OTH: Psychiatric

Question 1

Excessive anxiety not associated with realistically threatening specific situations

Answer 1

Anxiety disorder (anxiety neurosis) - generalized

Question 2

Acute, intense anxiety or terror; may be uncontrollable, accompanied by sympathetic signs, loss of mental control, sense of impending death

Answer 2

Panic attack

Question 3

Excessive and unreasonable fear leads to avoidance behaviors

Answer 3

Phobia

Question 4

Persistent anxiety manifested by repetitive, stereotypic acts; behaviors interfere with social functioning

Answer 4

Obsessive-compulsive behavior

Question 5

Exposure to traumatic event that produces variety of symptoms

Answer 5

PTSD

Question 6

PTSD sx:

1. ___ the traumatic event
2. Psychiatric numbing with __ responsiveness
3. __ from external world; __ guilt
4. Exaggerated __ arousal, ___alertness
5. Disturbed __
6. Ongoing __
7. Impaired __ and __

Answer 6

1. Re-experiencing
2. Reduced
3. Detachment; survivor’s
4. Autonomic, hyperalertness
5. Sleep
6. Irritability
7. Memory, concentration

Question 7

Physical signs or diseases that are related to emotional causes

Answer 7

Psychosomatic disorders (somatoform disorders)

Question 8

3 characteristics of psychosomatic disorders

Answer 8

1. Cannot be explained by identifiable pathology/process
2. Not under voluntary control
3. Patient frequently indifferent to symptoms

Question 9

Pt experiences neurological symptoms (weakness, paralysis, sensory symptoms) without evidence of specific neurological disease or other medical condition

Answer 9

Functional neurological symptom disorder (FNsD)

Question 10

With functional neurological symptom disorder, pts symptoms are real and cause significant loss of function/emotional distress. Symptoms can vary in __ and __or be __. Cause is __. Tx involves PT or OT for ___ and __ symptoms, and ___ tx.

Answer 10

Severity
Fluctuate, be persistent
Unknown
Functional and movement
Psychiatric

Question 11

Tx for FNsD

Answer 11

1. Physical symptoms are real- tx patient as you would any other pt with same presentation
2. Provide supportive environment
3. ID primary gain (internal conflicts); assist pt to use new alternative methods of stress mgmt
4. ID secondary gains (additional advantages)- do not reinforce attention/sympathy
5. Provide encouragement/support for total person

Question 12

Group of disorders characterized by disruptions in thought patterns of unknown etiology; biochemical imbalance in brain

Answer 12

Schizophrenia

Question 13

Schizophrenia sx:

1. Disordered __
2. Disordered __
3. Disordered __
4. ___ of affect
5. ___disturbances
6. Little __ into problems/behavior

Answer 13

1. Thinking
2. Speech
3. Perception
4. Inappropriateness
5. Functional
6. Insight

Question 14

Schizophrenia:

What is disordered thinking?

Answer 14

Fragmented thoughts, errors of logic, delusions, poor judgment, memory

Question 15

Schizophrenia:

What is disordered speech?

Answer 15

May be coherent, but unintelligible, incoherent, or mute

Question 16

Schizophrenia:

What is disordered perception?

Answer 16

Hallucinations and delusions

Question 17

Schizophrenia:

What is inappropriateness of affect?

Answer 17

Withdrawal of interest from other people and from outside world; loss of self-identity, self-direction; disordered interpersonal relations

Question 18

Schizophrenia:

What are functional disturbances?

Answer 18

Inability to function in daily life, work

Question 19

Type of schizophrenic disorder characterized by feelings of extreme suspiciousness, persecution, grandiosity (feelings of power/great wealth), or jealousy; withdrawal of all emotional contact with others

Answer 19

Paranoia

Question 20

Type of schizophrenic disorder characterized by mutism or stupor; unresponsiveness; catatonic posturing

Answer 20

Catatonia

Question 21

What is catatonic posturing?

Answer 21

Remains fixed, unable to move or talk for extended periods

Question 22

Disorder characterized by mood swings from depression to mania; biochemical dysfunction

Answer 22

Bipolar disorder (manic-depressive illness)

Question 23

Bipolar disorder: often intense ___, high energy and activity, excessive ___, decreased need for __, unrealistic beliefs, distractibility, poor judgment, denial… followed by extreme ___

Answer 23

Outbursts, euphoria, sleep

Depression

Question 24

Characteristics of grief process?

Answer 24

Somatic symptoms: fatigue, sighing, hyperventilation, anorexia, insomnia
Psychological symptoms: sorrow, discomfort, regret, guilt, anger

Question 25

Stages of grief process?

Answer 25

1. Shock and disbelief; inability to comprehend loss 2. Increased awareness and anguish; crying/anger common 3. Mourning 4. Resolution of loss 5. Idealization of lost person or function

Question 26

How do you help manage the grief process? | Provide ____ and ___ of grief process. Encourage expression of __, __. Respect ___, cultural or ___ customs.

