticotropin releasing hormone (CRH), adrenocorticotropic hormone (ACTH), Cortisol

Question 438

Hyperactivity of the HPA has been shown to be present in people with blank, as have possible elevated blank levels

Answer 438

Major Depressive Disorder and cortisol

Question 439

Evidence supports that major depression may be associated with what?

Answer 439

proinflammatory cytokine activation

Question 440

Hypovolemic hippocampus and hypovolemic prefrontal cortex-limbic striatal regions is common in what mental health condition?

Answer 440

Major Depressive Disorder

Question 441

Major depressive disorder is the leading cause of disability in the United States and is the most common psychiatric illness seen in primary care practices; however, only blank of people with major depressive disorder ever receive treatment

Answer 441

50%

Question 442

Major depressive disorder can occur at any age; however, the average age of onset is what?

Answer 442

Mid-20s

Question 443

Major depressive disorder is a greater source of morbidity for who than any other illness.

Answer 443

Women

Question 444

Major depressive disorder is associated with high mortality; blank of people with MDD will die by suicide. People with MDD have a blank greater risk of premature death than normal control population.

Answer 444

15%, four

Question 445

If left untreated, an episode of major depressive disorder usually lasts blank months or longer.

Answer 445

Four

Question 446

People with first episode of major depression have approximately a blank risk of a second episode. People who experience a second episode have approximately a blank risk of 3rd episode. People who experience 3rd episode have approximately a blank risk of 4thepisode.

Answer 446

60%, 70%, 90%

Question 447

Risk factors for what mental illness? Genetic loading especially a 1st degree relative, prior episode, female gender, postpartum., Medical comorbidity, single marital status, significant environment stressor especially multiple losses.

Answer 447

Major depressive disorder

Question 448

These questionnaires are common for what mental illness?
Patient health questionnaire 9, Edinburgh postnatal depression scale, Beck Depression Inventory, Hamilton Depression rating scale.

Answer 448

Major depressive disorder

Question 449

Typical somatic complaints for what mental illness? Bodily aches, pains, headaches, muscle pains, lack of energy, gastrointestinal problems.

Answer 449

Major depressive disorder

Question 450

Women often reports depressive symptoms occurring in fixed pattern around blank days before onset of menses, so assess menstrual history.

Answer 450

Several days

Question 451

Symptoms of depression that begin within 2 months of a significant loss such as death of a loved one and do not persist beyond 2 months are generally considered or not considered bereavement?

Answer 451

Considered. Beyond 2 months would be symptoms of MDD

Question 452

Mental status exam findings of what mental health condition? Appearance: unkempt, tired looking, clothing showing little attention or care about how the person looks, dark-colored, loose fitting clothing, significant weight change from baseline. Mood: sad, depressed, anxious, irritable. Affect: constricted or blunted, sad, tearful, anxious, irritable. Speech: nonproductive, slow response times, monotonal intonation. Thought process: usually organized but may be disorganized if psychosis is present, slowing, distractible, ruminative. Thought content: morbid preoccupation, suicidal ideation exist on continuum of severity.

Answer 452

Major depressive disorder

Question 453

Research evidence supports that it is or is not possible to predict accurately whether or when a person will attempt suicide?

Answer 453

Is not possible

Question 454

List of what? Presence of psychotic symptoms, history of past suicide attempts, history of 1st degree relative who committed suicide, concurrent substance abuse or dependency, current serious health problem.

Answer 454

Suicide risk especially high for persons with the symptoms or history

Question 455

Endocrine disorders common in what mental health condition? Hypothyroid, diabetes, hyperaldosteronism, Cushing’s or Addison’s disease

Answer 455

Major depressive disorder

Question 456

Neurological disorders common in what mental health condition? Stroke, epilepsy, dementia, Huntington’s disease, sleep apnea, Wilson’s disease, neoplasms, head trauma, multiple sclerosis, Parkinson’s disease

Answer 456

Major depressive disorder

Question 457

Cardiac disorders common in what mental health condition? Myocardial infarction, congestive heart failure, hypertension

Answer 457

Major depressive disorder

Question 458

Infectious and inflammatory states common in what mental health condition? Mono nucleus, AIDS, pneumonia, lupus, temporal arteritis, tuberculosis

Answer 458

Major depressive disorder

Question 459

Nutritional disorders common in what mental health condition? Pernicious anemia and pellagra

Answer 459

Major depressive disorder

Question 460

Other disorders common and what mental health condition? Fibromyalgia, chronic fatigue syndrome, bereavement or grief reaction, electrolyte imbalance, uremia and other renal conditions

Answer 460

Major depressive disorder

Question 461

Medications that can cause what mental health condition? Steroids, estrogen compounds, antihypertensive agents, anti-Parkinson’s agents, antineoplastic agents, antibacterial and antifungal agents, analgesics, Accutane, benzodiazepines

Answer 461

Major depressive disorder

Question 462

How many episodes of depression before considering continuing antidepressants indefinitely?

