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PMHNP Flashcards

1
Q

BET

What disorders have ELEVATED rates of OCD?

A

BIPOLAR, eating disorders, and Tourette’s.

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2
Q

Location of 5-HT in brain

A

Raphe Nuclei (Brain Stem)

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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

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4
Q

An over-importance of thoughts and need to control thoughts are characteristics of

A

OCD

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5
Q

OCD beliefs can include an inflated sense of responsibility an overestimate of

A

threat

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6
Q

OCD patients strive for perfection and are intolerant of

A

uncertainty

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7
Q

In individuals with schizophrenia or schizoaffective disorder, the prevalence of OCD is approximately

A

12%.

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8
Q

Name 5 body systems involved in panic disorder

A

ANS, Cognition (brain),

Cardiorespiratory (heart/lung),

GI (stomach), and Otoneurologic (ear)

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9
Q

True or False. Lipid solubility increase the absorption of drug into blood.

A

True

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10
Q

Ionization of a molecule determine its solubility. T/F

A

True

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11
Q

These bind to receptors with selectivity

A

Ligands

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12
Q

Large proteins on membrane or within cells that is the initial site of action

A

Receptors

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13
Q

Pavlov Classical Conditioning Experiment involved

A

Dog, bell, food

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14
Q

Type of learned behavior that reinforces/discourages acts

A

Operant Conditioning

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15
Q

Drugs are usually weak acid/bases and not readily

A

lipid soluable

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16
Q

Drugs can become ionized when dissolved in water depending on

A

The pH of solution and property of molecule.

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17
Q

The pKa is the solution a drug becomes

A

50/50 ionized/non-ionized in

acid need alkaline environments and vice versa

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18
Q

Grey Matter communicates _____ information

A

Sensorimotor

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19
Q

White Matter (Corpus Callosm)

A

Myelinated (Communicate between hemispheres)

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20
Q

Limbic System integrate emotions and regulate motivated

A

learning and behavior

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21
Q

Hippocampus is involved in these type of memories

A

New & long term

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22
Q

Nucleui Accumbens (Limibic System)

A

Reinforces Reward (VTA/Mesolimbic pathways)

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23
Q

Amygdala (Temporal Lobe)

A

Coordinate

Emotional Response and Memories

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24
Q

Dopamine is found in the

A

Substania Nigra and VTA

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25
Q

A decreased level of DA or cell death where it is stored leads to

A

Parkinson’s Disease

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26
Q

Glial (Glue) Cells provide _____ for neurons

A

metabolic support, protection, and insulation

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27
Q

Damage in the Wernicke’s Area (Left Hemisphere of Cortex T/P)

A

Impaired Language Comprehension and Confabulation

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28
Q

Broca’s Area (Left Frontal Lobe)

A

Impaired Reading/Writing/Speech (Aphasia),

But they CAN Comprehend

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29
Q

Cerebrum (Sensorimotor) FX

A

Balance and Position

Visual and Auditory

and Smooth Fine Motor

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30
Q

Lobe most responsible for rational thought, executive fx, movement

A

Frontal

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31
Q

Lobe most responsible for sensory, attention, space, touch, pain, and temperature

A

Parietal

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32
Q

Lobe responsible for hearing, speech related learning & memory

A

Temporal

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33
Q

Rapid Cycling occurs most often in BD I or II

A

II

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34
Q

Cranial Nerves the Pons Govern

A

Motor, eye, face, mouth

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35
Q

Which is safe to use in Bipolar patients TCAs or Wellbutrin

A

Wellbutrin

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36
Q

Sx in Mixed State Bipolar are

A

Apprear together but are less severe than full criteria

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37
Q

Failure of Trust vs Mistrust

A

Relationship and Suspicion

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38
Q

Failure of Autonomy vs Shame/Doubt

A

Self-Control and Dependency

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39
Q

Industry vs. Inferiority Failure

A

Difficulty learning and working

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40
Q

Initiative vs. Guilt Failure

A

Goal Orientation

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41
Q

Idenitity vs Role Confusion Failure

A

Poor self-identification in groups

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42
Q

Medications to tx Austism Aggression

A

Aripiprazole and Risperidone

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43
Q

SSRIs Approved for Children

A

Fluoxetine, fluvoxamine, sertraline

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44
Q

Name the 4 Piaget stages (end age 2711 15)

A

Sensorimotor

Preoperational (what you say it is)

Concrete (who’s who, and me?)

