Georgette Module 3 Exam Questions and Answers

Georgette Module 3 Exam Questions and Answers What is a decreased effect of the same dose of a medication overtime? - AnswersTolerance Ex. taking 2 pills of ibuprofen over a period of time so now needing to take 3 pills to achieve the same effect What is it called when there is a tendency of some regions of the brain to react to repeated LOW level bioelectrical stimulation by progressively boosting synaptic discharges thereby lowering seizure thresholds? - AnswersKindling Kindling explanation/definition - Answersprocess of neuronal membrane threshold sensitivity dysfunction -d/t subthreshold brain stimulation -brain's overly sensitive to electrical stimuli -neuronal misfiring (occurs w/o stimuli) 3 types of ADHD - AnswersInattention Hyperactivity/impulsivity Combined type Dx criteria for ADHD (all 3 types) - Answers-Hyperactivity & Inattentive type= 6 for children, 5 for adults -Combined type (6 in each area) -6 MONTHS -BEFORE AGE 12 -2 SETTINGS Inattentive ADHD criteria symptoms - Answers1. Lack of attention to detail 2. Dif. sustaining attention 3. No listen when spoken to directly 4. Doesn't follow through on instruction 5. Dif. organizing tasks/activities 6. Avoids sustained mental effort 7. Loses things 8. Easily distracted 9. Forgetful Hyperactivity ADHD Criteria symptoms - Answers1. Fidgets/squirms in seat 2. Leaves seat frequently 3. Restless/run or climbs where inappropriate 4. Can't engage in leisure activities QUIETLY 5. Always "on the go" 6. Talks excessively 7. Blurts out answer before question completed 8. Difficulty waiting turn 9. Interrupts others Brain Abnormalities Etiology of ADHD - Answersabnormalities in fronto-subcortical pathway aka the Frontal cortex, Basal Ganglia, RAS Basal Ganglia function - Answers-Motor control/learning -Executive function -Emotions RAS (reticular activating system) - Answersregulates arousal and sleep-wake transitions, ability to focus, fight-flight reponse what neurotransmitter abnormalities are seen in ADHD?? - AnswersNeurotransmitters= **DNS**(DA, NE, 5HT)** Stimulants for ADHD include and what ages are they approved for?? - AnswersAdderall (3 and up) Methylphenidate (6 and up) What should you assess prior to giving a stimulant for ADHD? why?? - Answerscardiac hx because they can cause elevated HR & BP, increase risk of MI/CVA/Aneurysm rupture Amphetamines are approved for what age?? - Answers***age 3 and older*** Methylphenidate is approved for what age?? - Answers**age 6 and older** Non-stimulants for ADHD include - Answers1. Alpha-agonists/Alpha2 adrenergic agonists= **Clonidine & Guanfacine** (approved ages 6-17 w/ ADHD) 2. Straterra (atomoxetine) approved for >/= 6yr Alpha-agonists FDA approved for ADHD and at what age - AnswersGuanfacine & Clonidine ages 6-17 with confirmed dx Straterra (Atomoxetine) is approved for what age in ADHD - Answers>/= 6 years with ADHD ***know** that for children <6 years old, what to give for ADHD - AnswersAdderall **Know** what to give when children turn 6 for ADHD - AnswersMethylphenidate DNS stands for and what is it?? - AnswersDA, NE, 5HT (abnormalities in ADHD and some others) If choosing between Guanfacine & Clonidine for ADHD, which should you choose on the test?? why? - AnswersGuanfacine, lasts longer & is less sedating Signs of stimulant abuse?? - Answers**Insomnia **Tremors **Increase in BP & HR **Heart Palpitations Agitation/Anxiety/Irritability/Mood swings/Elevated mood Nonpharmacological management for ADHD includes... - Answers-Behavioral therapy -Pt & Parent CBT program -Psychoeducation -Tx of learning d/o -Family therapy/edu. Follow up for ADHD, includes monitoring clinical progress _____ ______ - Answersover time Standardized rating scales for ADHD include..... - Answers1. **Vanderbilt ADHD Dx Parent & Teacher Rating Scales (PUBLIC, need in 2 settings)** 2. Conners' Parent & Teacher Rating Scale (Copyrighted, need permission to use) Borderline Personality Disorder Dx criteria - Answers1. *Impulsivity, often w/ self-damaging behavior* 2. *Recurrent suicidal behavior* 3. Frantic efforts to avoid real/imagined abandonment 4. Unstable/intense relationships 5. Identity disturbances 6. Chronic feelings of emptiness 7. Inappropriate/intensified anger responses Treatment for BPD - AnswersDBT (dialectical behavioral therapy) to dx person with personality disorder they have to be at least how old? - Answers18 years