Answer 462

More than two prior episodes of MDD

Question 463

What are these in MDD?
Depressed mood, sleep rest disturbances, anxiety, irritability, impaired concentration, impaired memory, appetite disturbance, agitation, anhedonia, impaired energy and motivation

Answer 463

Target symptoms of antidepressant treatment

Question 464

What class of antidepressants? Act primarily to increase serotonin levels in central nervous system by inhibiting their presynaptic reuptake

Answer 464

Selective serotonin reuptake inhibitors

Question 465

What class of antidepressants? Elevate serotonin and norepinephrine levels primarily by inhibiting their presynaptic reuptake

Answer 465

Tricyclic acids

Question 466

What class of antidepressants? Elevate serotonin and norepinephrine levels primarily by inhibiting MAO, the enzyme that breaks down monoamine neurotransmitters

Answer 466

Monoamine oxidase inhibitors

Question 467

What class of antidepressants? Inhibit dual reuptake of norepinephrine and serotonin. Action very selective on neurotransmitters. Elevate serotonin and norepinephrine levels by inhibiting their presynaptic reuptake.

Answer 467

Serotonin norepinephrine reuptake inhibitors

Question 468

What class of antidepressants? Inhibit dual reuptake of norepinephrine and dopamine. Action very selective on neurotransmitters. Elevate dopamine and norepinephrine levels by inhibiting their presynaptic reuptake.

Answer 468

Norepinephrine and dopamine reuptake inhibitors

Question 469

What class of antidepressants? Dual action. Agonist of serotonin 5HT-2 receptors. Action very selective on neurotransmitters. Elevate serotonin levels by inhibiting serotonin reuptake.

Answer 469

Serotonin agonist and reuptake inhibitors

Question 470

Specific foods to avoid for which drug group? Aged cheeses, such as blue, brie, camembert, and Roquefort. Meat: smoked, aged, and cured meats such as sausages, pastrami, and salami. Fish: Smoked, aged, and cured fish such as pickled herring and salted fish. Any aged and fermented beverages such as red wine, aged liquors, whiskey (gin and vodka permissible), beer (bottled and pasteurized permissible). Being incurred (tofu), soy products, sauerkraut, miso, yeast extract, MSG, right bananas, avocado

Answer 470

Tyramine free dietary considerations with monoamine oxidase inhibitors medications

Question 471

What class of medications, first-line treatment for first episode of major depression with mild to moderate symptoms. Serious side effects are rare. Much safer in overdose than TCAs. Also effective for panic disorder, obsessive-compulsive disorder, bulimia, general anxiety disorder, social phobia, posttraumatic stress disorder, and premenstrual dysphoric disorder.

Answer 471

SSRIs

Question 472

What class medications? Considered the second line drugs for treatment of major depressive disorder. Affect many neurotransmitters, leading to more side effects and possibly poor adherence. Anticholinergic: dry mouth, blurred vision, constipation, memory problems from muscarinic receptor blockade. Anti-adrenergic: orthostatic hypotension from alpha-1 receptor blockade. Antihistaminergic: sedation and weight gain from histamine receptor blockade. Electrocardiogram changes in cardiac dysrhythmias possible; avoiding clients known as susceptibility. Monitor EKG before treatment and annually in older adults. Unsafe and many co-occurring disorders such as cardiac disease. Known to induce hypomania and susceptible clients. Anticholinergic properties may be highly problematic but may also be useful in those who have significant bowel irritability. Adhere to a two week washout. Five weeks for fluoxetine before switching between the two classes of medications.

Answer 472

Tricyclic acids

Question 473

Muscarinic receptor blockade side effects

Answer 473

Dry mouth, blurred vision, constipation, memory problems

Question 474

alpha 1 receptor blockade side effects

Answer 474

Orthostatic hypotension

Question 475

histamine receptor blockade side effects

Answer 475

sedation and weight gain

Question 476

What class of medications? Not first or second line agents for major depressive disorder because of dangerous food and drug interactions. Hypertensive crisis occurs when taken in conjunction with foods containing tyramine a dietary precursor to norepinephrine. When inhibited tyramine exerts a strong vasopressin or affect stimulating the Reese of catecholamines, epinephrine, and norepinephrine, which can increase blood pressure and heart rate.

Answer 476

MAOIs or monoamine oxidase inhibitors

Question 477

List of medications associated with what?
Meperidine, decongestants, TCAs, atypical antipsychotics, st. john’s wort, l-tryptophan, stimulants and other sympathomimetics, asthma medications

Answer 477

Hypertensive crisis with MAOIs

Question 478

Medication to be given during a MAOI hypertensive crisis?

