Block 3 Behavioral Part-II

ptheodore's version from 2015-11-11 15:16



Question Answer
Jessie is a five-year-old girl who doesn't like foods with much texture or flavor. She prefers to eat foods that don't require lots of chewing, like soup, pasta, or oatmeal. Jessie has difficulty eating a range of foods and her mother struggles daily with getting her to consume the nutrients she needs to grow and thrive. Jessie is the smallest child in her class and has been severely underweight for two years. What’s going on?Avoidant/Restrictive Food Intake Disorder
Fear of gaining weight or of becoming fat, Disturbance in perceived body weight or shape, Restriction of energy intake relative to requirement are the characteristics of .....Anorexia
Excessive dieting and exercise, without binge eating or purging in the last 3 monthsAnorexia Nervosa
Binge eating and/or purging also present coupled with dietingAnorexia Nervosa
Relentless promotion of thinness, Focus on achievement and perfection & Emphasis on social acceptation are social causes of Anorexia Nervosa
Low self-esteem, Lack of confidence, Difficulty handling stress are psychological causes ofAnorexia Nervosa
28y F admitted with binge-eating followed by purging behaviors. These behaviors were very frequent with cycles between 10-20 times daily. Her BMI was 22 (within normal range). The patient admitted to bingeing in restaurants 4-5 times per day, often leaving without paying until she was caught and prosecuted. The patient admitted to stealing other people’s credit cards and using them to purchase food. She had frequent mood swings, anxiety, and depression Bulimia Nervosa
Eating excessive amounts of food, more than would be considered normal, Sense of lack of control during eating, Self-induced vomiting, Misuse of laxatives, diuretics, or drugs and Fasting and /or excessive exerciseBulimia Nervosa
Tricyclic antidepressants (TCA), Selective serotonin reuptake inhibitors (SSRI), Monoamine oxidase inhibitors (MAO-I) are drugs therapy forBulimia Nervosa
Which disorder characterized by Persistent eating of nonnutritive, nonfood substances for more that a 1 month?Pica Disorders
Onset most often presents in childhood (Edwards started aged 10) but may occur in adolescence and adulthood. Higher incidence in children diagnosed with intellectual disabilities (comorbidity) , can resulting in toxicity, poisoning, infections & malnutritionPica Disorders
Repeated regurgitation of food over a period of at least 1 month, Regurgitated food may be re-swallowed, re-chewed or spat out, Regurgitation is not attributable a biologically recognized medical condition, Typically from 30 seconds to 1 hour after eatingRumination Disorder
Repeated painless regurgitation/rechewing/expulsion of food, Begins soon after ingestion, Does not occur during sleep, Does not respond to standard Tx for gastroesophageal reflux, Does not include retching (rumination is effortless), No evidence of inflammatory, anatomic, metabolic, or neoplastic processes are diagnosis criteria forRumination Disorder
A 16 y/o Female admitted for restrictive food intake, excessive physical activity, body dissatisfaction and strong fear of gaining weight. Her BMI was 14.5. Patient presented with psychiatric symptoms including obsessional acts and thoughts, and depression. She admitted to having suicidal thoughts and was on Sertraline (100 mg). Her physiological status revealed a depressed metabolism with abnormal thyroid function testsAnorexia Nervosa
Rapid weight loss and very low body weight, Distorted body image and obsessive fear of weight gain, Obsessive preoccupation with food/calories, Skipping meals and avoiding eating with others, Excessive exercise (hyper gymnasia), Possible binge eating, Possible purging, Possible OCD are characteristics forAnorexia Nervosa
Tendency towards depression and anxiety, Low self-esteem, Lack of confidence, Difficulty handling stress, Very emotionally restrained, Perfectionism (control) are Psychological characteristics ofAnorexia Nervosa
Relentless promotion of thinness, Focus on achievement and perfection, Emphasis on social acceptation are social characteristics ofAnorexia Nervosa
Fear of gaining weight or of becoming fat, Disturbance in perceived body weight or shape, Restriction of energy intake relative to requirement under DSM-5 are the diagnosis criteria forAnorexia Nervosa
Maintaining low body weight by Voluntary starvation, Excessive exercise, Vomiting, Drugs (laxatives, amphetamines) are signs forAnorexia Nervosa
Stunted growth, Hypotension, Decreased white blood cell count, Decreased immune response, Sunken eyes, Headaches, Decaying teeth (Binging/Purging) are medical complications ofAnorexia Nervosa
Cognitive behavioral therapy, Family behavioral therapy & Zinc are the treatment option forAnorexia Nervosa
Sense of lack of control over one’s own life, Low self esteem, Social pressure are characteristics ofBulimia Nervosa
Eating excessive amounts of food, more than would be considered normal, Sense of lack of control during eating, Self-induced vomiting, Misuse of laxatives, diuretics, or drugs, Fasting and /or excessive exercise, At least once a week for 3 months are the criteria forBulimia Nervosa
Swollen salivary glands, Drug addiction, Mood changes, Seizures (due to low potassium) are signs & symptoms forBulimia Nervosa
The most common eating disorderBinge Eating Disorder
Which eating disorder doesn't compensated for purging eating disorder?Binge Eating Disorder
Eating, in a discrete period of time (e.g. 2hr period), an amount of food that is definitely larger than most people would eat, A sense of lack of control over eating during the episodeBinge Eating Disorder

