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324 Cards in this Set
- Front
- Back
|
What are the 5 different categories of catatonic motor behavior?
|
stupor, rigidity, waxy felxibility (catalepsy), excitement, posturing and mannerisms
|
|
|
This type of catatonic motor behavior is seen when the patient has a marked decrease in reactivity to the environment along with reduction of spontaneous movements and activity?
|
stupor
|
|
|
You try to move the patient and he exhibits resistance to passive movement. What kind of Catatonic motor behavior is this?
|
Rigidity
|
|
|
You go ahead and place John's right hand above his head and it stays there for 15 seconds. What kind of catatonic motor behavior is this?
|
waxy flexibility (catalepsy)
|
|
|
This is a type of catatonic motor behavior when the patient experiences purposeless and stereotyped excited motor activity not influenced by external stimuli?
|
Excitement
|
|
|
A patient exhibits manneristic gestures or tics, voluntarily assuming inappropriate or bizzare postures?
|
Posturing and mannerisms (seen in catatonic motor behavior)
|
|
|
What could be mistaken for catatonia, when a patient exhibits weird manneristic gestures or tics?
|
Tardive dyskinesia
|
|
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While talking about the patient's recent loss of her son, she elicits a smile and starts laughing. What kind of affect is this?
|
Inappropriate
|
|
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This is the term used to refer to the impoverished thinking and cognition that often occurs in patients with schizophrenia. The most common manifestations of this are poverty of speech and poverty of content of speech?
|
Alogia
|
|
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You interview the patient and are found that u need to constantly prompt the patient, his replies are brief and unelaborated. This best is described by what term?
|
Poverty of speech
|
|
|
The patient goes about awnsering the question in a long-winded, vague, over-abstract or overconcrete, repetetive and stereotyped response. It could have easily been shortened to a sentence. Not enough info has been given to anwser the question. What is this an example of?
|
Poverty of content of speech
|
|
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What is the difference between poverty of content of speech and circumstantiality?
|
Circumstantiality repsonses provide a wealth of detail
|
|
|
The patient starts to anwser the question but then pauses and after a minute says "What was I saying"?
|
Blocking
|
|
|
You question the patient but it takes him 30 seconds to reply. The patient takes a longer time to respond than what is considered normal?
|
Increased latency of response
|
|
|
The patient uses words and phrases repeatedly during his anwser?
|
perseveration
|
|
|
What are some examples of affective blunting or flattening?
|
Unchanged facial expression; Decreased spontaneous movements; Paucity of expressive gestures; Poor eye contact; Affective nonresponsivity; lack of vocal inflections
|
|
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What is an example of affective nonresponsivity?
|
you tell a funny joke and the patient does not smile (maybe affective blunting/flatening)
|
|
|
What does avolition-apathy manifest itself?
|
a characteristic lack of energy and drive, often leads to severe social and economic impairment
|
|
|
What are some characteristics of avolition-apathy?
|
poor grooming and hygiene; impersistence at work or school; physical anergia (just sits around)
|
|
|
Anhedonia-associality encompasses difficulties for the patient in what?
|
experiencing interest or pleasure (including hobbies, sexual interest; social interest (often alone); poor attention; social inattentiveness; may perform poorly on mini-mental
|
|
|
What are some of the Manic Symptoms?
|
Euphoric mood, Increase in activity, Racing thoughts, Inflated self esteem, Decreased need for sleep, Distractibility, Poor judgment
|
|
|
What are some depressive symptoms?
|
dysphoric mood (sad or unhappy); change in appetite or weight; insomnia or hypersomnia (increase REM); psychomotor agitation; psychomotor retardation; loss of interest, loss of energy, feelings of worthlesness, diminished ability to think or concentrate, recurrent thoughts of death/suicide, distinct quality of mood, nonreactivity to mood, diurnal variation
|
|
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T/F diurnal variation in mood is inconsistent with depression?
|
FALSE; this can be seen (some people feel better in the morning)
|
|
|
T/F Depressive mood is similar to that experienced when a loved one passes away?
|
FALSE; it will be subjectively different to the loss of loved done
|
|
|
A patient has discrete episodes of intense fear or discomfort. During these episodes he feels short of breath, dizzy, and shaking with palpitations. What is this liley?
|
panic attack (anxiety symptom)
|
|
|
Agoraphobia is associated with (depression, mania, anxiety)?
|
anxiety (fear of going outside)
|
|
|
John doesn't want to go to the party for fear of possible humiliation or embarrasment, he chooses to stay home. This is associated with (depression, anxiety, mania)?
|
anxiety (social phobia)
|
|
|
Specific phobias are associated with (depression, mania, anxiety)?
|
anxiety
|
|
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Susan has repetetive thoughts about hurting her child, she cosntantly is worrying about what these thoughts mean and tries very hard to supress them. This is a symptom of (depression, mania, anxiety)?
|
anxiety
|
|
|
James has to wash his hands over and over again after touching raw chicken. This is more likely (depressive symptom, manic symptom, anxiety)?
|
anxiety (compulsions)
|
|
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Phil recently stopped playing videogames and has recently experienced difficutly sleeping. He cannot sit still and when asked he admits that he has thought about suicide. What kinds of symptoms is Phil experiencing?
|
depressive
|
|
|
Miranda hasn't slept in the past few days because she says that she doesn’t need to. She appears to have an increased self-esteem. She recently bought a boat for no reason. Overall she says that she has been feeling very good. What kinds of symptoms could these be?
