Ch 5 Bio Assessment Of Pts W Psych Symptoms

Front 1

Complications of pharmacotherapy with regards to measurement of biogenic amines and psychotropic drugs can occur.
A. When on what two meds does a patient need to be monitored for agranulocytosis (very low WBC count)?
B. With what mood stabilizers in particular do liver function tests need to be performed (2)?
C. Patients taking mood stabilizer lithium can develop what two conditions? Which tests should be used to monitor other parts of the body when on lithium?

Back 1

A. agranulocytosis is a risk when pts are taking carbamazepine (mood stabilizer) or clozapine (antipsychotic agent)
B. Liver function tests need to be used with carbamazepine and valproic acid (both mood stabilizers)
C. Kidney function and thyroid function tests should be used with lithium. Lithium levels should be monitored regularly because of the drug's narrow therapeutic range. Patients taking lithium can develop hypothyroidism, and occasionally hyperthyroidism.

Front 2

What does dexamethasone do?

Back 2

Dexamethasone is a synthetic glucocorticoid that suppresses the secretion of cortisol. If one has a positive dexamethasone suppression test, it means that suppression of glucocorticoids does not occur or is very limited.

Though seen in major depressive disorder, positive findings are non-specific. Other conditions where a positive dexamethasone suppression test is probable would be in schizophrenia, dementia, Cushing disease, pregnancy, anorexia nervosa or severe weight loss, and other endocrine disorders. Also with alcohol use,abuse and withdrawal.

Front 3

True or False:
Patients with a positive dexamethasone suppression test usually respond well to treatment with antidepressant agents or to electroconvulsive therapy.

Back 3

TRUE

Front 4

Thyroid function tests are used to screen for hypothyroidism and hyperthyroidism, which can mimic ________ and ______, respectively.

Back 4

depression and anxiety

Symptoms of hypothyroidism: fatigue, weight gain, edema, hair loss, and cold intolerance
Symptoms of hyperthyroidism: rapid heartbeat, flushing, fever, weight loss and diarrhea.

Front 5

Some psychiatric symptoms are associated with endocrine and enzyme disorders. Match the condition with their signs and tell the psych symptoms.
1. Acute intermittent porphyria
2. Addison dz
3. Cushing dz

A. physical signs and symptoms include a round "moon"face, bruising, purple striae on the skin, sweating, facial hair, hypertension, fat on the back of the neck and positive DST
B. elevated porphobilinogen, severe pain, abdominal cramps, diarrhea and vomiting, seizures, cardiac arrthyhmias, flushing and purple discoloration of urine
C. hyperpigmentation of skin, especially in creases, low bp, pain, fainting, hypoglycemia, diarrhea and vomiting

Back 5

1. Acute intermittent porphyria = B. , psych symptoms are: paranoid delusions and hallucinations, depression and anxiety
2. Addison dz (hypocortisolism) = C. , psych symptoms include fatigue, depression, psychosis and confusion
3. Cushing dz = A. , psych symptoms include elevated mood, psychosis, anxiety and depression

Front 6

Electroencephalogram (EEG) measures electrical activity in the cortex. Delerium yields [ normal / abnormal ] EEGs whereas dementia yields [ normal / abnormal ] EEGs.

Back 6

Delerium = abnormal EEGs

Dementia = normal EEGs

Front 7

Which test is designed to follow improvement or deterioration in patients with suspected neurologic problems such as dementia and brain damage.
A. Folstein Mini-Mental State examination
B. Glasgow Coma scale
C. Halstead-Reitan battery
D. Luria- Nebraska neuropsychological battery
E. Bender visual motor gestalt test

Back 7

A. Folstein Mini-Mental State examination

Front 8

Which test is designed to assess level of consciousnes by rating patient responsiveness?
A. Folstein Mini-Mental State examination
B. Glasgow Coma scale
C. Halstead-Reitan battery
D. Luria- Nebraska neuropsychological battery
E. Bender visual motor gestalt test

Back 8

B. Glasgow Coma scale

Front 9

Which test is designed to detect and localize brain lesions and determine their effects?
A. Folstein Mini-Mental State examination
B. Glasgow Coma scale
C. Halstead-Reitan battery
D. Luria- Nebraska neuropsychological battery
E. Bender visual motor gestalt test

Back 9

C. Halstead-Reitan battery

Front 10

Which test is designed to determine L or R cerebral dominance and to identify specific types of brain dysfunction, such as dyslexia ?
A. Folstein Mini-Mental State examination
B. Glasgow Coma scale
C. Halstead-Reitan battery
D. Luria- Nebraska neuropsychological battery
E. Bender visual motor gestalt test

Back 10

D. Luria- Nebraska neuropsychological battery

Front 11

Which test is designed to evaluate visual and motor ability through the reproduction of designs?
A. Folstein Mini-Mental State examination
B. Glasgow Coma scale
C. Halstead-Reitan battery
D. Luria- Nebraska neuropsychological battery
E. Bender visual motor gestalt test

Back 11

E. Bender visual motor gestalt test

Front 12

Administration of __________ can provoke a panic attack in susceptible patients and can thus help to identify individuals with panic disorder. Inhalation of ____ can produce the same effect.

Back 12

sodium lactate , CO2

Front 13

In the galvanic skin response, the higher sweat gland activity, seen with sympathetic nervous system arousal as when lying, results in [ decreased / increased ] skin resistance and a positive test.

Back 13

decreased skin resistance --> positive test

note, though, that innocent but anxious people may also have positive tests (false positives)

Front 14

Regarding the Glasgow coma scale, the max total score is _____, lowest is _____. A GSC score of ____ indicates mild, ______ indicates moderate and ____ indicates severe neurologic impairment. Scores come from best eye-opening, response, best verbal response, and best motor response.

Back 14

Glasgow coma scale: high 15 and min 3.
mild is >12
moderate 9-12
severe neurologic impairment <9

see p. 47 table 5-4 for scoring breakdown