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44 Cards in this Set
- Front
- Back
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Benefits of group therapy in cancer pts |
improves quality of life, decreases fear, improves mood (and thus compliance), improves immune fxn |
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effect of depression in diabetes |
decreased compliance and poorer glycemic control |
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proven to increase mortality/disability post-infarct, increase heart rate variability, increase plt aggregation, and decreases compliance id Post-MI patients |
Depression |
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proved to increase heart rate variability, prolong QT interval, and associated with HTN in CAD pts |
anxiety |
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proven to precipitate cardiac events |
stress (espec. martial stress = 3x increase in risk) |
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5 common reasons for a psych consult in the ER |
1) chronic Pain /opoid dependence 2) Suicide attempt 3) Aggression/Anxiety 4) Intoxication/Withdraw 5) Delirium |
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What should you give a delirious patient? |
Haloperidal (decreases their agitation) |
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Sub-threshold emotional symptom of anxiety/depression that occurs w/in 3 months of stresser such as a medical diagnosis and lasts <6 months |
Adjustment Disorder |
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Pt that is able to 1) communicate their own medical decisions, 2) Fully understands condition and trx options, 3) Knows consequences of for-going trx, 4) can tell you how they came to their decision |
Patient with full Capacitance (*not the same as competence) |
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increase the risk that an individual will express a psychiatric phenotype if placed in the correct environment |
susceptability gene |
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Chromosome affected in huntingtons? |
Chr 14 |
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Chance that an individual will have a disorder if one of their first degree relatives has the disorder |
Recurrence Risk Ratio |
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Genetic Influence / Environmental Influence |
Heritability |
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LOD score in linkage study that suggests that 2 genes may be inherited together |
LOD of 3+ (ie 1000 : 1 chance they are linked) |
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examines if an allele is more common in a disorder than in control population |
association study |
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Gene associated with ADHD |
Dopamine Transporter (DAT) and DRD4 gene |
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3 Genes associated with Early-Onset Alzheimers |
1) Amyloid Precursor Protein on Chr 21 2) Presenilin 1 on Chr 14 3) Presenilin 2 on Chr 1 |
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2 Alleles associated with Late-Onset Alzheimers |
1) ApoEe4 - increases risk 2) ApoEe2 - decreases risk (protective) |
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Neurobiological phenotype seen in family members of patients with schizophrenia
- Includes eye-tracking dysfxn, neuropsych deficits, structural brain abnormalities, decrease AEP, decreased NMDA
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Endophenotypes |
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Gene associated with Schizophrenia and DiGeorge Synd. |
22q11 deletion |
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Class of Genes associated with Bipolar D/O |
Clock genes (CACNA) that effect circadian rhythms |
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Gene associated with Major Depression |
short allele of serotonin transporter gene |
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1yr+ usage of an addictive substance w/ 2+ of the following: larger intake than intended, cut-back attempts, 2+hr/day devoted, cravings, failure to full fill obligations, social problems as result, give up recreational activities, hazardous use, use w/ knowledge of a physical condition, tolerance, w/draw |
Substance Abuse D/O |
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Not currently using |
Abstinenance |
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Not currently using and taking actions to prevent use in the future |
Sobriety/Recovery |
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No drug use in a non-controlled environment for 3-12 months |
Early Remission |
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No drug used in a non-controlled environment for 12+ months |
Sustained Remission |
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Slurred speech, ataxic gait, disinhibited, impaired judgement. W/drawl is fatal, |
Sedatives/Hypnotics = Alcohol, Barbituates, Benzo's |
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Increased energy and confidence, paranoia, increased heart rate and BP. OD is fatal, causing cardio and neurotoxicity |
Stimulants = meth, amphetamines, cocaine, bath salts, nicotine, caffeine |
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Sedation, analgesia, constipation, impotence, constricted pupils, decreased appetite. |
Opioids = opium, heroin, oxy, hydrocodone, morphine |
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Anxiety and hallucinations with no withdraw symptoms |
Hallucinogens = LSD, mescaline/peyote, ectasy (meth + Mescaline), shrooms, PCP |
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Decreased learning/memory, impaired judgement, paranoia, + drug test for 4-6 wks, short-term memory loss w/ chronic use and increase rate of schizophrenia |
Cannabis |
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Neuroadaption where there is an upregulation of receptors that gets unmasked when a drug is a suddenly absent |
Withdrawl |
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Trx for withdrawl where agonist agents are slowly tapered off |
Detoxification |
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Elevated BP/heart rate/temp/reflexes, tremors, N/V, decreased appetite, diaphoresis, anxious, irratability |
Phase 1 of alcohol w/drawl (6-12 hr post-drink) |
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Elevated BP/heart rate/temp/reflexes, tremors, N/V, decreased appetite, diaphoresis, anxious, irratability, and hallucinations |
Phase 2 of alcohol w/drawl (24 hr post-drink) |
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Elevated BP/heart rate/temp/reflexes, tremors, N/V, decreased appetite, diaphoresis, anxious, irratability, seizures |
Phase 3 of alcohol w/drawl (6-48 hr post-drink) |
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"Delirium Tremens" - confused, disoriented, hallucinations, and potentially fatal |
Phase 4 of alcohol w/drawl (2-10 days post-drink) |
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Trx for alcohol w/drawl |
Benzodiazapines (IV for phase 3+), IV fluids + thiamine, drug screen, monitor glucose/electrolytes/LFT, Hospitalize phase 2+, ICU for phase 4 |
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Decreased Heart rate and BP,craving, irritability that peaks w/in 1-2 days of quitting but persists for weeks |
Nicotine withdrawl |
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Trx for Nicotine W/drawl |
Bupropion (block Nicotinic and Dopa receptors and allows smoking till day 9), Nicotine replacement tapered for 8 weeks |
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increased sleep & appetite, anergy |
crack and meth w/drawl |
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Dilated pupils, sweaty irritable, runny nose, yawning, diarrhea, piloerrection = |
opiod w/drawl |
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Irritable, depression, insomnia |
cannabis w/drawl |