Answer 478

Phentolamine

Question 479

List of symptoms associated with what? Agitation, restlessness, rapid heart rate, elevation of blood pressure, headache, sweating, shivering, goosebumps, mild clonic jerking, loss of coordination, confusion, fever, seizures, unconsciousness

Answer 479

Serotonin syndrome

Question 480

List of clinically significant side effects of what drug class? Insomnia, hypertensive crisis, weight gain, anticholinergic side effects, lightheadedness, dizziness, and sexual dysfunction

Answer 480

MAOIs

Question 481

What is? Grand mal seizure induced in an anesthetized person. Usual courses 6 to 12 treatments. Mechanism of action neurotransmitter theory increases dopamine, serotonin, and norepinephrine. Releases hormones such as prolactin, thyroid stimulating hormone, pituitary hormones, endorphins, and adrenocorticotropic hormone

Answer 481

Electroconvulsive therapy

Question 482

What is? Involves placement of a small wire coil on scalp to conduct electrical current, creating a magnetic field through the tissues of the head. Sessions typically last 40 minutes in typical course is five sessions per week for six weeks.

Answer 482

Transcranial magnetic stimulation

Question 483

What is? Pacemaker -like device implanted in left side of chest the stimulate left branch of nerve; transcutaneous device being tested

Answer 483

Vagal nerve stimulation

Question 484

What is? 2500 to 10,000 lux light for 30 minutes up to two hours 1 to 2 times daily

Answer 484

Phototherapy

Question 485

What type of therapy? Modifies perceptions, decreases negativity, increased sense of internal control, enhance coping skills, modify environmental factors contributing to illness.

Answer 485

Cognitive behavioral therapy

Question 486

What type of therapy? Focus on precipitant stressor, cope with immediate impact of major depressive disorder on personal life, modify contributory environmental factors

Answer 486

Brief therapy a.k.a. solution focused therapy

Question 487

What type of therapy? Improve decision-making, improve socialization skills, improve assessment of individual strengths, gain new coping skills

Answer 487

Group therapy

Question 488

What type of therapy? Enhance family coping, improved knowledge base, plan for relapse, gain insight into effects of major depressive disorder on family unit, undertake psychoeducation for family members about the illness state of major depressive disorder.

Answer 488

Family therapy

Question 489

What type of therapy? Modifies perceptions, decreases negativity, increased sense of internal control, enhance coping skills, modify environmental factors contributing to illness.

Answer 489

Cognitive behavioral therapy

Question 490

What type of therapy? Focus on precipitant stressor, cope with immediate impact of major depressive disorder on personal life, modify contributory environmental factors

Answer 490

Brief therapy a.k.a. solution focused therapy

Question 491

What type of therapy? Improve decision-making, improve socialization skills, improve assessment of individual strengths, gain new coping skills

Answer 491

Group therapy

Question 492

What type of therapy? Enhance family coping, improved knowledge base, plan for relapse, gain insight into effects of major depressive disorder on family unit, undertake psychoeducation for family members about the illness state of major depressive disorder.

Answer 492

Family therapy

Question 493

Risk factors for what? Ages 45 or older if male, ages 55 or older if female, divorce, single, or separated, white, living alone, psychiatric disorder, physical illness, substance abuse, previous suicide attempt, family history of suicide, recent loss, male gender

Answer 493

Risk factors for suicide

Question 494

What is? A disorder similar to major depressive disorder but with less acute symptoms; with a more protracted, chronic disease course; and without any manifestation of psychotic symptoms. Less discrete episodes of illness than major depressive disorder. Symptoms often go undetected and therefore untreated for years. Vegetative symptoms much less common in this disorder when compared to major depressive disorder

Answer 494

Persistent depressive disorder also known as dysthymia

Question 495

Some core symptoms are less common in this age group before onset of puberty: psychosis, motor retardation, hypersomnia, increase appetite

Answer 495

Children

Question 496

Major depressive disorder often has a strong separation anxiety component and what age group

Answer 496

Children

Question 497

What percentage of elderly are more likely to die within the first year in a long-term care facility?

Answer 497

65%

Question 498

Cognition and memory symptoms of major depressive disorder in the older adult population often are confused with dementia related symptoms called what?

Answer 498

Pseudo-dementia

Question 499

Clients with dementia usually have a premorbid history of what declining condition?

Answer 499

Slowly

Question 500

A major depressive disorder, cognitive changes have a relatively what onset and are significant when compared to premorbid functioning?

Answer 500

Acute

Question 501

Symptoms of what syndrome? Autonomic instability, altered sensorium, restlessness, myoclonus, hyperreflexia, hypothermia, diaphoresis, tremor, chills, diarrhea and cramps, ataxia, headache, and insomnia

Answer 501

Serotonin syndrome

Question 502

SSRIs and MAOIs, drug and herbal interactions, SSRIs and St. John’s wort. These drug combinations can cause what?

