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Personality Disorders
persistent disorders characterized by a relatively inflexible reaction to stress
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antisocial
psycho/sociopath that acts out conflict without remorse or guilt and has difficulty following rules
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compulsive
descriptive of thoughts or behavior which are automatic responses to anxiety or stress. A common example is compulsive hand washing caused by an obsession with cleanliness or a phobia of being unclean. Also see obsessive
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Hysterical aka Histrionic
attention seeking, aggressive, seductive person, who is unable to be deeply involved emotionally
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Narcissism
attention seeking, regards no one else as important, strong admiration for self/exhibitionist
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Paranoid
preoccupations with delusions, sensitive, defensive, suspicion leading to agrression, unfounded beliefs that others want to harm him
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Passive Aggressive
taking aggressive actions in an indirect manner, argumentative
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Schizoid
ungluing of reason and emotion. introverted and withdrawn, emotionally cold and distant, avoids social interaction. delusions and hallucinations
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Defense mechanisms
unconscious strategies utilized to cope with reality
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Denial
refusal to perceive unpleasant realities. painful subject stems from external sources such as impulses or fantasies. most commonly seen in alcoholics
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projection
act of assigning a feeling or belief to another person, group, or to the outside world
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Rationalization
attributing one's own unacceptable desires and impulses to someone else
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Reaction formation
depressed, unacceptable behavior expressed in an exaggerated form of an opposite behavior
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Regression
a response to stress in which an individual reverts to a less developmentally mature stage. acts like a child
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Repression
the unconscious exclusion of painful impulses, desires, or fears from teh conscious mind
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Transference
redirecting ones feelings (aggresion or affection) from one person to another
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Sublimation
channeling unacceptable impulses or energy into socially acceptable activity
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anxiety disorders
patients with anxiety disorders usually present with physical symptoms to physicians. Physical symptoms: heart palpitations, increased heart rate, shortness of breath, sweating tingling, dizziness
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Anxiety
A state of intense apprehension or worry often accompanied by physical symptoms such as shakin, intense feelings in the gut, etc, common in mental illness or after a very distressing experience
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Panic Disorder
repeated attacks of severe anxiety. Attacks last from 5-30 minutes
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Obsessive- Compulsive
- obsession: reoccuring intrusive thought or image that seems senseless or unpleasant
- compulsion: activity designed to reduce anxiety that a person feels compelled to repeat with no conscious desire to do so.
- Perfectionist, inflexible, uncontrollably entangled with details and highly repetitive activities
- presistent thoughts are obsessive while persistent actions are compulsive
- most often begins in early adolescence but can begin in childhood
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Phobic
- an irrational or unrealistic fear of a situation, animal, person, or activity
- agoraphobia-public spaces, acrophobia-heights, astrophobia- thunder and lightening, astraphobia- fear of stars or celestial space
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Somatoform Disorders
psychological conflicts take on a physical form adn no organic evidence exists to explain symptom
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Somatoform Disorders
psychological conflicts take on a physical form and no organic evidence exists to explain symptom
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Somatization Disorder
chronic, cyclic multiple somatic complaints not due to a physical illness. Symptoms cannot be explained by physical syndrome. Patient seeks treatmentand changes life as a result of the symptoms. Patient presents with symptoms in a vague and exaggerated way. More concerned with discomfort than disease
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Hypochondriasis
an exaggerated preoccupation with bodily functions and fear that one is suffering from serious disease. Pt believes they have a disease or one is soon going to occur. Disease is thought to be imminent. Patient presents with having dx himself in a very detailed way, hoping for a dreaded dx.
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Conversion Hysteria aka Conversion Reaction
Loss or change of physical fxn caused by a psychological conflict. COnversion symptoms are not supported by medical evidence but not faked. Often appear rapidly after trauma. Involuntary response. Most common disability seen: paralysis, blindness, mutism, deafness, seizures
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Body Dysmorphic Disorder
Pervasive belief that a body part is a misshapen or malformed. Pt able to admit that she or he is exaggerateing. May avoid mirrors or social contact
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Affective Disorder
severe fluctuation of mood or personality
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Alcoholism
associated with delirium tremens and folate deficiency
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Anorexia Nervosa
severe restriction of calories. fear of fat and body image distortion, amenorrhea, excessive exercise, unreasonable fear of gaining weight
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Bipolar Affective Disorder aka manic depressive
Behavior alternates between mania and melancholia, highs and lows, first occurs between childhood and age 50. Avg manic episode last 3 months, depressive phase 6-9 months
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Bulimia Nervosa
preoccupation with food, bringe eating with subsequent purging, body image distortion
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Catatonia
associated with muscle inhibition.
