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83 Cards in this Set

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__________ disorders are mood disorders marked severe, pathologic mood swings. Extreme highs (mania or hypomania) alternating with extreme lows (depression).
Bipolar
__________ is characterized by:
-elation
-euphoria
-agitation or irritability
-hyperexcitability
-hyperactivity
-rapid thought and speech
Mania
______________ refers to an expansive, elevated, or agitated mood that resembles mania but is less intense and lacks psychotic symptoms
hypomania
_______disorders occurs in three major types.
bipolar
Bipolar ____ disorder- is the classic and most severe disease form. the patient has maniac episodes or mixed episodes that alternate with major depressive episodes.
Bipolar I
Bipolar ___ disorder- that patient doesnt experience severe mania but instead has milder episodes of hypomania that alternate with depressive episodes.
Bipolar II
In _______ disorder, that patient has a history of numerous hypomaniac episodes intermingled with numerous depressive episodes that dont meet the criteria for major depressive episodes.
Cyclothymic disorder
With rapid ________ the patient has 4 or more distinct periods of depression, mania, hypomania, or mixed states occur within a 12 month period.
cycling
With severe _______ , the patient may have delusions, paranoid thinking and an inflated sense of self-esteem ranging from uncritical self-confidence to marked grandiosity.
mania
during a _________ episode, the patient may report or exhibit:
low self esteem
overwhelming inertia
social withdrawel
feelings of hopelessness, apathy, or self-approach
difficuly concentrating or thinking clearly.
depressive
Treatment of bipolar disorder requires drug therapy. ________is highly effective.
Lithium
_________may be prescribed for rapid cyclers or for patients who cant tolerate lithium.
Depakote
Lithium has a narrow margin of safety and can easily cause toxicity. the patient must maintain a therapeutic blood level for 7 to 10 days before the desired effects appear.
therapeutic level is ____________.
0.5-1.5
Carbamazepine (__________) may be useful in treating mania, although it isnt approved by the FDA for bipolar disorder.
Tegretol
advise pt to take lithium with food or after meals to avoid stomach upset. Restricting ________intake increases lithium toxicity.
sodium
in __________disorder, short periods of mild depression alternate with short periods of hypomania. the person never goes more than 2 months without symptoms of depression or hypomania.
cyclothymic
both the depressive and hypomania periods of ___________ disorder are shorter and less severe than in Bipolar I and II disorder.
cyclothymia
the patient experiencing the ______phase may report or exhibit:
insomnia
hyperactivity
inflated self esteem
increased productivity and creativity
over involvement in pleasurable activities, including sex
physical restlessness
rapid speech
hypomanic phase
Signs and symptoms during the ________ phase may include:
insomnia and hypersomnia
feelings of inadequacy
decreased productivity
social withdrawel
loss of libido
loss of interest in pleasurable activities
lethargy
depressed speech
crying
depressive phase
Pharmacologic options for __________ disorder include:
lithium
carbamazepine (tegretol)
valproic acid (depakote)
Verapamil (calan)
cyclothymic disorder
Major depressive disorder (also called unipolar major depression) is a syndrome of a persistent sad mood lasting ____ weeks or longer
2 weeks
symptoms of _______depression (such as disinterest in pleasurable activities, hopelessness, and loss of mood reactivity)
severe
______the most serious complication can occur if feeling of worthlessness, guilt nad hopelessness are so overwhelming that the person no longer considers life worth living.
suicide
the incidence of major depression _____with age.
rises
a patient with _____ depression may seem unhappy or apathetic, and report changes such as : feeling down in the dumps, increased or decreased appetite, sleep disturbances, insomnia or early awakening, disinterest in sex, difficulty concentrating or thinking clearly, easy distractibility, low self esteem, poor coping, constipation or diarrhea.
major
___________ drug work by modifying the activity of relevant neurotransmitter pathways.
antidepressant
Celexa, Prozac, Luvox, Zoloft and Paxil are included in what drug class?
SSRI's
________ inhibit serotonin reuptake and may inhibit the reuptake of other neurotransmitters as well.
They have become the first choice treatment for most patients.