|
Manic
|
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Frank recently stopped going to baseball games, his favorite hobby. His wife complains that he makes no effort to satisfy his sexual drive. She also says that he has been "distant", and has problems making and keeping friends, spending all of his time alone. What can frank have?
|
Anhedonia-asociality (usually seen in mood disorders and schizos)
|
|
|
Tom comes in porrly dressed and smell aweful. He recently got fired from his job and has been sitting around the house not doing anything. When asked he does not feel sad or depressed. What is this an example of?
|
Avolition apathy (common in schizo)
|
|
|
During the interview, sam has no change in vocal inflection, has poor eye contact, fails to smile at the joke said, and his face appears wooden. This is an example of?
|
affective blunting/flattening
|
|
|
delusion
|
"false beliefs; the severity depends on the persistence, complexity, extent to which the patient acts or doubts them and extent at which they deviate from nonpsychotic ppls beliefs.
|
|
|
overvalued ideas
|
beliefs held with less delusional intensity
|
|
|
persecutory deluisions
|
ppl who believe they are being conspired against or persecuted in some way
|
|
|
delusions of jealousy
|
believes that his/her spouse or partner is having an affair with someone
|
|
|
delusions of sin or guilt
|
"patient believes that he or she has committed some terrible sin or done something unforgivable
|
|
|
grandiose delusions
|
patient that he or she has special powers or abilities of is a famous person, such as a rock star, napoleon or christ
|
|
|
religious delusions
|
the patient is preoccupied with false beliefs of a religious nature. they must be outside the range of beliefs considered normal for the patients cultural and religious background
|
|
|
somatic delusions
|
the patient believes that somehow his or her body is diseased, abnormal or changed. ex. belief that his or her stomach is rotting
|
|
|
ideas and delusion of reference
|
"pts believes that insignificant remarks, statements or events refer to him or her or have some special meaning for him or her.
|
|
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delusions of passivity
|
"pts has a subjective experience that his or her feelings or actions are controlled by some outside forces
|
|
|
delusions of mind reading
|
pts believes that people can read his or her mind or know his or her thoughts
|
|
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thought broadcasting/audible thoughts
|
"pts believes that his or her thoughts are broadcasted so that he or she or others can hear them
|
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thought insertion
|
pts believes that thoughts that are not his or her own have been inserted into his or her mind
|
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thought withdrawal
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pts believes that thoughts have been taken away from his or her mind. describes a subjective experience where they begin a thought and it is quickly removed by some outside force
|
|
|
auditory hallucinations
|
hearing voices speaking to them is most common, but can involve also hearing noises or sounds (these later are less severe)
|
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voices commenting
|
hearing a voice that makes a running commentary on the pts behavior or thought as it occurs
|
|
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voices conversing
|
hearing two or more voices talking with each other usually discussing something about the pt.
|
|
|
somatic or tactile hallucinations
|
experiencing peculiar physical sensations in the body. they can involve burning, itching, tingling or feeling the body changing shape/size
|
|
|
olfactory hallucinations
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experiences unusual smells that are typically quite unpleasant. ex. pt believes they smell bad.
|
|
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visual hallucination
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"the patient sees shapes or ppl that are not actually present
|
|
|
disorganized speech
|
"positive formal thought disorder" is fluent speech that tends to communicate poorly for a variety of reasons. skip form topic to topic , join words, ignore the question asked
|
|
|
derailment
|
loose associations is a pattern of spontaneous speech that slip off track onto another that is clearly bur obliquely related or onto one completely unrelated
|
|
|
tangentiality
|
pt responds to the question in an oblique, tangential or even irrelevant manner
|
|
|
incoherence
|
word salad, schizophasia is a pattern of speech that is incomprehensible at times; often is accompanied by derailment, but the words/phrase that are joined do not make sense
|
|
|
illogically
|
pts has a pattern of speech in which conclusions are reached that do not follow logically
|
|
|
circumstantiality
|
pt has a pattern of speech that is very indirect and delayed in reaching its goals ideas. speaker gives way to many details
|
|
|
pressure of speech
|
increased amount of spontaneous speech as compared with what is considered ordinary socially customary
|
|
|
distractible speech
|
in the course of a discussion/interview the pt stops talking in the middle of the sentence or idea and changes the subject in response to nearby stimulus, such as an obj. on the desk etc.
|
|
|
clanging
|
pt has a pattern of speech in which sounds rather than meaningful relations appear to govern word choice, so that the intelligibility of the speech is impaired and redundant words are introduced in addition to rhyming relationships
|
|
|
chronic/insidiuos onset "
|
dementia
|
|
|
acute or rapid onset"
|
delirium
|
|
|
sensorium clouded"
|
delirium
|
|
|
sensorium unimpaired early on"
|
dementia
|
|
|
normal level or arousal "
|
dementia
|
|
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agitation or stupor"
|
delirium
|
|
|
usually progressive and deteriorating"
|
dementia
|
|
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often reversible"
|
delirium
|
|
|
common in nursing homes and psych hospitals"
|
dementia
|
|
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common in medical, surgical and neurological wards"
|
delirium
|
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what is the hallmark of delirium
|
rapid development of disorientation, confusion and global cognitive impairment
|
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what are the causes of delirium
|
due to some med. condition, substance induced, multiple etiologies, idopathic
|
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how do you manage/treat delirium
|
"identify the underlying cause of the delirium and treat the cause
|
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true or false delirium is NOT a disease its a syndrome
|
TRUE
|
|
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if an alcoholic patient who is post surgical becomes delirious what medication is indicated
|
benzodiazepines can help with the withdrawal state
|
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what are the 4 A's of dementia
|
aphasia, amnesia, apraxia (failure to carry out complex motor activities), agnosia (failure to recognize or id objects)
|
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what is the most common degenerative dementia
|
"alzheimers disease
|
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in familial alzheimers mutations have been linked to what chromosomes
|
1, 14, 21
|
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with alzheimers what is seen on CT or MRI
|
cortical atrophy and enlarged cerebral ventricles
|
|
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loss of cholinergic neurons in the basal forebrain is consistent with what dementia?
