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FOB Exam 1: Assessing the patient
FOB exam 1
55
Anatomy
Graduate
02/02/2011

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Term
___ ___ ___ __ ___ is a structured systemic interview designed specifically to apply to DSM criteria. It is available in several versions for different pathologies. It is most useful as a ___ __.
Definition
Structured Clinical Interview for Diagnosis (SCID)
- research tool
Term
___ ___ ___ _ __ ___ is a 2-stage system where the patient completes 26 item screen that assesses depression, anxiety, alcohol abuse, somatoform disorders, and eating disorders. During the 2nd stage the provider adminishes follow up. This takes 8-15 minutes.
Definition
Primary Care Screen for Mental Disorders (PRIME-MD)
Term
outline of psychiatric evaluation:
Definition
Identification of patient and informants
Chief Complaint
History of Current Illness
Past History
Family History
Social History
General Medical History
Mental Status Exam
Physical Examination
Neurological examination
Term
with suicidal thoughts need to ask about ___ , ___, __, and ___. __ per __ in the past ___ is considered high frequency. Persistence over time needs to be considered.
Definition
frequency
intrusiveness
plan
constraints
Once per day in the past week
Term
Lack of suicidal ideation but thoughts of “Wish I wasn’t here”. Or “I want to get away from all this”. Can be considered equivalent to active ideation
Definition
Term
__ in __ bipolar people commit suicide. Suicide is more common with ___ and ___.
Definition
1 in 10

depression and bipolar disorder
Term
MOST IMPORTANT TIME FRAME FOR SUICIDE THOUGHTS IS HOW MANY TIMES IN THE LAST WEEK. Suicide is a time limited behavior. It is considered to be a problem solving mechanism for a very short period of time.
Definition
Term
to assess intrusiveness of suicidal thoughts what could you ask?
Definition
“When you have these suicidal thoughts how do you feel?” “How do these thoughts effect your every day activities?”
Thoughts that produce discomfort or sense of peace are equally suggestive of increased potential
Thoughts that interfere with every day activities are suggestive of increased potential
Term
when assessing plan ask and consider:
Definition
“How do you intend to kill yourself?” “How available are the means to kill yourself?”
Presence of a plan may increase risk assessment but with adolescents, people with alcohol or drug abuse or disorders with disinhibition may not have a plan but be at high risk
Assess availability of means - Are they present? What would the patient need to do to access means?
Assess lethality of the method- the more lethal the means the higher the risk
Term
Assess Saliency of Constraints - “How important is your religion to you?” “How important is what your family would think if you kill yourself?” Constraints that of of minimal importance indicate increased risk
Assess Permanency of Constraints - “How long are your children going to be visiting you?” Constraints that are time limited indicate increased risk
Definition
Term
demographics at increased risk of suicide:
Definition
- single or widowed
- males 45-60 or 65 and above
Term
Slight lifting of severity of depression with antidepressants especially if presentation includes anergia could increase risk of suicide b/c now have energy to do so.
Definition
Term
screening test done with psychological patients:
Definition
CBC with differential
Complete Blood Chemistries
Thyroid Function Tests
RPR/VDRL: check for syphilis
UA
Urine Tox Screen
EEG
Chest X-ray for those over 35 b/c lung, stomach, and breast cancer often metastacize to brain
Plasma Levels for Medications
Term
common medical problems included in differential diagnosis of psych. patients:
Definition
Multi-infarct Dementia
Subdural Hematoma
Normal Pressure Hydrocephalus
Tumors
HIV-related Dementia
Temporal Lobe Epilepsy
Toxic Exposure
Vitamin Deficiency
CNS infections e.g. syphilis
Substance induced Symptoms
Neuropsychiatric Effects of Medical Treatment
Term
common medical problems included in differential diagnosis of psych. patients:
Definition
Multi-infarct Dementia
Subdural Hematoma
Normal Pressure Hydrocephalus
Tumors
HIV-related Dementia
Temporal Lobe Epilepsy
Toxic Exposure
Vitamin Deficiency
CNS infections e.g. syphilis
Substance induced Symptoms
Neuropsychiatric Effects of Medical Treatment
Term
Psychosis is a severe mental illness with impaired ___ testing, bizarre __ and ___ and inappropriate ___.
Definition
- impaired reality testing
- bizarre hallucinations and delusions
- inappropriate affect
Term
psychosis positive symptoms:
Definition
Positive symptoms- exaggeration or distortion of functions of normal activities such as perception or thinking
delusions- fixed false belief
hallucinations- false perceptions in the absence of stimuli
disorganized speech- speech that does not communicate
bizarre behavior
inappropriate affect
Term
Psychosis negative symptoms:
Definition
Negative Symptoms- diminution or loss of functions normally present such as speech or emotional expression
Alogia- impoverished thinking shown by non fluent empty speech (poverty of speech) and fluent empty speech (poverty of content)
Affective blunting- limited emotional responding
Avolitional-apathy - loss of motivation
Anhedonia-asociality - loss of pleasure
Attentional Impairment
Term
define alogia:
Definition
impoverished thinking shown by nonfluent empty speech and empty fluent speech
Term
avolitional apathy defintion:
Definition
lack of motivation
Term
Anhedonia asocially defintion:
Definition
loss of pleasure
Term
common types of delusions:
Definition
- persecutory
- jealousy
- sin or guilt
- grandiose
- religious
- somatic
- reference
- controlled
- mind-reading
- thought broadcasting
- thought insertion
- thought withdrawal
Term
example of persecutory delusion:
Definition
feelings like someone is going to harm you
Term
delusion of jealousy?