SSRI's
_______ such as Effexor , inhibit norepinephrine uptake. they are generally used as second line agents for patients with major depressive disorder.
SNRI's
atypical antidepressants such as Bupropion (_______), is thought to inhibit reuptake of serotonin, norepinephrine and dopamine to varying degrees.
Wellbutrin
An older class of antidepressants, _________ inhibit the reuptake of norephinephrine, serotonin, and dopamine and cause a gradual decline in beta-adrengic receptors. Examples include Elavil, Pamelor, Tofranil.
although they can be effective, they may cause intolerable adverse effects, and they are generally not used as first line agents
TCA's
_________, such as phenelzine (Nardil) and tranylcypromine (parnate) increase norepinephrine, serotonin, and dopamine levels by inhibiting MAO, an enzyme that inactivates them.
MAOI's
______ may be prescribed for patients with atypical depression (for example, depression marked by an increased appetite and increased sleep, rather than anorexia and insomnia) or for patients who dont respond to TCA's.
MAOI's
_______ carry a high risk of adverse effects and dangerous interactions with various foods and meds.
MAOI's
In ______, a tiny electrical current is applied to the patients brain through electrodes. the current produces a seizure lasting from 30 seconds to 1 minute.
ECT
With MAOI's caution pt not to ingest foods and beverages containing tyramine, caffeine, or tryptophan. Ingesting tyramine can cause a ________________.
Hypertensive crises
Instruct patient to avoid meperidine (_________), epinephrine, local anesthetics, decongestants, cough medicines, diet pills, and most over the counter agents with MAOI's.
Demerol
With _______ such as Prozac warn the patient not to take within 14 days of taking an MAOI.
SSRI
suicide risk __________ as depression lifts.
rises
patients who exhibit pessimism, disinterest and low self esteem typically respond to ________ drugs.
antidepressant
______disorders are often accompanied by mood disorders and substance abuse, as well as medical disorders. twice as common in women and only 1/3 of sufferers receive treatment
anxiety
in addition to female gender, risk factors for _________ disorders include:
younger than age 45
marital seperation or divorce
hx of childhood physical or sexual abuse
low socioeconomic status
anxiety
______ disorder represents anxiety in its most severe form. the person has recurrent, unexpected panic attacks that cause intense apprehension and feelings of impending doom.
Panic
Panic attacks occur suddlenly with no warning- usually build to peak intensity within ____to ____ minutes and rarely last longer than 30 minutes. repeated attacks may continue to recur for hours.
10 to 15 minutes
during a ________ attack the pt may fear their dying, going crazy or losing control of their emotions or behavior. pt may experience chest pain and SOB. because they occur spontaneously- the pt worries about when the next one will occur and may change lifestyle to avoid
panic
with panic attacks, the earlier the onset the ____ the risk of coexisting illnesses, chronicity and impairment. Panic disorder rarely begins after age 50.
greater
______ is a response to external stimuli
Fear
______-is an extreme level of anxiety
Panic
_________- is the intense fear or avoidance of situations or places that may be difficult or embarrassing to leave, or in which help might not be available. The patient eventually will begin to avoid situations where they feel uncomfortable
Agoraphobia
Agoraphobia is an adverse behavioral outcome of repeated ________ attacks
panic
Among __________ patients, common fears include large public spaces (parks, malls, theaters and supermarkets) crowds, and places where the person feels trapped (airplanes, rush hour traffic or on a bridge)
agoraphobia
The doctor may prescribe a tricyclic antidepressant (TCA) such as amitriptyline (____) or a selective serotonin reuptake inhibitor (SSRI) such as paroxetine (Paxil) to treat a panic attack.
Elavil
IN __________ the anxiety is persistent, overwhelming, uncontrollable and out of proportion to the stimulus.
to relieve anxiety, many sufferers self-medicate with alcohol and anitanxiety drugs.
