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64 Cards in this Set
- Front
- Back
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What is a common presentation of anxious or depressed feelings in children with adjustment disorder?
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Somatic complaints - headaches and stomach aches
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When are symptoms considered 'Clinically Significant"?
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When they hav a marked impact on functioning in a variety of ways
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What is the hallmark of Conduct Disorder?
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Violation of the rights of others
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What is the time frame necessary for diagnosing Adjustment Disorder?
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Emotional response to a stressor with mood symptoms within 3 months of the stressor onset, but no LONGER than 6 months
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What re the 5 specific subtypes of Adjustment Disorder?
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-With depressed mood
-With anxiety -With mixed anxiety and depressed mood -With disturbance of conduct -With mixed disturbance of conduct and emotions |
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What is the best therapy for cases of Adjustment Disorder with nonmajor functional impairment?
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Supportive Psychotherapy
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What occurs in Supportive Psychotherapy?
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Patients are taught to confront issues such as phobias and stressors
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What is the LARGEST concern in the differential diagnosis of Adjustment Disorder?
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MDD - major depression
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What is the DIFFERENCE between Adjustment disorder and MDD?
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-DEGREE - symptoms are less severe in Adj disorder, and don't tend to persist if the stressor is removed
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And the treatment of choice for Adjustment Disorder is:
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Psychotherapy
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What is a common presentation of anxious or depressed feelings in children with adjustment disorder?
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Somatic complaints - headaches and stomach aches
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When are symptoms considered 'Clinically Significant"?
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When they hav a marked impact on functioning in a variety of ways
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What is the hallmark of Conduct Disorder?
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Violation of the rights of others
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What is the time frame necessary for diagnosing Adjustment Disorder?
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Emotional response to a stressor with mood symptoms within 3 months of the stressor onset, but no LONGER than 6 months
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What re the 5 specific subtypes of Adjustment Disorder?
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-With depressed mood
-With anxiety -With mixed anxiety and depressed mood -With disturbance of conduct -With mixed disturbance of conduct and emotions |
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What is the best therapy for cases of Adjustment Disorder with nonmajor functional impairment?
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Supportive Psychotherapy
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What occurs in Supportive Psychotherapy?
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Patients are taught to confront issues such as phobias and stressors
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What is the LARGEST concern in the differential diagnosis of Adjustment Disorder?
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MDD - major depression
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What is the DIFFERENCE between Adjustment disorder and MDD?
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-DEGREE - symptoms are less severe in Adj disorder, and don't tend to persist if the stressor is removed
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And the treatment of choice for Adjustment Disorder is:
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Psychotherapy
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What distinguishes Factitious disorder from Somatoform or Conversion disorder?
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The patient CONSCIOUSLY creates their medical illness in factitious disorder
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How is Factitious disorder different from Malingering?
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The primary gain is just to be sick, there is no 2ndry gain
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What is Pseudologia phantastica?
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The telling of "tall tales" or lying - often seen in Factitious disorder
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What is Munchausen syndrome?
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Factitious disorder with repeated episodes of seeking admission at various hospitals and lots of pseudologia phantastica
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For what other mental illness do patients with Factitious disorder often also meet criteria for?
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Borderline personality disorder
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What is the most likely diagnosis in a 2 1/2 yr old with new onset of wakign up at nite, screaming, with autonomic hyperarousal?
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Sleep terror disorder
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What is the treatment recommended for Sleep Terror Disorder?
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-Protect child from injury
-Do nothing It's time limited |
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What are the 4 major diagnostic criteria for Sleep Terror Disorder?
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-Episodes of apparent abrupt awakening usually early in the sleep cycle
-Intense emotion exhibited -Unable to calm/soothe -No memory the morning after |
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What is DYSsomnia?
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Sleep difficulty with the DURATION and TYPE of sleep
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What is PARAsomnia?
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Sleep disorder assoc w/ problems during the STAGES of sleep
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What is Somnambulism?
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Sleepwalking
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What is the Sleep Cycle?
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The brain wave activity associated with varying stages of sleep; from lite to deep
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What is Delta Sleep?
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The sleep stage where there is LAVH:
-LOW amplitute -High Voltage |
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When does Delta Sleep occur?
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In stage 3-4 slow wave sleep, the deepest stages which are nonREM sleep
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What is REM?
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Sleep stage characterized w/
-Rapid eye movements -Wakeful pattern of electrical brain activity |
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In what type of sleep are the most vivid of dreams likely to occur?
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REM
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What % of children and adults have Sleep Terror Disorder?
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3% children
1% adults |
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How does Sleep Terror Disorder typically manifest itself?
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As emotional and behavioral disturbances at night
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In what sleep stages/cycle does Sleep Terror Disorder occur?
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Delta/Slow wave sleep - Stages 3-4
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What are 3 things that can increase the frequency of Sleep Terror episodes?
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-Sleep deprivation
-Fever -CNS depressants |
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What is the prognosis for sleep terror disorder like in general?
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Good! Usually self-limiting with time
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What is the main difference between Sleep Terrors and Nightmares?
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Sleep terrors are in Delta or SWS, not remembered in morning
Nightmares are in REM - so you do remember in the morning |
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How many stages of sleep ARE there and WHAT are they?
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FIVE:
1, 2, Delta (3/4), and REM |
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Regarding sleep stage 1:
-Waves are what type -Muscles -Eyes |
Theta waves
Muscles relaxing Eyes - slow/rolling mvmts The nodding off period |
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Regarding sleep stage 2:
-Waves are what type -Muscles -Eyes |
K complexes/Sleep spindles
Little muslce activity No eye movements |
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Delta wave sleep:
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HIGH amplitude
Low frequency |
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REM sleep:
-Waves are what type -Muscles -Eyes |
HIGH frequency/Low amplitude
NO muscle tone - Cataplexy RAPID eye movements |
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What are Dyssomnias characterized by?
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-Excessive sleepiness
-Difficulty initiating sleep -Difficulty maintaining sleep |
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What are 2 INTRINSIC dyssomnias?
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-Narcolepsy
-Obstructive sleep apnea |
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What are 3 EXTRINSIC dyssomnias?
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-Poor sleep hygiene
-Allergies -Insufficient sleep |
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What are Parasomnias?
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Disorders of sleep DURING sleep or on WAKING UP (arousal)
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When do Night terrors and Somnambulism occur in sleep?
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During arousal from Delta wave sleep
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What age patients HAVE more delta sleep, and when in the night does it tend to occur?
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Young - children
Earlier in the night - before midnite |
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When do Nightmare disorders occur in sleep?
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During REM
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What is one of the most COMMON disorders of sleep in children?
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Enuresis
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What is the difference between Primary and 2ndry Enuresis?
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Primary - never was able to not wet the bed
Secondary - started bedwetting after a period of continence |
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At what age should pharmacologic or behavioral treatment for enuresis begin to be considered?
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Age 7
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What is the behavioral treatment for Enuresis?
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Using a Bell and Pad
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What is the success rate of the bell/pad method of treating enuresis?
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75%
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What ia pharmacologic therapy for enuresis?
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Desmopressin DDAVP
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What is Desmopressin?
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Synthetic ADH analog
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Which has a higher rate of recividsm (relapse); bell/pad or desmopressin?
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Desmopressin
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What is another pharmacologic therapy for bedwetting?
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Imipramine - low dose
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What is the duration of sleep problems needed for the diagnosis of Primary Insomnia?
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1 month
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