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Psych 2 Test 2
Nova Orlando
84
Psychology
Graduate
03/29/2011

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Term
over half of all suicides are committed with...
Definition
firearms
Term
There is a strong link between suicide and this condition
Definition
depression
Term
90% of people who die of suicide have one of these two conditions
Definition
an existing mental illness or substance abuse problems
Term
highest suicide rate is for
Definition
white men over 85
Term
in the month prior to suicide 75% of victims have done this
Definition
visited the doctor
Term
7 risk factors for suicide
Definition
prior attempt, FHX of metal/substance abuse, family violence, firearms in the home, incarceration, exposure to suicidal behavior
Term
alterations in this are linked with suicides
Definition
neurotransmitters such as serotonin
Term
_____ attempt suicide more often, but _____ are more successful.
Definition
women, men
Term
men usually attempt suicide by
Definition
more lethal means (hanging, asphyxiation, breathing vehicle exhaust gas, and firearms)
Term
any sort of self harming behavior, whether or not the intent is to commit suicide.
Definition
deliberate self harm (non-lethal drug OD, self-injury, etc)
Term
warning signs of suicide (19)
Definition
(anything that would make you suspicious of depression)
ideation, substance abuse, purposelessness, anger, trapped, hopelessness, withdrawal, anxiety, recklessness, mood disturbance, talkign about suicide, look for ways to die, statements of hopelessness, preoccupation with death, suddenly happy/calm, loss of intesest in normal cares, visiting/calling close friends, making final arrangements, giving away prized possessions.
Term
check for these 2 things in an assaultive/aggressive pt
Definition
hx of head trauma/brain infection, and hx of domestic violence/sexual abuse.
Term
7 steps to approaching a violent pt
Definition
observe for weapons, provide access to opened door, maintain social space, observe for clues to aggression, maintain calm demeanor, listen, do NOT argue/challenge/give orders
Term
what is the essential feature in ALL dissociative disorders?
Definition
disruption in the usually integrated functions of consciousness, memory, identity, or perception. Can be sudden or gradual, transient or chronic.
Term
inability to recall important personal information, usually of a truamatic or stressful nature, that is too extensive to be explained by normal forgetfulness.
Definition
Dissociative Amnesia
Term
person fails to recall events that occurred during a particular time (early childhood truama recalled later in life)
Definition
localized amnesia
Term
person can recall some but not all of the events pertinent to a particular time period (combat vet)
Definition
selective amnesia
Term
failure to recall encompasses the person's entire life (usually present to ED or police station)
Definition
generalized amnesia
Term
inability to recall events subsequent to a specific time up to and including the present
Definition
continuous amnesia
Term
loss of memory of certain categories of information such as all memories relating to one's family or a particular family member
Definition
systematized amnesia
Term
sudden unexpected travel away from home or one's customary place of daily activities, with inabilty to recall some or all of one's past
Definition
Dissociative Fugue
Term
presence of two or more distinct identities or personality states - each with its own relatively enduring pattern of percieving, relating to, and thinking about the environment and self
Definition
dissociative identity disorder
Term
are children's imaginary playmates or other childhood fantasy play included in Dissociative Identity Disorder?
Definition
No
Term
associated physical findings with dissociative identity disorders (5)
Definition
self inflicted injuries or signs of physical abuse, migraines or other HA, IBS, asthma, dissociative disorders
Term
In dissociative identity disorder who tends to have more identies males or females?
Definition
females (15), males (8)
Term
In dissociative identity disorder which personality has the more complete memory?
Definition
the more hostile, controlling, "protector" identities
Term
transitions among identities can happen in seconds and are usually marked by (4)
Definition
rapid blinking, facial changes, changes in voice or demeanor, disruption in the individual's train of though
Term
"out of body experience" during "death" or excessive G-Force with pilot training
Definition
depersonalization disorder
Term
persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of one's mental process or body
Definition
depersonalization disorder
Term
what remains intact during the depersonalization experience
Definition
reality testing
Term
disorders with dissociative symptoms that do not meet criteria for any specific dissociative disorder (5 examples given)
Definition
dissociative disorder not otherwise specified. Can include brain washing, thought reform, indoctrination while captive, derealization not accompanied by depersonalization, and dissociatve trance disorder
Term
feeling that the external world is strange or unreal
Definition
derealization
Term
symptoms that may accompany depersonaliation disorder (3)
Definition
derealization, alteration in size/shape of objects, people may seem unfamiliar or mechanical
Term
both delirium and dementia affect...
Definition
cognitive functioning
Term
cognitive refers to (6)
Definition
attention, consciousness, language, speech, memory, orientation in space
Term
historical red flags (11)
Definition
progressively declining level of consciousness/neuro exam, pupillary asymmetry, seizures, repeated vomiting, double vision, worsening HA, can't recognize people/places, behaves unusually, slurred speech, unsteady on feet, weakness/numbness in arms/legs
Term
score of less than ___ on MMSE requiers further evaluation
Definition
24
Term
can't remember emotionally charged events but can remember objective facts and events
Definition
psychogenic amnesia
Term
can't remember objective facts
Definition
organic amnesia
Term
loss of memory for events immediately prior to the disorder
Definition
retrograde amnesia
Term
demented pt has problems with _____ memory but ____ memory remains intact
Definition
recent, remote
Term
what may be the first or only manifestation of (new) medical or neurological process
Definition
psychiatric syndrome
Term
gradual/insidious onset, progressive, affects memory, language, visual-spatial skills, and praxis. Visual or auditory hallucinations, often fixed paranoid delusions. not usually reversible.
