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What are the 5 Axis?
- I: mental disorder (depression)
- II: personality (ODD, ADHD)
- III: Medical (pneumonia)
- IV: Environment (probs w/law, community, family)
- V: GAF
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What is the ID?
Hungry infant. No problem solving.
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What is ego? What stage of life does it emerge?
Problem solver, reality tester. 4-5 month.
"Hungry man. I know i'm hungry and i know how to solve it"
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Superego
all the should and should nots.
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decrease in norepi?
depression
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decrease in serotonin?
depression
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increase in serotonin?
anxiety.
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decrease in GABA?
- anxiety
- schizo
- mania
- huntington's
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increase in GABA??
reduction in anxiety
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decrease in glutamate?
psychosis
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increase in glutamate?
improvement in behavioral tasks
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increase in ach?
depression
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decrease in ach?
- alzheimer's
- huntington's
- parkinson's
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SE of SSRI?
no orgasm. no libido.
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SE of MAOI?
MAOI tyramine crisis.
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Can you use MAOIs with other antidepress?
No.
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what does lithium do to nervous and muscular?
tremor, ataxia, confusion, convulsions.
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what does lithium do to digestive?
diarrhea
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what does lithium do to cardiac?
arrythmias
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does lithium cause polyuria, polydipsia, edema?
Yes
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what does lithium do to endocrine?
goiter and hypothyroid
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when is a mental pt admitted?
suicide/homicide/needs acute medical
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does an interpreter cost money?
no
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how do you pick an appropriate interpreter for a pt?
close to age, gender, social status, religion, culture (has to be able to interpret culture)
non verbals interpreted from their culture. not western
NOT family.
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what is beneficence?
promote good of others
(staying to calm an anxious pt)
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what is autonomy?
respecting other's rights to make own decisions
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What is justice
duty to share resources equally
(nurse cares equally for suicide pt and brain aneurysm)
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what is fidelity?
doing no wrong to pt
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what is veracity
communicate truthfully
(don't lie about effects and SE of drugs to pt)
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What is the least restrictive alt. doctrine?
the least invasive way must be used first, then go on to the more agressive.
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What does the least restrictive doctrine mean for restraints?
the least time needed is always used.
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What are the 3 stages of GAS? (general adaption syndrome)
- alarm or acute
- resistance or adaption
- exhaustion
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What is distress and eustress?
distress is stressors.
eustress is the good events. (vacation, called in for an interview)
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cognitive stress release techniques.
meditation
imagery
breathing
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who develops the defense mechanisms? Id, Ego, Superego?
Ego.
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What are the levels of anxiety?
- -Mild (restlessness)
- -moderate (agitation)
- -severe (can't function)
- -panic (distorted perception)
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What is a panic attack?
sudden onset of fear/impending doom
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what is agoraphobia?
fear about being in a place or situation where you can't escape or it might be embarrassing.
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What is the difference between a panic disorder and a panic attack?
Panic attack is a panic disorder w/o agoraphobia. (comes out of the blue. no time to think that there is a situation with no escape)
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What does release of GABA do to the anxiety?
calms you down
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what is the psychodyamic theory of anxiety
it's contagious
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what is the behavioral theory of anxiety?
learned response to stimuli
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cognitive theory for anxiety?
caused by distortion in thoughts
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what rating scale do you use to assess anxiety?
hamilton rating scale
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Why are benzos the major med to use for anxiety?
quick onset.
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why are benzos used the most but not for long periods?
quick onset, but risk for dependency.
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how long does buspar need to take effect? why would i use that instead of benzo?
2-4 weeks. doesn't have risk for dependency.
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how are antihistamines used?
nonaddictive alt. to benzos. anxiety and substance abuse.
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How are beta blockers used?
stops beta receptors. so heart doesn't beat as fast. treats "winter blues".
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what is used to treat GAD, PTSD...
anticonvulsant.
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what is the leading cause of disability in the US.
depression
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MDD (major depression disorder) is more common in men or women?
women.
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which has a higher success rate for killing themselves? men or women?
men.
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How do you differentiate b/w MDD and DD (dysthymic disorder)?
duration and severity of Sx.
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why are endorphins important with depression?
reduces sensitivity to pain
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how is exercise important to depression?
gain control and relax.
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What did Pavlov come up with?
classical conditioning. the dog and the bell.
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what did John B. Watson come up with?
Behaviorism theory. girl and the hammer and rat.
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what did B. F. Skinner come up with?
operant conditioning.
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