|
alzheimers
|
|
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what are the major cholinergic projections?
|
nucleus basalis projects to the neocortex and pedunculopotine nucleus projects to the thalamus
|
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what are risk factors for alzheimers?
|
head injury, downs, low educational/occupational level and family history
|
|
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a mutation of Apolipoprotein E on chromosome 19 increase a patients risk of?
|
alzheimers
|
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what are some characteristic atopsy findings of an alzheimers brain
|
senile plaques, neurofibillary tangles- hyperphosphorylated tau protein, neuronal granulovaculoar degeneration of nerve cell bodies, hirano bodies
|
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what are the clinical features of lewy body dementia
|
irreversible, progressive, visual hallucinations and parkinsonian features occur early on, lewy bodies are seen in the cerebral cortex,
|
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what is a lewy body
|
eosinophilic inclusion bodies
|
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what drugs are pts with lewy body dementia extremely sensitive too?
|
"sensitive to the extrapyramidal side effects of antipsychotics
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what is the histopath of picks/frontotemporal dementia
|
tau positive inclusions (pick bodies)
|
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what are the two clinical syndromes of pick/frontotemporal dementia
|
"disinhibition and shallow affect, socially inappropriate behavior,
|
|
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what is the clinical presentation of huntingtons
|
"mild depression, anxiety, frank hallucinations and delusions
|
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what chromosome is implicated in huntingtons
|
chromosome 4
|
|
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what is clinical presentation of Creutzfeldt Jakob? EEG presentation?
|
"severe cerebellar and/or extrapyramidal signs along with myoclonus
|
|
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how do you get Creutzfelt Jakob disease
|
"sporadically or via infection
|
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is there treatment of huntingtons or creutzfeldt jakob
|
NO
|
|
|
social?"
|
"BIO-memantine- NMDA blocker(cognitive enhance), cholinesterase inhibitor, SSRI for depression - all drugs just slow decline
|
|
|
what are the treatable forms of dementia
|
vascular, normal pressure hydrocephalus, infections, metabolic disorders, nutritional disorders
|
|
|
what metabolic disorders cause dementia
|
"chronic thyroid, parathyroid, adrenal and pituitary disease can cause reversible dementia
|
|
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what nutritional disorders can cause dementia
|
"chronic alcoholism leading to thiamine deficiency leading to wernickes
|
|
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what are common infections that cause dementia
|
"mengitis/encephlalitis causing virus/bacteria
|
|
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what is the triad of normal hydrocephalus
|
dementia, gait disturbance and urinary incontinence
|
|
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what is the mechanism of normal pressure hydrocephalus
|
"excessive accumulation of CSF in the ventricles do to a block in flow
|
|
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what is the second most common cause of dementia
|
vascular dementia
|
|
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what is vascular dementia
|
"dementia caused by mutlitple infarcts and results from the accumulation of cerebral infarcts in a person with atherosclerotic disease
|
|
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true or false a high mortality is associated with delirium
|
TRUE
|
|
|
What are the 5 different categories of catatonic motor behavior?
|
stupor, rigidity, waxy felxibility (catalepsy), excitement, posturing and mannerisms
|
|
|
This type of catatonic motor behavior is seen when the patient has a marked decrease in reactivity to the environment along with reduction of spontaneous movements and activity?
|
stupor
|
|
|
You try to move the patient and he exhibits resistance to passive movement. What kind of Catatonic motor behavior is this?
|
Rigidity
|
|
|
You go ahead and place John's right hand above his head and it stays there for 15 seconds. What kind of catatonic motor behavior is this?
|
waxy flexibility (catalepsy)
|
|
|
This is a type of catatonic motor behavior when the patient experiences purposeless and stereotyped excited motor activity not influenced by external stimuli?
|
Excitement
|
|
|
A patient exhibits manneristic gestures or tics, voluntarily assuming inappropriate or bizzare postures?
|
Posturing and mannerisms (seen in catatonic motor behavior)
|
|
|
What could be mistaken for catatonia, when a patient exhibits weird manneristic gestures or tics?
|
Tardive dyskinesia
|
|
|
While talking about the patient's recent loss of her son, she elicits a smile and starts laughing. What kind of affect is this?
|
Inappropriate
|
|
|
This is the term used to refer to the impoverished thinking and cognition that often occurs in patients with schizophrenia. The most common manifestations of this are poverty of speech and poverty of content of speech?
|
Alogia
|
|
|
You interview the patient and are found that u need to constantly prompt the patient, his replies are brief and unelaborated. This best is described by what term?
|
Poverty of speech
|
|
|
The patient goes about awnsering the question in a long-winded, vague, over-abstract or overconcrete, repetetive and stereotyped response. It could have easily been shortened to a sentence. Not enough info has been given to anwser the question. What is this an example of?
|
Poverty of content of speech
|
|
|
What is the difference between poverty of content of speech and circumstantiality?