Formal (abstract)

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45
Q

Name Freud’s 5 Stages 136 twelve-eighteen

A

Oral (mouthy)

Anal (OCD)

Phallic (Oepidus)

Latency

Genital (SEX)

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46
Q

ASSO

Name Mahler Stages of Development

A

Autism 2

Symbiosis 3-5

Separation-Individuation 5-16

Object Constancy 25-36

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47
Q

Elevated BP Reading

A

120/80

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48
Q

Stage 1 HTN Reading

A

130/80

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49
Q

Most sensitive indicator of renal fx

A

Creatinine 0.5-1.5mg

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50
Q

Diabetes fasting reading of ??? on one or more occasions

A

126

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51
Q

A glucose reading of 200 with s/s of ??? is indicative of diabetes

A

Hyperglycemia

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52
Q

BUN to Creatinine Ratio is usually

A

10:1

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53
Q

Which is more sensitive to liver damage, AST or ALT?

A

ALT

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54
Q

Serotonin Syndrome Sx

A

Libby Zion

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55
Q

Schizoaffective Disorder

Characterized by periods in which Manic and/or Major Depressive Episodes are concurrent with the

active-phase symptoms of

A

Schizophrenia

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56
Q

In Schizoaffective Disorder positive schizophrenia sx are present at least 2 weeks in the absence of _____ symptoms are present _____ of the time.

A

Bipolar and Majority

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57
Q

In Schizoaffective Disorder positive schizophrenia sx are present at least _____ in the absence of bipolar symptoms are present majority of the time.

A

2 weeks

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58
Q

BD I with psychotic features if those symptoms have occurred exclusively during _____ episodes.

A

Manic and Major Depressive.

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59
Q

Bipolar I Disorder with psychotic features if symptoms occurred exclusively during polar episodes.

Opposed to _______.

A

Schizoaffective

60
Q

Schizophrenia, Delusional Disorder, or Schizophreniform Disorder is characterized by psychotic sx and

A

Manic or Major Depressive Episodes.

61
Q

The dx of Schizophrenia, Delusional Disorder, or Schizophreniform Disorder may be given in the presence of BD sx if_____

A

Mania and MDD is present minority of the time OR sx appreared separately.

62
Q

BD, ODD, Trichotillomania, and Excoriation DO have impulsivity and ___ in common

A

OCD

63
Q

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

A

By the age of 6-12 years.

64
Q

Tasks of Complex Attention Domain

A

Processing Speed

Divided, Selective, Sustained

65
Q

Executive Function Tasks (Besides Mulitasking/Decision-Making)

A

planning,

working memory,

responding to feedback/error correction,

overriding habits

66
Q

Tasks of Learning and Memory Domain

A

immediate and recent memory

[free & cued recall, and recognition memory]

67
Q

Aunt Linda

Tasks of Social Cognition

A

recognition of emotions,

theory of mind,

behavioral regulation

68
Q

The Language Domain

A

receptive & expressive language [including naming, fluency, and grammar and syntax]

69
Q

Perceptual-Motor Ability Domains

A

construction and visual perception

70
Q

Visual hallucinations and parkinsonian features tend to occur early in the illness.

Rapid progression compared to Alz

Conventional antipsychotics lead to EPS

A

LEWY BODY

71
Q

Language VARIANT or 3 or more behavioral symptoms like

Behavioral disinhibition

Apathy or inertia

Perseverative, stereotyped or compulsive/ritualistic behavior

Hyperorality and dietary changes.

A

FTL NCD

72
Q

In Vascular Dementia there is evidence for decline is prominent in these domains

A

complex attention (including processing speed) and executive function

73
Q

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.