GAD- Generalized anxiety disorder
Age of onset for GAD is _____ but all age groups are affected
20's
Signs and symptoms of ______ fall into 3 general categories-
1) excessive physiological arousal
2) distorted cognitive processes
3) poor coping
GAD
________ may occur after someone experiences or witnesses a serious traumatic event. characterized by persistent and recurrent flashbacks, reliving the event, or nightmares of the event- along with avoidance of reminders of it
PTSD
______PTSD is diagnosed if symptoms appear within 6 months of the trauma.
Acute
With PTSD symptoms appear later then ___ months- delayed or chronic PTSD is diagnosed
6 months
Risk factors for _______ include:
limited social supports
high anxiety levels
low self esteem
neurotic and extroverted characteristics
hx of psychiatric disorders
previous dx of an acute stress disorder that failed to resolve within 1 month
PTSD
to relieve PTSD symptoms the doctor may prescribe benzodiazepines, beta blockers, monoamine oxidase inhibitors or TCA's. Sertraline (_______) an SSRI antidepressant, is also prescribed to treat PTSD
Zoloft
_________disorder is a syndrome of anxiety and behavioral disturbances that occurs within 4 weeks of an extreme trauma. symptoms start during or shortly after the trauma and impair functioning in at least one key area.
Unlike PTSD this disorder resolves within 4 weeks
Acute stress disorder
Acute stress disorder happens _______ after the trauma (acute)
Shortly
PTSD takes a bit longer to emerge (_______)
delayed
a hallmark of acute stress disorder is ________- a defense mechanism in which the patient separates anxiety-provoking thoughts and emotions from the rest of the psyche.
may be accompanied by poor memory or the traumatic event or even complete amnesia of it.
dissociation
_____phobia refers to marked, persistent fear or anxiety in social or performance situations. the anxiety causes the sufferer to avoid these situations whenever possible
social
visible signs of _______ phobia, such as blushing or profuse seating, heighten the patients fear of disapproval and may become an additional focus of fear.
social
in _______ phobia, a person experiences intense, irrational anxiety when exposed to anticipating a specific feared object or situation.
specific
_______ is characterized by unwanted, recurrent, intrusive thoughts or images (obsessions) which the person tries to alleviate through repetitive behaviors or mental acts (compulsions). the compulsions are meant to reduce the anxiety or prevent some dreaded event from happening
OCD
_______behaviors and activities take up more than 1 hour per day.
usual onset is gradual- over months or years.
OCD
signs and symptoms of acute stress disorder may occur_______-
as early as 2 days after a trauma
fear of situations or places that may be difficult or embarrassing to leave describes__________
agoraphobia
unresolved conflicts, a tendency to misinterpret events and avoidance of new situations may be risk factors for _________
GAD
The fear of losing ones mind or having a heart attack is most likely to occur in___________
panic disorder
flashbacks of an unpleasant, terrifying or painful experience may occur in _________
PTSD
fear of embarrassing oneself in public characterizes _______________
social phobia
a patient with a history of panic attacks says he feels trapped after an attack. he most likely fears:_________
loss of control
_______ disorders are a group of psychiatric disorders in which the patient has persisten somatic (physical) complaints that cant be explained by a physical disorder, substance use or another mental disorder. symptoms are linked to psychological factors
somatoform
patients with ________ disorder, often develop panic attacks or agoraphobia
somatization
__________ disorders may be linked to a heightened awareness of normal body sensations
somatoform
Signs of somatform disorders
S-
I-
G-
N-
S-
S- sexual or reproductive symptoms
I- intense pain
G- GI problems
N- neurologic symptoms
S- symptoms of anxiety and depression
________disorders are marked by disruption of the fundamental aspect of waking consciousness- memory, identity, consciousness, and the general experience and perception of oneself and the surroundings
Dissociative disorders
a patient with ________ disorder may report that they feel detached from their entire being and body, as if watching from a distance or living in a dream. may report sensory anesthesia, loss of self control, difficult speaking and feelings of derealization and losing touch with reality
depersonalization
a lack of openness and flexibility in daily routines, as well as in interpersonal relationships and expectations; a preoccupation with orderliness and perfectionism; treatment options that dont fit in with the patients cognitive schema will be rejected quickly
obsessive-compulsive personality disorder