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OMS III > Psych > Flashcards

Psych Flashcards

1
Q

Childhood Disorders

A

Intellectual Disability (formerly mental retardation)
Autism Spectrum Disorders
ADHD
Tourette Disorder

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2
Q

Intellectual Disability (formerly mental retardation)

Definition

A

In order to determine the level of intellectual disability, patients must exhibit deficits in both interllectual functioniong (cognitive abilities) as well as social adaptive functioning (the ability to do daily activites). the disorder is momre frequent in boys, with the highest incidence in school age children.

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3
Q

Mild mental retardation

IQ range:

Level of functioning:

A

IQ range: 50-55 to 70

Level of functioning: reaches sixth grade level of education, can work and live independently, needs help in difficult or stressful situations

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4
Q

Moderate mental retardation

IQ range:

Level of functioning:

A

IQ range: 30-4- to 50-55

Level of functioning: reaches second grade level of education, may work with supervision and support, neds help in mildly stressful situations

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5
Q

Severe mental retardation

IQ range:

Level of functioning:

A

IQ range: 20-25 to 35-40

Level of functioning: little or no speech, very limited abilities to manage self-care

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6
Q

Profound mental retardation

IQ range:

Level of functioning:

A

IQ range: below 20

Level of functioning: needs continuous care and supervision

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7
Q

Intellectual Disability (formerly mental retardation)

Treatment

A

Genetic counseling, prenatal care, and safe environements for exptectant mothers

if due to medical conditions, effective treatmeent for disorder

special education to improve level of functioning

behavioral therapy to help reduce negative behaviors

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8
Q

Autism Spectrum Disorders

definition

A

Autism Spectrum Disorders are characterized by problems in social interactions, and language wthat tend to occur in children yougner than age 3 and impari daily functioning. this diagnosis has replaced autism, Rett’s syndrome, and Asperger’s disorder

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9
Q

Autism Spectrum Disorders

symptoms

A

children with ongoing Autism Spectrum Disorders have ongoing deficits in social communicaitons and social interactionacross variousareas. the deficits include social connection, poor eye contact, and problems iwth language, relationships, and understanding others. other features include stereotyped or repetitive movements, inflexibility, and unusual interest in sensory aspects of the environment.

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10
Q

Autism Spectrum Disorders

treatment

A

the goal of the treatment is to improve the patient’s abitlity to develop relationships, attend school, and achieve independent living.patients with autism specturm diosrders may benefit from behabioral modification programs that seek to imporove language and ability to connect iwth others. if the patient is aggressive, use antipsychotic medications such as risperidone.

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11
Q

Autism Spectrum Disorders

facts

A

more common in boys

usually seen by 3 months of age

rule out deafness

language deficits, aggression, lack separation anxiety, are withdrawn

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12
Q

Attention Deficit Hyperactivity Disorder

Definition

A

a disorder characterized by inattention. short attention span, or hyperactivity that is severe enough to interfere with daily functioning in school, home, or work. the sx must be presetn fro more than 6 months and usually appear before the age of 7. the sx may persist into adulthood

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13
Q

Attention Deficit Hyperactivity Disorder

diagnosis

A

sx must be present in at least 2 areas, such as home and school. at home, children interrupt others, fidget in charis, and run or climb excessively; are unabel to engage in leusre activities; and talk excessibely. at school, they are unabelt o pay attn, make careless mistakes in schoolwork, do not follow through with instructions, have difficulties organizing tasks, and are easily distracted.

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14
Q

Attention Deficit Hyperactivity Disorder

1st line treatment

A

methylphenidate and dextroamphetamine. side effects include insomaina, decreased appetite, GI disturbances, increased anxiety, and headach. these drugs work well in reducing these sx of inattention and hyperactivity bc they affect the noradrenergic and dopaminergic pathways of attention

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15
Q

Attention Deficit Hyperactivity Disorder

2nd line treatment

A

atomoxetine, a ne reuptake inhibitor with fewer side effects and less risk of abuse. the alpha-2 agonists clonidine and guanfacine can also be used, because they enhance cognition and attention in the prefrontal cortex.

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16
Q

Oppositional defiant disorder

Epidemiology

A

usually noted by age 8; seen more in boys than girls before puberty, but equal incidence after puberty

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17
Q

Oppositional defiant disorder

Features

A

often argue with others, lose temper, easily annoyed by others, and blame others for their mistakes. tend to have problems with authority figures and justify theri bhabior as response to others’ actions. these behabiors manifest with others that do not include siblings

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18
Q

Oppositional defiant disorder

Treatment

A

teach parents appropriate child managmeent skills and how to lessen the oppositional behavior

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19
Q

Conduct disorder

Epidemiology

A

seen more frequently in boys and in children whose parents ahve antisocial pernoality disorder and alcohol dependence. dx is given only to those under the age 0f 18 years

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20
Q

Conduct disorder

Features

A

persistent behabior where rules are broken. these inlcude aggression to tohers such as bullying, cruelty to animals, fighting, or using weapons. destory property such as vandalism or setting fires. steal items from others or lie to obtain goods from others. violate rules(turancy, runnign away from home, breaking curfew)

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21
Q

Conduct disorder

Treatment

A

behaviroal intervention using rewards fro prosocial and nonaggressive behavior. if aggressive, antipsychotic meds may be used

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22
Q

Disruptive mood dysregulation (DMDD)

Epidemiology

A

seen more frequently in boys age 6-10 years. should not be diagnosed before the age of 6 or after the age of 18. children with DMDD usually do not develop bipolars disorder int adulthood; they are more likely to develop depression anxiety.

