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PSYCH > TOPIC 9 - neurodevelopment & neurocognitive disorders > Flashcards

TOPIC 9 - neurodevelopment & neurocognitive disorders Flashcards

1
Q

factors related to childhood neurodevelopment disorders

A

genetics
biochemistry : a genetic imbalance in a nutrient needed for NT synthesis can result in brain chemistry problems
environment : abuse or neglect impacts wellbeing

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2
Q

developmental milestones

A

Crawling
Walking
Fine motor skills
Physical skills
Problem-solving
Socialization
Language & communication

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3
Q

what is the result of delayed socialization and communication skill development

A

isolation

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4
Q

deficit in social reciprocity

A

trouble with how the child responds or reciprocates when socially interactive

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5
Q

deficit in joint attention

A

trouble with wanting to share an interest

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6
Q

deficit in nonverbal communication

A

trouble with ability to use or interpret nonverbal cues

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7
Q

deficit in social relationships

A

trouble making and maintaining relationships

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8
Q

which approach is most effective for autism

A

interdisciplinary treatment using family centered practice and the use of the community collaboration model

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9
Q

ASD severity level 1

A

speaks in full sentences, difficulty with conversations

difficulty changing activities, difficulty with organization and planning

minimal support needed

can be managed in classroom

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10
Q

ASD severity level 2

A

notable deficit in verbal and nonverbal social communication

does not initiate social interactions

repetitive behaviors are observable

change in routine leads to distress

moderate support needed

may require specialized classroom

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11
Q

ASD severity level 3

A

few spoken words

rarely interacts with others

very resistant to change

need for repetition interferes with daily life

substantial support needed

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12
Q

goal of family centered practice

A

create a partnership so that the family fully participates in all aspects of the individual’s care

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13
Q

interdisciplinary treatment

A

behavior management therapy
cognitive therapy
family centered care
community collaboration model

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14
Q

medications for ASD

A

atypical antipsychotics used for reducing aggressive and or self harm behaviors
SSRI’s and beta blockers for obsessions and anxiety

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15
Q

most effective atypical antipsychotic

A

risperidone

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16
Q

categories of ADHD

A

inattentive, hyperactive/impulsive, combined

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17
Q

diagnostic method for ADHD

A

Vanderbilt Assessment Scale

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18
Q

problem areas with ADHD

A

concentrating, focusing, inattentiveness, not listening, lack of follow through, organization, time management, forgetfulness

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19
Q

school observations in children with ADHD

A

fidgeting in seat, inappropriately running or climbing, blurt out answers, interrupt or talk excessively, inconsistent or messy assignments

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20
Q

interdisciplinary treatments for ADHD

A

Behavioral Modification/Behavioral Therapy
Parent Training
School Accommodations

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21
Q

medications for ADHD

A

Increase frontal lobe activity in the brain
Increase attention span
Decrease impulsive behavior, restlessness & hyperactivity
CNS stimulant medications
Non-stimulant medications

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22
Q

stimulant medications

A

highly effective treatments that have been safely used for decades.
EX : methylphenidate, amphetamines, dexmethylphenidate, lisdexamfetamine

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23
Q

non stimulant medications

A

EX : atomoxetine, guanfacine, clonidine
alternatives for those who do not respond well to stimulants or if a non-stimulant is preferred.

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24
Q

when to give methylphenidate

A

6-8 hours before bedtime

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25
Q

what to monitor with methylphenidate

A

insomnia

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26
Q

when to give methylphenidate ER

A

12 hours prior to bedtime

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27
Q

what to monitor with atomoxetine

A

can stunt growth (monitor height and weight)

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28
Q

primary encopresis disorder

A

the person have had continuous soiling throughout their lives, without any period in which they were successfully toilet trained

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29
Q

secondary encopresis disorder

A

may develop after toilet training has occurred usually due to encountering stressful experiences such as upon entering school or encountering other experiences that might be stressful

