Test 4 psych

Question 1

Rivastigmine(Exelon)

Answer 1

• Treatment to mild to moderate AD and PD
• Can be used in later stages
• Inhibits AChE selectively in the cortex and the hippocampus more than in other parts of the brain.
• This drug is advantageous for patients who do not respond to other anticholinergic drugs or who are in the later stages of AD
• Side effects: nausea, vomiting, and dizziness
• Transdermal form is effective and has fewer peripheral side effects as compared with the oral form.

Question 2

tacrine(Cognex)

Answer 2

potential for hepatic toxicity, rarely used because of side effects

Question 3

donepezil(Aricept)

Answer 3

– it requires only once-per-day dosing.
– Enhances cholinergic function by the reversible inhibition of the hydrolysis of Ach by AChE.
– Slows progression
– Effective when cholinergic neurons are intact.
– May produce gastrointestinal side effects by inhibiting AChE in the periphery

Question 4

Glantamine (Razadyne)

Answer 4

• Treats mild to moderate AD
• It is a reversible inhibitor for AChE
• It increases the availability of ACh; affects nicotinic cholinergic receptors in such a way that AChE inhibition can theoretically be enhanced
• Shown to decrease agitation and to increase cognition
• Twice daily dosing

Question 5

Memantine (Namanda)

Answer 5

• Treats moderate to severe AD
• It is an N-methyl-D-aspartate receptor antagonist that blocks the effects of excess glutamate.
• Blocks the excitotoxic effects of glutamate while allowing normal glutamate neurotransmission to occur.

Question 6

Kubler Ross (5 Stages)

Answer 6

1. Denial – Shock and disbelief
2. Anger – struggling with fate(Why me? Or It’s not fair!)
3. Bargaining – making deals with a higher power in the hope of a cure
4. Depression and despair – realizing that death is inevitable
5. Acceptance – succumbing to fate with relative calmness

Question 7

Stages of Grief

Answer 7

1. Avoidance (numbing and blunting)
2. Confrontation (disorganization and despair)
3. Reestablishment (reorganization and recovery)

Question 8

Chronic Sorrow

Answer 8

• a form of grief that often includes characteristics of other forms of grief but that differs with regard to several essential aspects.
• 1st chronic sorrow is a response to ongoing loss; 2nd persons who are experiencing chronic sorrow seldom experience disability
• Who would be at risk? Parents with children with mental disabilities, schizophrenia, or other chronic illness; spouses of persons with long term chronic illnesses, such as multiple sclerosis alcoholism, or AD; and persons with similar disorders

Question 9

Primary (Irreversable) Dementia

Answer 9

Alzeimer’s Disease, Vascular Dementia, Picks Disease, Huntington’s Disease
Parkinson’s Dementia, Creutzfeidt-Jakob disease

Question 10

Dementia: Reversible (secondary)

Answer 10

Delirium, Depression, Amnestic disorders, Tumors, Infection, Trauma, Some cerebral emboli

Question 11

Recent memory loss but keeps long term memory

Answer 11

Stage 1: Mild (2-4 years)

Question 12

• Patients have problems naming common items, they repeat things, and they lose things easily, and they get lost frequently.

Answer 12

Stage 1: Mild (2-4 years)

Question 13

Inability to find words and the use of inappropriate words

Answer 13

Stage 1: Mild (2-4 years)

Question 14

Neologism – invented and meaningless words

Answer 14

Stage 1: Mild (2-4 years)

Question 15

Show signs of personality changes

Answer 15

Stage 1: Mild (2-4 years)

Question 16

They are self awareness of loss that many patients suffer profound depression

Answer 16

Stage 1: Mild (2-4 years)

Question 17

Intellectual decline continues to increase and includes amnesia, disorientation, apriaxia, aphasia, and depression

Answer 17

Stage 2: Moderate (2-10 years)

Question 18

Lead to the loss of the ability to care for oneself

Answer 18

Stage 2: Moderate (2-10 years)

Question 19

Difficulty making decision as a result of decreased concentration

Answer 19

Stage 2: Moderate (2-10 years)

Question 20

Lack the cognitive skills to make appropriate judgments

Answer 20

Stage 2: Moderate (2-10 years)

Question 21

Develop delusion that are paranoid in nature

Answer 21

Stage 2: Moderate (2-10 years)

Question 22

Both short- and long-term memory are affected

Answer 22

Stage 2: Moderate (2-10 years)

Question 23

Perseveration

Answer 23

Stage 2: Moderate (2-10 years)

Question 24

Sundowning

Answer 24

Stage 2: Moderate (2-10 years)

Question 25

Sleep Disturbance

Answer 25

Stage 2: Moderate (2-10 years)

Question 26

Catastrophic reactions: A sudden or gradual negative change in behavior caused by the inability to understand and cope with environmental stimuli. Reach excessively, out of proportion to the situation, or panic and act out violently.