A

Prion

74
Q

For major ALZ neurocognitive disorder,

at least two domains must be impaired based on history or testing

A

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
Q

Personality disorders may be accurately diagnosed before the age of 18 if symptoms are clearly present for more than

A

1 year.

76
Q

People with personality disorders have enduring maladaptive patterns related to their

A

thoughts, behaviors, reactions, and internal experiences

77
Q

With PD, co-occurring mood or anxiety or substance-related conditions, and significant psycho-social issues are considered the rule rather than

A

the exception

78
Q

the strong emotional content of a borderline presentation can be mistaken for

A

mood disorder episodes.

79
Q

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

A

MDD or BD I/II episode.

80
Q

This PD is not diagnosed in persons with schizophrenia or other psychotic disorders because these conditions are typically accompanied by a seclusive lifestyle.

A

Schizoid

81
Q

Borderline personality disorder tends to be characterized by chronic mood instability, whereas depression and bipolar disorder are characterized by sustained episodes of

A

mood pathology

82
Q

PD traits may be early (or prodromal) manifestations of schizophrenia.

A

Schizoptypal

83
Q

Antisocial personality disorder is characterized by a pervasive pattern of poor

A

social conformity,

deceitfulness,

impulsivity,

criminality,

and lack of remorse

84
Q

ni·hil·ism

A

the rejection of all religious and moral principles, often in the belief that life is meaningless.

85
Q

To fabricate imaginary experiences as compensation for loss of memory.

A

Confabulate

86
Q

Reaction formation

A

opposite action

87
Q

Specific Phobia is limited to one stimulus, whereas agoraphobia’s diagnostic criteria require at least

A

two situations.

88
Q

Mood DOs in children include failure

A

to achieve expected weight gains

89
Q

ODD

If the child is under 5, the behavior must persistent most days for at least 6 months. If 5 or older, at least

A

once a week

90
Q

ages <5/5 and up

ODD Criteria need 4 SX from the 3 Categories…

A

angry/irritable mood,

argumentative/defiant behavior

vindictiveness

91
Q

To meet the criteria of pedophilic disorder, the individual should be at least age 16, at least ___ years older

A

5

92
Q

Most paraphilic disorders develop during

A

puberty or adolescence and

should occur over a period of at least 6 months

93
Q

Hamilton Anxiety (Hi) Rating Scale

Hamilton Depression Rating Scale

A

(A) 25-30

(D) 14-18

94
Q

PHQ-9 and GAD-7

A

Moderate 10-14

95
Q

Beck Depression

A

21-30

96
Q
A
97
Q

A Positive Mood DO Questionaire

A

7/13 Part I

Yes Part II

Mod/Severe Part III

98
Q

MMSE score closer to 24-30 is ideal,

Mild impairment range is

A

18-23

99
Q

CAD

Cx

Accident

Lower Respiratory Tract Infections

CVA are ____

A

Top 5 Killers of Adults

100
Q

Number 1 & 2 Cancer mortality regardless of gender

A

Lung/Colorectal 45-75

101
Q

1# Cancer killer/incidence in Women

A

Ovarian/Breast

102
Q

2nd most common and killing cancer in Men

A

Prostate

103
Q

Sensitivity/Specificity

Incidence/Prevalence

A

Positive/Negative

IF/Porportion

104
Q

ENZYME INDUCTION Increase or Decrease enzyme metabolism

A

Increase

105
Q

Drug competition due to the limited number of enzymes cause

A

Inhibition

of one or more drugs that use the same metabolic system

106
Q

Autoreceptors inhibit ____ release

A

catecholamine

107
Q

Carbamepazine and oral contraceptives are metabolized by

A

3A4

108
Q

Induction increases metabolism and decrease the

A

effect

109
Q

Antidepressants and caffeine are metabolized by

A

1A2 (cigarette smoke inducer)

110
Q

Grapefruit Juice is a ____ Inhibitor

A

3A4

Last at least 24 hours and dissipates over several days

111
Q

50% of Asians groups have trouble metabolizing

A

Acetaldehyde (helps breakdown ETOH)