30
Q

retentive encopresis disorder

A

overflow incontinence due to constipation. If not treated, serious complications such as megalocolon can occur, which may affect colon peristalsis

31
Q

nonretentive encopresis

A

refers to soiling without evidence of fecal constipation and retention. This form ofencopresis is characteristics include fecal incontinence accompanied by daily bowel movements that are normal in size and consistency

32
Q

enuresis symptoms are normal up to what age

A

5

33
Q

encopresis symptoms are normal up to what age

A

4

34
Q

enuresis definition

A

repeated urinary incontinence
Involuntary or intentional voiding in clothing, bed, etc.
Nocturnal, diurnal, or both

35
Q

encopresis definition

A

repeated incontinence of feces into inappropriate places
Involuntary or intentional voiding (places may include clothing, on floors, in waste receptacles, etc.)
Primary, secondary, retentive, and nonretentive types

36
Q

assessment of elimination disorders

A

distended abdomen
poor appetite
incontinent episodes past expected toilet training age

37
Q

interventions for elimination disorders

A

Parent education
Toileting schedules (even during the night for enuresis)
Specialist referrals if needed
Behavior training / therapies
Medication

38
Q

medications for enuresis

A

imipramine
desmopressin
oxybutynin
indomethacin
SSRIs

39
Q

interventions for enuresis

A

parent education
toileting schedule
limit fluids before bed
positive reinforcement
bell and pad methods
bladder training
school EP

40
Q

interventions for encopresis

A

parent education
referral to gastroenterologist
increase dietary fiber and fluid
toileting schedule
enhanced toilet accessibility
CBT
Meds : suppository, enema, laxative

41
Q

structural changes to functional areas of the brain in dementia

A

atrophy
ventricle enlargement
plaques
tangles
damaged brain cells
neurodegeneration

42
Q

what must you rule out or treat first before dementia diagnosis

A

medical conditions
substance use / abuse
cumulative anticholinergic drug effects

43
Q

diagnostic assessments for dementia

A

electroencephalography (EEG)
neuroimaging (MRI, CT)
laboratory testing
MMSE, mini-cog, mental status exams

44
Q

DSM5 diagnostic criteria for mild cognitive impairment

A

Cognitive decline from a previous level of functioning in one or more cognitive domains.
Major symptom: Memory impairment
Excludes people with dementia or age-related memory impairment
Cognitive impairment do not interfere with independent day-to-day activities, and socialization

45
Q

path to diagnosing mild cognitive impairment

A

Standardized neuropsychological test indicate modest impairment.
Mental status exam
Reports from family, friends, or clinicians

46
Q

MCI assessment

A

Forgetfulness- important events or appointments
Difficulty following conversations
Difficulty following a plot in books or movies
Have trouble navigating familiar places
Becomes overwhelmed by previously easy task
Require greater effort and time to perform task (use to be performed effortlessly)

47
Q

defense mechanisms of MCI

A

Denial- hiding memory deficits
Confabulation- making-up stories or answers to maintain self esteem when something is forgotten
Perseveration- repetition of phrases or behavior
Avoidance- avoid answering questions

48
Q

primary dementia

A

Irreversible
Progressive (four stages)
Not secondary to any other disease process
Example: Alzheimer’s disease (AD)

49
Q

secondary dementia

A

Result of some other pathologic process
Example: Acquired immunodeficiency syndrome (AIDS)/HIV, (older adults remain sexually active), vascular dementia, Pick’s disease, Huntington’s disease
Depression often mimics signs/symptoms of dementia

50
Q

when you see fluctuating levels of alertness what should you suspect

A

delirium NOT dementia

51
Q

risk factors for alzheimers

A

Age and gender: (Affects women more than men)
Incidence doubles after age 65
Older African Americans (twice as likely to develop AD)
Hispanic Americans (1.5 times more likely)