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23
Q

Disruptive mood dysregulation (DMDD)

Features

A

chronic, severe, persistent irritability with temper outbursts and agnry, irritable, or sad mood betweent he outbursts.these occur almost every day, are noticable by others, and are out of proprtion to the situations. the outbursts are inconsistent with developmetnal issues. Sx occur year-round; there is no period lasting 3 months or more w/o all sx.the sx are severe neough to intergere with home, school, or peers

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24
Q

Disruptive mood dysregulation (DMDD)

Treatment

A

treatment is individualized tot he needs of the pariculare childs and his/her family it may include individual therapy as well as work with the child’s family and/or school. it may also include the use of medications to address specific sx

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25
Q

Difference between oppositional defiance disorder and conduct disorder

A

in odd kids do not brak rules of society and do not commit crimes

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26
Q

disruptive mood dysregulation disorder overview

A

children with intermittent explosive diosrder arenot aggressive on such a conitnuous basis

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27
Q

Tourette Disorder

definition

A

characterized by the oset of mutiple tics, lasting more than 1 year, and is seen before the age of 18, more commonly seen in boys and will begin by the age of 7

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28
Q

Tourette Disorder

motor tics

A

most commonly involve the muscles of the face and neck:

head shaking and blinking

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29
Q

Tourette Disorder

vocal tics

A

grunting, coughing, and thraot clearing

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30
Q

Tourette Disorder

treatment

A

dopamin antagonists, such as the antipsychotic agents like haloperidol, pimozide, and risperidone.

can also use clonidine, an alpha 2 agonist

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31
Q

Mood disorders

A

MDD

bipolar disorder

persistent depressive disorder (dysthymia)

cyclothymic disorder

mdd with atypical features

mdd with seasonal pattern

bereavement

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32
Q

Major Deppressive Disorder

definition

A

mood disorders peresent with at least a 2 week course of sx that is a change fromt he perivous level of unctioning. the sx included derpressed mood or anhedionia (absence of pleasure) and 4 others including depressed mood most of the day, weight canges, sleep changes, psychomotor disturbances, fatigue, poor concentrations, and thoughts of death and worthlessness

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33
Q

Major Deppressive Disorder

diagnosis

A

rule out any medical causes, the nost common of which is hypothyroidism. the mos tcommon neurological assocaitons are Parkinsons diease and neurocognitive disorders

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34
Q

Major Deppressive Disorder

first - line treatment

A

SSRI such as fluoxetine, paroxetine, sertrlaine, citolopram, or escitalopram. ssris are chosen due their effectiveness and relatively mild side effects, and because they are less toxic in overdoes than other antidepressants

if no effect after 4 weeks, withch to other SSRI

if some improvement is noted, but not ful response, increase the dose of the SSRI

although TCA’s can be sued, their lethal potential militates against routin use

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35
Q

Major Deppressive Disorder

second-line treamtent

A

SNRIs such as venlafaxine, duloxetine, or desvenlafaxine. side effects include htn and sweating

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36
Q

Major Deppressive Disorder

psychotherapy

A

such as cognitive therapy has been proven to be effective. the goal of cognitive therapy is to reduce derpession by teaching patients to identify negative congitions and develop positive ways of thinking

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37
Q

ssri’s should not be taken with

A

mao inhibitors bc they dacuse a dramatic increase in serotonin

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38
Q

pt with depression and neuropathic pain

A

use duloxetine, since it is approved for both depression and neuropathy

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39
Q

pt with depression who is fearful of wieght gain or sexual side effects or is a smoker tyring to quit

A

use bupropion, since it has fewer sexual side effects and less wieght fain than SSRIs. may also be used as adjunct or replacement treatment for SSRI-induced sexual side effects. bupropion has been approved for smoking cessation

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40
Q

Mirtazapine

A

antidepressant and sedative effects

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41
Q

Bipolar Disorder

Definition

A

a mood siroder whre the pt experiences manic sx that alst at least one week that cause significant disress int he elvel of fucntioning. usually starts with depression and increased energy despite lack of sleep

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42
Q

Bipolar Disorder

manic sx

A

elevated mood, increased self-esteem, distracitbility, pressured speech, decreased need for sleep, an increase in goal-directed activity, racing thoughts, and excessive involvement in pleasurable activities

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43
Q

Bipolar Disorder

diagnosis

A

make sure the condition is not secondary to drug use, such as cocaine or amphetamine use. obtain a good hx and urine drug screen

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44
Q

Mania vs hypomania

A

mania - last more than 1 week, affect functioning and are severe enough to warrant hospitalization

hypomania - last less than one week, do not severely affect functioning, and are not severe enough to warrant hospitalization

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45
Q

Bipolar Disorder type I

A

mania and depression

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46
Q

Bipolar Disorder

type II

A

hypomania and depression

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47
Q

Bipolar Disorder occurs more frequently in

A

young individuals

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48
Q

Bipolar Disorder

treatment for acute mania

A

use lithium, valpric acis, and atypical antipsychotics as first line treatments

if severe sx use atypical antipsychotics due to shorter onset of action

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49
Q

Bipolar Disorder

treatment for bipolar depression

A

use lithium, quetiapine, lurasidone, or lamotrigine. lurasidone is approved for bipolar depression and is the only medication in pregnancy category B indicated for the disorder

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50
Q

when do you not use lithium

A

if kidneys are compromised

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51
Q

lithium is the correct answer to

A

most Bipolar Disorder questions

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52
Q

Bipolar Disorder pt who is on lithium is combative and aggressive

A

put on antipsychotic, no reason to get lithium level if they are physcially aggressive

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53
Q

Persistent Depressive Disorder (formely dysthymia)

A

characterized by the presence of depressed mood that lasts most of the day and is preseent almost continously. sx must be preset formore than 2 years (1 year in children or adolescents).

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54
Q

Persistent Depressive Disorder (formely dysthymia)

treatment

A

antidepressant medications and psychotherapy

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55
Q

cyclothymic disorder

A

characterized by the presence of hypomanic episodes and mild depression. sx must be present for more than 2 years

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56
Q

cyclothymic disorder

treatment

A

lithium, valproic acid or anitpsychotic medications, and psychotherapy

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57
Q

Major Depressive Disorder with Atypical Features

A

charactierzed by reverse vegetative changes such as incrase sleep, increased wieght, and increased appetite, and interpersonal rejection snesitivity that results in significant social or occupational impairment. the paitest mood tends to be worse in the evcening. pts may complain of extermities feeling heavy

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58
Q

Major Depressive Disorder with Atypical Features

treatment

A

ssris (fluoxetine, sertlraine, paroxetine, citalopram, escitalopram) or MAOIs (phenelzine, isocarboxazid, or tranylcypromine).

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59
Q

Major Depressive Disorder with Atypical Features

usually the right answer

A

maois

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60
Q

Major depressive disorder with seasonal pattern (formerly seasonal affective disorder)

A

Cahracterized by seasonal hanges in mood during fall and winter. sx include wieght fain, increased sleep, and lethargy.

