Ipe Spring Final

Front 1

Sexual Response Cycle

Back 1

Desire, Excitement (arousal) & plateau, Orgasm, Resolution

Front 2

Name 2 disorders associated with the DESIRE phase of the sexual response cycle.

Back 2

Hypoactive Sexual Desire Disorder
Sexual Aversion Disorder

Front 3

What are the physiological changes that occur during excitement (arousal)? (x5)

Back 3

vasoconstriction, skeletal muscle tension, hyperventilation, tachycardia, increased BP

Front 4

Name 2 disorders associated with the EXCITEMENT phase of the sexual response cycle.

Back 4

Female Sexual Arousal Disorder
Male Erectile Disorder

Front 5

What are the physiologic changes that occur during orgasm? (x4)

Back 5

rhythmic contractions of reproductive organs and mm, ejaculation, tachycardia, increased BP

Front 6

Name 3 disorders associate with the ORGASM phase of the sexual response cycle.

Back 6

Female Orgasmic Disorder
Male Orgasmic Disorder
Premature Ejaculation

Front 7

During what phase of the sexual response cycle are men refractory for a period of time?

Back 7

Resolution

Front 8

Name 3 sexual dysfunction disorders NOT associated with any specific phase of the sexual response cycle.

Back 8

Sexual Pain Disorder
Sexual Dysfunction due to General Med. Condition
Substance-Induced Sexual Dysfunction

Front 9

Adrenal Insufficiency,
Cushings,
Hyperprolactinemai,
Hypo/Hyperthyroidism,
Hypogonadism (testicular, ovarian, liver disease), Hypopituitarism

Back 9

Endocrine Disorders that cause sexual dysfunction

Front 10

Cord lesions,
Disc Disease of Lumbosacral Spine,
MS,
Neurogenic Bladder,
Neuromuscular Disease,
Peripheral Neuropathy,
Temporal/Cortical Lobe Leisons

Back 10

Neurological Disorders that cause sexual dysfunction - generally affecting the arousal and orgasm phases

Front 11

Large Artery Disease (Leriche's),
Small Artery Disease (Pelvic Vascular Insufficiency),
Venous Insufficiency

Back 11

Vascular Disease that cause sexual dysfunction

Front 12

What medications can cause sexual dysfunction?

Back 12

Antihypertensives,
Substance Abuse,
Psychiatric medications,
[Antihistamines, L-Dopa, Phenytoin, Bromocyptine] (CNS Drugs)
Hormones,
[Cimetidine, Digoxin, Disulfriam, Chemo]

Front 13

Under which section of ILLSS are sexual history questions asked?

Back 13

Interpersonal Relationships

Front 14

Give the 8 Step Approach to a Sexual History

Back 14

1. Take sexual history
2. assess causal factors
3. assess life-cycle issues
4. preform targeted physical exam
5. order tests
6. diagnose the sexual dysfunction
7, initiate treatment
8. refer to specialist

Front 15

Give the 10 components that should be part of every sexual history.

Back 15

Relationship status, sexual orientation, Frequency/type of sex, means of contraception, money or drug exchange?, sexual abuse, history of preg., history of STI, alcohol/ drug use, sex practices/fetishes

Front 16

How should you order your open and close-ended questions?

Back 16

May want to begin with close-ended and follow-up with open-ended to help with pt's comfort level

Front 17

Is appropriate to use the terms "impotence" or "adultery"

Back 17

No - demeaning and judgmental words

Front 18

How can you assess the pt's sexual functioning? (Men)

Back 18

Do you have any problems developing or maintaining an erection?
Any uncomfortable sensations with ejaculation?

Front 19

How can you assess the pt's sexual functioning? (Women)

Back 19

Do you have problems becoming excited or with lubrication?

Front 20

How can you assess the pt's sexual functioning? (both sexes)

Back 20

Do you have any problems with sexual interest?
Are you satisfied with your sexual functioning?
Do you reach orgasm? In the right amount of time?
Any changes in your or your partner's sexual experience lately?
Any pain with intercourse?
Does your illness interfere with sexual activity?

Front 21

What are some pyschcosocial/psychiatric illnesses that can cause sexual dysfunction?

Back 21

Depression (~40% of men and 50% of women with depression have dysfunction)
Bipolar Disorder
Social stress

Front 22

What specialist would you refer a pt. with a Bio related, psycho related, or social related sexual dysfunction?

Back 22

Bio - med specialist
Psycho - psychologist, psychiatrist, licensed sex therapist
Social - social worker, support group, domestic violence program, substance abuse program

Front 23

What STDs should be reported to public officials?

Back 23

infectious diseases (Chlamydia, Gonorrhea, Syphylis, Hep A), HIV, Injury caused by weapon or crime, impaired driver

Front 24

What is the purpose of the mental status Examination?

Back 24

obtain a comprehensive cross-sectional description of pt's mental state during 1st couple encounters with pt. in order to explore appropriate line of questions, generate a hypothesis, make an accurate diagnosis and trx plan

Front 25

What data is used in assessing the mental status of a pt?

Back 25

observation of pt. while giving exam,
focused questions about current symptoms,
medical or psychological testing

Front 26

Are the mental status exam and the Mini-Mental State Exam (MSE) the same thing?

Back 26

NO- MSE is a brief neuro-psychological screening of cognitive functioning

Front 27

What are the 10 components of the mental status exam?