52
Q

prodromal phase of alzheimers disease

A

brain changes occur 10-20 years prior to symptoms

53
Q

4 A’s

A

Amnesia - Amnesia/memory impairment
Aphasia - Initially has difficulty finding correct word, then only uses a few words, finally babbling or mutism
Apraxia - Loss of purposeful movement (e.g.,walking, dressing self)
Agnosia - Loss of ability to recognize sounds (auditory agnosia), recognize objects (visual or tactile agnosia)

54
Q

stage 1 of alzheimers disease

A

Short-term memory loss: loses things, forgets things
Difficulty learning new things
Occupational abilities may be intact, often able to work
Behavioral problems: depression, apathy
Impaired activities: grocery shopping, managing finances

55
Q

stage 2 of alzheimers disease

A

memory gaps related to persons history
obvious ADL deficits
labile mood, paranoia, anger, aggression, jealousy
altered sleep pattern
driving hazard
around the clock care and supervision needed
activity and social withdrawl
defense mechanism : denial

56
Q

stage 3 of alzheimers disease (severe)

A

Severe agnosia: unable to identify people (spouse, family members, friends)
Advanced apraxia: requires repeated instructions for simple tasks
Severe memory loss (e.g., location of toilet, leads to incontinence)
Behavior/mood: agitation, violence, paranoia, and delusions, wandering
Institutionalization may be necessary due to :
Wandering
Danger to self or others
Incontinence
Behavior affect the sleep and general health of others
Total dependence on others for ADLs

57
Q

stage 4 (final stage)

A

agraphia : may lose ability to read and write
hyperorality : a need to taste or chew, puts everything in mouth
hypermetamorphosis : a need to touch everything
severe apraxia : lose ability to walk
dysphagia : difficulty swallowing
aphasia : inability to speak
seizures
weight loss
insomnia
stupor
coma
death

58
Q

dementia interventions

A

always introduce yourself and refer to client by name
speak slowly
use short, simple words and phrases
maintain 1 or 2 arms distance
if delusional : acknowledge feelings and reinforce reality
if verbally aggressive : acknowledge feelings and change topics

59
Q

health maintenance with dementia

A

Encourage client participation with care
Allow client to preform all task within his/her capabilities
Always allow client to wear their own clothing
Use clothing with elastic, and replace buttons and zipper with Velcro
Give step-by-step instructions (allow time to perform task)
If resistive to care, return at a later time

60
Q

nutrition for dementia

A

Monitor food and fluid intake
Offer finger foods
Weigh once a week
During period of Hyperorality: watch for client eating non food items (i.e. artificial fruits, soaps)

61
Q

elimination interventions for dementia

A

Implement bowel and bladder training program
Use incontinent supplies (e.g., pads or briefs)

62
Q

sleep interventions for dementia

A

Keep room lights on
Keep room clutter free
Maintain calm environment throughout the day

63
Q

home safety for dementia patients

A

gradually restrict driving
remove throw rugs
minimize sensory stimulation
label rooms
install safety bars in bathroom

64
Q

interventions for wandering clients with dementia

A

Place mattress on the floor at night
Have client wear a medic alert and provide local police with a recent picture
Use complex locks, place locks at top of doors

65
Q

major neurotransmitters involved in alzheimers

A

acetylcholine and glutamate

66
Q

cholinesterase inhibitors : slows progression in mild to moderate stages

A

donepezil (Aricept)
rivastigmine (Exelon)
galantamine(Razadyne)

67
Q

NMDA receptor antagonist : slow progression in moderate to severe stages

A

memantine

68
Q

combination drugs : for moderate to severe stages

A

Namzaric (memantine hydrochloride extended-release (ER) combined with donepezil

69
Q

drugs to treat co occurring depressive disorders

A

SSRIs - lower side effect, ordered for depression
mirtazapine (Remeron), side effects of weight gain and sedation are often beneficial

70
Q

non pharm treatment

A

CBT
maintain comfort levels
behavioral interventions
physical exercise
picture magazines
compensatory memory aids
reality orientation
reminiscence/memory therapy
simple group activity

PSYCH (15 decks)

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