|
Circumstantiality repsonses provide a wealth of detail
|
|
|
The patient starts to anwser the question but then pauses and after a minute says "What was I saying"?
|
Blocking
|
|
|
You question the patient but it takes him 30 seconds to reply. The patient takes a longer time to respond than what is considered normal?
|
Increased latency of response
|
|
|
The patient uses words and phrases repeatedly during his anwser?
|
perseveration
|
|
|
What are some examples of affective blunting or flattening?
|
Unchanged facial expression; Decreased spontaneous movements; Paucity of expressive gestures; Poor eye contact; Affective nonresponsivity; lack of vocal inflections
|
|
|
What is an example of affective nonresponsivity?
|
you tell a funny joke and the patient does not smile (maybe affective blunting/flatening)
|
|
|
What does avolition-apathy manifest itself?
|
a characteristic lack of energy and drive, often leads to severe social and economic impairment
|
|
|
What are some characteristics of avolition-apathy?
|
poor grooming and hygiene; impersistence at work or school; physical anergia (just sits around)
|
|
|
Anhedonia-associality encompasses difficulties for the patient in what?
|
experiencing interest or pleasure (including hobbies, sexual interest; social interest (often alone); poor attention; social inattentiveness; may perform poorly on mini-mental
|
|
|
What are some of the Manic Symptoms?
|
Euphoric mood, Increase in activity, Racing thoughts, Inflated self esteem, Decreased need for sleep, Distractibility, Poor judgment
|
|
|
What are some depressive symptoms?
|
dysphoric mood (sad or unhappy); change in appetite or weight; insomnia or hypersomnia (increase REM); psychomotor agitation; psychomotor retardation; loss of interest, loss of energy, feelings of worthlesness, diminished ability to think or concentrate, recurrent thoughts of death/suicide, distinct quality of mood, nonreactivity to mood, diurnal variation
|
|
|
T/F diurnal variation in mood is inconsistent with depression?
|
FALSE; this can be seen (some people feel better in the morning)
|
|
|
T/F Depressive mood is similar to that experienced when a loved one passes away?
|
FALSE; it will be subjectively different to the loss of loved done
|
|
|
A patient has discrete episodes of intense fear or discomfort. During these episodes he feels short of breath, dizzy, and shaking with palpitations. What is this liley?
|
panic attack (anxiety symptom)
|
|
|
Agoraphobia is associated with (depression, mania, anxiety)?
|
anxiety (fear of going outside)
|
|
|
John doesn't want to go to the party for fear of possible humiliation or embarrasment, he chooses to stay home. This is associated with (depression, anxiety, mania)?
|
anxiety (social phobia)
|
|
|
Specific phobias are associated with (depression, mania, anxiety)?
|
anxiety
|
|
|
Susan has repetetive thoughts about hurting her child, she cosntantly is worrying about what these thoughts mean and tries very hard to supress them. This is a symptom of (depression, mania, anxiety)?
|
anxiety
|
|
|
James has to wash his hands over and over again after touching raw chicken. This is more likely (depressive symptom, manic symptom, anxiety)?
|
anxiety (compulsions)
|
|
|
Phil recently stopped playing videogames and has recently experienced difficutly sleeping. He cannot sit still and when asked he admits that he has thought about suicide. What kinds of symptoms is Phil experiencing?
|
depressive
|
|
|
Miranda hasn't slept in the past few days because she says that she doesn’t need to. She appears to have an increased self-esteem. She recently bought a boat for no reason. Overall she says that she has been feeling very good. What kinds of symptoms could these be?
|
Manic
|
|
|
Frank recently stopped going to baseball games, his favorite hobby. His wife complains that he makes no effort to satisfy his sexual drive. She also says that he has been "distant", and has problems making and keeping friends, spending all of his time alone. What can frank have?
|
Anhedonia-asociality (usually seen in mood disorders and schizos)
|
|
|
Tom comes in porrly dressed and smell aweful. He recently got fired from his job and has been sitting around the house not doing anything. When asked he does not feel sad or depressed. What is this an example of?
|
Avolition apathy (common in schizo)
|
|
|
During the interview, sam has no change in vocal inflection, has poor eye contact, fails to smile at the joke said, and his face appears wooden. This is an example of?
|
affective blunting/flattening
|
|
|
delusion
|
"false beliefs; the severity depends on the persistence, complexity, extent to which the patient acts or doubts them and extent at which they deviate from nonpsychotic ppls beliefs.
|
|
|
overvalued ideas
|
beliefs held with less delusional intensity
|
|
|
persecutory deluisions
|
ppl who believe they are being conspired against or persecuted in some way
|
|
|
delusions of jealousy
|
believes that his/her spouse or partner is having an affair with someone
|
|
|
delusions of sin or guilt
|
"patient believes that he or she has committed some terrible sin or done something unforgivable
|
|
|
grandiose delusions
|
patient that he or she has special powers or abilities of is a famous person, such as a rock star, napoleon or christ
|
|
|
religious delusions
|
the patient is preoccupied with false beliefs of a religious nature. they must be outside the range of beliefs considered normal for the patients cultural and religious background
|
|
|
somatic delusions
|
the patient believes that somehow his or her body is diseased, abnormal or changed. ex. belief that his or her stomach is rotting
|
|
|
ideas and delusion of reference
|
"pts believes that insignificant remarks, statements or events refer to him or her or have some special meaning for him or her.
