Physical Diagnosis Chapter 16
Terms
undefined, object
copy deck
- Describe the response of a lethargic patient
- Lethargic patients are drowsy but open their eyes and look at you, respond to questions, and then fall asleep
- Describe the response of an obtunded patient
- Obtunded patients open their eyes and look at you, but respond slowly and are somewhat confused
- What is affect?
- an observable, usually episodic, feeling or tone expressed through voice, facial expression, and demeanor
- What is dysarthria?
- refers to defective articulation
- What is aphasia?
- a disorder of language
- List some abnormalities of speech that suggest aphasia
- - hesitancies and gaps in the flow and rhythm of words - disturbed inflections, such as a monotone - circumlocutions (when phrases or sentences are substituted for a word the person cannot think of) - paraphasias (when words are malformed, wrong, or invented)
- List and describe 5 methods for testing aphasia
- 1. word comprehension - ask the patient to follow a one-stage command and two-stage command such as: "point to your nose" 2. repetition - ask the patient to repeat a phrase of one-syllable words (ex. "No ifs, ands, or butts) 3. naming - ask the patient to name the parts of a watch 4. reading comprehension - ask the patient to read a paragraph aloud 5. writing - ask the patient to write a sentence
- Name and describe 2 abnormalities of perception
- 1. illusions - misinterpretation of real extrenal stimuli 2. hallucinations - subjective sensory perceptions in the absence of relevant external stimuli
- Name 3 tests to evaluate for attention
- - digit span - serial 7s - spelling backward
- List 9 symptoms of depression.
- 1. depressed mood 2. markedly diminished interest in almost all activities 3. significant weight gain/loss or increased/decreased appetite 4. insomnia or hypersomnia 5. psychomotor agitation or retardation 6. fatigue or loss of energy 7. feelings of worthlessness or inappropriate guilt 8. inability to think/concentrate or indecisiveness 9. recurrent thoughts of death/suicide or a specific plan for or attempt at suicide
- Describe the criteria used to diagnose a major depressive episode
- - at least 5 of the 9 symptoms must be present - one of the symptoms must be either depressend mood or markedly diminished interest or pleasure - symptoms must be present during the same 2-week period
- Define manic episode and give symptoms of a manic episode
- A manic episode is a distinct period of abnormally and persistently elevated, expansive, or irritable mood (present for at least a week) with at least 3 of the following symptoms: - inflated self-esteem or grandiosity - decreased need for sleep - more talkative than usual or pressure to keep talking - flight of ideas or racing thoughts - distractibility - increased goal-directed activity or psychomotor agitation - excessive involvement in pleasrurable high-risk activity
- What is a dysthymic disorder?
- - a depressed mood and symptoms for most of the day, for more days than not, over at least 2 years - freedom from symptoms last no more than 2 months at a time
- What is cyclothymic episode?
- - numerous periods of hypomanic and depressive symptoms that last for at least 2 years - freedom from symptoms last no more than 2 months at a time
- Name 2 common types of aphasia
- 1. Wernicke's aphasia 2. Broca's aphasia
- What are characteristics of Wernicke's aphasia?
- - fluent, rapid, effortless words - inflections and articulatoins are good, but sentences lack meaning and words are malformed (paraphasias) or invented (neologisms) - speech may be totally incomprehensible - impaired word comprehension, repetition, naming, reading comprehension, and naming - lesion is located in the posterior superior temporal lobe
- What are characteristics of Broca's Aphasia?
- - nonfluent, slow, with laborious effort - inflection and articulation are impaired but words are meaningful - word and reading comprehension are fair to good - repetition, naming, and writing are impaired - lesion is in the posterior inferior frontal lobe
- What is a panic disorder?
- - defined by recurrent, unexpected panic attacks, which are a discrete period of intense fear or discomfort that develops abruptly and peaks with 10 minutes - symptoms involve at least 4 of the following: 1. palpitations, tachycardia 2. sweating 3. trembling 4. SOB 5. a feeling of choking 6. chest pain 7. nausea or abdominal distress 8. feeling dizzing, unsteady, lightheaded, or faint 9. feelings of unreality ofr depersonalization 10. fear of losing contraol or going crazy 11. fear of dying 12. paresthesias
- What is acute stress disorder?
- - a person experiences a traumatic event that involved actual or threatened death and responds with intese fear, helplessness, or horror - immediately after event, the person experiences at least 3 of the following dissociative symptoms: 1. a subjective sense of numbing, detachment, or absence of emotional responsiveness 2. reduced awareness of surroundings (daze) 3. feelings of unreality 4. feelings of depersonalization 5. amnesia for an important part of the event
- What is generalized anxiety disorder?
- - a disorder that lacks a specific traumatic event or focus for concern - involves at least 3 of the following symptoms: 1. feeling restless 2. being easily fatigued 3. difficulty in concentrating or mind going blank 4. irritability 5. muscle tension 6. difficulty in falling or staying asleep, or restless, unsatisfying sleep
- What are symptoms for diagnosing schizophrenia?
- - manifestations of at least 2 of the following: 1. delusions 2. hallucinations 3. disorganized speech 4. grossly disorganized or catatonic behavior 5. negative symptoms (flat affect, alogia, and avolition) - continuous signs of disturbance must persist for at least 6 months
- What is schizoaffective disorder?
- - has both mood disturbance (either depressive, manic, or mixed) with symptoms of schizophrenia - must also have delusions or hallucinations for at least 2 weeks without prominent mood symptoms during the same period of time
- What is delusional disorder?
- - characterized by nonbizarre delusions that involve situations in real life - delusion persists for at least a month - person's functioning is not markedly impaired and behavior is not obviously odd - tactile and olfactory hallucinations related to delusion may be present
- Describe a breif psychotic disorder
- - at least 1 of the following psychotic symptoms present: 1. delusions 2. hallucinations 3. disordered speech 4. disorganized or catatonic behavior - disturbance last at least 1 day but less than 1 month - person returns to his or her prior functional level