PMHNP Flashcards
1
Q
BET
What disorders have ELEVATED rates of OCD?
A
BIPOLAR, eating disorders, and Tourette’s.
2
Q
Location of 5-HT in brain
A
Raphe Nuclei (Brain Stem)
3
Q
The most common type of delusions (i.e., belief that one is going to be harmed, harassed, and so forth by an individual, organization, or other group)
A
Persecutory
4
Q
An over-importance of thoughts and need to control thoughts are characteristics of
A
OCD
5
Q
OCD beliefs can include an inflated sense of responsibility an overestimate of
A
threat
6
Q
OCD patients strive for perfection and are intolerant of
A
uncertainty
7
Q
In individuals with schizophrenia or schizoaffective disorder, the prevalence of OCD is approximately
A
12%.
8
Q
Name 5 body systems involved in panic disorder
A
ANS, Cognition (brain),
Cardiorespiratory (heart/lung),
GI (stomach), and Otoneurologic (ear)
9
Q
True or False. Lipid solubility increase the absorption of drug into blood.
A
True
10
Q
Ionization of a molecule determine its solubility. T/F
A
True
11
Q
These bind to receptors with selectivity
A
Ligands
12
Q
Large proteins on membrane or within cells that is the initial site of action
A
Receptors
13
Q
Pavlov Classical Conditioning Experiment involved
A
Dog, bell, food
14
Q
Type of learned behavior that reinforces/discourages acts
A
Operant Conditioning
15
Q
Drugs are usually weak acid/bases and not readily
A
lipid soluable
16
Q
Drugs can become ionized when dissolved in water depending on
A
The pH of solution and property of molecule.
17
Q
The pKa is the solution a drug becomes
A
50/50 ionized/non-ionized in
acid need alkaline environments and vice versa
18
Q
Grey Matter communicates _____ information
A
Sensorimotor
19
Q
White Matter (Corpus Callosm)
A
Myelinated (Communicate between hemispheres)
20
Q
Limbic System integrate emotions and regulate motivated
A
learning and behavior
21
Q
Hippocampus is involved in these type of memories
A
New & long term
22
Q
Nucleui Accumbens (Limibic System)
A
Reinforces Reward (VTA/Mesolimbic pathways)
23
Q
Amygdala (Temporal Lobe)
A
Coordinate
Emotional Response and Memories
24
Q
Dopamine is found in the
A
Substania Nigra and VTA
25
A decreased level of DA or cell death where it is stored leads to
Parkinson's Disease
26
Glial (Glue) Cells provide _____ for neurons
metabolic support, protection, and insulation
27
Damage in the Wernicke's Area (Left Hemisphere of Cortex T/P)
Impaired Language Comprehension and Confabulation
28
Broca's Area **(Left Frontal Lobe)**
Impaired Reading/Writing/Speech **(Aphasia)**,
But they **CAN** Comprehend
29
Cerebrum **(Sensorimotor)** FX
Balance and Position
Visual and Auditory
and Smooth Fine Motor
30
Lobe most responsible for rational thought, executive fx, movement
Frontal
31
Lobe most responsible for sensory, attention, space, touch, pain, and temperature
Parietal
32
Lobe responsible for hearing, speech related learning & memory
Temporal
33
Rapid Cycling occurs most often in BD I or II
II
34
Cranial Nerves the Pons Govern
Motor, eye, face, mouth
35
Which is safe to use in Bipolar patients TCAs or Wellbutrin
Wellbutrin
36
Sx in Mixed State Bipolar are
Apprear together but are less severe than full criteria
37
Failure of Trust vs Mistrust
Relationship and Suspicion
38
Failure of Autonomy vs Shame/Doubt
Self-Control and Dependency
39
Industry vs. Inferiority Failure
Difficulty learning and working
40
Initiative vs. Guilt Failure
Goal Orientation
41
Idenitity vs Role Confusion Failure
Poor self-identification in groups
42
Medications to tx Austism Aggression
Aripiprazole and Risperidone
43
SSRIs Approved for Children
Fluoxetine, fluvoxamine, sertraline
44
Name the 4 Piaget stages (end age **2711 15**)
Sensorimotor
Preoperational (what you say it is)
Concrete (who's who, and me?)