Definition
constantly worried spouse is cheating
Term
delusion of sin or guilt:
Definition
feel you have done something terrible and need punishment
Term
grandiose delusion
Definition
you have special powers
Term
somatic delusion:
Definition
body functioning differently
Term
reference delusion:
Definition
TV/magazines are talking to you/sending you messages
Term
thought broadcasting delusion:
Definition
feel thoughts are being broadcast to others
Term
Bizarre or Disorganized Behavior - Observe and Ask
Clothing and Appearance- “Does anyone say anything to you about the way you dress?”
Social or Sexual Behavior- “Have you done anything that others may think is unusual?”
Aggressive and Agitated- “Have you been unusually angry or irritable lately?”
Ritualistic/Stereotyped Behavior- “Are there things you have to do over and over or in a certain way or order?”
Definition
Term
examples of disorganized speech:
Definition
- loose associations
- tangentiality
- schizophasia
- illogicality
- circumstantiality
- pressured speech
- clang speech
Term
define loose associations:
Definition
disjointed speech that gets speaker more and more off track as they continue
Term
tangentiality definition:
Definition
unrelated or minimally related response to a question
Term
schizophasia aka
Definition
word salad: incoherent nonsensical speech
Term
Illogicality:
Definition
reaching conclusion wihtout logical relationship
Term
clang speech:
Definition
sounds rather than meaning govern speech
Term
alogia:
Definition
Poverty of speech
Poverty of content
Thought blocking- train of thought that becomes interrupted and can not be continued
Increased response latency
Perseveration- repeated ideas, words or phrases
Term
affective blunting:
Definition
Unchanging facial expression
Decreased spontaneous movement
Paucity of Gestures
Poor eye contact
Affective nonresponsivity
Lack of Prosody- lack of normal vocal inflections
Term
Avolition-Apathy
Definition
Grooming and hygiene
Impersistence at work or school
Physical anergia
Term
Anhedonia-Asociality
Definition
“What do you do for enjoyment?”
“How would you describe your sex drive?”
“Do you have friends or feel close to anyone?”
Term
manic symptoms:
Definition
- euphoric mood
- irritability
- increased activity
- racing thoughts
- inflated sense of self/grandiosity
- decreased need for sleep
- distractibility
- poor judgement
Term
Depressive symptoms:
Definition
- dysphoric mood
- change in appetite or weight
- sleep disturbances
- psychomotor agitation (restless or agitated )
- anhedonia
- anergia/fatigue
- suicidal thoughts
- psychomotor retardation
- feeling of worthlessness
- helplessness
- hopelessness
- attention/concentration
- diurnal variation
Term
symptoms of anxiety:
Definition
- panic attacks
- agoraphobia- afraid to leave house
- social phobia
- specific phobia
- obsessions
- compulsions
Term
types of psychological testing:
Definition
- personality measures
- developomental assessment
- intellectual assessment
- achievement testing
- aptitude/vocational
- neuropsychological testing
Term
Objective Personality Tests: (structured, standardized self-report measures)
Definition
- Minnesota Multiphasic Personality Inventory
- Personality Assessment Inventory
Term
Projective-unstructured or semi-structured with vague or ambiguous stimuli Personaly Tests:
Definition
- Rorschach
- Thematic Apperception Test
Term
Developmental Assessments:
Definition
- Bayley Scales of Infant Development
- Denver Developmental Screening Test
Term
Intellectual Assessments:
Definition
- Stanford-Binet Intelligence Scale
- Wechsler Intelligence Scales
Term
Achievement testing:
Definition
- Wide-Range Achievement Test
- Peabody Individual Achievement Test
Term
Clinical Neuropsychology is a specialty in psychology that examines the relationship between __ and the __ functioning in the areas of ___, ___, ___, and ___ functioning.
Definition
- behavior and the brain
- cognitive
- sensory
- motor
- emotional
Term
Neurpsychological assessment is indicated to identify ___ deficits, to help determine the course of an illness that effects brain function, to assess ___ effects, to assess ___ ___ and to evaluate the effects of treatment.
Definition
- cognitive
- neurotoxic
- learning disorders
Term
Specific tests and batteries have been developed to assess executive functions, memory, attention & concentration, orientation, perceptual &perceptual motor functions, sensory-motor functions, language functions and constructional processes.
Definition
Term
Depression specific assessment:
Definition
- Beck Depression Inventory
- Geriatric Depression Scale
- Zung Self-assessment Depression Scale
Term
Anxiety Specific Assessment:
Definition
- Beck Anxiety Inventory
- State-Trait Anxiety Inventory
Term
Medical Specific Assessment:
Definition
Million Behavioral Medicine Diagnostic
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