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51 Cards in this Set
- Front
- Back
sx formation is unconscious; emotional disorders characterized by physical sx that suggest organic pathology
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somatoform disorders
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sx formation is conscious; feign mental or physical illness or actually induce physical illness for psyc reasons
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factitious disorder
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sx formation is conscious; feign mental or physical illness or actually induce physical illness for tangible gain
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malingering
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5 classifications of somatoform disorder:
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somatization, conversion, hypochondriasis, body dysmorphic and pain
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involves the defense mech of somatization to unconsciously express an unacceptable emotion as a physical sx to avoid dealing
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primary gain
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sx once established serves a useful purpose
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secondary gain
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dx criteria for somatization disorder
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at least 4 pain sx, 2 GI sx, 1 sex sx and 1 pseudoneuro sx over years; beings before 30 yo
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dx criteria for conversion disorder
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1 or more sx affecting voluntary motor or sensory function; produced or preceded by psych stress
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dx criteria for hypochondriasis
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at least 6 mo of fear/idea of having a serious illness based on misinterpretation of bodily sx
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dx criteria for body dysmorphic disorder
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preoccupation with imagined prob with appearance, not accounted for by anorexia
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dx criteria for pain disorder
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psych factors are involved in onset or other aspect of pain
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when do somatoform disorders tend to start?
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early adulthood
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tx for hypochondriasis
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SSRI
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la belle indifference is associated with what somatoform disorder?
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conversion disorder
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most common conversion disorder sx (6)
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paralysis, bizarre seizures, globus hystericus, paresthesias, anesthesias, visual probs
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conversion disorder is often co-morbid with what 2 other disorders?
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histrionic PD and depression
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what quickens the sx resolution of conversion disorder?
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hypnosis or drug-assisted interviewing
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is plastic surgery likely to relieve sx of body dysmorphic disorder?
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no
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most useful strategy in treating somatoform disorders:
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strong and supportive doc-pt relationship
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most commonly feigned sx are (4)
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abd pain, fever, blood in urine and seizures
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multiple cross-hatched abd scars or grid abdomen are evidence of what?
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previous unnecessary surgeries
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what is a common profession for those with factitious disorder?
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health professional
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adult, usually a parent, feigns or induces illness in child to gain attention
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factitious disorder by proxy
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is factitious disorder by proxy a form of child abuse?
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yes
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those with factitious disorder often have a hx of what?
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serious childhood illness
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is malingering a psychiatric illness?
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no
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psych factors likely to affect the course or tx of medical condition (6)
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psych illness (depression), other medical illness, stress, maladaptive health behavior, personality trait, coping mech
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increased release of ACTH leads to what that is impt to psychosomatic disorder
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immune system depression
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what personality trait is the key component to increased risk for heart disease?
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hostility
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very high life event stressors
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death of spouse, divorce, marital separation, death of close family member
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high life event stressors
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major personal loss de to illness/injury, marriage, job loss, retirement, major loss of health of close family member, birth/adoption
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moderate life event stressors
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major debt, promotion/demotion, child leaving home
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low life event stressors
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changing residence, vacation, major holiday
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homeostatic mech that the body uses in response to social stress
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general adaptation syndrome
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common psych complaints in medically ill pts (3)
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depression, anxiety, disorientation
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certain pt populations more likely to be psych stressed include (6)
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hospitalized, ICU, CCU, AIDS, renal dialysis, chronic pain
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pts in ICU/CCU are particularly at risk for what psych sx?
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delirium or ICU psychosis
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what is first way to decrease the risk of ICU psychosis?
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enhance sensory and social input, allow then control over as much as they can
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pts with AIDS have additional stressors like: (5)
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fatal illness, guilt, costly/painful tx, withdrawal from drugs, reveal sexual orientation
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chronic pain must last how long to be dx?
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at least 6 mo
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relief of pain caused by physical illness is best achieved by:
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analgesics or nerve-blocking surgical procedures or implants, antidepressants and antiseziure meds
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implants that provide electrical stimulation of large diam afferent nerves
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gate control theory of pain control
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is a person with chronic pain more likely to become depressed or addicted to pain meds?
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depressed
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when is the best time to admin analgesic?
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before the pt asks for it
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what is the best way to admin pain meds to kids?
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orally or transdermally
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subjective responsiveness to inactive pharm agent
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placebo response
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what is the proposed mech for placebo response?
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real changes in neural function such as release of endogenous opiods
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can you give a pt a placebo without telling them?
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no, unless you are in a research setting
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what 2 NTs are implicated in experience of pain?
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serotonin, glutamate
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2 actions of antidepressants in pain tx
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stimulate efferent inhibitory pain paths and improve sx of depression
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if a person presents with first case of depression, anxiety or psychosis at age 50, do you think psych or medical?
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medical
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