|
|
|
delusions of passivity
|
"pts has a subjective experience that his or her feelings or actions are controlled by some outside forces
|
|
|
delusions of mind reading
|
pts believes that people can read his or her mind or know his or her thoughts
|
|
|
thought broadcasting/audible thoughts
|
"pts believes that his or her thoughts are broadcasted so that he or she or others can hear them
|
|
|
thought insertion
|
pts believes that thoughts that are not his or her own have been inserted into his or her mind
|
|
|
thought withdrawal
|
pts believes that thoughts have been taken away from his or her mind. describes a subjective experience where they begin a thought and it is quickly removed by some outside force
|
|
|
auditory hallucinations
|
hearing voices speaking to them is most common, but can involve also hearing noises or sounds (these later are less severe)
|
|
|
voices commenting
|
hearing a voice that makes a running commentary on the pts behavior or thought as it occurs
|
|
|
voices conversing
|
hearing two or more voices talking with each other usually discussing something about the pt.
|
|
|
somatic or tactile hallucinations
|
experiencing peculiar physical sensations in the body. they can involve burning, itching, tingling or feeling the body changing shape/size
|
|
|
olfactory hallucinations
|
experiences unusual smells that are typically quite unpleasant. ex. pt believes they smell bad.
|
|
|
visual hallucination
|
"the patient sees shapes or ppl that are not actually present
|
|
|
disorganized speech
|
"positive formal thought disorder" is fluent speech that tends to communicate poorly for a variety of reasons. skip form topic to topic , join words, ignore the question asked
|
|
|
derailment
|
loose associations is a pattern of spontaneous speech that slip off track onto another that is clearly bur obliquely related or onto one completely unrelated
|
|
|
tangentiality
|
pt responds to the question in an oblique, tangential or even irrelevant manner
|
|
|
incoherence
|
word salad, schizophasia is a pattern of speech that is incomprehensible at times; often is accompanied by derailment, but the words/phrase that are joined do not make sense
|
|
|
illogically
|
pts has a pattern of speech in which conclusions are reached that do not follow logically
|
|
|
circumstantiality
|
pt has a pattern of speech that is very indirect and delayed in reaching its goals ideas. speaker gives way to many details
|
|
|
pressure of speech
|
increased amount of spontaneous speech as compared with what is considered ordinary socially customary
|
|
|
distractible speech
|
in the course of a discussion/interview the pt stops talking in the middle of the sentence or idea and changes the subject in response to nearby stimulus, such as an obj. on the desk etc.
|
|
|
clanging
|
pt has a pattern of speech in which sounds rather than meaningful relations appear to govern word choice, so that the intelligibility of the speech is impaired and redundant words are introduced in addition to rhyming relationships
|
|
|
chronic/insidiuos onset "
|
dementia
|
|
|
acute or rapid onset"
|
delirium
|
|
|
sensorium clouded"
|
delirium
|
|
|
sensorium unimpaired early on"
|
dementia
|
|
|
normal level or arousal "
|
dementia
|
|
|
agitation or stupor"
|
delirium
|
|
|
usually progressive and deteriorating"
|
dementia
|
|
|
often reversible"
|
delirium
|
|
|
common in nursing homes and psych hospitals"
|
dementia
|
|
|
common in medical, surgical and neurological wards"
|
delirium
|
|
|
what is the hallmark of delirium
|
rapid development of disorientation, confusion and global cognitive impairment
|
|
|
what are the causes of delirium
|
due to some med. condition, substance induced, multiple etiologies, idopathic
|
|
|
how do you manage/treat delirium
|
"identify the underlying cause of the delirium and treat the cause
|
|
|
true or false delirium is NOT a disease its a syndrome
|
TRUE
|
|
|
if an alcoholic patient who is post surgical becomes delirious what medication is indicated
|
benzodiazepines can help with the withdrawal state
|
|
|
what are the 4 A's of dementia
|
aphasia, amnesia, apraxia (failure to carry out complex motor activities), agnosia (failure to recognize or id objects)
|
|
|
what is the most common degenerative dementia
|
"alzheimers disease
|
|
|
in familial alzheimers mutations have been linked to what chromosomes
|
1, 14, 21
|
|
|
with alzheimers what is seen on CT or MRI
|
cortical atrophy and enlarged cerebral ventricles
|
|
|
loss of cholinergic neurons in the basal forebrain is consistent with what dementia?
|
alzheimers
|
|
|
what are the major cholinergic projections?
|
nucleus basalis projects to the neocortex and pedunculopotine nucleus projects to the thalamus
|
|
|
what are risk factors for alzheimers?
|
head injury, downs, low educational/occupational level and family history
|
|
|
a mutation of Apolipoprotein E on chromosome 19 increase a patients risk of?
|
alzheimers
|
|
|
what are some characteristic atopsy findings of an alzheimers brain
|
senile plaques, neurofibillary tangles- hyperphosphorylated tau protein, neuronal granulovaculoar degeneration of nerve cell bodies, hirano bodies
|
|
|
what are the clinical features of lewy body dementia
|
irreversible, progressive, visual hallucinations and parkinsonian features occur early on, lewy bodies are seen in the cerebral cortex,
|
|
|
what is a lewy body
|
eosinophilic inclusion bodies
|
|
|
what drugs are pts with lewy body dementia extremely sensitive too?
|
"sensitive to the extrapyramidal side effects of antipsychotics
|
|
|
what is the histopath of picks/frontotemporal dementia
|
tau positive inclusions (pick bodies)
|
|
|
what are the two clinical syndromes of pick/frontotemporal dementia
|
"disinhibition and shallow affect, socially inappropriate behavior,
|
|
|
what is the clinical presentation of huntingtons
|
"mild depression, anxiety, frank hallucinations and delusions
|
|
|
what chromosome is implicated in huntingtons
|
chromosome 4
|
|
|
what is clinical presentation of Creutzfeldt Jakob? EEG presentation?