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61
Q

Major depressive disorder with seasonal pattern (formerly seasonal affective disorder)

treatment

A

phototherapy and bupropion or ssris

in phototherapy pts should be 12-18 inches from a source of 10000lux of white fluorescet light w/o uv wavelngtsh for 30 minutes each morning, eyes should be open but not necessary to look at the light

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62
Q

Postpartum blues or “baby blues”

onset

A

immediately after birth up to 2 weeks

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63
Q

Postpartum blues or “baby blues”

sx

A

sadness, mood lability tearfulness

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64
Q

Postpartum blues or “baby blues”

mothers feelings towards baby

A

no negative feelings

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65
Q

Postpartum blues or “baby blues”

treatment

A

supportive, usually self-limited

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66
Q

Depressive disorder with peripartum onset

onset

A

wihtin 1-3 months after virth

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67
Q

Depressive disorder with peripartum onset

sx

A

depressed mood, weight changes, sleep disturbances, and excessive anxiety

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68
Q

Depressive disorder with peripartum onset

mothers feelings towards baby

A

may have negative feelings toward baby

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69
Q

Depressive disorder with peripartum onset

treatment

A

antidepressant medications

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70
Q

Bipolar disorder with peripartum onset

brieft psychotic disorder with peripartum onset

onset

A

during regnancy up to 4 weeks after birth

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71
Q

Bipolar disorder with peripartum onset

brieft psychotic disorder with peripartum onset

sx

A

depression, mania, hallucinations, delusions, and htoughts of harm

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72
Q

Bipolar disorder with peripartum onset

brieft psychotic disorder with peripartum onset

mothers feelings towards baby

A

may have thoughts of harming baby

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73
Q

Bipolar disorder with peripartum onset

brieft psychotic disorder with peripartum onset

treatment

A

antipsychotic medications, lithium, and possibbley antidpressants

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74
Q

Bereavement (grief)

A

normal bereavement usually begins after the death of a loved one and includes feelings of sadness, worryign about the deceased, irritability, sleep difficulties, poor concentrations, and tearfulness.

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75
Q

Bereavement (grief)

timeframe

A

typically lasts less than 6 months to 1 year but can go longer

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76
Q

Bereavement (grief)

treatment

A

supportive psychotherapy

pharmacotherapy is the wrong answer

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77
Q

Diagnosis of major epresion (greater severity than bereavement)

A

htoughts of death

morbid preoccupation with worthlessness

marked psychomotor retardation

psychosis

prolonged functional impairment

sx last longer than 2 weeks and adverstly affect funtioning

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78
Q

Trycyclic antidepressants

A

amitriptyline, nortriptyline, imipramine

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79
Q

Trycyclic antidepressants

ae

A

hypo/hypertenstion, dry mouth, constipation, confusion, arrhythmias, sexual side effects, wieght gain, gi distrubances

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80
Q

Monamine oxidase inhibitors

A

phenelzine, isocarboxazid, tranylcypromine

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81
Q

Monamine oxidase inhibitors

ae

A

monitor diet, givent aht food righ in tryamine will produce htn. safe foods include white wine and processed chees. unsafe foods include red wine, aged cheese, and chocolate

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82
Q

SSRI

A

fluoxetine, paroxetine, sertraline, citalopram, citalopram, escitalopram, fluvoxamine

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83
Q

SSRI

ae

A

ha, weight changes, sexual side effects, GI distrubances

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84
Q

SNRI

A

venlafaxine, duloxetine, desenlafaxine

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85
Q

SNRI

ae

A

htn, blurry vision, weight changes, sexual side effects, GI disturbances

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86
Q

Buproprion ae

A

increased risk for seizures

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87
Q

trazodone ae

A

priapism

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88
Q

mirtazapine ae

A

weight gain and sedation

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89
Q

Lithium

ae

A

tremors, weight gain, gi distrubance, nephrotoxic, teratogenic, leukocytosis, diabetes insipidus

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90
Q

lithium

severe toxicity

A

confusion, ataxia, lethargy, and abrnomral reflexes

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91
Q

Valproic Acid ae

A

tremors, weight gain, gi distrubances, alopecia, teratogenic, hepatotoxic. must monitor levels; toxicity causes hypnatremia, coma, or death

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92
Q

Lamotrigine ae

A

stevens-johnson syndrome

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93
Q

electricoconvulsive therapy

A

ha, transient memory loss

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94
Q

what is the single most effective treatment for depression

A

ECT, usually used for refractory pts, all others are equal in effectiveness but ssris have best side effect profile

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95
Q

Serotonin Syndrome

definition

A

a potentially life-threatening disorder occurring as a result of therapeutic drugs use of SSRIs. often with inadvetent interagions between drugs, od, or recreational use of drugs that are serotonergic in origin

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96
Q

Serotonin Syndrome

common sx

A

cognitive effects: agitation confusion hallucinations hypomania

autonomic effects: sweating, hyperthermia, tachycardia, nausea, diarrhea, shivering

somatic effects: termors, myoclonus

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97
Q

Serotonin Syndrome

treatment

A

stop ssri med

sx treatement of fever diarreha htn

cyproheptadine (serotonin antagonist)

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98
Q

Brief Psychotic Disorder

duration of sx

A

more than 1 day but less than 1 month

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99
Q

Brief Psychotic Disorder

sx

A

delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior

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100
Q

Brief Psychotic Disorder

treatment

A

antipsychotic medication

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101
Q

Schizophreniform disorders

duration of sx

A

more than 1 month but less than 6 months

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102
Q

Schizophreniform disorders

sx

A

delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative sx (flat affext, poor grooming, social withdrawal)

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103
Q

Schizophreniform disorders

treatment

A

antipsychotic medications

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104
Q

Schizophrenia

duration of sx

A

more than 6 months

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105
Q

Schizophrenia

sx

A

delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative sx (flat affext, poor grooming, social withdrawal). severly affects level of functioning.

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106
Q

Schizophrenia

treatment

A

antipsychotic medications

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107
Q

Scizophrenia

definition

A

a thought disorder that imparis judgment, behavior, and the ability to interpret reality. the sc must be present for at least 6 months and itmust affext functioning. there is an equal incidency in men and women but it affexte mean earlier due the earlier age of onset. urine drug screen is improtatnt in order to rule out occaine or amphetamine use

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108
Q

Scizophrenia

treatment for acutely psychotic

A

hospitalize

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109
Q

Scizophrenia

first line treament

A

ensure pt safter and use an atypical antipsychotic:

risperidone
olanzapine
quetipaine
ziprasidone
aripiprazole
paliperidone
iloperidone
lurasidone
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110
Q

Scizophrenia

emergency situations

A

if im medications is needed, consider shorta citing meds like:

olanzapine
ziprazidone

haldol is still used but it has more side effects so pick atypical first if given the choice

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111
Q

Scizophrenia

treatment for noncompliant patients

A

consider a long actine antipsychotic med like risperidone or paliperidone as first line treatment

hadol and fluphenazine are sitll used by have more side effects

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112
Q

Scizophrenia

clozapine

A

is used only when pts do not respond to an adequate trial of typical or atypical antipsychotics; never used as a first-line treatment.

