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Behavioral Med > Sleeping & Eating Disorders > Flashcards

Sleeping & Eating Disorders Flashcards

1
Q

difficulty initiating or maintaining sleep or nonrestorative sleep despite adequate opportunity and circumstances for sleep

A

insomnia

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2
Q

insomnia symptoms that last at least 1 month but less than 3 months

A

episodic

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3
Q

insomnia symptoms that last 3 months or longer

A

persistent

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4
Q

two or more episodes of insomnia within the space of 1 year

A

recurrent

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5
Q

what is the most common form of insomnia?

A

acute insomnia (lasts a few days/weeks)

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6
Q

what 3 diagnostic tests should be considered for a patient presenting with insomnia?

A

polysomnography
thyroid-stimulating hormone
urine toxicology

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7
Q

what 2 questionaries can be used for a patient presenting with insomnia?

A

Pittsburgh sleep quality index (PSQI)
Sleep problems

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8
Q

what are 3 general managements for patients with insomnia?

A

counsel about sleep hygiene
cognitive behavioral therapy
medications

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9
Q

which medication can be used to treat insomnia chronically?

A

rozerem (melatonin receptor agonist)

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10
Q

7 medications used to treat insomnia, but have abuse potential

A

zalepion
zolpidem
eszopidone
triazolam
temazepam
estazolam
flurazepam

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11
Q

what should we counsel to patients with insomnia NOT to use?

A

OTC antihistamines

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12
Q

incurable rapid eye movement (REM) sleep disorder characterized by excessive daytime sleepiness; may be associated with cataplexy, hypnagogic hallucinations, or sleep paralysis

A

narcolepsy

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13
Q

what is type 1 narcolepsy?

A

narcolepsy with cataplexy

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14
Q

what is type 2 narcolepsy?

A

narcolepsy without cataplexy

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15
Q

which type of narcolepsy is most common?

A

type 1

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16
Q

narcolepsy results from the loss of the neuropeptides _____ and _____

A

orexin-A
orexin-B

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17
Q

what ages does narcolepsy peak?

A

15 and 35

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18
Q

infrequent cataplexy (less than once per week), need for naps once or twice per day, and less disturbed nocturnal sleep

A

mild narcolepsy

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19
Q

cataplexy once daily or every few days, disturbed nocturnal sleep, and need for multiple naps daily

A

moderate narcolepsy

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20
Q

drug-resistant cataplexy with multiple attacks daily, constant sleepiness, and disturbed nocturnal sleep

A

severe narcolepsy

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21
Q

what is the classic tetrad of narcolepsy presentation?

A

EDS
cataplexy
sleep paralysis
hypnagogic hallucinations

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22
Q

what are the 2 cardinal symptoms of narcolepsy?

A

EDS
sleep attacks during stimulating situations (driving)

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23
Q

how long can sudden sleep attacks last in narcolepsy?

A

5-20 mins

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24
Q

sudden transient episode of total or partial loss of motor tone, triggered by strong emotions (laughing, anger, or fright)

A

cataplexy

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25
Q

transient inability to move or speak either while falling asleep or on awakening

A

sleep paralysis

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26
Q

in which type of narcolepsy does sleep paralysis occur?

A

type 1

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27
Q

in which type of narcolepsy do hallucinations occur?

A

type 1

28
Q

what kind of behavior may be present in narcolepsy? (2)

A

retrograde amnesia
automatic behavior

29
Q

what are 2 diagnostics that can be used for narcolepsy?

A

polysomnography
multiple sleep latency test

30
Q

what is the first step in treatment of narcolepsy?

A

improve sleep hygiene

31
Q

what are the first line medications used to treat EDS for narcolepsy? (2)

A

modafinil
armodafinil

32
Q

which medication is the only medication proven effective and FDA-approved for both EDS and cataplexy?

A

Xyrem

33
Q

what medications are used as second line treatment for narcolepsy if first line fails or patient is unable to tolerate it?

A

methylphenidate (ritalin)
dextroamphetamine

34
Q

abnormal behavioral, experimental, or physiological events occurring in association with sleep, specific sleep stages, or sleep-wake transitions

A

parasomnias

35
Q

what are the 2 most common types of parasomnias?