|
"severe cerebellar and/or extrapyramidal signs along with myoclonus
|
|
|
how do you get Creutzfelt Jakob disease
|
"sporadically or via infection
|
|
|
is there treatment of huntingtons or creutzfeldt jakob
|
NO
|
|
|
social?"
|
"BIO-memantine- NMDA blocker(cognitive enhance), cholinesterase inhibitor, SSRI for depression - all drugs just slow decline
|
|
|
what are the treatable forms of dementia
|
vascular, normal pressure hydrocephalus, infections, metabolic disorders, nutritional disorders
|
|
|
what metabolic disorders cause dementia
|
"chronic thyroid, parathyroid, adrenal and pituitary disease can cause reversible dementia
|
|
|
what nutritional disorders can cause dementia
|
"chronic alcoholism leading to thiamine deficiency leading to wernickes
|
|
|
what are common infections that cause dementia
|
"mengitis/encephlalitis causing virus/bacteria
|
|
|
what is the triad of normal hydrocephalus
|
dementia, gait disturbance and urinary incontinence
|
|
|
what is the mechanism of normal pressure hydrocephalus
|
"excessive accumulation of CSF in the ventricles do to a block in flow
|
|
|
what is the second most common cause of dementia
|
vascular dementia
|
|
|
what is vascular dementia
|
"dementia caused by mutlitple infarcts and results from the accumulation of cerebral infarcts in a person with atherosclerotic disease
|
|
|
true or false a high mortality is associated with delirium
|
TRUE
|
|
|
What are the 5 different categories of catatonic motor behavior?
|
stupor, rigidity, waxy felxibility (catalepsy), excitement, posturing and mannerisms
|
|
|
This type of catatonic motor behavior is seen when the patient has a marked decrease in reactivity to the environment along with reduction of spontaneous movements and activity?
|
stupor
|
|
|
You try to move the patient and he exhibits resistance to passive movement. What kind of Catatonic motor behavior is this?
|
Rigidity
|
|
|
You go ahead and place John's right hand above his head and it stays there for 15 seconds. What kind of catatonic motor behavior is this?
|
waxy flexibility (catalepsy)
|
|
|
This is a type of catatonic motor behavior when the patient experiences purposeless and stereotyped excited motor activity not influenced by external stimuli?
|
Excitement
|
|
|
A patient exhibits manneristic gestures or tics, voluntarily assuming inappropriate or bizzare postures?
|
Posturing and mannerisms (seen in catatonic motor behavior)
|
|
|
What could be mistaken for catatonia, when a patient exhibits weird manneristic gestures or tics?
|
Tardive dyskinesia
|
|
|
While talking about the patient's recent loss of her son, she elicits a smile and starts laughing. What kind of affect is this?
|
Inappropriate
|
|
|
This is the term used to refer to the impoverished thinking and cognition that often occurs in patients with schizophrenia. The most common manifestations of this are poverty of speech and poverty of content of speech?
|
Alogia
|
|
|
You interview the patient and are found that u need to constantly prompt the patient, his replies are brief and unelaborated. This best is described by what term?
|
Poverty of speech
|
|
|
The patient goes about awnsering the question in a long-winded, vague, over-abstract or overconcrete, repetetive and stereotyped response. It could have easily been shortened to a sentence. Not enough info has been given to anwser the question. What is this an example of?
|
Poverty of content of speech
|
|
|
What is the difference between poverty of content of speech and circumstantiality?
|
Circumstantiality repsonses provide a wealth of detail
|
|
|
The patient starts to anwser the question but then pauses and after a minute says "What was I saying"?
|
Blocking
|
|
|
You question the patient but it takes him 30 seconds to reply. The patient takes a longer time to respond than what is considered normal?
|
Increased latency of response
|
|
|
The patient uses words and phrases repeatedly during his anwser?
|
perseveration
|
|
|
What are some examples of affective blunting or flattening?
|
Unchanged facial expression; Decreased spontaneous movements; Paucity of expressive gestures; Poor eye contact; Affective nonresponsivity; lack of vocal inflections
|
|
|
What is an example of affective nonresponsivity?
|
you tell a funny joke and the patient does not smile (maybe affective blunting/flatening)
|
|
|
What does avolition-apathy manifest itself?
|
a characteristic lack of energy and drive, often leads to severe social and economic impairment
|
|
|
What are some characteristics of avolition-apathy?
|
poor grooming and hygiene; impersistence at work or school; physical anergia (just sits around)
|
|
|
Anhedonia-associality encompasses difficulties for the patient in what?
|
experiencing interest or pleasure (including hobbies, sexual interest; social interest (often alone); poor attention; social inattentiveness; may perform poorly on mini-mental
|
|
|
What are some of the Manic Symptoms?
|
Euphoric mood, Increase in activity, Racing thoughts, Inflated self esteem, Decreased need for sleep, Distractibility, Poor judgment
|
|
|
What are some depressive symptoms?
|
dysphoric mood (sad or unhappy); change in appetite or weight; insomnia or hypersomnia (increase REM); psychomotor agitation; psychomotor retardation; loss of interest, loss of energy, feelings of worthlesness, diminished ability to think or concentrate, recurrent thoughts of death/suicide, distinct quality of mood, nonreactivity to mood, diurnal variation
|
|
|
T/F diurnal variation in mood is inconsistent with depression?