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113
Q

need to know

A

side effect profiles of atypical antipsychotics.

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114
Q

Clozapine ae

A

Greater incidence of diabetes and wieght gain; avoid in diabetic and obese patients

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115
Q

Risperidone ae

A

greater incidence of movement disorders

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116
Q

Quetiapine ae

A

lower indicdence of movement diosrders; appropriate for use in pats with existing movement disorders

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117
Q

Ziprasidone ae

A

increased risk of prolongation of QT interval; avoid in pts with conduction defects

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118
Q

Clozapine ae

A

high risk of agranulocytosis; need to monitor cbc on regular basis; never used as first-line tratment given side-effect profile

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119
Q

Aripiprazole ae

A

partial dopamin agonist, approved as adjunct tratment for major depressive disored

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120
Q

Lurasidone ae

A

the only antipsychotic in pregnancy catefor B; safer for use in pregnant patients

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121
Q

Atypical antidepressant side effects

-pines

A

olanzapine, quetiapine, asenapine, clozapine

increased risk of weigh tgain, metabolic syndrome, diabetes

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122
Q

Atypical antidepressant side effects

-dones

A

risperidone, lurasidone, ziprasidone, iloperidone

increased risk of movement disorders, cardiac conduction problems

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123
Q

Meds least likely to cause weight gain and metabolic syndrome

A

abilify and ziprasidone

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124
Q

Acute Dystonia

onset of sx

A

hours to days

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125
Q

Acute Dystonia

sx

A

muscle spasms, such as torticollis, laryngeal spasms, occulogyric crisis

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126
Q

Acute Dystonia

treatment

A

benztropine, trihexyphenidyl, diphenhydramine

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127
Q

Akathisia

onset of sx

A

weeks

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128
Q

Akathisia

sx

A

generalized restlessness, pacing, rocking, inability to relax

129
Q

Akathisia

treatment

A

reduce does, bblockers, switch to atypical med, benzo

130
Q

Tardive Dyskinesia

onset of sx

A

rare before 6 months

131
Q

Tardive Dyskinesia

sx

A

abnormal involuntary movements of head, limb, and trunk. perioral movements are the most common

132
Q

Tardive Dyskinesia

treatment

A

switch to atypical antipsyhcotic. clozapine has the least risk

133
Q

Neuroleptic Malignant Syndrome

onset of sx

A

not time limited

134
Q

Neuroleptic Malignant Syndrome

sx

A

muscular rigidity, fever, autonomic changes, agitation, and obtundation

135
Q

Neuroleptic Malignant Syndrome

treatment

A

dantrolene or bromocriptine

136
Q

Delusional Disorder

definition

A

charactierized by the prominence of non-bizarre delusions for more than one month and no impariment in level of ucntioning (eg the pt may believe the country is about to be invaded, but he or shee sitll oeys the law, goes to work, and pays bills) Hallucinations, if present, are not prominent and are related to the delusional theme

137
Q

delusional disorder

treatment

A

aytpical antipsychotic agents as first-line therapy

consider psychotherapy to help romote reality testing

138
Q

Anxiety Disorders

A

panic disorder

phobias

139
Q

Panic Disorder defintion

A

the experience of intense anxiety along with feelings of dread and doom. this is accompanied by at least 4 sx. these sensations typically last less than 30 minutes and may be accompanied by agoraphobia

140
Q

agoraphobia

A

defined as the fear of places where escape is felt to be difficult

141
Q

Panic Disorder

sx

A

need at least 4 of the following autonomic hyperactivity sx:

diaphoresis, trembling, chest pain, fear of dying, chills, palpitations, sob, nausea, dizziness, dissociative sx and paresthesias.

142
Q

Panic Disorder typical case

A

women, can occur at any time, and usually has no specific stressor

143
Q

Panic Disorder

rule out

A

thyroid dz, hypoglycemia, and cardiac disease

144
Q

Panic disorder

treatment

A

ssris (typically fluoxetine, paroxetine, and sertraline) are indicated for this disorder

along with ssris pats may benefit from benzos (such as alparzolam, clonazepam, or lorazepam) begin with botht hen taper and dc the benzo givent he potential for abuse

behavioral and individual therapy are also helpful in conjction with med (not as sole treatment)

145
Q

first-line treatment for panic disorder

A

ssris

146
Q

fisr-line treatment for panic attack

A

benzos

147
Q

presenting with autonomic hyperactivity

A

panic attack

148
Q

telling the dr a story about panic attacks

A

panic disorder

149
Q

Phobias

definition

A

a phobia is the fear of an object or situation and the need to aboid it.

specific or social

150
Q

specific phobia

A

fear of an object such as animals heights or cars

151
Q

social phobia

A

fear of a situation, such as public restrooms, eating in public, or public speaking. these involve sitatuations where something potentially embarrassing may happen

152
Q

Phobias

diagnosis

A

usually can be made by obtaining a goo dhx where pts indicate anxiety sx in specific siutations or when in contact with feared objects

153
Q

Phobias

treatment

A

behavioral modification tehniques such as systematic desensitization, inwhich the pt while relaxed is exposed, often only in miagniation, to progressively more frightening aspects of the feared objects

pts are also tauht rleaxation techniques such as breathign or guided imagery

154
Q

when are bblockers like propanolol and tenolol used for phobias

A

only for performance anxiety such as stage fright. they are given 30-60 minutes beofre the performance

155
Q

Obsessive Compulsive Disorder

definition

A

a disroder where pts typically experience either obsessions alone or, most commonly, a combination of obsession and compultsion typically affect the individuals level of functioning

156
Q

obsession

A

thoughts taht are intrusive, senseless, and distressing to the pt, thus increasing anxiety. these includ efear of contamination

157
Q

compulsions

A

rituals, such as counting and chekcing, that are performed to neutralize obsessie thorughts. these are time consuming and tend to lower anxiety

158
Q

Obsessive Compulsive Disorder

diagnosis

A

seen more frequentlyu in young pts. there is an equal incidence in men and womn, ocd can coexist with tourette disorder