Answer 502

Serotonin syndrome

Question 503

Clients who have had blank or more episodes of major depressive disorder usually require lifelong medications

Answer 503

Three

Question 504

Common in this mental health diagnosis: chronically depressed mood that occurs for most of the day, more days than not, for at least two years. Prominent presence of low self-esteem, self-criticism, and a perception of general incompetence compared to others.

Answer 504

Persistent depressive disorder or dysthymia

Question 505

What mental health diseases associated with these personality disorders: borderline, histrionic, narcissistic, avoidant, and dependent

Answer 505

Persistent depressive disorder or dysthymia

Question 506

This mental health disease is associated with several childhood disorders: attention deficit hyperactivity disorder, conduct disorder, anxiety disorder, and learning disorders.. Symptoms required for diagnosis is only one year compared with two years for adults. In children, the mood usually described as irritable rather than sad but may report both irritability and sadness. Low self-esteem, poor social skills, and pessimism.

Answer 506

Persistent depressive disorder or dysthymia

Question 507

Unlike in major depression, blank is usually preserved in the grieving person.

Answer 507

Self-esteem

Question 508

In the absence of other significant clinical symptoms, blank usually is classified as adjustment disorder

Answer 508

Grief

Question 509

Blank percent of older adults who lose a spouse experience depression within the first year that loss

Answer 509

20%

Question 510

Grief occurs in blank percent of clients after cardiac surgery

Answer 510

50%

Question 511

What mental health diagnosis? Dysphoric symptoms that occur in response to changing sex steroid hormones which occurred during the ovulatory menstrual cycle. Symptoms generally began during the luteal phase, approximately one week before onset of menses, and generally left within a day or two after menses has begun. Common symptoms include: marked lability, irritability, depressed mood, anxiety, low energy, sleep disturbance. Symptoms occur repeatedly during each menstrual cycle and there must be a symptom free. In the follicular phase, after menses has occurred. Symptoms may worsen as the woman becomes perimenopausal. Symptoms cause marked impairment in functioning and sense of well-being. A careful evaluation must be completed to rule out other mood disorders. Treatment may consist of hormonal contraceptives, SSRI antidepressants, or both.

Answer 511

Premenstrual dysphoric disorder

Question 512

What mental health diagnosis? Complex brain-based illness with the primary characteristic of disturbance and mood. Mood disturbance often of both polarities: depressive, expansive or manic. Several patterns: single polarities symptoms only, distinct symptom patterns of alternating polarity, manic symptoms alternating with depressive symptoms. Mixed co-occurring symptoms. Presents with excessive or distorted degree of sadness or relation, or both. Manifests with behavioral, affective, cognitive, and somatic symptoms. May have precipitating event, situation, or concern but often occurs without any precipitating stressor identified. Has complex genetic, biochemical, environmental etiological factors

Answer 512

Bipolar disorder

Question 513

Biological theories for what mental health disorder? GABA deregulation, increase noradrenergic activity, voltage gated ion channel abnormalities, brain becomes overly sensitive to electrical stimuli, Neuronal misfiring occurs, process becomes automatic; neuronal firing occurs even without stimuli.

Answer 513

Bipolar disorder

Question 514

Blank increased risk is relative has bipolar disorder1

Answer 514

24%

Question 515

Blank increased risk if relative has bipolar disorder type II

Answer 515

5%

Question 516

What mental health diagnoses? Period of abnormally or persistently elevated, expansive, or irritable mood, lasting for at least one week. Mood episode has rapid development and escalation of symptoms over a few days. Often precipitated by significant environmental stressor. Mood disturbance may result in brief psychotic symptoms. Manic episodes last days of several months. Brief duration and ending more abruptly the major depressive episodes. In 60% of people, major depressive episode immediately precedes or follows manic episode. Persistent of other suggestive symptoms: decreased need for sleep, feels rested after three hours sleep on average, usually a marked difference from normal baseline sleep pattern, inflated self-esteem, grandiosity, increase goal-directed activities, excessive involvement in pleasurable activities with a high potential for painful consequence, unrestrained buying sprees, sexual indiscretions, unsound business ventures, excessive substance use or abuse, and highly recurrent depressive episodes. Recurrent shifts in polarity referring to major depressive episodes to manic episodes or mixed episodes.

Answer 516

Bipolar disorder

Question 517

What is? Similar to mania, more brief in duration, episode not as severe as mania, does not require hospitalization, does not cause significant functional impairment.