|
FALSE; this can be seen (some people feel better in the morning)
|
|
|
T/F Depressive mood is similar to that experienced when a loved one passes away?
|
FALSE; it will be subjectively different to the loss of loved done
|
|
|
A patient has discrete episodes of intense fear or discomfort. During these episodes he feels short of breath, dizzy, and shaking with palpitations. What is this liley?
|
panic attack (anxiety symptom)
|
|
|
Agoraphobia is associated with (depression, mania, anxiety)?
|
anxiety (fear of going outside)
|
|
|
John doesn't want to go to the party for fear of possible humiliation or embarrasment, he chooses to stay home. This is associated with (depression, anxiety, mania)?
|
anxiety (social phobia)
|
|
|
Specific phobias are associated with (depression, mania, anxiety)?
|
anxiety
|
|
|
Susan has repetetive thoughts about hurting her child, she cosntantly is worrying about what these thoughts mean and tries very hard to supress them. This is a symptom of (depression, mania, anxiety)?
|
anxiety
|
|
|
James has to wash his hands over and over again after touching raw chicken. This is more likely (depressive symptom, manic symptom, anxiety)?
|
anxiety (compulsions)
|
|
|
Phil recently stopped playing videogames and has recently experienced difficutly sleeping. He cannot sit still and when asked he admits that he has thought about suicide. What kinds of symptoms is Phil experiencing?
|
depressive
|
|
|
Miranda hasn't slept in the past few days because she says that she doesn’t need to. She appears to have an increased self-esteem. She recently bought a boat for no reason. Overall she says that she has been feeling very good. What kinds of symptoms could these be?
|
Manic
|
|
|
Frank recently stopped going to baseball games, his favorite hobby. His wife complains that he makes no effort to satisfy his sexual drive. She also says that he has been "distant", and has problems making and keeping friends, spending all of his time alone. What can frank have?
|
Anhedonia-asociality (usually seen in mood disorders and schizos)
|
|
|
Tom comes in porrly dressed and smell aweful. He recently got fired from his job and has been sitting around the house not doing anything. When asked he does not feel sad or depressed. What is this an example of?
|
Avolition apathy (common in schizo)
|
|
|
During the interview, sam has no change in vocal inflection, has poor eye contact, fails to smile at the joke said, and his face appears wooden. This is an example of?
|
affective blunting/flattening
|
|
|
delusion
|
"false beliefs; the severity depends on the persistence, complexity, extent to which the patient acts or doubts them and extent at which they deviate from nonpsychotic ppls beliefs.
|
|
|
overvalued ideas
|
beliefs held with less delusional intensity
|
|
|
persecutory deluisions
|
ppl who believe they are being conspired against or persecuted in some way
|
|
|
delusions of jealousy
|
believes that his/her spouse or partner is having an affair with someone
|
|
|
delusions of sin or guilt
|
"patient believes that he or she has committed some terrible sin or done something unforgivable
|
|
|
grandiose delusions
|
patient that he or she has special powers or abilities of is a famous person, such as a rock star, napoleon or christ
|
|
|
religious delusions
|
the patient is preoccupied with false beliefs of a religious nature. they must be outside the range of beliefs considered normal for the patients cultural and religious background
|
|
|
somatic delusions
|
the patient believes that somehow his or her body is diseased, abnormal or changed. ex. belief that his or her stomach is rotting
|
|
|
ideas and delusion of reference
|
"pts believes that insignificant remarks, statements or events refer to him or her or have some special meaning for him or her.
|
|
|
delusions of passivity
|
"pts has a subjective experience that his or her feelings or actions are controlled by some outside forces
|
|
|
delusions of mind reading
|
pts believes that people can read his or her mind or know his or her thoughts
|
|
|
thought broadcasting/audible thoughts
|
"pts believes that his or her thoughts are broadcasted so that he or she or others can hear them
|
|
|
thought insertion
|
pts believes that thoughts that are not his or her own have been inserted into his or her mind
|
|
|
thought withdrawal
|
pts believes that thoughts have been taken away from his or her mind. describes a subjective experience where they begin a thought and it is quickly removed by some outside force
|
|
|
auditory hallucinations
|
hearing voices speaking to them is most common, but can involve also hearing noises or sounds (these later are less severe)
|
|
|
voices commenting
|
hearing a voice that makes a running commentary on the pts behavior or thought as it occurs
|
|
|
voices conversing
|
hearing two or more voices talking with each other usually discussing something about the pt.
|
|
|
somatic or tactile hallucinations
|
experiencing peculiar physical sensations in the body. they can involve burning, itching, tingling or feeling the body changing shape/size
|
|
|
olfactory hallucinations
|
experiences unusual smells that are typically quite unpleasant. ex. pt believes they smell bad.
|
|
|
visual hallucination
|
"the patient sees shapes or ppl that are not actually present
|
|
|
disorganized speech
|
"positive formal thought disorder" is fluent speech that tends to communicate poorly for a variety of reasons. skip form topic to topic , join words, ignore the question asked
|
|
|
derailment
|
loose associations is a pattern of spontaneous speech that slip off track onto another that is clearly bur obliquely related or onto one completely unrelated
|
|
|
tangentiality
|
pt responds to the question in an oblique, tangential or even irrelevant manner
|
|
|
incoherence
|
word salad, schizophasia is a pattern of speech that is incomprehensible at times; often is accompanied by derailment, but the words/phrase that are joined do not make sense
|
|
|
illogically
|
pts has a pattern of speech in which conclusions are reached that do not follow logically
|
|
|
circumstantiality
|
pt has a pattern of speech that is very indirect and delayed in reaching its goals ideas. speaker gives way to many details
|
|
|
pressure of speech
|
increased amount of spontaneous speech as compared with what is considered ordinary socially customary
|
|
|
distractible speech
|
in the course of a discussion/interview the pt stops talking in the middle of the sentence or idea and changes the subject in response to nearby stimulus, such as an obj. on the desk etc.