159
Q

Obsessive Compulsive Disorder

treatment

A

ssris are the treatment of choice. fluoxetine, paroxetine, sertrlaine, citalopra, or fluvoxamine ar emost commonly used as first-line agents

the main behavioral therapy used is exposure and response prevention

160
Q

Obsessive Compulsive Disorder

tcas

A

if no ssirs and just tcas choose clomipramine

161
Q

Hoarding Disorder

A

individuals with hoarding disorder have problems discarding their posessions such taht the home is overwhelmed by cluetter. the horading affets the indivviduals’s level of functioning and imparis his/her abitlity to maintain a safe environment

162
Q

Hoarding Disorder

traetment

A

ssris ar the treatment of choice

pts benefit from behavvioral modification techniques or psychotherapy (such as cognitive behavioral therapy)

163
Q

Body dysmorphic disorder

A

Individuals with body dysmorphic disorder believe that some body part is abnormal, defective, or misshapen, although others do not see these perceived defects. These beliefs significantly impair in the patient’s level of functioning. paitents spend excessive time checking the mirror and seeking reassurance.

164
Q

Body dysmorphic disorder

treatment

A

SSRIs combined with individual psychotherapy are the treatment of choice

165
Q

Posttraumatic Stress Disorder and Acute Stress Disorder

Definition

A

In both postraumatic stress disorder and acute stress disorder, individuals have been exposed to a stressor to which they react with fear and helplessness.

Patients continually relive the event and avoid anything that remids them of the event . these stressors are usually overwhelming and involve such events as war, rape, hurricanes, or earthquakes.

166
Q

Posttraumatic Stress Disorder and Acute Stress Disorder

Sx

A

adversely affect the patients level of ucntioning

startle response, hypervigilance, sleep disturbances, anger outbursts, and concentration difficulties.

167
Q

Posttraumatic stress disorder vs acute stress disorder

posttraumatic stress disorder

A

sx last for more than 1 month

168
Q

Posttraumatic stress disorder vs acute stress disorder

acute stress disorder

A

sx last for more than 2 days and a maximum of 1 month. They occur within 1 month of the traumatic event

169
Q

Posttraumatic Stress Disorder and Acute Stress Disorder

diagnosis

A

the main feature in correctly identifying the diagnosis is determining the time period when the traumatic events occurred in relationship to the sx. depression and substance abuse must be ruled out, bc both worsen the dx

170
Q

Posttraumatic Stress Disorder and Acute Stress Disorder

first-line treatment

A

paroxetine and sertraline. prazosin is used to reduce the incidence of nightmares

relaxation techniques and hypnosis have been proven to be helpful in these patients

psychotherapy after traumatic events will allow for the development of coping techniques and acceptance of the event

171
Q

Generalized Anxiety Disorder

definition

A

this is a disorder in which patietns experience excessive anxiety and worry about most things, lasting more than 6 months. typically, the anxiety is out of proportion to the event.

patients are usually women and complain of feeling anxious as long as they can remember

172
Q

Generalized Anxiety Disorder

sx

A

anxiety is out of proprtion to the event

fatigue

concentration difficulties

sleep problems

muscle tension

restlessness

173
Q

Generalized Anxiety Disorder

treatment

A

SSRIs such as fluoxetine, paroxetin, sertraline, or citalopram are inidicated in this disorder

Venlafaxine and buspirone are also effective

psychotherapy and behavioral therapy are beneficialas well, but are not considered first-line agents.

174
Q

Main feature of generalized anxiety disorder

A

chronic worrying about things taht do not merit concern

accompanied by otehr sx of anxiety as well as sleep and concetration problmes

175
Q

Antianxiety medication

A

benzos (diazepam, lorazepam, clonazepam, alprazolam, oxazepam, chlordiazepoxide, temazepam, flurazepam)

buspirone

176
Q

Antianxiety medication

benzos ae

A

sedation, confusion, memory deficity, respiratory depression, and increased addiction potential

177
Q

Antianxiety medication

buspirone ae

A

headaches, nausea, dizziness

178
Q

Lorazepam

Indications

A

used frequently in emergency situationsbc it can be given im

179
Q

Clonazepam

Indications

A

may be used if addiction is a concern given its longer half-life

180
Q

Chlordiazepoxide, oxazepam, lorazepam

Indications

A

used frequently in treatment of alcohol withdrawal.

181
Q

Benzos of choice for patients with liver problems

A

lorazepam and oxazepam

182
Q

Alprazolam

Indications

A

used frequently in panic attaxk and panic disorder

183
Q

Flumazepam, temazepam, triazolam

Indications

A

used as hypnotics (rarely used)

184
Q

Flumazenil

A

benzodiazepine antagonist

used when the overdose is acute and you are certain that ehre is no chronic dependance

185
Q

Why not give flumazenil to benzo dependant patients

A

it can cause seizures from acute withdrawal which can be tremor or seizures similar to delirium tremens (alcohol withdrawal)

186
Q

Intoxication

A

Reversible experience with a substance that leads to either psychological or pysiological changes

187
Q

Withdrawal

A

Cessation or reduction of a substance leading to either psychological or physicological changes

188
Q

Use

A

Maladaptive pattern of use of substances that leads to engaging in hazardous situations, legal problems, inability to fulfill obligations, and continued use despite adverse consequences and cravings

189
Q

Alcohol

Signs and sx of intoxication

A

Talkative, sullen, gregarious, moody, disinhibited

190
Q

Alcohol

Treatment of intoxication

A

mechanical ventilation if severe

191
Q

Alcohol

Signs and sx of withdrawal

A

tremors, hallucinations, seizures, delirium tremens

192
Q

Alcohol

Treament of withdrawal

A

benzos, thiamine, multivitamins, folic acid

193
Q

Amphetamines and cocaine (synthetic forms: bath salts)

Signs and sx of intoxication

A

euphoria, hypervigiliance, autonomic hyperactivity, weight loss, pupillary dilatation, perceptual disturbances

194
Q

Amphetamines and cocaine (synthetic forms: bath salts)

Treatment of intoxication

A

antipsychotics and/or benzos and/or antihypertensives

195
Q

Amphetamines and cocaine (synthetic forms: bath salts)

Signs and sx of withdrawal

A

anxiety, tremulousness, headache, increased appetite, depression, risk of suicide

196
Q

Amphetamines and cocaine (synthetic forms: bath salts)