Formal (abstract)
45
Name Freud's 5 Stages 136 **twelve-eighteen**
Oral (mouthy)
Anal (OCD)
Phallic (Oepidus)
Latency
Genital (SEX)
46
# ASSO
Name Mahler Stages of Development
Autism **2**
Symbiosis **3-5**
Separation-Individuation **5-16**
Object Constancy **25-36**
47
Elevated BP Reading
120/80
48
Stage 1 HTN Reading
130/80
49
Most sensitive indicator of renal fx
Creatinine 0.5-1.5mg
50
Diabetes fasting reading of ??? on one or more occasions
126
51
A glucose reading of 200 with s/s of ??? is indicative of diabetes
Hyperglycemia
52
BUN to Creatinine Ratio is usually
10:1
53
Which is more sensitive to liver damage, AST or ALT?
ALT
54
Serotonin Syndrome Sx
Libby Zion
55
Schizoaffective Disorder
## Footnote
Characterized by periods in which Manic and/or Major Depressive Episodes are concurrent with the
active-phase symptoms of
Schizophrenia
56
In **Schizoaffective Disorder** positive schizophrenia sx are present at least 2 weeks in the absence of _____ symptoms are present _____ of the time.
Bipolar and Majority
57
In Schizoaffective Disorder positive schizophrenia sx are present at least _____ in the absence of bipolar symptoms are present majority of the time.
2 weeks
58
BD I with psychotic features if those symptoms have occurred exclusively during _____ episodes.
Manic and Major Depressive.
59
Bipolar I Disorder with psychotic features if symptoms occurred exclusively during polar episodes.
Opposed to \_\_\_\_\_\_\_.
Schizoaffective
60
Schizophrenia, Delusional Disorder, or Schizophreniform Disorder is characterized by psychotic sx and
Manic or Major Depressive Episodes.
61
The dx of Schizophrenia, Delusional Disorder, or Schizophreniform Disorder may be given in the presence of BD sx if\_\_\_\_\_
Mania and MDD is present **minority** of the time OR sx appreared **separately**.
62
BD, ODD, Trichotillomania, and Excoriation DO have impulsivity and ___ in common
OCD
63
Anxiety disorders have the earliest age of onset of all of the major classes of mental and behavioral disorders. The median age of onset is
By the age of 6-12 years.
64
Tasks of Complex Attention Domain
Processing Speed
Divided, Selective, Sustained
65
Executive Function Tasks (Besides Mulitasking/Decision-Making)
planning,
working memory,
responding to feedback/error correction,
overriding habits
66
Tasks of Learning and Memory Domain
immediate and recent memory
[free & cued recall, and recognition memory]
67
# Aunt Linda
Tasks of Social Cognition
recognition of emotions,
theory of mind,
behavioral regulation
68
The Language Domain
**receptive** & **expressive** language [including naming, fluency, and grammar and syntax]
69
Perceptual-Motor Ability Domains
construction and visual perception
70
**Visual hallucinations** and **parkinsonian** features tend to occur **early** in the illness.
**Rapid progression** compared to Alz
Conventional antipsychotics lead to **EPS**
LEWY BODY
71
Language VARIANT or 3 or more behavioral symptoms like
**Behavioral disinhibition**
Apathy or inertia
Perseverative, stereotyped or compulsive/ritualistic behavior
Hyperorality and dietary changes.
FTL NCD
72
In Vascular Dementia there is evidence for decline is prominent in these domains
complex attention (including processing speed) and executive function
73
The NCD disease is accompanied by **ataxia, myoclonus, chorea, and dystonia.**
The course is typically rapidly progressive over as little as 6 months. The diagnosis is confirmed with brain biopsy or autopsy.