Answer 517

Hypomania

Question 518

Common symptoms and what mental status exam findings? Psychomotor restlessness or agitation, frequent change of dress, prone to bright colored, often sexualized dress, dramatic or flamboyant dress usually out of character for person when compared to non-symptomatic periods. Speech is rapid loud pressured difficult interop joking relevant amusing word clanging and severely ill clients. Affect is often labile, irritable, overly theoretical and dramatic. Mood is euphoric cheerful high expensive irritable. Thought process is thought racing flight of ideas thoughts disorganized incoherent and severely ill clients. Thought content often inflated, indiscriminate enthusiasm, inflated sensibilities bordering on delusional, increase sexual content. Orientation usually fully. Memory impaired short-term and care to recall. Concentration highly distractible. Judgment is poor prone to imprudent behavior choices for potential for negative consequences. Insight the person usually does not recognize that he or she is ill. Resist treatment options.

Answer 518

Mania typical for bipolar.

Question 519

If first onset of manic symptoms occur after age 40, most likely symptoms are or are not caused by another medical condition.

Answer 519

Are caused by another medical condition.

Question 520

This list of medical conditions can mimic what symptoms? Endocrine disorders, hyperthyroidism, intoxication or withdrawal from illicit drug use, medications, and even some antidepressants.

Answer 520

Manic symptoms

Question 521

These medications can cause what?

Captopril, cimetidine, corticosteroids, cyclosporine, disulfiram, hydralazine, isoniazid

Answer 521

Manic symptoms

Question 522

What medication is the gold standard for treating manic episodes, evidence of anti-suicidal effects,

Answer 522

Lithium

Question 523

What drugs therapeutic serum range is 0.5 to 1.2 and when do you draw the level?

Answer 523

Lithium, 12 hours post dose

Question 524

Clinical findings with toxicity of what medication? Weight gain, impaired thyroid functioning, hand tremors, fatigue, mental cloudiness, headaches, nystagmus, maculopapular rash, pruritus, Acme, G.I. upset, diarrhea, vomiting, cramps, anorexia, polyuria, diabetes insipidus, edema, t wave inversions, dysrhythmias, leukocytosis.

Answer 524

Lithium

Question 525

Black’s box warning for what anticonvulsant medication: agranulocytosis and aplastic anemia

Answer 525

carbamazepine

Question 526

Black box warning for what medication: hepatotoxicity and pancreatitis

Answer 526

valproic acid/divalproex

Question 527

Black box warning for what medication: serious rash

Answer 527

Lamotrigine

Question 528

When should labs be drawn after start of Tegretol, Depakote and what labs?

Answer 528

One week, standardize rating scales help to monitor clinical status or, 12 hour trough serum drug level, CBC, LFTs

Question 529

Signs and symptoms of what life-threatening syndrome? Facial swelling, tongue swelling, macules, papules, confluent erythematic rash, burning rash, prodromal headache, malaise, arthralgia, and painful mucous membranes may occur before rash occurs.

Answer 529

Steven Johnson syndrome

Question 530

Standardized rating scales help monitor clinical status, establish baseline functioning, and monitor disorder course over time. What is one used for mania?

Answer 530

Young mania rating scale

Question 531

Routine evaluation of CBC, renal function, and thyroid and parathyroid function including thyroid stimulating hormone calcium levels is needed for clients taking what long term?

Answer 531

Lithium

Question 532

What mental health diagnoses? Chronic/fluctuating mood disorder with symptoms similar to but less severe than bipolar disorder. Numerous periods of hypomanic and dysthymic symptoms

Answer 532

Cyclothymic Disorder

Question 533

What mental health diagnosis? Fluctuating mood episodes, affected people can function well during hypomanic episodes, may experience clinically slipped into stress or impaired function related to cyclicity, unpredictable mood changes, often regarded by others as temperamental, moody, unpredictable, inconsistent, and unreliable. No psychotic episodes.

Answer 533

Cyclothymic disorder

Question 534

What level of anxiety? Normative level experienced by all, which functions to motivate. Vital signs normal, pupils constricted, minimal increase in muscle tone. Perceptual field broadened, heightened awareness of environment.

Answer 534

Level 1 mild anxiety

Question 535

What level of anxiety? Normative level experienced by most in response to significant stressors. Vital signs normal, mild increased heart rate, moderate increase in muscle tone. Subjective feeling of tension or worry, narrowed perceptions.

Answer 535

Level 2 mild anxiety

Question 536

What level of anxiety? Pathological level. Autonomic nervous system triggered, fight or flight response, pupils dilated, vital signs increased, diaphoresis, muscles rigid, hearing decreased, pain threshold increase, urinary frequency, diarrhea. Perceptual field greatly narrowed, difficulty with problem solving, distorted perception of time, selective inattention, dissociative sensations, autonomic behavior. Scattered perceptions

Answer 536

Level III Severe Anxiety.

Question 537

What level of anxiety? Pathological level. Your symptoms markedly increased. Client is pale, hypotensive, as poor eye hand coordination, muscle pains, marked decrease in hearing, dizziness, shortness of breath. Scattered perceptions, unable to attend to environmental stimuli, logical thinking, may exhibit hallucinations or delusions.