112
Q

Computed tomography (CT) indications

A

dementia or depression

general cognitive

workup for first-break psychosis

113
Q

CT Help differentiate subtypes of Alzheimer’s disease and show

A

GABA abusers have cerebral atrophy

Schizophrenics have Cortical/Cerebellar atrophy and Increased Ventricles

114
Q

CT scans with contrast enhances the visualization of

A

tumors, strokes, abscesses, and other infections

115
Q

HSA

MRI can distinguish structural brain abnormalities that may be associated with behavior changes and

A

Huntington’s, Strokes, Atherosclerosis

116
Q

Examples of Functional Imaging which show detail biochemical distributions are

A

PET, SPECT, fMRI, MRS

117
Q

On ____ imagining, Alzheimer’s disease show a decrease in bilateral temporoparietal perfusion on

A

SPECT

118
Q

Schizophrenic patients show less frontal activation and more left temporal activation

on word fluency tasks on this imaging tests _____ .

A

fMRI

119
Q

evaluate brain function and metabolism, lithium,

A
120
Q

In hyperthyroidism TSH down and

T3 is (80-230) and

serum antinuclear antibodies (w/o lupus or collagen)

A

elevated

121
Q

Graves disease iodine uptake is

A

High

122
Q

If subacute thyroiditis is the cause of hyperthyroidism there will be low uptake of

A

iodine (tx w/propranolol)

123
Q

TSH level in hypothyroidism is UP and

A

T4/Sodium/BG is low

124
Q

PrEP formulation recommended for all people

A

Emitricitabine/tenofovir/disoproxil fumarate (Truvada)

125
Q

Tanner Stages I-IV

Tanner Stages in Boys

A

II- Balls

III- Longer Penis

IV- Glan/Ruggae

126
Q

Tanner Stages I-IV

Tanner Girls

A

II- Buds

III- Bigger

IV- Nipple/Areola

127
Q

Tanner Stages I-IV

Tanner Pubic Hair

A

II- Sparse

III- Dark

IV- Volume (somewhat decreased)

128
Q

Thalamus is a

A

Relay Center

129
Q

Clubhouse is Patient ran and offers

A

Variety of Services

130
Q

Multisystemic Therapy is for the youth and offers

A

Home and school support and parent skills

131
Q

Fairweather Lodge Hospital Trains

A

Group home residents that become business partners

132
Q

The percentage of patients with SMI that don’t respond to medications

A

15%-30%

133
Q

People with BD may wait ___ years and Schizophrenics may wait ___ before seeking tx

A

10 and 2

134
Q

Rapid DC of Lithium increases suicidal ideations ___ fold

A

20-fold

135
Q

Key Human Sexuality Development Markers

A

6-9 homoplay

10-13 romantic interest

13-20 strong desire

136
Q

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

A

NCD

137
Q

Good enough mother allows

A

interpersonal safety and development of true self.

138
Q

Interpersonal Theory (Sullivan)

The Good, Bad, and Not Me which has

A

Intense Anxiety which leads to Denial/Dissociation

139
Q

Parent-Adult-Child

Transactional Analysis (Berne) focuses on the past and present

seek to balance

A

Super Ego and ID

140
Q

Gestalt (Perls) focuses on the Now and personal responsibilty to achieve mastery

Avoidance leads to

A

Growth disorders

141
Q

Person-Centered (Rogers) no techniques aside from the TA

Help person find their own

A

growth, meaning, and actualization

142
Q

Rational-Emotive (Ellis) must examine

A

beliefs that lead to behavior

143
Q

CBT (Beck) involve

A

Schemas

Primary & Secondary Thinking

Downward Arrow

Paradox/Exaggerations

144
Q

DBT (Linehan) 4 Stages

Main One is

A

Therapy interupting behaviors then DEARMAN

145
Q

DEARMAN

A

describe, express, assert, reinforce, mindfulness, appear confident, and negotiate.

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