Prion
74
For major **ALZ** neurocognitive disorder,
at least two domains must be impaired based on **history** or **testing**
a. Clear evidence of decline in memory and learning
b. Steadily progressive, gradual decline in cognition, without extended plateaus.
c. No evidence of mixed etiology
75
Personality disorders may be accurately diagnosed before the age of 18 if symptoms are clearly present for more than
1 year.
76
People with personality disorders have enduring maladaptive patterns related to their
thoughts, behaviors, reactions, and internal experiences
77
With PD, co-occurring mood or anxiety or substance-related conditions, and significant psycho-social issues are considered the rule rather than
the exception
78
the strong emotional content of a borderline presentation can be mistaken for
mood disorder episodes.
79
In an effort to describe their **affective in-stability, intense anger, or impulsivity**, persons with borderline personality disorder may endorse symptoms that sound consistent with
MDD or BD I/II episode.
80
This PD is not diagnosed in persons with schizophrenia or other psychotic disorders because these conditions are typically accompanied by a seclusive lifestyle.
Schizoid
81
Borderline personality disorder tends to be characterized by chronic mood **instability**, whereas depression and bipolar disorder are characterized by sustained episodes of
mood **pathology**
82
PD traits may be early (or prodromal) manifestations of schizophrenia.
Schizoptypal
83
Antisocial personality disorder is characterized by a pervasive pattern of poor
social conformity,
deceitfulness,
impulsivity,
criminality,
and lack of remorse
84
ni·hil·ism
the rejection of all religious and moral principles, often in the belief that life is meaningless.
85
To fabricate imaginary experiences as compensation for loss of memory.
Confabulate
86
Reaction formation
opposite action
87
Specific Phobia is limited to one stimulus, whereas agoraphobia's diagnostic criteria require at least
two situations.
88
Mood DOs in children include failure
to achieve expected weight gains
89
ODD
If the child is under 5, the behavior must persistent **most days for at least 6 months**. If 5 or older, at least
once a week
90
# ages \<5/5 and up
ODD Criteria need **4 SX** from the 3 Categories...
angry/irritable mood,
argumentative/defiant behavior
vindictiveness
91
To meet the criteria of pedophilic disorder, the individual should be at least age 16, at least ___ years older
5
92
Most paraphilic disorders develop during
**puberty or adolescence** and
should occur over a period of **at least 6 months**
93
Hamilton **Anxiety (Hi)** Rating Scale
Hamilton **Depression** Rating Scale
(A) 25-30
(D) 14-18
94
PHQ-9 and GAD-7
Moderate 10-14
95
Beck Depression
21-30
96
97
A ***Positive*** Mood DO Questionaire
7/13 Part I
Yes Part II
Mod/Severe Part III
98
MMSE score closer to 24-30 is ideal,
Mild impairment range is
18-23
99
CAD
Cx
Accident
Lower Respiratory Tract Infections
CVA are \_\_\_\_
Top 5 Killers of Adults
100
Number 1 & 2 Cancer mortality regardless of gender
Lung/Colorectal **45-75**
101
1# Cancer killer/incidence in Women
Ovarian/Breast
102
2nd most common and killing cancer in Men
Prostate
103
Sensitivity/Specificity
Incidence/Prevalence
**Positive/Negative**
**IF/Porportion**
104
ENZYME INDUCTION Increase or Decrease enzyme metabolism
Increase
105
Drug competition due to the limited number of enzymes cause
**Inhibition**
of one or more drugs that use the same metabolic system
106
Autoreceptors inhibit ____ release
catecholamine
107
Carbamepazine and oral contraceptives are metabolized by
3A4
108
Induction increases metabolism and decrease the
effect
109
Antidepressants and caffeine are metabolized by
1A2 (cigarette smoke inducer)
110
Grapefruit Juice is a ____ Inhibitor
3A4
Last at least 24 hours and dissipates over several days
111
50% of Asians groups have trouble metabolizing
Acetaldehyde (helps breakdown ETOH)
112
Computed tomography (CT) indications
dementia or depression
general cognitive
workup for **first-break psychosis**
113
CT Help differentiate **subtypes of Alzheimer's** disease and show
**GABA** abusers have cerebral atrophy
Schizophrenics have **Cortical/Cerebellar atrophy** and **Increased Ventricles**
114
CT scans with contrast enhances the visualization of
tumors, strokes, abscesses, and other infections
115
# HSA
MRI can distinguish structural brain abnormalities that may be associated with behavior changes and
**H**untington's, **S**trokes, **A**therosclerosis
116
Examples of Functional Imaging which show detail biochemical distributions are
PET, SPECT, fMRI, MRS
117
On ____ imagining, Alzheimer's disease show a **decrease** in bilateral temporoparietal perfusion on
SPECT
118
Schizophrenic patients show ***less* frontal activation** and **more left temporal activation**
on word fluency tasks on this imaging tests _____ .
