Tenta 1

Question 1

Essay about Lennart /OK

You work as a nurse at the local primary health center. Your first patient of the day is Lennart. Lennart is 73 years old and a widower since 3 years ago. He is a farmer and lives by himself by the countryside. He’s interested in deer hunting and fishing.
He is a known patient at your primary health center due to his diabetes and high blood pressure since many years. Now it is time for his annual diabetes check-up. You’ve met Lennart many times before and previously always had a smile on his face and hunting stories to tell. A jolly good fellow!

Today when you meet him he looks tired, ravaged and doesn’t smell good nor has shaved lately. You’ve never seen him likes this before. He hardly answers your questions about his well being. When you try to make him tell a hunting story, he just shakes his head and says “No, not today”. When you ask him if he takes his insulin on a regular basis, he says; “I don’t care about that anymore. What difference does it make?”

You react on Lennars unwillingness to answer the questions and sense that something is wrong with him.

A: Which psychiatric condition/conditions do you suspect that Lennart is suffering from? Justify (rättfärdiga/förklara) your answer (1 point).

B: Identify 3 suicide risk factors in Lennart’s case. Justify (rättfärdiga/förklara) your answer (3 points).

C: Give 2 examples of adequate (adekvat) questions you can ask Lennart in a suicide assessment. Justify (rättfärdiga/förklara) your answer (2 points).

Answer 1

A) Depression - för han uppvisar följande symptom:
Adhenomi
nedstämdhet
irritation
pessimisstisk

B)
S - man
A - 79
D - depression

Dessa 3 faktorer är de första 3 som används i SAD person scale, där man går till 10 poäng max för att
upptäcka suicidrisk, på bara de 3 första bokstäverna har lennart 3 poäng.

C) Vad känns meningslöst?
Tänker du mycket på döden?
Hur länge har du känt så här?
Har du funderat på att ta ditt liv?

Question 2

Neurotransmitters /function, impact /OK

Match the neurotransmitters with their functions/impact!

Regulates arousal and alertness (vakenhet)

Cognition, motivation, movement

Regulates bowel movements (tarmrörelser)
and/or mood

• Dopamine
• Serotonin
• Norepinephrine (noradrenalin)

Answer 2

Regulates arousal and alertness (vakenhet)
- Norepinephrine (noradrenalin)

Cognition, motivation, movement
- Dopamine

Regulates bowel movements (tarmrörelser) and/or mood
- Serotonin

Question 3

Benzodiazepine statements /OK

Select the correct statement regarding benzodiazepines and benzodiazepine treatment.
Select one alternative:

Increased risk of suicide in the beginning of the treatment

Associated to risk of tolerance and abuse

Ineffective in alleviating (sv. “lindra”) anxiety

Often a suitable drug for older people

Increased risk of heart attack in the beginning of the treatment

Answer 3

Associated to risk of tolerance and abuse

Question 4

Hallucinations

Hallucinations are common symptoms in several psychotic disorders. Choose the correct statement (påstående) regarding hallucinations!
Select one alternative:

Hallucinations always include perceptions from at least two senses (hearing, vision, smell, touch, taste)

Hallucinations are involuntary (ofrivilliga) movements and extrapyramidal sensations

Hallucinations are sensatory perceptions. They are not triggerd by external stimulus.

Answer 4

Hallucinations are sensatory perceptions. They are not triggerd by external stimulus.

Question 5

Suicide risk factors /OK

Correct and incorrect statements regarding suicide risk factors!

Tell which one is correct and incorrect:

Physical illness
Drug and alcohol abuse
Psychiatric disorder
History of suicidal behaviour in family

Answer 5

All are true!

Question 6

Schizophrenia/schizophrenic /OK

As a nurse in a professional context I correctly use the term…

“A patient with schizophrenia”
“A schizophrenic patient”

Answer 6

“A patient with schizophrenia”

Question 7

Essay bipolarity/depression

Depression and bipolar disorder are two different diagnoses. Describe what makes them different and how they are are similar. (Beskriv vad som skiljer dem åt och på vilket sätt de är lika)

Answer 7

Bipolär sjukdom kännetecknas av episoder av mani, omväxlande med episoder av depression. Det är alltså rörelsen mellan två motpoler, därav namnet - bipolär.

Depression är ett tillstånd av långvarig nedstämdhet och inaktivitet som kan påverka en persons tankar, beteende och känslor.

Dessa skiljer sig i och med den karakteristiska manin som är en återkommande aspekt vid bipolär sjukdom men ej närvarar vid depression. De skiljer sig även i etiologin där bipolär sjukdom till stor del beror på ärftlighet medan depression beror på kemiska förändringar i hjärnan, så som låga serotoninvärden. De liknar varandra mer under den depressiva perioden och i hur behandlingen ser ut, då den både är farmakologisk och terapeutisk.

Question 8

Positive/negative symptoms /OK

Match the values regarding psychotic disorders Positive/Negative symptom:

• Delusions
• Hallucinations
• Poor social function
• Thought blocking

Answer 8

• Delusions = Positiv
• Hallucinations = Positiv
• Poor social function = Negativ
• Thought blocking = Negativ

Question 9

Major Depressive Disorder Increase or decrease /OK

There has been an increase in Major Depressive Disorder over the past 50 years.

True or False?

Answer 9

True!

Question 10

CS /OK

Central stimulants are effective for treating…
Select one alternative:

• Depressions
• Bipolarity
• ADHD
• Psychosis

Answer 10

• ADHD

Question 11

Bipolar Disorder Statements /OK

Select true or false regarding bipolar disorder!

Bipolar disorder can be cured.

Divided in the subgroups Bipolar A and Bipolar B

Can be treated with lithium

Includes periods of euthymia (neutral mood)

Includes periods of hypomania and/or mania

Is not associated with higher risk of suicide

Answer 11

Bipolar disorder can be cured = False!

Divided in the subgroups Bipolar A and Bipolar B = False!

Can be treated with lithium = True!

Includes periods of euthymia (neutral mood) = True!

Includes periods of hypomania and/or mania = True!

Is not associated with higher risk of suicide = False!

Question 12

Choose Anxiety Disorder /OK

Select the anxiety disorder characterized by thoughts, impulses or images that persist (tankar, impulser och bilder som kvarstår) and recur (återkommer) and cannot be dismissed from the mind and/or ritualistic and repeated behaviors.

Select one alternative:

• Panic Disorder
• Posttraumatic Stress Disorder
• Phobia
• Obsessive Compulsive Disorder
• Generalized Anxiety Disorder

Answer 12

• Obsessive Compulsive Disorder

Question 13

Essay ADHD

Mention the name of the diagnostic tool used in diagnosis of ADHD and briefly (kort) describe how it is used
(2p)

What does the abbreviation (förkortning) ADHD stand for? (1p)

Name two common characteristic features (karaktäristiska drag) of a person diagnosed with ADHD (1p)

Answer 13

DSM 5
Kriterier som används för att diagnostisera ADHD.
DSM-5 är en handbok för psykiatriska diagnoser, för att få diagnoser ska man uppfylla olika kriterier i DSM.
Bland annat måste symtom ha uppkommit före sju års ålder och varat i över 6 månader. Symtomen ska
också innebära stora svårigheter och de kan anses som en funktionsnedsättning inom både skola/arbete
och i hemmet.

Attention Deficit Hyperactivity Disorder

Oförmåga att sitta still, svårt att koncentrera sig på en uppgift.