Treament of withdrawal

A

bupropion and/or bromocriptine

197
Q

Cannabis (synthetic forms: K2 and spice)

Signs and sx of intoxication

A

impaired motor coordination, slowed sense of time, social withdrawal, increased appetite, conjunctival injection

198
Q

Cannabis (synthetic forms: K2 and spice)

Treatment of intoxication

A

consider use of antipsychotoics if pt is psychotic

199
Q

Cannabis (synthetic forms: K2 and spice)

Signs and sx of withdrawal

A

irritability, anger, anxiety, sleep problems, restlessness, appetite problems

200
Q

Cannabis (synthetic forms: K2 and spice)

Treament of withdrawal

A

sypmtomatic

201
Q

Hallucinogens

Signs and sx of intoxication

A

ideas of reference, perceptual disturances, possible increase in psychosis, impaired judment, tremors, incoordination, dissociative sx

202
Q

Hallucinogens

Treatment of intoxication

A

antipsychotics and/or benzos and/or talking down

203
Q

Hallucinogens

Signs and sx of withdrawal

A

none

204
Q

Hallucinogens

Treament of withdrawal

A

none

205
Q

Inhalants

Signs and sx of intoxication

A

belligerence, apathy, aggression, impaired judgment, stupor, or coma

206
Q

Inhalants

Treatment of intoxication

A

antipsychotics

207
Q

Inhalants

Signs and sx of withdrawal

A

none

208
Q

Inhalants

Treament of withdrawal

A

none

209
Q

Opiates (synthetic forms: desomorphin aka krokodil)

Signs and sx of intoxication

A

apathy, dysphoria, pupillary constriction, drowsiness, slurred speech, coma, or death

210
Q

Opiates (synthetic forms: desomorphin aka krokodil)

Treatment of intoxication

A

naloxone

211
Q

Opiates (synthetic forms: desomorphin aka krokodil)

Signs and sx of withdrawal

A

fever, chills, lacrimation, abdominal cramps, muscle spasms, diarrhea

212
Q

Opiates (synthetic forms: desomorphin aka krokodil)

Treament of withdrawal

A

clonidine, mehtadone, or buprenorphine

213
Q

Phencyclidine (PCP)

Signs and sx of intoxication

A

belligerence, psychomotor agitation, violence, nystagmus, htn, seizures

214
Q

Phencyclidine (PCP)

Treatment of intoxication

A

antipsychotics, and/or benzos and/or talking down

215
Q

Phencyclidine (PCP)

Signs and sx of withdrawal

A

none

216
Q

Phencyclidine (PCP)

Treament of withdrawal

A

none

217
Q

Anabolic Steroids

Signs and sx of intoxication

A

Irritability, aggression, mania, psychosis

218
Q

Anabolic Steroids

Treatment of intoxication

A

antipsychotics

219
Q

Anabolic Steroids

Signs and sx of withdrawal

A

depression, headaches, anxiety, increased concern over body’s physical state

220
Q

Anabolic Steroids

Treament of withdrawal

A

SSRI

221
Q

Positive CAGE test

A

two positive responses of the 4 questions

222
Q

What is the CAGE test used for

A

to determine if someone is an alcoholic

223
Q

CAGE test questions

A

C: have you ever tried to cut down on your drinking

A: have you ever gotten annoyed by others who have criticized your drinking

G: have you ever felt guilty about your drinking?

E:Have you ever use dalcohol as an eye-opener

224
Q

Detoxification:

A

usually 5 to 10 days, mostly in hospital settings to assure safe detoxification

225
Q

Rehabilitation:

A

usually 28 days or more, with a focus on relapse prevention technique

226
Q

Pharmacologic treatments for substance abuse

A

disulfram (acetaldehyde dehydrogenase inhibitor), naltrexone (opiod receptor antagonist) and acamprosate

227
Q

most withdrawal questions

A

are asked in a hospital setting the next day after admission

228
Q

Somatic Symptom Disorder (formerly somatoform disorders)

definition

A

somatic sx disorder is characterized by the presence of one or more somatic symptoms that are distressinga nd cause impairment in functioning.

229
Q

Somatic Symptom Disorder (formerly somatoform disorders)

Sx

A

excessive thoughts, feelings, or behaviors related to the somatic sx that are manifested by disproportionate and persistent thoughts about the seriousness of the sx, intense ancisty about the sxm and excessive time devoted to the sx or helath concerns.

230
Q

Somatic Symptom Disorder (formerly somatoform disorders)

diagnosis

A

a pt must be symptomatic for more than 6 motnhs to be diagnosed with somatic sx disorder. the disorder is mostly seen in young women and usually has some psychological component of which the pt iw unaware.

231
Q

Somatic Symptom Disorder (formerly somatoform disorders)

treatment

A

psychotherapy is the treatment of choic given the psychological source of the sx

232
Q

Illness anxiety disorder (formerly hypochondiasis)

A

patients believe that htey have some specific disease despite constant reassurance

233
Q

Conversion

A

Typically affects voluntary motor or sensory functions that are indicative of a medical condition but are usually caused by psychological factors. Can be associated with “la belle indifference” where the pt is unconcerned about his or her impairment

234
Q

Factitious Disorder

definition

A

an individual faces an illness in order to get attention and emotional support in the pt role. This can be either a psychological or physical illness.

235
Q

Factitious Disorder

Psychological Sx

A

hallucinations, delusions, depression, and bizarre behavior

236
Q

Factitious Disorder

Physical sx

A

abdominal pain, depression, fever, nausea, vomiting, or hematomas. at ties these individuals may inflict life theatening injuies on themselves in order to get attn

237
Q

Factitious Disorder

imposed on others

A

when a caregive fakes signs and sx on another person (usually a child) in order to assume the sick role.

238
Q

Factitious Disorder

diagnosis

A

typically, patients with this disorder are women who may have a hx of being employed in healthcare.men more often have physical sx. the pts ultimate goal is to gain admissio to the hospita. you must always exclude any medical disorder with similar sx.