Answer 26

Support, understanding Feelings, memory Privacy, religious

Question 27

Stages of death/dying: (6)

Answer 27

1. Denial 2. Anger/resentment 3. Bargaining 4. Depression 6. Acceptance

Question 28

Death/dying: Denial- allow denial. Protective compensatory mechanism necessary until such time as pt is ready to face his/her illness. Provide opportunities for what?

Answer 28

Pt to question, confront illness and impending death

Question 29

Death/dying: Anger, resentment: patients may become ___ and __ others. Be __, allow pt to express anger, frustration, resentment. Encourage focus on ___ strategies.

Answer 29

Disruptive, blame Supportive Coping

Question 30

Death/dying: Bargaining- pts bargain for time to complete life tasks; turn to religion or others, make promises in return for function. What can you do?

Answer 30

Provide accurate information, truthful and honest answers

Question 31

Death/dying: Depression- pts acknowledge impending death, withdraw from life; demonstrate overwhelming sense of loss and have __ __. Observe closely for ___. Allay fears and anxieties, especially loneliness and ___. Assist in providing comfort.

Answer 31

Low motivation Suicidal ideas Isolation

Question 32

Death/dying: | Acceptance and preparation- acceptance of their condition, relate more to __ make plans for future.

Answer 32

Family

Question 33

PT interventions Motivate pts, manage human side of rehab. Establish boundaries of professional relationship: identify problems, ___, ___, roles and ____.

Answer 33

Expectations, purpose, responsibilities

Question 34

PT interventions | Provide empathetic understanding: capacity o understand what pt is experiencing from __ __

Answer 34

Patient’s perspective

Question 35

PT interventions | Recognize losses; allow opportunity to mourn “old self.” Ask ____ questions that reflect what pt is feeling

Answer 35

Open-need

Question 36

PT interventions | ___ is not helpful or therapeutic; caregiver is closely affected by pt’s behavior (ex: therapist cries when pt cries)

Answer 36

Sympathy

Question 37

PT interventions | Set realistic, meaningful goals; how?

Answer 37

Involve the pt and family | Self-determination is important

Question 38

PT interventions | Set realistic time frames for rehab program; including what?

Answer 38

Recognize symptoms, stages of grief process or death and ying and adjust accordingly

Question 39

PT interventions | Recognize and reinforce healthy, positive, socially appropriate behaviors: allow pt to do what?

Answer 39

Experience success

Question 40

PT interventions | Recognize secondary gains, unacceptable behaviors- PT should do what with this?

Answer 40

Do not encourage or reinforce (ex: malingering behaviors such as avoidance of work)

Question 41

PT interventions Provide environment conductive to pt’s emotional state, learning, optimal fxn. 1. Provide message of hope tempered with realism 2. Keep pts ___ 3. Lay adequate groundwork or preparation for ___ 4. Help establish personal __ and __; acknowledge whole person

Answer 41

Informed Expected changes/discharge Dignity, self-worth

Question 42

PT interventions Help pts identify feelings, successful coping strategies, recognize successful conflict resolution and rehab gains. Stress ability to ___, stress that recovery is unique and ___

Answer 42

Overcome major obstacles | Highly individual

Question 43

Red flags for depression: (just a few of them) 1. Sleep habits? 2. Psychomotor imbalance: ? 3. Feelings of ?

Answer 43

Insomnia, hypersomnia, decreased energy Agitation or excess fatigue/irritability Worthlessness, helplessness, guilt

Question 44

med tx for depression

Answer 44

Tricyclic antidepressant drugs

Question 45

Red flags: tricyclic antidepressant drugs- | May exhibit disturbed ___, postural ___, falls and __, increased __, dysrhythmias, ___ mvmt, seizures

Answer 45

``` Balance Hypotension Fx HR Ataxic ```

Question 46

Covering up weakness by stressing desirable or strong trait

Answer 46

Compensation

Question 47

Refusal to recognize reality

Answer 47

Denial

Question 48

Refusal or inability to recall undesirable past thoughts/events

Answer 48

Repression

Question 49

Transferring of emotion to a less dangerous substitute

Answer 49

Displacement

Question 50

Defensive reaction in which behavior is exactly opposite what is expected

Answer 50

Reaction formation

Question 51

Attributing of your own undesirable behavior to another

Answer 51

Projection

Question 52

Justification of behaviors using reasons other than real reason

Answer 52

Rationalization

Question 53

Resorting to earlier more immature pattern of functioning

Answer 53

Regression

Question 54

1. Total body coping/adaptation to catastrophic event 2. Alarm stage fight or flight (sympathetic response) 3. Sustained resistance 4. Chronic resistance, exhaustion leading to stress-related illnesses

Answer 54

General adaptation syndrome (GAS)