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72 Cards in this Set
- Front
- Back
- 3rd side (hint)
Most common childhood psychiatric disorders
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- pervasive disorders
- ADHD - Disruptive disorders |
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Mental retardation ranges
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- 50-70 = mild
- 35-50 = moderate - 20-35 = severe - below 20 = profound |
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% children with learning disorder
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5%
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Motor skills disorder often coexists with _______ _______
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communication disorders
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Treatment for motor skills disorder
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tx w/ sensory integration programs
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Tx for communication disorders
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Speech therapy
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Pervasive developmental disorders
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- autism
- childhood disintegrative disorder - asperger's disorder |
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Aspergers disorder
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Similar to autism but without language problem
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Rett's disorder
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rare - girls only - 0-5 mos - occurs after normal period of function - tx similar to autism
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Autism
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little eye contact and few facial experssions, hand flapping, body twisting, head banging, doesn't relate to peers
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Meds for autism
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used to treat sx, not disorder
- Antipsychotics; ReVia, Anafranil, Catabres, stimulants |
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goals in autism tx
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reduce behavioral sx and promote learning, development, and language skills
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Meds for ADHD
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stimulants: Ritalin, Adderall, Dexedrine, Cylert
--- antidepressants (eg. strattera, an SSRI) are 2nd choice. |
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Activity peaks (pattern for manic vs. ADHD patient)
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manic patient has 1 peak of activity/day
ADHD pt has 2 peaks/day |
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Important risk factor in conduct behavior
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child abuse
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Difference between conduct disorder and Oppositional Defiant Disorder
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Opp/Def feel bad and are aware of the effect of their behaviors on others
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Med tx for tic disorders
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treated w/ atypical antipsychotics such as olanzapine or risperidone
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coprolalia
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use of socially unacceptable words; frequently obscene
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palilalia
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repeating of ones own sounds or sords
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echolalia
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repeating the last-heard sound, word, or phrase
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transient tic disorder
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single or multiple vocal and/or motor tics, but does not last longer than 12 mos
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encopresis
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defecating in inappropriate places by a child of at least 4 years
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enuresis
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repeated urination during day or night in clothes or bed after age 5
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Tx for separation anxiety disorder
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behavior mod activities -- parent education and family therapy are essential
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Reactive Attachment disorder
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markedly distrubed and developmentally inappropriate social relatedness in most situations... begins before age 5
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Reactive Attachment Disorder is associated with _______ __________ _____
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grossly pathogenic care
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examples of stereotypic movement disorder
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Waving, rocking, twirling objects, nailbiting, head-banging, picking at skin or body orifices
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stereotypic movement disorder is associated with...
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many metabolic, genetic, and neuroogic disorders and mental retardation ... cause unknown
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tx for stereotypic movement disorder
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no specific tx has been shown effective ...
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drug tx for stereotypic movement disorder
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anafranil and norpramin effective in severe nail biting... Halidol and thorazine effective in tx associated w/ mental retardation and autism
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DSM-IV-TR sx for anorexia nervosa
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- < or = to 85% body wt
- amenorrhea 3 consec cycles - body image disturbance - feelings of inneffectiveness - need to control environment |
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long-term stats for anorexia
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- 30% recover
- 30% partially improve - 30% remain chronically ill - 10% die of anorexia-related causes |
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Meds for bulemia
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some positive response to SSRIs
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long-term stats for bulimia
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- 50% recover
- 20% continue to be bulimic - 30% have episodic bouts of bulimia - 1/3 of fully recovered clients have a relapse. - death rate for bulimia is 3% or less |
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Biologic factors of eating disorders
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- genetic vulnerability
- disruptions in the nuclei of the hypothalamus r/t hunger and satiety - neurochemical changes |
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enmeshment
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lack of clear role boundaries
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drug tx for anorexia
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- elavil and the antihistamine periactin can promote wt gain
- Xyprexia because of its effect on body image distortions - Prozac prevents relapse |
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psychotheraputic tx for anorexia
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family and individual therapy
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drug tx for bulimia
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antidepressants: Norpramin, tofranil, Elavil, Pamelor, Nardil, Prozac... only short term and only 25% effective
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psychotheraputic tx for bulimia
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cognitive-behavioral therapy... most tx is outpatient
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alexithymia
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difficulty identifying and expressing feelings
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med tx for delirium
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if restless or safety risk, low-dose antipsychotic (halidol .5-1 mg, may give IM) sedatives and benzodiazepines may worsen the delirium
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tx for delirium caused by ETOH withdrawal
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tx w/ benzodiazepines
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Aphasia
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deterioration of language
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Apraxia
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impaired motor function
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Agnosia
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inability to recognize names of objects
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Disturbance in executive function
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affects abstract thinking, planning, initiating, sequence, monitoring
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difference in progression between vascular dementia and regular dementia
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vascular dementia has a rapid and stepwise progression while alzheimers progress slowly
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mild symptom of dementia
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forgetfulness more than normal
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moderate sx of dementia
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confusion, more memory loss, oriented to person and place
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Severe sx of dementia
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personality changes, delusional, forgets names, needs assistance w/ ADLs
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Genetic link to alzheimers?
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Abnormal APOE gene r/t alzheimers
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Pick's disease
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degenerative brain disease affects frontal and temporal lobes - similar sx to alzheimers - age 50-60 - death in 2 to 5 years
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Creutzfeldt-Jakob disease
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cns disorder - age 40 to 60 - altered vision, los of coordination - progresses rapidly (months) - caused by an infections particle
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Huntington 's disease
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inherited , dominant disease - cerebral atrophy, demyelination, enlargement of ventricles.
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sx of huntington's disease
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facial contortions, twisting, turning, and tongue movements - personality changes, memory loss, decreased iiintellect. - 20 to 30 years to die
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medication for dementia
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Cognex, Aricept, Exelon, and Reminyl = cholinesterase inhibitors ... slow effect
- antidepresant - antipsychotics - mood stabilizers |
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Amnestic disorder
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disturbance in memory resulting form the physiologic effects of a general medical condition
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common sx of amnestic disorder
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confusion, disorientation, and attentional deficits
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Korsakoff's syndrome
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ETOH induced amnestic disorder from chronic thimine or vit B deficiency
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Asthenia
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numbness
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additional sx of depression in the elderly
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hypochondriasis, somatization, worsening of sx of pre-existing conditions w/ out physical cause, irritability or agitation, asthenia, etc
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cluster A personality disorders
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Paranoid, schizoid, schizotypal,
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cluster B personality disorders
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antisocial, borderline, histronic, harcissistic
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Cluster C personality disorders
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avoidant, dependent, OCD
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4 symptom categories for pharmacalogical tx in personality disorders
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- cognitive-perceptual distortions, including psychotic sx
- affective sx and mood dysregulation - aggression & behavioral dysfunction - anxiety |
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Meds for cognitive-perceptual disturbances
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low-dose antipsychotics
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personality disorders
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meds for mood dysregulation
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Lithium, tegretol, depakote, low-dose neuroleptics, SSRIs, MAOIs, atypical antipsychotics
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personality disorders
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meds for aggression
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Lithium, anticonvulsant mood stabilizers, benzodiazepines, and low-dose neuroleptics
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personality disorders
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anxiety meds
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SSRIs, MAOIs, or low-dose antipsychotics
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personality disorders
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Defense mechanism used by paranoid personality disorder
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projection - attribution of ones undesired impulses to another
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nursing intervention for histronic personality disorder
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give feedback about social interactions; teach social skills through role playing
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