239
Q

Factitious Disorder cannot be diagnosed without first

A

confirming that a legitimate medical illness is not present

240
Q

Factitious Disorder

treatment

A

no specific theapry has been proven to be effective in these patients. when a child is involved in Factitious Disorder imposed on others, child protective services should be contacted to ensure the child’s safety

241
Q

Malingering

definition

A

characterized by the conscious production of signs and symptoms for an obvious gain, such as avoiding work, evading criminal prosecution, or achieving financial gain

242
Q

Malingering is not

A

a mental illness

243
Q

Malingering

diagnosis

A

seen more frequently in prisoners and military personnel. it is typically diagnosed when there is a discrepancy betweent he pts complaints and actual physical or laboratory findings. if medical evaluation reveals malingering, then confront the pt with the outcome

244
Q

A lack of cooperation from patients is characteristic of

A

Malingering

245
Q

Adjustment Disorder

definition

A

characterized by a maladaptive reaction to an identifiable stressor, such as loos of job, divorce, or failure in school.

246
Q

Adjustment Disorder

sx

A

usually occur within 3 months of the stressor and must remit within 6 months of removal of the stressor.

the sx include anxiety, depression, or disturbances of conduct.

they are severe enough to cause impairment in functioning

247
Q

Adjustment Disorder

treatment

A

psycotherapy is the treatment of choice. both individual and group therapy have been used effectively

248
Q

Personality disorders

A

a group of disorders that are characterized by personality patterns that inflexible and maladaptive

249
Q

Paranoid

A

suspicious, mistrusful, secretive, isolated, and questioning of the loyalty of family and friends

250
Q

Schizoid

A

choice of solitary activities, lack of close friends, emotional coldness, no desire for enjoyment or close relationships

251
Q

Schizotypal

A

Ideas of refernce, magical thinking, odd thinking, exxentric behavior, increased social anxiety, brief psychotic episodes

252
Q

Histrionic

A

must be the center of attention, inappropriate sexual behavior, self-dramatization, use phyuscial appearance to draw attention to self

253
Q

Antisocial

A

Failure to conform to social rules, deceitful, lack of remorse, impulsive, aggressive towards others, irresponsible, must be over the age of 18

254
Q

Borderline

A

unstable relationshiops, impulsive, recurrent suicidal behaviors, chronic feelings of emptiness, inappropriate anger, dissociative sx when severely stressed, brief psychotic episodes

255
Q

Narcissistic

A

Grandiose sense of self, belief that they are special, lack of emmpathy, sense of entitlement, require excessive admiration

256
Q

Avoidant

A

Unwilling to get involved with people, views self as socially inept, reluctant to take risks, feelings of inadequacy

257
Q

Dependant

A

Difficulty making day to day decisions, unable to assume responsibility, unable to express disagreement, fear of being alone, seeks relationship as source of care

258
Q

Obsessive compulsive

A

preoccupied with details, rigid, orderly, perfectionist, excessively devoted to work, inflexible

259
Q

Adjustment Disorder

treatment

A

individual psychotherapy

medications if mood or anxiety sx are present

260
Q

What personality diosreders have been associated with positive psychotic sx

A

borderline and schizotypal personality disorders

261
Q

Anorexia Nervosa

Definition

A

Characterized by the failure to maintaine a normal body wieght, fear of and preoccupation with gaining weight and body image disturbance. there is an unrealistic self-evaluation as overweight. these pts tend to deny their

262
Q

Anorexia Nervosa

sx

A

these pts tend to deny their emaciated conditions. they show great concern with appearance and frequently examine and weight themselves. they typically lose wiegh tby maintaining strict caloric control, excessive exercise, purging, and fasting, with laxative and diuretic abuse

263
Q

Anorexia Nervosa

Diagnosis

A

anorexia is seen more frequently in teenage girls between ages of 14 and 18. there is evidence of severe weight loss. hypotension, bradycardia, lanugo hair and edema may be present. EKG changes such as rhythym disorders occur as a result of potassium deficiency, Arrhythmia is the most common cause of death.

264
Q

Anorexia Nervosa

treatment

A

Hospitalization to prevent dehydration, starvation, electrolyte imbalances, and death

psychotherapy

behavioral therapy

ssris have been used to promote wieght gain

265
Q

Bulimia Nervosa

definition

A

Characetized by frequent binge eating, as evidenced by eating large amoutns of ood in a discrete amount of time, as well as a loack of control of overeating episodes. This is accompanied by a compensatory behavior to prevent weight gain in the form of purging,, misuse of laxatives and diuretics, fasting, and excessive exercise. the patients self-evaluation is unduly influenced by body shape and weight

266
Q

Bulimia Nervosa

diagnosis

A

bulimia is seen more frequently in woemn and occurs later in adolescence than anorexia nervosa. most of these women are of normal weight but do have a history of obesity

267
Q

Bulimia Nervosa

treatment

A

does not require hospitalization unless severe electrolyte abnormality is present

psycotherapy

ssris

268
Q

Binge Eating Disorder

A

The essential feature of binge eating disorder is reccuernt episodes of binge eating that occur at least 3 times per week for more than 3 months. patients are overweigt, and they usually lack a sense of control over their eating habits.

269
Q

Binge Eating Disorder

episodes

A

associated with eating faster than usual, eating until feeling uncomfortably full, eating large amounts of food in the absence of hunger, eating alone, and feeling disgusted with oneself after the eating episode

270
Q

Binge Eating Disorder

treatment

A

topiramate has been proven efficacious for binge eating disorder. ssris may have limited benefits

psychoteraphy is indicated, including cognitive behavioral therapy, interpersonal psychotherapy, and dialectic behavioral therapy

271
Q

Eating Disorder Not Otherwise Specified

A

A designation of eating disorder noth otherwise specified (NOS) is used when patients do not meet criteria for either anorexia nervosa or bulimia nervosa

272
Q

Binge Eating Disorder

exammples

A

criteria for anorexia present in girls but menstruation is normal

anorexic patient with normal weight

use of compensator behavior after eating normal amounts of food

273
Q

Sleep Disorders

A

Narcolepsy

Sleep Apnea

Insomnia

274
Q

Narcolepsy

definition

A

Excessive daytime sleepiness and abnormalities of REM sleep, narcolepsy most frequently begins in young adulthood.

sleep studies are usually indicated in the diagnosis

no therapy has been found to be curative

275
Q

Narcolepsy

treatment

A

no therapy has been found to be curative

the pt is managed with forced naps during the day

modafinil is a medication used to maintain alertness

therapy can also include methylphenidate and dextroamphetamine

gammahydroxybutryate (GHB) may be given at bedtime to induce sx of narcolepsy and contain them at night.