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Dystheymic Disorder
mild chronic depression. symptoms need to occur most of the time for 2 years. Begins in adolescence or early adulthood. Same symptoms as depression but not as severe
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Hallucinations
perception problems
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Involutional Melancholia
a period of depression associated with menopause
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Schizophrenia
delusions, hallucinations, social withdrawal, daily fxn impairment and bizarre behavior
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Transvestite
a person who adopts the dress of the opposite sex, cross dressing
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Aversion
used to treat alcoholics by associated drinking with unpleasant consequences
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Classical Conditioning
two events that occur close together in time become fused in the persons mind (Pavlov's dogs)
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Operant Conditioning
a satisfying reinforcement strengthens the behavior. Unsatisfying consequences weaken behavior and make it less likely to be repeated
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Negative Reinforcment
Taking away the aversive stimulus in response to a person's action increases the action. Ex: picking up a crying baby
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Flooding
a form of desensitization for the treatment of phobias and related disorders in which the patient is repeatedly exposed to emotionally distressing stimuli of high intensity
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Modeling
a behavior modification technique in which one is taught to imitate the desired behavior of another
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Rorschach Test
Psychological testing using a series of inkblot images
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Wechsler Scale
A method of IQ testing
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Freud
- development of free association and dream analysis as a route to the unconscious mind. Developed the psychosexual stages of development going from oral to anal to phallic or genital. ANAL is stubborn and develops an order to every aspect of life.
- Id: basic instincts, EGO: reality and control, Superego: guilt and consciousness
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Jung
collective unconscious of man; used for psychoanalysis
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Maslow
hierarchy of human needs; physiology, safety, love, esteem, and self actualiazation
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Pavlov
classical conditioning
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Skinner
operant conditioning
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Acetaminophen
- tylenol; an antipyretic analgesic that causes liver damage
- fever reducer
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Activated charcoal
an absorbent
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Acyclovir
antiviral (herpes)
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Allopurinol
used to treat chronic gout
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Barbituarates
sleepign pills can produce respiratory depression
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Benzodiazepine
used to treat anxiety side effect is tremors muscle relaxant
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Beta Blockers
given for hypertension and arrhythmias; blocks epinephrine and norepinephrine
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Carbon Monoxide
associated blue mucous membranes. poisoning cherry red lips and skin
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Carbon Tetrachloride
it was formerly widely used in fire extinguishers as a precursor to refrigerants, and as a cleaning agent. it is a colorless liquid with a sweet smell that can be detected at low levels
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chloroform
a clear volatile liquid with a strong smell like either. it was once administered by inhalation to produce anesthesia and given as an analgesic and a remedy for cough. it is quite toxic to the kidney and the liver
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Chlorpromazine
a drug used to treat schizophrenia
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Cholinesterase Inhibitor
an organophosphate
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Cocaine
classification as a narcotic; lidocaine used as a local anesthetic
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Colchicine
used to treat acute symptomatic gout
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Cyanide
has the taste of cherry seeds or almonds
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EDTA
best substance to remove lead from blood chelation therapy
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Emetic
a substance that makes you vomit;
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Epinephrine
used in the treatment of anaphylactic shock
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Expectorant
alleviateds coughing; an antitussin
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Gastric Lavage
pumping of the stomach
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haldol
- used to treat psychotic disorders
- controls motor tics and verbal tics in adults and children who have tourettes disorder
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Hallucinogenic Drugs
mushrooms and nutmegs
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Lead Poisoning
blue gums produces
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lithium
a drug used to treat bipolarity that produces tremors
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nitroglycerine
used to treat episodes of angina in people who have coronary artery disease
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NSAID
non steroidal anti inflammatory; antipyretic, analgesic; feldene
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Prozac
used to treat depression , obsessive compulsive disorder, some eating disorders and panic attacks
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Reserpine
antipsychoticand antihypertensive drug
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Salicylates
aspirin, causes bleeding, inhibits prostaglandins and associated with deafness and reye's syndrome
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Seconal
brand name druf with an active ingredient called secobarbital
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Chloral Hydrate
short term treatment of insomnia
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syrup of ipecac
