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- adjustment disorder
- developmental stages e.g.. beginning school, leaving home, moving back into
parental home, marriage/separation/divorce, becoming a parent, empty nest,
retirement, etc.
- occurs within 3 months of a stressor
- psychotherapy is TOC
Dx criteria:
a. development of emotional or behavioral symptoms in response to stressor(s)
occurring within 3 months of said stressor
b. evidence of 1 or both of the following:
> marked distress is out of proportion to the severity or intensity of the stressor
s)
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> significant impairment in social, occupational, or other important area of
function e.g. at home
c. once the stressor has terminated, symptoms do not persist more than an
additional 6 months
A 14 y/o new patient presents to your practice with her mom. She is one month
s/p moving to a new city and beginning high school. Mom reports she is already
failing three classes. She also states her daughter is no longer contributing to
chores around the house and she often stays in her room, avoiding socializing
with kids from school who have tried to invite her to hang out with them.
What might you diagnose her with?
Disorder is often associated with what?
Timing for this?
Management?
Diagnostic criteria?
- Have you ever been asked to CUT down on drinking?
- Have people ANNOYED you by criticizing your drinking?
- Have you felt bad or GUILTY about your drinking?
s)
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- Have you ever had a drink first thing in the morning to steady your nerves or get
rid of a hangover? (EYE opener)
*each question is one point, a score of 2 or higher is clinically significant
CAGE screening for alcohol dependence
- 2-5 days after the last drink
- delirium (altered sensorium), hallucinations, agitation
- abnormal VS-> tachycardia, HTN, fever
- diaphoresis
Delirium tremens:
Onset?
CM?
- pts taking tramadol, opioids
- pts with acute hepatitis, liver failure
Naltrexone (for alcohol use disorders):
s)
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Avoid in those patients with what meds/conditions? (2 each)
it causes nausea/vomiting if alcohol is consumed
What is the role of disulfiram in alcohol use disorders?
- beta-amyloid plaques
- neurofibrillary tangles (tau proteins)
*acetylcholine deficiency is also a hypothesis in this dz
- cortical atrophy
- forgetfulness
- apraxia
- short term memory abnormal
- short, slow, shuffling, wide-based steps
- speech hesitant
- paranoia
- primitive reflexes emerge
s)
=BEHAVIORAL
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GRADESOLUTION
HIGH