Back 27

Gen. Appearance and Psychomotor Behavior,
Attitude (Raport),
Consciousness,
Attention and Concentration,
Speech,
Affect,
Mood,
Thinking and Perception,
Insight and Judgement,
Executive Functioning and Memory

Front 28

Psycho-motor, eye contact, mannerisms, abnormality of mvmts, language use

Back 28

Behavior (part of MSE)

Front 29

Pt's approach to interview and interaction with examiner: Cooperative, polite, hostile, vigilant,, defensive, suspicious

Back 29

Attitude (part of MSE)

Front 30

Disoriented, Confused, Attention loss, Distractable

Back 30

Attention and Concentration (part of MSE)

Front 31

Depressed, Dysphoric, Euthymic, euphoric, expansive

Back 31

Mood (part of MSE)

Front 32

Visible and audible manifestations of pt's response to external and internal events:
posture, facial mvmt, grooming, autonomic responses

Back 32

Affect (part of MSE)

Front 33

Flat, constricted, full, stable vs labile (constantly changing), congruent, reactive

Back 33

Mood

Front 34

Goal-directed, logical and connected, cicumstantiality, tangentiality, flight of ideas, though blocking

Back 34

Thought process (part of MSE)

Front 35

Topics, Danger, Obsessions & Compulsions, Delusions, Hallucinations

Back 35

Thought Content (part of MSE)

Front 36

Can pt. understand illness, causes, treatment, or consequences of one's actions?

Back 36

Insight and Judgement (part of MSE)

Front 37

What aspect of speech are you most concerned with for the MSE?

Back 37

Production of speech (content is assessed during thought content)

Front 38

What is the most subjective part of the MSE? Why?

Back 38

Attitude (Rapport) - depends on interview situation, skill/behavior of Dr., pre-existing relationship b/w Dr. and pt.

Front 39

What is psychogenic stupor?

Back 39

motor immobility and mutism

Front 40

Disturbances in sensory receptors and insight into hallucinations

Back 40

perception

Front 41

Pt's explanatory account of problem and understanding of trx options. 3 parts: recognition of condition, adherence to trx, ability to re-label unusual mental events as pathologic

Back 41

insight

Front 42

Pt. is able to choose appropriate goals and behaviors and integrate outside reality, internal stress, and living skills

Back 42

Judgement

Front 43

Planning, organizing, sequencing, abstracting, inhibition, mental flexability

Back 43

executive functioning

Front 44

What are the 6 neurocognitive domains of the DSM-5?

Back 44

complex attention,
executive functioning,
learning and memory,
language,
perceptual-motor,
social cognition (recognition of emotions and theory of mind)

Front 45

What scores on the Mini-Mental state Score indicate a 4th grade, 8th grade, high school, or college education?

Back 45

4th grade = 19-25
8th grade = 23-26
High School = 25-29
College = 27-29

Front 46

What are the diagnostic features of depression? How many are needed for a diagnosis?

Back 46

SIG ME CAPS - Sleep, Interest, Guilt, Mood, Energy, Concentration, Appetite, Pyschmotor, Suicide
Need 5 for Diagnosis with one being depressed mood or decrease in interests

Front 47

Chronic/Low-grade Depressed Mood for at least 2 years for majority of day, more days than not, more common in women, pts often comes in with psychomotor complaint

Back 47

Persistent Depressive disoder (Dysthymic Disorder)

Front 48

What are the risk factors for suicide?

Back 48

SAD PERSON(A)S - Sex (increased risk w/ males), age, depression, previous attempt, ethanol abuse, rational thinking, social support lacking, organized planning, no spouse, Abuse history, sickness

Front 49

Marked fear or anxiety about 1+ social situations where pt is exposed to scrutiny by others

Back 49

Social anxiety Disorder

Front 50

Recurrent, unexpected surges of intense fear or discomfort that reaches a peak w/in min. and is a accompanied by SNS arousal

Back 50

Panic Disoder

Front 51

Excessive anxiety/worry that is difficult to control and is accompanied by restlessness, sleep disturbance, fatigue, difficulty concentrating, mm tension, irritability, body pain. Must be present for at lease 6 months!

Back 51

Generalized Anxiety Disoder (GAD)

Front 52

How to screen for GAD

Back 52

WIPOA - Worry, Intrusive images, Panic, Obsessions, Avoidance

Front 53

Exposure to actual or threatened death/injury/sexual violence causing recurrent/intrusive memories of the event, recurrent/distressing dreams, dissociated rxn (flashbacks), prolonged psych distress and physical symptoms when exposed to external/internal cues, avoidance of stimuli related to event, negative alternations in mood associated with traumatic event, alterations in arousal and reactivity

Back 53

PTSD

Front 54

What's the difference between PTSD and Acute Stress Disorder?

Back 54

Acute Stress Disorder has a duration of one month or less while PTSD must occur for longer than one month

Front 55

Emotional/behavioral symptoms in response to an identifiable stressor occurring within 3 months of onset of stressor. Often occurs with anxiety, depressed mood, disturbance in conduct

Back 55

Adjustment Disorder

Front 56

Maladaptive pattern of substance use manifested by recurrent and consequences related to repeated use of substance

Back 56

Abuse

Front 57

Cognitive/Behavioral/Physiological symptoms that indicate that the individual uses the substance despite many substance-related symptoms

Back 57

Dependency

Front 58

Pattern of alcohol use leading to impairment or distress with alcohol being taken in larger amounts for longer periods of time than intended, multiple unsuccessful efforts to cut back, many activities to obtain/use/recover from alcohol, a craving for alcohol, and a failure to fulfill obligations at work

Back 58

Alcohol Use Disoder

Front 59

Substance abuse requirements for men and women

Back 59

Men: >14 drinks/week or >4/day more than 1x/week

Women: >7 drinks/week or >3/day more than 1x per week

Front 60

What are the diagnostic criteria for GAD?

Back 60

In last 2 weeks have you: felt nervous/anxious/on edge? Unable to stop or control worrying?
0 point for not at all, 1 point for several days, 2 for more than half the days, 3 for almost every day. Greater than 3 indicates a positive screen.