276
Q

Specific Features of Narcolepsy

A

sleep attaxks

cataplexy

hynogogic and hynopompic hallucinatios

sleep paralysis

277
Q

Specific Features of Narcolepsy

sleep attaxks

A

episodes of irresistibel sleepiness and feeling refreshed upone awakening

278
Q

Specific Features of Narcolepsy

cataplexy

A

sudden loss of muscle tone: considered pathognomonic andmay be precipitated by loud noise or emotions

279
Q

Specific Features of Narcolepsy

hypnogogic and hypnoponpic hallucinations

A

hallucinations that occur as the patient is going to sleep and waking up

280
Q

Specific Features of Narcolepsy

sleep paralysis

A

patient awake but unable to move; this typically occurs upon awakening

281
Q

Sleep Apnea

Definition

A

characterized by the cessation of airflow at the nose or mouth during sleep due to obstruction of the upper airway. this results in episodes of decresed arterial oxygenation saturation and episodic arousal

282
Q

Sleep Apnea

diagnosis

A

patients are typically overwieght, have a very loud snore, and complain of daytime fatigue.

polysonmography will show episodes of apnea lasting more than 10 seconds. Accompanied by decreased arterial oxygenation, bradycardia, and increased diaphragmatic effort

283
Q

Sleep Apnea

medical complications

A

arrhthymias, pulmonary htn, and occasionally death

284
Q

Sleep Apnea

treatment

A

nasal continuous airway pressur (CPAP)

weight loss

corrective surgery

avoidane of sedatives and alcohol, which worsen the condition

285
Q

Insomnia

definition

A

characterized by the inability to intiiate or maintaine sleep. Insomnia may be due to anxiety and depression. it is severe enough to adversely affect level of fucntioning.

286
Q

Insomnia

Diagnosis

A

typically seen in women who copmlain of feeling tired or have increased appetite andyawning

287
Q

Insomnia

treatment

A

treatment consists of lseep hygiene techniques such as going to bed and waking up at the same time, avoiding caffeinated beverages, and avoiding daytime naps.

Behavioral modification techniques include using the bed only for sleeping and not for reading, watching TV, or eating.

Medical Therapy consists of zolpidem, eszopiclone, or zaleplon

288
Q

Sexual identity

A

based on a person’s sexual characteristics

289
Q

Gender Identity

A

based on a person’s sense of maleness or femaleness, established by the age of 3

290
Q

Gender role

A

based on external patterns of behavior that reflect inner sense of gender identity

291
Q

Sexual orientation

A

Based on person’s choice of love object; may be heterosexual, homosexual, bisexual, or asexual.

292
Q

Masturbation

A

normal precursor of object related sexual behavior

all men and women mastrubate

commonly seen in adolescents, adults, and elderly

problematic only if it adversely interferes with daily functioning

293
Q

Homosexuality

A

not considered a mental illness unless it is ego-dystonic (the person is not happy with his/her sexual orientation)

may be considered normal experimentation in teenagers

294
Q

Impotence

Definition

A

persitent or recurrent inability to attain or maintain an erection until completion of the sexual act

295
Q

Premature ejaculation

Definition

A

ejaculation before penetration or just after penetration, usually due to anxiety

296
Q

genitopelvic pain disorder (formerly dyspareunia)

Definition

A

pain associted with sexual intercourse, not diagnosed if due to medical condition

297
Q

Penetration disorder (formerly vaginismus)

Definition

A

involuntary constriction of the outer third of vagina preventing penile insertion

298
Q

Impotence

Treatment

A

rule out medial causes or medication, psychotherapy, couples sexual therapy

299
Q

Premature ejaculation

Treatment

A

psychotherapy, behavioral modification techniques (stop and go, squeeze), SSRI medication

300
Q

genitopelvic pain disorder (formerly dyspareunia

Treatment

A

psychotherapy

301
Q

Penetration disorder (formerly vaginismus)

Treatment

A

psycotherapy, dilator therapy

302
Q

Paraphilic Disorders (formerly paraphilias)

definition

A

group of disorders that are recurrent, sexually arousing, adn seen mor efrequently in men

303
Q

Paraphilic Disorders (formerly paraphilias)

diagnosis

A

usually focus on humiliation, nonconsenting partners, or use of nonliving objects, must occur for more than 6 months and cause distress as well as adversely affect level of functioning. do not diagnose if doen ine experimentation

304
Q

Exhibitionism

A

recurrent urge to expose oneself to strangers

305
Q

Fetishism

A

recurrent use of nonliving objects to achieve sexual pleasure

306
Q

Pedophilia

A

recurrent urges or arousal toward prepubescent children

307
Q

Masochism

A

recurretn urge or behavior involving the act of humiliation

308
Q

Sadism

A

recurrent urge or behavior involving acts in which physical or spychological suffering of victim is exciting

309
Q

Tranvestic Fetishism

A

recurrent urge or behavior involving cross dressing for sexual gratification; usually found in heterosexual males

310
Q

Frotteurism

A

Rubbing, usually ones pelvis or erect penis, against a nonconsenting person for sexual gratification.

311
Q

Paraphilic Disorders (formerly paraphilias)

treatment

A

individual psychotherapy

behavioral modification techniques such as aversive conditioning

antiandrogens or SSRIs to reduce sexual drive

312
Q

Gender Dysphoria (formerly Gender Identity Disorder)

Diagnosis

A

characterized by the persistent discomfort and sense of inappropriateness regarding the pateitns assigned sex

313
Q

Gender Dysphoria (formerly Gender Identity Disorder)

diagnosis

A

gender identity disorder will manifest by wearing the opposite genders clothes, using toys assigned to the opposite sex, play with opposite sex children when young, and feeling unhappy about the person’s own sexual assignent. Patients will take hormones when older to deepen voice, if female, or soften voice with

314
Q

Gender Dysphoria (formerly Gender Identity Disorder)

trying to change

A

Patients will take hormones when older to deepen voice, if female, or soften voice, if male. Women may bind their breasts and men may hide their penis and testicles. it is seen more frequently in young men

315
Q

Gender Dysphoria (formerly Gender Identity Disorder

treatment)

A

sexual reassignment surgery if approved

individual psycotherapy

316
Q

Suicide

Presentation

A

recent suicide attempt

complaints of suicidal thoughts

admission of suicidal thoughts

demonstration of suicidal behaviors (eg buying weapons, giving away possessions, or writing a will)

317
Q

Suicide

Risk Factors

A

men

older adults

social isolation

presence of psychiatric illness/drug abuse

perceived hopelessness

previous attempts

318
Q

Suicide

treatment

A

hospitalize patient

take all threats seriously

OMS III (21 decks)

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