Answer 537

Level IV panic

Question 538

What is? A Latino cultural syndrome usually provoked by disruptions and family bonds and may be manifested by trembling, crying, and screaming. The attacks are usually variance in the presence of others in the person often feels relief afterwards

Answer 538

Ataques de nervios

Question 539

What is the first-line treatment for children at a tour diagnosed with an anxiety disorder.

Answer 539

Psychotherapy

Question 540

What is this theory? This theory is based on work of who, who believed that anxiety initially occurs in response to the stimulation of birth in need of the input to adapt to the changed environment. Subsequent anxiety results from intrapsychic conflict. The process of unconscious repression of sexual drive is at the core of much of the conflict. Conflict exists between instinctual needs of the id and the superego a.k.a. conscience; anxiety signals the person of the need to deal with the id superego conflict. Conflict is unconscious, but anxiety is consciously perceived. Conflict entails spirit of punishment and of doing wrong. Defense mechanisms are unconsciously used by the person that the conflict. The behavioral manifestations of anxiety disorder stem from the pathological overuse of defense mechanisms.

Answer 540

Sigmund Freud, psychodynamic theory

Question 541

What theory? This theory is based on work of who, who believe that humans are goal directed toward attainment of satisfaction and security needs. Satisfaction and security needs are normally met in interpersonal interactions. Anxiety arises when a person’s needs are unmet. Anxiety is first experience in infants interactions with his or her mother. When anxiety arises because of interpersonal conflict. Conflict occurs when a person perceives his or her needs will not be met because read action, feelings of inferiority, or inability to engage with significant others. Sense of self becomes based on the person’s perception of how others view him or her.

Answer 541

Interpersonal theory

Question 542

What theory? Pathological levels of anxiety result from neurobiological deficits in normal brain functioning. Deficits are genetically mediated by and involve predominantly the limbic system, midline brain system area, and sections of the cortex. Deficits predispose a person to abnormal stress responses, with hyperactivity of autonomic nervous system causing symptoms such as increased heart rate and pressure, diaphoresis, papillary dilation, tremors, and increased respiratory rate.

Answer 542

Neurobiological theory

Question 543

Threat is perceived, and blank signals the hypothalamus to secrete blank.

Answer 543

Amygdala and corticotrophin-releasing hormone.

Question 544

The amygdala also activates the what to start the fight or flight response.

Answer 544

Sympathetic nervous system

Question 545

The pituitary is stimulated to release what?

Answer 545

Adrenocorticotropic hormone

Question 546

The adrenal glands stimulated by the what and stimulates the release of what which in turn off the alarm system and restores the body to homeostasis.

Answer 546

Adrenocorticotropic hormone and cortisol in

Question 547

In anxiety disorders, the amygdala may not be able to shut off the response or there may not be enough what the stop the fight or flight response.

Answer 547

Cortisol

Question 548

Neurobiological deficits results in low levels of the neurotransmitter gamma aminobutyric acid, chemical responsible for inhibitory responses neurons in high levels of norepinephrine, the chemical associated with what response?

Answer 548

Fight or flight

Question 549

Neurotransmitters involved in suppressing the HPA axis are what and what?

Answer 549

Serotonin and GABA

Question 550

A first degree relative of a person with panic disorder is up to blank times more likely than general population to develop panic disorder

Answer 550

8 times

Question 551

If a first-degree relative of a person developed panic disorder before age 20, that person is up to blank times more likely than general population to develop panic disoder

Answer 551

20 times

Question 552

This disorder is common, with the lifetime surveillance of 28.8% among the general US population. Except for obsessive-compulsive disorder and social phobia, this disorder is common in girls and women more so than boys and men. This disorders manifest in adolescence and early adulthood. Median age is 11.

Answer 552

Anxiety

Question 553

Is it pathological level of anxiety or not? Anxiety is perceived of as distressing and out of control, anxiety is not seen as caused by life events, anxiety is accompanied by somatic complaints, anxiety interferes with social, occupational, and recreation activities and with activities of daily living.

Answer 553

Pathological level of anxiety

Question 554

What is the Hamilton rate scale used for?

Answer 554

Establishing and monitoring the client’s anxiety level over time.

Question 555

Most of the medications known to improve symptoms of anxiety act directly or indirectly on the blank systems

Answer 555

GABA system

Question 556

Standardized rating scales used for what? Zung’s Self-rating Scale, Hamilton Rating Scale, and Yale-Brown Scale

Answer 556

Anxiety.

Question 557

What mental health disorder is experienced as discrete episodes or attacks with sudden onset of intense apprehension, fearfulness, or terror, often associated with sense of impending doom. Attacks occur without warning and in the absence of any real danger. Attacks build the peak of intensity without a short, self-limiting time, usually within 10 minutes of onset. Is more common in women than in men.