|
|
|
clanging
|
pt has a pattern of speech in which sounds rather than meaningful relations appear to govern word choice, so that the intelligibility of the speech is impaired and redundant words are introduced in addition to rhyming relationships
|
|
|
chronic/insidiuos onset "
|
dementia
|
|
|
acute or rapid onset"
|
delirium
|
|
|
sensorium clouded"
|
delirium
|
|
|
sensorium unimpaired early on"
|
dementia
|
|
|
normal level or arousal "
|
dementia
|
|
|
agitation or stupor"
|
delirium
|
|
|
usually progressive and deteriorating"
|
dementia
|
|
|
often reversible"
|
delirium
|
|
|
common in nursing homes and psych hospitals"
|
dementia
|
|
|
common in medical, surgical and neurological wards"
|
delirium
|
|
|
what is the hallmark of delirium
|
rapid development of disorientation, confusion and global cognitive impairment
|
|
|
what are the causes of delirium
|
due to some med. condition, substance induced, multiple etiologies, idopathic
|
|
|
how do you manage/treat delirium
|
"identify the underlying cause of the delirium and treat the cause
|
|
|
true or false delirium is NOT a disease its a syndrome
|
TRUE
|
|
|
if an alcoholic patient who is post surgical becomes delirious what medication is indicated
|
benzodiazepines can help with the withdrawal state
|
|
|
what are the 4 A's of dementia
|
aphasia, amnesia, apraxia (failure to carry out complex motor activities), agnosia (failure to recognize or id objects)
|
|
|
what is the most common degenerative dementia
|
"alzheimers disease
|
|
|
in familial alzheimers mutations have been linked to what chromosomes
|
1, 14, 21
|
|
|
with alzheimers what is seen on CT or MRI
|
cortical atrophy and enlarged cerebral ventricles
|
|
|
loss of cholinergic neurons in the basal forebrain is consistent with what dementia?
|
alzheimers
|
|
|
what are the major cholinergic projections?
|
nucleus basalis projects to the neocortex and pedunculopotine nucleus projects to the thalamus
|
|
|
what are risk factors for alzheimers?
|
head injury, downs, low educational/occupational level and family history
|
|
|
a mutation of Apolipoprotein E on chromosome 19 increase a patients risk of?
|
alzheimers
|
|
|
what are some characteristic atopsy findings of an alzheimers brain
|
senile plaques, neurofibillary tangles- hyperphosphorylated tau protein, neuronal granulovaculoar degeneration of nerve cell bodies, hirano bodies
|
|
|
what are the clinical features of lewy body dementia
|
irreversible, progressive, visual hallucinations and parkinsonian features occur early on, lewy bodies are seen in the cerebral cortex,
|
|
|
what is a lewy body
|
eosinophilic inclusion bodies
|
|
|
what drugs are pts with lewy body dementia extremely sensitive too?
|
"sensitive to the extrapyramidal side effects of antipsychotics
|
|
|
what is the histopath of picks/frontotemporal dementia
|
tau positive inclusions (pick bodies)
|
|
|
what are the two clinical syndromes of pick/frontotemporal dementia
|
"disinhibition and shallow affect, socially inappropriate behavior,
|
|
|
what is the clinical presentation of huntingtons
|
"mild depression, anxiety, frank hallucinations and delusions
|
|
|
what chromosome is implicated in huntingtons
|
chromosome 4
|
|
|
what is clinical presentation of Creutzfeldt Jakob? EEG presentation?
|
"severe cerebellar and/or extrapyramidal signs along with myoclonus
|
|
|
how do you get Creutzfelt Jakob disease
|
"sporadically or via infection
|
|
|
is there treatment of huntingtons or creutzfeldt jakob
|
NO
|
|
|
social?"
|
"BIO-memantine- NMDA blocker(cognitive enhance), cholinesterase inhibitor, SSRI for depression - all drugs just slow decline
|
|
|
what are the treatable forms of dementia
|
vascular, normal pressure hydrocephalus, infections, metabolic disorders, nutritional disorders
|
|
|
what metabolic disorders cause dementia
|
"chronic thyroid, parathyroid, adrenal and pituitary disease can cause reversible dementia
|
|
|
what nutritional disorders can cause dementia
|
"chronic alcoholism leading to thiamine deficiency leading to wernickes
|
|
|
what are common infections that cause dementia
|
"mengitis/encephlalitis causing virus/bacteria
|
|
|
what is the triad of normal hydrocephalus
|
dementia, gait disturbance and urinary incontinence
|
|
|
what is the mechanism of normal pressure hydrocephalus
|
"excessive accumulation of CSF in the ventricles do to a block in flow
|
|
|
what is the second most common cause of dementia
|
vascular dementia
|
|
|
what is vascular dementia
|
"dementia caused by mutlitple infarcts and results from the accumulation of cerebral infarcts in a person with atherosclerotic disease
|
|
|
true or false a high mortality is associated with delirium
|
TRUE
|