induces vomitting
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Tranquilizers
predisposes elderly to falls
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tricyclic
anti depressants
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tricyclic
anti depressantes
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tyramine
causes hypertension in those taking MAO inhibitors and is found in wine and cheese
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warfarin
an anticoagulant/ Vit K antagonist, increased clotting time
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Pneumoconiosis
chronic respiratory diesease caused by the inhalation of various mineral or metallic particles
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asbestosis
caused by inhalation of asbestos dust. leads to mesothelioma
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siderosis
caused by iron dust
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Anthracosis
caused by coal dust
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byssinosis
caused by cotton dust
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silicosis
caused by glass, sand/ stone dust
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alpha fetoprotein
measured in pregnant women using maternal blood or amniotic fluid as a screening test for a subset of developmental abnormalities. it is prinicpally increased in open neural tube defects and decreased in down syndrome
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amenorrhea
abnormal cessation of menses
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Amniocentesis
done for the health of the fetus, chromosomes, lung maturity
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breast milk
deficient in vit d and iron
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colostrum
first breast milk
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dilation of the cervix
expansion or stretching of the cervix during the first stage of labor
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dysmenorrhea
painful menses
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dystocia
abnormal painful or prolonged labor
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effacement
thinning of the cervix
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Engagement
decent of the fetal skull to the level of ischial spines
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Hyperemesis gravidarum
excessive nausea and vomiting during pregnancy
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laparoscopy
the most common surgical procedure for the diagnosis and treatment of endometriosis
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lightening
baby drops into the pelvis 2 weeks before delivery and produces lower abdominal pain
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linea nigra
dark streak down teh midline of the abdomen seen during pregnancy
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lochia
vaginal discharge after delivery of the placenta and throughout the puerperium 1st red 2nd yellow and 3rd white
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menarche
1st menstrual cycel
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Mittelschmerz
pain in abdomen at ovulation
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multiparous
more than one delivery of viable infant
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nulliparous
never given birth to a viable infant
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primpara
first pregnancy with a viable infant
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Post partum infection
most commonly from c section
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puerperium
period of time after teh delivery of the placenta to the complete involution of the organs; infection during this time is referred to as puerperal spesis
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quickening
1st perception by the mother of fetal life
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station
identifies the fetal position in relation to the spines of the ischium
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signs of pregnancy
menses 3 weeks late adn presence of fetal heartbeat
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chadwick's sign
bluish discoloration of the vagina
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goodells sign
softening of the tip of the cervix
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hegar's sign
softening of the isthmus of the uterus
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piskacek's sign
enlargment of the uterus near the uterine tube over the site of implantation
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atonic uterus
most common reason for post partum hemorrhage
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braxton hick's contractions
early uterine contractions (oxytocin) without cervical changes
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cervix
most common malignancy of the female genital tract
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chloasma aka melasma
- brown hyperpigmentation of the face
- mask of pregnancy
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chorocarcinoma
malignancy of the placenta due to abnormal epithelium
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cystocele
herniation of the urinary bladder into the vagina
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eclampsia
toxemia of pregnancy caused by hypertension leading to convulsions
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endometriosis
- abnormal endometrial tissue outside the uterus
- abdominal and back pain
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endometritis
- most common type of post partum infection
- staph or strep
- inflammation of endometrium
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fibrocystic breast disease
palpable nodules in breast after ovulation with regression after menses
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hydatidiform mole
benign of trophoblastic tissue which develops at teh placenta
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pre eclampsia
- toxemia of pregnancy with the following sign
- hypertension
- edema
- proteinuria
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rectocele
herniation of the rectum into the vagina
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FSH
- responsible for maturation of the follicle
- day 1-14 in mentsrual cycle
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HCG
promotes health of corpus leuteum used to detect pregnancey
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LH
most responsible for ovulation
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Oxytocin