Answer 557

Panic disorder

Question 558

Diagnostic criteria of what disorder? Discrete episode in which client experiences 4 or more of the following symptoms having a sudden onset and peaking within 10 minute of onset: Paresthesia, chills or hot flushing, fear or losing control or of going crazy, fear of dying, shortness of breath or smothering sensation, palpitations, pounding, or accelerated heart rate, chest pain, tightness, or discomfort, sweating, trembling or shaking, nausea or abdominal distress. After first attack, persistent concern over having another attack, worry over the consequences of initial attack, or a significant behavioral change related to attack. With high somatic sensations, clients are often sensitive to new somatic experiences or perceptions. Often intolerant of or concerned with common side effects of medication treatments. Discouraged or ashamed about “failure” to control emotions and over concern about dying when no other pathology identified.

Answer 558

Panic Disorder

Question 559

What mental health disorder is experienced as discrete episodes or attacks with sudden onset of intense apprehension, fearfulness, or terror, often associated with sense of impending doom. Attacks occur without warning and in the absence of any real danger. Attacks build the peak of intensity without a short, self-limiting time, usually within 10 minutes of onset. Is more common in women than in men.

Answer 559

Panic disorder

Question 560

Diagnostic criteria of what disorder? Discrete episode in which client experiences 4 or more of the following symptoms having a sudden onset and peaking within 10 minute of onset: Paresthesia, chills or hot flushing, fear or losing control or of going crazy, fear of dying, shortness of breath or smothering sensation, palpitations, pounding, or accelerated heart rate, chest pain, tightness, or discomfort, sweating, trembling or shaking, nausea or abdominal distress. After first attack, persistent concern over having another attack, worry over the consequences of initial attack, or a significant behavioral change related to attack. With high somatic sensations, clients are often sensitive to new somatic experiences or perceptions. Often intolerant of or concerned with common side effects of medication treatments. Discouraged or ashamed about “failure” to control emotions and over concern about dying when no other pathology identified.

Answer 560

Panic Disorder

Question 561

What mental health diagnosis is characterized by avoidance of places or situations from which escape may be difficult or embarrassing or in which help may not be available in the event of perceived need, such as a panic attack. Up to 50% of people meeting criteria for this report panic attacks or panic disorder preceded onset of this. The anxiety usually leads to avoidant behavior that impairs a person’s ability to travel, to work, or to carry out responsibilities of daily living. Differential diagnosis is assisted by the awareness that people with agoraphobia feel better and report less significant concerns with anxiety when accompanied by a trusted companion. When people meet criteria for this and panic or other anxiety disorder, both diagnoses should be assigned.

Answer 561

Agoraphobia

Question 562

If first episode of panic attack symptoms occur after age 45 consider what?

Answer 562

Consider general medical disorder

Question 563

Agoraphobia subtype; examples include driving, enclosed spaces, tunnels or bridges, or flying

Answer 563

Situational Type

Question 564

Agoraphobia subtype; examples include driving, enclosed spaces, tunnels or bridges, or flying

Answer 564

Situational Type

Question 565

Agoraphobia subtype; cued by seeing blood or an injury or by receiving an injection or other invasive medical procedure

Answer 565

blood injection injury type

Question 566

Agoraphobia subtype; cued by seeing blood or an injury or by receiving an injection or other invasive medical procedure

Answer 566

blood injection injury type

Question 567

Agoraphobia subtype; fear cued by choking, vomiting, or fear of a specific illness

Answer 567

other type.

Question 568

What mental health diagnosis is a marked and persistent fear of social or performance situations in which embarrassment may occur. Levels often are sufficient to fit criteria for a situationally bound panic attack. The disorder has an estimated 3 to 13% prevalence rate amongst the U.S. population. Rates are equal for the genders. Should be diagnosed only if symptoms persist for longer than 6 months.

Answer 568

Social Anxiety Disorder

Question 569

Common descriptive features of this mental illness:
Hypersensitivity to criticism, negative self evaluations, sensitivity to rejection, low self esteem, inferiority feelings, lack of assertiveness. Common physical exam findings sweating, tremors, palpitations, muscle tension, diarrhea, blushing

Answer 569

Social Anxiety Disorder

Question 570

What mental health illness? Excessive worry, apprehension, or anxiety about events or activities occurs more days than not for a period of at least 6 months. The person finds it hard to control it. No clear link exists to life events or stressors. Worry and anxiety interfere with activities of daily living. The nature and focus of worry shift frequently. A pattern of waxing and waning of symptoms exists. Symptoms worsen as life events stress the person.