Neurocognitive Disorders

Question Answer
Disturbance in attention and awareness, Develops over a short period of time (hours to a few days), Refers to a rapid change from a baseline, Additional disturbance in cognition (e.g., memory, language), Disturbances are not better explained by another preexisting, establishedDelirium
Hypoactive, hyperactive or alternation between hyperactive & hypoactive are clinical presentation forDelirium
Rapid onset of severe confusion and disorientation, with fluctuating intensity, Sudden withdrawal from interaction with outside world are characteristics of Delirium
Sudden withdrawal from interaction with outside world are characteristics ofHypoactive Delirium
Rapid onset of severe confusion and disorientation, with fluctuating intensity are characteristics ofHyperactive Delirium
Often preceded by prodromal symptoms (restlessness, fear), Symptoms last while causes are present typically less than 1wk, Fluctuates during the day often worse at night, Normally resolves within 2wks after cause(s) are removed are prognosis forDelirium
How do you treat delirium?remove underlying cause
Decreased ACh function in the dorsal tegmental pathway is the physiopathology ofDelirium
Severity of delirium correlates with Acetylcholine degradation
Hypoactive delirium can also be confused withDepression & Schizophrenia
Which neurocognitive disorder can be Diagnosis must be made against a previous baseline performanceDelirium
Events occurring during this neurocognitive disorder are often poorly recalled laterDelirium
A major cognitive disorder that is characterized by confusion and disorientation, aphasia, apraxia, agnosia & executive dysfunctionDementia
Loss of the ability to produce or understand languageaphasia
Inability to perform particular purposive actionsApraxia
Problems recognizing familiar persons and objectsAgnosia
Inability to plan, organize or reasonExecutive dysfunction
Types of dementias which involve the cerebral cortex & affects thinking, memory & languages is calledCortical Dementias disorders
Types of dementias originating beneath the cortex that is mostly affect speed of thinking, ability to initiate activities, memory language deficits not present at beginning at the beginning calledSubcortical Dementias
The most common dementia isAlzheimer's
Neurofibrillary tangles, Plaques (clusters of beta-amyloid), Behavioral changes before cognitive decline, Decline in IQ, Insidious onset and gradual impairment,Onset aged 80-100 are the characteristics ofAlzheimer's
Frontotemporal Lobar degenerationPick's Disease
Symptom onset similar to ALZ, but presents only with atrophy to the frontal and temporal lobesPick's disease
Loss of Sympathy/empathy, Perseveration, Stereotypical behaviors, Decline in executive function, Possible decline in language ability are symptoms forPick's Disease
Multiple small strokes resulting in cognitive impairment (especially memory loss) Vascular Disease
Second most common cause of dementia (~15%), Sudden onset of cognitive dysfunction, Stepwise loss of some function with each infarct are characteristics ofVascular disease
Focal neurological symptoms such as gait, speech & vision are seen inVascular Disease
Common causes of dementia in the elderly causes due to damage in the cortexLewy Body Disease
Fluctuating alertness and attention, Hallucinations, Problems with movement and posture, Parkinson’s like symptoms-->Tremor & Bradykinesia are characteristics ofLewy Body Disease
If Lewy bodies are found in the basal ganglia the differential diagnosis isParkinson's
If Lewy bodies are found in the basal ganglia the differential isLewy Body Disease
Alzheimer’s like cognitive impairments due to lossACh neurons
Dementia onset greater that 1 yr after motor deficitsParkinson's
Dementia onset less that 1yr Lewy body disease
Affects long-term autobiographical memories but leaves semantic and implicit memories intactAmnesia
Cognitive deficits seen in patients with major depressive disorder with no dementia like symptoms (validity of the term is debatable)Pseudodementia
A neurocognitive disorder which is most often seen in boxers, but also NFL playersTraumatic Brain Injury Dementia
A subcortical dementia, characterized by More motor deficits but and less language abnormalities, Memory and language moslty spared in the early and mid stages, Higher rates of depression and psychosisHuntington's Disease
Loss of dopaminergic neurons in the substantia nigra and appearance of Lewy bodiesParkinson's Disease
Loss of memories for events prior to an incidentRetrograde amnesia
Inability to create new memories after an eventAnterograde amnesia
Inability to create new memories after an event & Loss of memories for events prior to an incidentGlobal Amnesia
Confused state after a traumatic brain injury with anterograde amnesiaPost-traumatic amnesia
Anterograde amnesia that resolves less than 24hrs, Most likely due to temporal lobe ischemiaTransient global amnesia
Partial memory loss due to excessive, alcohol consumption, Only events during drinking are forgottenBlackout Phenomenon
Global amnesia with more severe retrograde deficits, First Wernicke’s encephalopathy, Then Korsakoff’s (85% if left untreated), Difficulty learning new information, Lack of insight into their condition, Confabulation (especially early on)Wernicke-Korsakoff’s syndrome
Temporary loss of personal identity while impulsively wandering away from homes and employmentDissociative Fugue State
A psychogenic amnesia for AM’s typically about a psychologically traumatic events based on Freud theory. It is characterized by localized amnesia, selective amnesia, generalized amnesia, global transient amnesia, situation of specific events such as rape, war & PTSDDissociative Amnesia
A memory deficit which is characterized by confusing about self-identity, no other sign of illness, may rebuild entirely new life, new name, alternatively return to a previous life periodDissociative Fugue Disorder