PEP II Final Exam | Questions with 100% Correct Answers

PEP II Final Exam | Questions with 100% Correct Answers What is judgement? critical thinking, problem solving, would they make the right decision? (how is patient meeting social and family obligations) give scenarios and see how they act Ex: what would you do if you saw an envelope on the ground? What is insight? awareness of illness, recognizing they need treatment and how their illness affects others (mental illness lacks insight) aware of condition Conditions with lack insight MENTAL ILLNESS --personality disorders, OCD, schizophrenia, dementia What is circumlocution? use a different phrase instead of the word they're trying to say word substitution ex: father of my father What is perseveration? saying the same word/phrase over and over What are flight of ideas? rapid, continuous flow of ideas w/ vague association ex: the sky is blue. I feel blue. I can feel my heartbeat What are loose associations? lack of connection between ideas What is a word salad? a bunch of words that don’t connect What are clang associations? rhyming What are neologisms? making up whatever you say What is echolalia? repeat whatever you say What is aphasia and what are the types? Def: speech is disordered -expressive (broca) -receptive (wernicke) -both What is mood, affect, and congruency? -mood: what they tell you they feel -affect: what you observe -congruency: mood and affect should match -- INCONGRUENT WHEN THEY DONT MATCH What are risk factors for suicide? - previous attempt - social isolation -older men or women -divorced or widowed -living alone -mental health disorder, depression, hopelessness -serious chronic or terminal health condition -fmhx of suicide or attempt -knowing someone who recently committed suicide -significant personal losses or challenges -having a plan -alcohol/substance use disorder -access to firearms or other means of self-harm What is circumstantial thinking? go around and takes a long time to answer question eventually get there What is tangential thinking? patient doesn’t ever answer the question (lack of goal directed associations between ideas - flight of ideas) What is ideas of reference? misinterpretation of incidents and events in the outside world having direct personal reference to the patient Ex: watch commercial and think people are actually talking about them What is depersonalization? sensation of detachment within the self, or being a detached observer of oneself What is derealizaiton? out of body experience alterations in perception or experience of external world so that it seems unreal; pt aware thoughts are abnormal What is a phobia? persistent, irrational fear What is an obsession? repetitive, intrusive thoughts What is a compulsion? repetitive behavior What is a hallucination? sensory experiences not based in reality, false perception of something that is not there What is an illusion? there is a sensory input but it is misinterpreted (leaves rustling = people whispering) What is a delusion? fixed, false beliefs firmly held despite contradictory evidence What is the mini-cog exam? -mini-cog: three items (item identification, draw clock, recall items) -- QUICK What is the MMSE? orientation, registration, attention/calculation, recall, language, intersecting pentagon What are some questions that assess orientation? What is the year? Season? day? Date? Month? where are we (state, county, city, hospital, floor)? How would you assess attention and calculation? Count backwards by 7 from 100 (stop after 5) or spell world backwards How do you assess recall? Ask patient to recall the three items used during the registration portion. How do you assess language? -name two objects (show objects and ask what they are) -repitition (repeat "no ifs, ands, or buts") -3 stage command -reading (read sentence from paper) -writing (ask them to write a sentence with a subject and verb) How do you assess copying? draw two intersecting pentagons What are advantages of MMSE? relatively quick and easy to perform, no addition equipment needed, provides method of monitoring deterioration over time What are disadvantages of MMSE? -bias against people w/ poor education, should be used in patients with at least an 8th grade education -bias against visually impaired -can’t be used in pts w/ language barrier unless translated -may need adjustment for cultural differences What are subjective findings in depression? -feels sad, hopeless, worthless, guilt -no interest or pleasure in what was previously of interest -fatigue or loss of energy -insomnia or excessive sleeping -increased/decreased appetite -weight gain or loss What are objective findings in depression? -poor concentration -slowed thought process and speech -poor eye contact -agitation, irritability or restlessness What are subjective findings in anxiety? -Chronic worry -restlessness -irritable -tense -fatigue -poor concentration -sleep disturbance What are objective findings in anxiety? -impaired attention -motor tension -tremors -restlessness What are subjective findings of mania? -hyperactivity -overconfidence, exaggerated view of own abilities -impaired occupational, social and interpersonal functioning -excessive involvement in pleasurable activities w/ high potential for serious or painful consequences -decreased need for sleep -racing thoughts -lack of impulse control What are objective findings of mania? -grandiose or persecutory delusions, euphoria -increased talkativeness or pressure to keep talking, may involve excessive rhyming or puns -flight of ideas -impaired attention, easily distracted -impaired judgement -hypersexual behavior Outside forces are controlling thoughts, feelings, actions Delusions of control Inflated sense of self worth, power, or wealth delusions of grandeur Aa person, usually of higher status, in love w/ patient erotomanic delusions Patient has a physical defect (delusion) somatic delusions Others are trying to cause harm Persecutory delusions Describe the physical exam of the thyroid inspect thyroid for position and shape inspect thyroid for movement when swallowing auscultate thyroid for bruits palpate thyroid for size, shape, consistency, masses, nodules and tenderness palpate thyroid while swallowing