A

Non-rapid eye movement (NREM) sleep arousal disorder
Rapid eye movement (REM) sleep behavior disorder

36
Q

parasomnia of repeated episodes of complex motor behavior initiated during sleep, during any stage of NREM sleep

A

sleep walking

37
Q

during which part of the night does sleep walking most commonly occur?

A

during first 3rd of the night

38
Q

unwanted recurrent episodes of eating with varying degrees of amnesia, ranging from no awareness to full awareness without the ability to not eat

A

sleep-related eating

39
Q

varying degrees of sexual activity occur as complex behaviors arising from sleep without conscious awareness

A

sexsomnia

40
Q

repeated occurrence of precipitous awakenings from sleep, usually beginning with a panicky scream or cry

A

sleep terrors

41
Q

when do sleep terrors usually occur? how long do they last?

A

during the first 3rd of the major sleep episode and last 1-10 mins

42
Q

what diagnostic study can be used for parasomnias?

A

polysomnography with audiovisual monitoring

43
Q

what are the 2 parasomnias?

A

sleep walking
sleep terrors

44
Q

what medication can be used for adult patients with NREM parasomnias?

A

clonazepam

45
Q

persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food; significantly impairs physical health or psychosocial functioning

A

feeding/eating disorders

46
Q

what leads to the death of the patient if they have anorexia nervosa?

A

subsequent malnutrition = multiorgan damage

47
Q

restriction of energy intake relative to requirement, leading to significantly low body weight in the context of age, sex, developmental trajectory, and physical health

A

anorexia nervosa

48
Q

a patient presents with extensive exercise, amenorrhea, weakness, cold intolerance, constipation/bloating, growth arrest, and history of fractures. what are they suspicious for?

A

anorexia nervosa

49
Q

what mnemonic do we use for anorexia nervosa and bulimia nervosa?

A

SCOFF

50
Q

what are the parts of the SCOFF questionnaire?

A

Sick - make yourself sick because you feel uncomfortably full?

Control - worry about losing control over how much you eat?

One stone (14 pounds) - losing more than one stone in a 3-mo period?

Fat - believe yourself to be fat when others say you are too thin?

Food - food dominates your life?

51
Q

how many yes answers to the SCOFF questionnaire provides a 100% sensitivity for anorexia and bulimia?

A

2 or more

52
Q

what are 3 abnormal vital signs noted in anorexia nervosa?

A

hypothermia
bradycardia
orthostatic hypotension

53
Q

in anorexia nervosa, a body weight of less than _____ of expected is present

A

85%

54
Q

what are the 4 levels of anorexia nervosa?

A

mild: BMI about 17
moderate: BMI 16-16.9
severe: BMI 15-15.9
extreme: BMI less than 15

55
Q

what type of management should be used for patients with anorexia nervosa?

A

outpatient

56
Q

what is the average weekly weight gain goal for anorexia nervosa?

A

0.5 - 1kg

57
Q

what are the 2 treatment goals for anorexia nervosa?

A

weight restoration
CBT

58
Q

what type of medications can be used with CBT to treat anorexia nervosa?

A

SSRIs

59
Q

a pattern of discrete periods of binge eating + lack of control overeating, followed by compensatory behaviors like self-induced vomiting and misuse of laxatives

A

bulimia nervosa

60
Q

what is the time period of binge eating for bulimia nervosa?

A

within 2 hr period

61
Q

how often must binge eating and compensatory behaviors occur to diagnose bulimia nervosa?

A

at least 1/week for 3 months

62
Q

what is the first-line treatment for bulimia nervosa?

A

CBT

63
Q

what medication can be used in conjunction with CBT for bulimia nervosa?

A

SSRIs (prozac)

64
Q

eating a lot of food in a short period of time with loss of control

A

binge-eating disorder

65
Q

what is the essential feature of binge-eating disorder?

A

recurrent episodes of binge eating at least 1/week for 3 months

66
Q

an eating or feeding disturbance - apparent lack of interest in eating food - as manifested by persistent failure to meet appropriate nutritional needs

A

avoidant/restrictive food intake disorder

Behavioral Med (9 decks)

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