Definition
dementia
Term
acute, rapid onset, fluctuating course, deficits = attention, memory, level of consciousness, and orientation. hallucinations = visual. delusions = persecutory but fleeting and fragmented. usually reversible
Definition
delirium
Term
progressive decline in memory, a decrease in the patient's ability to perform activities of daily living, psychiatric problems, personality changes and problem behaviors.
Definition
dementia
Term
arise from a disorder affecting the cerebral cortex, the outer layers of the brain that play a critical role in thinking abilities like memory and language.
Definition
cortical dementias
Term
2 forms of cortical dementias
Definition
Alzheimer's and Creutzfeldt-Jakob
Term
2 symptoms of cortical dementias
Definition
severe memory loss and aphasia
Term
result from dysfunction in the parts of the brain that are beneath the cortex.
Definition
subcortical dementias
Term
3 examples of subcortical dementias
Definition
Parkinson's, Huntington's, AIDS dementia
Term
symptoms of subcortical dementias
Definition
changes in their speed of thinking and ability to initiate activities
Term
non-treatable causes of dementia (5)
Definition
Alzheimer's, Vascular Dementia, Dementias associated with Parkinson's, AIDS dementia, Creutzfeldt-Jakob disease
Term
3 microscopic changes characteristic of Alzheimer's
Definition
Nuerofibrillary tangles, Cortical atrophy, and B-Amyloid Plaques
Term
what genotype is implicated in the genetic transmission of Alzheimer's
Definition
Apolipoprotein E4
Term
gradual forgetfulness, speech halting, disorientation to time then place, decline in mobility, behavior, temperament, and conduct, symptoms progress over 7-15 years.
Definition
Alzheimer's
Term
late manifestations of Alzheimer's include...
Definition
psychiatric symptoms, loss of social graces, seizures, EPS rigidity and bradykinesias, grasping and sucking reflexes, myoclonus, incontinence, spasticity, and hemiparesis
Term
Diagnostic studies for Alzheimer's
Definition
no labs, use MRI or CT, EEG, PET scan, and neuropsychiatric testing
Term
tx for mild to moderate Alzheimer's
Definition
reversible acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine), also antipsychotics, antidepressants, and anxiolytics
Term
treatment for more severe Alzheimer's
Definition
memantine (neuroprotective), can be used alone or added to a cholinesterase inhibitor
Term
Alternative therapies for Alzheimer's Dementia
Definition
Vitamin E, Gingko Biloba (not advocated at present)
Term
the absence or loss of social, moral, or intellectual vitality or vigor (pt stops eating and drinking)
Definition
inatiation
Term
memory impairment and one or more of the following (aphasia, apraxia, agnosia, or disturbances in executive functioning)
Definition
Alzheimer's dementia
Term
early onset Alzheimer's is less than how old?
Definition
65
Term
itracytoplasmic inclusions in cortex and brainstem (no tangles or plaques)
Definition
Lewy Bodies
Term
disease marked by parkinsonian features, dementia, and a frequent tendency to episodic delirium
Definition
Lewy Body Dementia
Term
what should be avoided in Lewy Body Dementia?
Definition
antipsychotics (pts are more sensitive to these drugs)
Term
treatment for Parkinsonian features
Definition
L-Dopa
Term
code Gnereal Medical Condition associated with dementia on what axis?
Definition
3
Term
transmissible, slowly progressive, degenerative, and fatal disease affecting the central nervous system of adult cattle....
Definition
Bovine Spongiform Encephalopathy (Mad Cow Disease)
Term
early sxs = withdrawal, anxiety, depression, and insomnia. Later sxs = unsteady movement, slurred speech, and numbness
Definition
Mad Cow Disease
Term
is Mad Cow fatal?
Definition
yes, usually within 13 months
Term
several smaller infarcts may cause very mild symptoms in a step-wise progression until one tips the pt "over the edge"
Definition
Vascular (Multi-Infarct) Dementia
Term
sxs = difficulty with organization and solving complex problems, slowed thinking, distraction, and difficulty retrieving words from memory
Definition
vascular (multi-infarct) dementia
Term
incidence of vascular dementia rises in conjuction with these disorders (6)
Definition
hypertension, cardiac disease, diabetes, smoking, alcoholism, and hyperlipidemia
Term
treatment of vascular dementia
Definition
manage HTN and other CV risk factors. Calcium Channel Blockers, Consider anti-platelet drugs, regular exercise and healthy diet. Cholinesterase inhibitors, glutamate receptor agonist
Term
substance induceed persisting dementia can be associated with these substances (6)
Definition
alcohol, inhalant, sedative, hypnotic, anxiolytic or unknown
Term
pdeudodementia is also known as this
Definition
depression
Term
depression is most commonly mistaken for
Definition
dementia
Term
pt appears "normal" but confused
Definition
dementia
Term
pt is aware of their deficits
Definition
deperssion
Term
pt can appear sleepy, disoriented, and inattentive
Definition
delirium
Term
contributors to ADHD (4)
Definition
genetic disorders, environmental factors, social environments, brain injuries
Term
if the parents of a child have ADHD, the child has up to a ____% chance of developing the disorder
Definition
57
Term
persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and is more severe than is typically observed in individuals at comparable levels of development.
Definition
ADHD
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