uterine contractions during labor and milk let down following delivery
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prolactin
responsible for milk production
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1st stage of labor
- 1st meaningful contraction to full dilation of the cervix to 10 cm
- longest stage
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2nd stage of labor
full dilation of cervix to delivery of baby
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3rd stage of labor
delivery of baby to delivery of placenta most dangerous for mom due to infections
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4th stage of labor
period of time from delivery of placenta to several hours when the tone of the uterus is established and the uterus contracts expelling any remaining contents
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Placenta Praevia
low lying placenta with partial obstruction of the internal os
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Placenta abruptio
normally placed, detaches from site spontaneous abortion premature separation
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placenta accreta
does not separate after delivery
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battledore placenta
umbilical cord is attached at teh margin of the placenta. it rarely occurs and does not affect placental functioning
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Pap Smear Classification
- 1 normal
- 2 atypical or benign
- 3 dysplasia or pre cancer
- 4 in situ non invasive carcinoma
- 5 malignancy or invasive
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assisted walking
10-14 months
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unassisted walking
12-18 months
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talking
10-15 words at 18 months
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umbilical cord falls off in 7-10 days
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posterior fontanelle
closes at 3 months
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anterior fontanelle
closes at 2 years
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depressed fontanelle indicates
dehydration
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bulging fontanelle
due to intracranial pressure possible excessive crying
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APGAR score
- heart rate, respiratory rate, color, muscle tone, reflex irritability NOT birth weight
- 7-10 normal, 4-6 monitor, less tahn 3 problem
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lanugo
fuzzy hair on baby skin
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mongolian spots
bluish ill defined areas of skin on but and scrotal region
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premature
infant born between 26-37 weeks and weigh less than 2500 g
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vernix caseosa
white cheesy substance on teh baby's skin at birth
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botulism
food poisoning produced by honey, corn syrup, and molasses in newborn
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caput succedeum
baby's head has an unusual shape due to swelling of the scalp, considered benign
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cradle cap
similar to seborrheic dermatitis in an adult
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erythroblastosis fetalis
hemolytic anemia in the fetus or neonate caused by transplacental transmission of maternal antibodies to fetal RBCs. the disorder usually results from incmopatiblity between maternal and fetal blood groups often Rh antigens
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fetal alcohol syndrome
presents with delayed growth microcephaly and retardation
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kwashiorkor
protein malnutrition
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leukemia
most common cancer in children and in Down's syndrome ALL
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Marasmus
general malnutrition
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prickly heat
milaria from sweat glands
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prolapsed cord
leads to fetal suffocation
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vit k
prvents hmorrhage in newborns
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Rubella aka german measles
- 3 day measles
- maculopapular rash and mild fever
- danger to the fetus in the 1st tri because it may result in birth defects
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Rubeola
- koplic spots, runny nose, lasts 2 weeks
- maculaopapular rash and high fever
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Chicken Pox
maculopapular rash herpes virus
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mumps
mild disease in children and adults located in teh parotid gland that can produce orchitis
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Croup
childhood disease characterized by a resonant barking cough
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Pertussis aka whooping cough
- caused by bordetella pertussis
- fatalities are due to bronchopneumonia
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Diphtheria
gray pseudomembrane
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Scarlet Fever
- group a strep pyogenes
- peeling of superficial tongue
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Roseola Infantum
rash starts on the trunk and goes to the extremities. rash comes out when fever breaks
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rooting reflex
established by stroking teh corner of teh mouth; the infan'ts mouth will open and turn to the side that was touched; most basic prmiitve reflex originated from teh brain stem
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sucking reflex
elicited by placing a finger or nipple in the mouth of the newborn stimulates oxytocin release
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tonic neck reflex
doc rotates head of a supine baby and the ipsilateral arm and leg extended while the contralateral arma nd leg flex
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moro aka startle relfex
arms and legs flare out to teh side in response to loud sound and are then brought back into body soensory integrations
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Landau Reflex
infant should attempt to raise teh head and arch the back when placed in a prone position
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DJD
most common geriatric neuromuscular complaint
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arcus senilis
grayish opaque ring around the cornea
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presbyopia
loss of elasticity of the lens or hardening of the lens