Answer 26

Stage 2: Moderate (2-10 years)

Question 27

What is a Catastrophic reaction?

Answer 27

: A sudden or gradual negative change in behavior caused by the inability to understand and cope with environmental stimuli. Reach excessively, out of proportion to the situation, or panic and act out violently.

Question 28

What is sundowning?

Answer 28

- Increased negative behavioral disturbance such as irritation or confusion occurring during the afternoon or eveninga

Question 29

What is perseveration?

Answer 29

Repetitive verbalizations or motions

Question 30

JAMCO

Answer 30

``` Judgment Affect Memory Cognition Orientation ```

Question 31

unable to perform motor activities despite intact function

Answer 31

Apraxia

Question 32

difficulties with object identification

Answer 32

Agnosia

Question 33

difficulties writing things down

Answer 33

Agraphia

Question 34

deficits in language functioning

Answer 34

Aphasia

Question 35

Etiology of AD

Answer 35

Pathological: Cerebral atrophy, neuritic plaques, neurofibrillary tangles Genetic: chromosome 19, Apolipoprotein E gene Nongeneitc: inflammation, decreased folic acid, decreased estrogen Neurochemical: decreased acetylcholine ACh

Question 36

ACT – crisis intervention approach

Answer 36

* Assess immediate needs and treats * Connect to support groups, social services, disaster relief, etc. * Trauma treatment plans, treatment of acute stress reactions and trauma recovery groups

Question 37

Psychological stages after a disaster

Answer 37

1. Heroic Phase 2. Honeymoon Phase (1 week to 3 to 6 months) 3. Disillusionment phase (2 months to 2 to 3 years) 4. Reconstruction phase (2 months to 1 to 2 years)

Question 38

real events that threaten physical health or loss

Answer 38

External (Situational)

Question 39

May not be obvious to someone else: feelings of betrayal or fear, threat to a belief

Answer 39

Internal (Subjective)

Question 40

(phase of life): e.g. Midlife crisis

Answer 40

Maturational * Old coping skills no longer helpful * Ineffective defense mechanisms until new coping skills develop * Adventitious (disaster): natural or man-made disaster

Question 41

Unplanned and accidental | • Natural disaster (hurricane, car accident), Crime of violence (murder, rape)

Answer 41

Adventitious

Question 42

Cycle of Violence Phase 1: Tension Building

Answer 42

• Major battering usually does not occur. Perpetrator establishes complete control usually by inflection of emotional abuse

Question 43

Cycle of Violence Phase 2: Acute Battering

Answer 43

• Tension can no longer be contained and acute battering occurs

Question 44

Cycle of Violence Phase 3: Honeymoon Stage

Answer 44

• Perpetrator begs for forgiveness, promises never to do it again. Appears to have remorse then tension starts to build and cycle is repeated

Question 45

Emergency escape plan

Answer 45

* A plan for a fast escape when violence occurs * Identify signs of escalation of violence and designate this as the time to leave * Include in plan a destination and a way to get there * Have the hotline referral telephone number of a shelter or safe house and a contact person * Keep important papers hidden in a place they can be obtained easily

Question 46

Who is at risk for spousal abuse?

Answer 46

• Spousal: Legal marriage, pregnant, partner who tries to leave the relationship

Question 47

Who is at risk for child abuse?

Answer 47

under the age of 3, kids who are looked as to be different, child of an unwanted pregnancy, premature kid, child who has a prolonged illness

Question 48

Atypical medication for eating disorders - Cause weight gain

Answer 48

Zyprexa

Question 49

SSRI medication for eating disorders

Answer 49

Prozac

Question 50

Patients cannot use or understand words

Answer 50

Stage 3: Severe (1-3 years)

Question 51

Cannot recognize themselves or others

Answer 51

Stage 3: Severe (1-3 years)

Question 52

No longer care for themselves

Answer 52

Stage 3: Severe (1-3 years)

Question 53

Totally dependent on others

Answer 53

Stage 3: Severe (1-3 years)

Question 54

Lose weight and bladder control

Answer 54

Stage 3: Severe (1-3 years)

Question 55

Develop secondary illnesses and conditions

Answer 55

Stage 3: Severe (1-3 years)

Question 56

Immobility may lead to pneumonia, UTI, and development of pressure ulcers

Answer 56

Stage 3: Severe (1-3 years)

Question 57

Progressive loss of neurons leads to the loss of the ability to swallow which may lead to aspiration pneumonia

Answer 57

Stage 3: Severe (1-3 years)