fMRI
119
evaluate brain function and metabolism, lithium,
120
In hyperthyroidism TSH **down** and
T3 is **(80-230)** and
serum antinuclear antibodies (w/o lupus or collagen)
elevated
121
Graves disease iodine uptake is
High
122
If **subacute thyroiditis** is the cause of hyperthyroidism there will be low uptake of
iodine (tx w/propranolol)
123
**TSH** level in hypothyroidism is **UP** and
**T4/Sodium/BG** is low
124
PrEP formulation recommended for all people
Emitricitabine/tenofovir/**disoproxil fumarate (Truvada)**
125
# Tanner Stages I-IV
Tanner Stages in Boys
II- Balls
III- Longer Penis
IV- Glan/Ruggae
126
# Tanner Stages I-IV
Tanner Girls
II- Buds
III- Bigger
IV- Nipple/Areola
127
# Tanner Stages I-IV
Tanner Pubic Hair
II- Sparse
III- Dark
IV- Volume (somewhat decreased)
128
Thalamus is a
Relay Center
129
Clubhouse is Patient ran and offers
Variety of Services
130
Multisystemic Therapy is for the youth and offers
Home and school support and parent skills
131
Fairweather Lodge Hospital Trains
Group home residents that become business partners
132
The percentage of patients with SMI that don't respond to medications
15%-30%
133
People with BD may wait ___ years and Schizophrenics may wait ___ before seeking tx
10 and 2
134
Rapid DC of Lithium increases suicidal ideations ___ fold
20-fold
135
Key Human Sexuality Development Markers
6-9 homoplay
10-13 romantic interest
13-20 strong desire
136
a. Clear evidence of decline in memory and learning
b. Steadily progressive, gradual decline in cognition, without extended plateaus.
c. No evidence of mixed etiology
is hallmark of
NCD
137
Good enough mother allows
interpersonal safety and development of true self.
138
Interpersonal Theory (Sullivan)
The Good, Bad, and Not Me which has
**Intense Anxiety** which leads to **Denial/Dissociation**
139
# Parent-Adult-Child
Transactional Analysis (Berne) focuses on the past and present
seek to balance
Super Ego and ID
140
Gestalt (Perls) focuses on the Now and **personal responsibilty** to achieve mastery
Avoidance leads to
Growth disorders
141
Person-Centered (Rogers) no techniques aside from the TA
Help person find their own
growth, meaning, and actualization
142
Rational-Emotive (Ellis) must examine
**beliefs** that lead to **behavior**
143
CBT (Beck) involve
Schemas
Primary & Secondary Thinking
Downward Arrow
Paradox/Exaggerations
144
DBT (Linehan) 4 Stages
Main **One** is
Therapy interupting behaviors then DEARMAN
145
DEARMAN
describe, express, assert, reinforce, mindfulness, appear confident, and negotiate.