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presbycussis
inability to hear high frequencies
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diabetes mellitus
most common endocrine malfuntion on the elderly
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iron deficient anemia
most common anemia in geriatrics
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multiple myeloma
most common plasma cell dyscrasia
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wernicke-korsakoff syndrome
seen in those with alcohol abuse B1 thiamin deficiency
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hip fracture
most common fractured bone in the elderly
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rodent ulcer
basal cell carcinoma
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Squamous cell
itchy scaly patch
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macular degeneration
most common visual problem in the elderly causing blindness
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alzheimer's disease
mental deterioratoin, amnesia, depression, anxiety and rigidity best dx at autopsy
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tonometer
checks for glaucoma
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vit d and calcium
reduces the risk of fracture in the elderly
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PET
- positron emission test
- measure blood volume, oxygen uptake transport, metabolism
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ageism
discriminatory treatment of the elderly
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osler's sign
pretibial myxedema seen in graves' disease
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abandonment
transfer of a pt to another doctor wiouth the patient's consent
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assault
threat of violence to another person
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battery
adjusting without consent
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binding arbitration
has no appeal process
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civil court
malpractice cases against chiropractors are tried in this court
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contract
acceptance, consideration, 2 or more competent parties, legal object, and consent to contract
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employers must pay
workers compensation, FICA and SS for their employees
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good samaritan law
good faith rendering of care at an emergency isn't liable for ciivl damages
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informed consent
providing the patien with feasible alternatives and informed of dangers of treatment
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libel
false statement submitted in writing that harms another
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malpractice
a professional negligence by act or omission by a health care provider in which care provided deviates from accepted standards of practice in teh medical community and causes injury or death to the patient
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negligence
failur to conform to the standard of care expected and ipmosed by law
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plaintiff
where teh urden of proof lies in a court of law
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respondent superior
employer is responsible for actions of employees
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slander
a false verbal statement about another
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standards of care
a formal dx and treatment process a doctor will follow for a pt with a certain set of symptoms or specific illness. taht standard will follow guidelines and protocols that eperts would agree with as most appropriate also called best practice
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statute of limitation
length of time you have to sue for an injury
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substandard care
the standard of care is the basis on which negligence and fault are determined in medical malpractice lawsuits. it referes to the level of care, skill, and knowledge that is expected of all phsicians in a particular field, in a particular region, acting in similar cirumstances. substandard care, treatment and surgery occur when a doctor fails to meet this standard of care
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tort
the body of the law which allows an injured person to obtain compensation from teh person who caused teh injury
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emergency assessment
check responsiveness, open airway, check breathing, give breaths, check pulse
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battle sign
ecchymosis around the mastoid, indicates possible basilar skull fracture
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raccoon sign
when the injury produces black and blue spots around the eyes
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lightening injuries
move out of danger, activate EMS, monitor for respiratory and cardiac arrest, look for both entrance and exit wounds. prolonged resuscitation may be required
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positioning
cardiogenic shock; supine with feet higher than the head. anaphylactic shock; upright; lower extremity or pelvic injury supine
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adult cpr
- airway, breathing and circulations
- chest compressions 2 rescue breaths, 20 chest compressions, 2 breaths repeat.
- stop cpr if help arrives or u are too tired.
- recovery position side lying with bottom arm extended over head and upper leg bent
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choking infant procedure
5 back blows and 5 chest thrusts
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burns
- 1st redness epidermis
- 2nd blisters epidermis and dermis but not the base of the dermis
- 3rd charring of the skin
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epidural hematoma
result of traumawith a faster bleeding rate. causes an increase in intracranial pressure
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subdural hematoma
usually the result of a serious head injury. acute subdural hematomas are among the dealiest of all head injuries. symptoms of subdural hemorrhage have a slwoer onset than those of epidural hemorrhages because the lower pressure veins bleed more slowly than artieries
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subarachnoid hematoma
usually the result of a cerbral aneurysm. consider a form of storke
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