Answer 570

General Anxiety Disorder

Question 571

What mental health illness? Anxiety and worry are out of proportion to the actual likelihood or effect of the feared event. People report subjective distress caused by the constant worry but do not always describe the worry as excessive. Excessive anxiety and worry last for more days than not for at least 6 months. The person finds it difficult to control.

Answer 571

General Anxiety Disorder.

Question 572

What mental health illness? Anxiety and worry are out of proportion to the actual likelihood or effect of the feared event. People report subjective distress caused by the constant worry but do not always describe the worry as excessive. Excessive anxiety and worry last for more days than not for at least 6 months. The person finds it difficult to control.

Answer 572

General Anxiety Disorder.

Question 573

What mental health illness? Developmentally inappropriate and excessive distress occurring after the age of four when faced with separation from a major attachment figure.

Answer 573

Separation anxiety disorder

Question 574

What mental health illness? Is the presence of anxiety provoking obsessions or compulsions that function to reduce the person subjective anxiety level. Defined as recurrent and persistent thoughts, impulses, or images that are experiencing cause anxiety and distress. Experienced as intrusive and inappropriate. Ego dystonic experience in which a person feels the content of the session is alien to his or her belief structure and not the kind of common thought, impulse, or image here she usually experiences

Answer 574

Obsessive-compulsive disorder and definition of accession

Question 575

What mental health illness? Disease rates higher in people with a 1st degree relative who has this versus the general population. Rates are also higher in people with a 1st degree relative who has Tourette’s syndrome than in the general population. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections or pandas should be considered in all children with sudden onset of the symptoms.

Answer 575

Obsessive-compulsive disorder

Question 576

What mental health disease? Is the reexperiencing of an extremely traumatic event accompanied by symptoms of increased arousal and avoidance of stimuli associated with the trauma. Trauma includes military combat, violent personal assaults such as robbery or rape, kidnapping or hostage situation, terrorist attack, torture, prolong sexual abuse, natural or human made disasters, observing the death of or significantly injury to another, unexpectedly witnessing of any of the above traumas, learning of the sudden or unexpected death of a significant injury to family member or close friend. Symptoms cannot predate exposure to trauma.

Answer 576

PTSD

Question 577

What mental health disease? Is the reexperiencing of an extremely traumatic event accompanied by symptoms of increased arousal and avoidance of stimuli associated with the trauma. Trauma includes military combat, violent personal assaults such as robbery or rape, kidnapping or hostage situation, terrorist attack, torture, prolong sexual abuse, natural or human made disasters, observing the death of or significantly injury to another, unexpectedly witnessing of any of the above traumas, learning of the sudden or unexpected death of a significant injury to family member or close friend. Symptoms cannot predate exposure to trauma.

Answer 577

PTSD

Question 578

Duration of symptoms less than three months for this mental illness

Answer 578

Acute PTSD

Question 579

At least six months between traumatic event and the onset of symptoms for this mental illness

Answer 579

Delayed onset PTSD

Question 580

At least six months between traumatic event and the onset of symptoms for this mental illness

Answer 580

Delayed onset PTSD

Question 581

What mental health illness? Depersonalization or derealization and amnesia. Defense mechanism that protects a person from overwhelming anxiety by emotionally separating. Causes gaps or interruptions in the person’s memory. Persistent feeling of oneself not being real or in the environment not being real reality testing remains intact. Perceived as uncomfortable. Characterized by two or more distinct personality states.

Answer 581

Dissociative disorders

Question 582

What mental health illness? Depersonalization or derealization and amnesia. Defense mechanism that protects a person from overwhelming anxiety by emotionally separating. Causes gaps or interruptions in the person’s memory. Persistent feeling of oneself not being real or in the environment not being real reality testing remains intact. Perceived as uncomfortable. Characterized by two or more distinct personality states.

Answer 582

Dissociative disorders

Question 583

What mental health diagnosis? Preoccupation with one or more perceived defects or flaws in physical appearance. Engages in repetitive behaviors in response to appearance concerns. Preoccupation causes considerable distress. Insight ranges from good to poor to absent.

Answer 583

Body dysmorphic disorder

Question 584

What mental health diagnosis? Persistent difficulty discarding possessions, regardless of actual value. Experiences marked distress in response to pressure to discard. Results in accumulation of possessions that compromise living space or ability to function, including maintaining a safe environment for self or others. Insight ranges from good to poor to absent.

Answer 584

Hoarding disorder

Question 585

What mental health diagnosis? Recurrent pulling out of one’s hair despite repeated attempts to stop. Causes significant distress or impairment in functioning. Her bowling is not an attempt to improve perceived deficit or flaw.

Answer 585

Trichotillomania

Question 586

What mental health diagnosis? Recurrent skin picking that results in lesions despite attempts to stop. Results in significant distress or impairment. Behavior not better explained by physiological response the substance or intentional attempt at self harm.

Answer 586

Excoriation Disorder