NURS 6501 Knowledge Check: Psychological Disorders
NURS 6501 Knowledge Check: Psychological Disorders
Question 1
4 out of 4 points
Scenario 1: Schizophrenia
A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”. The boyfriend relates episodes of unexpected rage and crying.
PMH: noncontributory
FH: positive for a first cousin who “had mental problems”.
SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.
NURS 6501 Knowledge Check Psychological Disorders
PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed.
DIAGOSIS: schizophrenia.
Questions
1. What are known characteristics of schizophrenia and relate those to this patient.
Selected Answer:
Schizophrenia is a chronic and serious mental disorder that changes the way you think, feel, and act, The cause is unknown. The Symptoms are gradual, not presented at the same time. Schizophrenia usually starts between the age of 16 years and 30 years, earlier in men than women. The characteristic of schizophrenia as related to this patient changes in her behavior, Hallucinations, auditory and visual, an auditory hallucination that the voices told her to quit college because she is dump the delusion that people wanted to harm her, Problem concentrating.
Correct Answer:
Positive symptoms of schizophrenia include hallucinations that may be auditory, olfactory, somatic-tactile, visual,
NURS 6501 Knowledge Check Psychological Disorders
voices commenting, and voices conversing. Delusions are also positive symptoms and include delusion of being controlled, delusion of mind reading, delusion of reference, delusion of grandiosity, guilt, persecution, somatic thought broadcasting, thought insertion and thought withdrawal. Thought disorder symptoms include distractible speech, incoherence, illogicality, circumstantially, and derailment. Bizarre behaviors are other positive symptoms of schizophrenia. Those behaviors include aggressiveness and agitated states, clothing appearance, repetitive stereotyped, and social and sexual behavior. This patient exhibited signs of auditory hallucinations, disheveled appearance, and persecution.
Response Feedback:
[None Given]
Question 2
4 out of 4 points
Scenario 1: Schizophrenia
A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”. The boyfriend relates episodes of unexpected rage and crying.
PMH: noncontributory
FH: positive for a first cousin who “had mental problems”.
SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.
PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed.
DIAGOSIS: schizophrenia.
Question:
1. Genetics are sometimes attached to schizophrenia explain this.
Selected Answer:
Genetic can be linked to the disorder, it can run in the families. if one parent has schizophrenia, the children have a 10% chance of developing the disorder. it is now clear that it combined the effect of many genes, each playing an important role. It has a variable susceptible genes interacting with the environmental factors. The genetic factors have strong evidence for 9 linkages sites : 1q,5q,6p,6q,8p,10p,13q,15q and 22q.
Correct Answer:
The causes of schizophrenia are not known. There are probably at least 2 sets of risk factors, genetic and perinatal. In addition, undefined socioenvironmental factors may increase the risk of schizophrenia in international migrants or urban populations of ethnic minorities. Increased paternal age is associated with a greater risk of schizophrenia. The risk of schizophrenia is elevated in biologic relatives of persons with schizophrenia but not in adopted relatives. The risk of schizophrenia in first-degree relatives of persons with schizophrenia is 10%. If both parents have schizophrenia, the risk of schizophrenia in their child is 40%. Concordance for schizophrenia is about 10% for dizygotic twins and 40-50% for monozygotic twins. Genome-wide association studies have identified many candidate genes, but the individual gene variants that have been implicated so far account for only a small fraction of schizophrenia cases, and these findings have not always been replicated in different studies. The genes that have been found mostly change a gene’s expression or a protein’s function in a small way.
Response Feedback:
[None Given]
Question 3
4 out of 4 points
Scenario 1: Schizophrenia
A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”. The boyfriend relates episodes of unexpected rage and crying.
PMH: noncontributory
FH: positive for a first cousin who “had mental problems”.
SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.
PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed.
DIAGOSIS: schizophrenia.
Question:
What roles do neurotransmitters play in the development of schizophrenia?
Selected Answer:
occurs due to a chemical imbalance in the brain. The neurotransmitters are the carriers of brain activity The neurotransmitters like dopamine, glutamine, GABA, serotonin, norepinephrine, and oxytocin are responsible for schizophrenia but dopamine has a major role to play.
Correct Answer:
Abnormalities of the dopaminergic system are thought to exist in schizophrenia. The first observable effective antipsychotic drugs, chlorpromazine and reserpine, were structurally different from each other, but they shared antidopaminergic properties. Drugs that diminish the firing rates of mesolimbic dopamine D2 neurons are antipsychotic, and drugs that stimulate these neurons (eg, amphetamines) exacerbate psychotic symptoms. Hypodopaminergic activity in the mesocortical system, leading to negative symptoms, and hyperdopaminergic activity in the mesolimbic system, leading to positive symptoms, may coexist. The newer antipsychotic drugs block both dopamine D2 and serotonin (5- hydroxytryptamine [5-HT]) receptors. Clozapine, probably the most effective antipsychotic agent, is a particularly weak dopamine D2 antagonist. Thus, other neurotransmitter systems, such as norepinephrine, serotonin, and gamma-aminobutyric acid (GABA), are undoubtedly involved.
Response Feedback:
[None Given]
Question 4
4 out of 4 points
Scenario 1: Schizophrenia
A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”. The boyfriend relates episodes of unexpected rage and crying.
PMH: noncontributory
FH: positive for a first cousin who “had mental problems”.
SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.
PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed.
DIAGOSIS: schizophrenia.
Questions:
Explain what structural abnormalities are seen in people with schizophrenia.
Selected Answer:
The structural abnormalities will be seen on PATHOLOGY on functional magnetic resonance imaging studies will show consistent dysmorphological findings in schizophrenia are the lateral ventricle enlargement, which is indicative of reduced brain volume, and third ventricular enlargement which suggest a reduction in cortical gray and white matter and in certain areas such as the frontal lobes, and temporal lobe volume and reduction of overall brain volume.
Correct Answer:
Advances in neuroimaging studies show differences between the brains of those with schizophrenia and those without this disorder. In people with schizophrenia, the ventricles are somewhat larger, there is decreased brain volume in medial temporal areas, and changes are seen in the hippocampus. Magnetic resonance imaging (MRI) studies show anatomic abnormalities in a network of neocortical and limbic regions and interconnecting white-matter tracts. Some studies using diffusion tensor imaging (DTI) to examine white matter found that 2 networks of white-matter tracts are reduced in schizophrenia. Brain imaging showed reductions in whole-brain volume and in left and right prefrontal and temporal lobe volumes in many people who are at high genetic risk for schizophrenia. The changes in prefrontal lobes are associated with increasing severity of psychotic symptoms. MRI studies of schizophrenic patients show that structural brain abnormalities may progress over time. The abnormalities identified included loss of whole-brain volume in both gray and white matter and increases in lateral ventricular volume.
Response Feedback:
[None Given]
Question 5
4 out of 4 points
Scenario 2: Bipolar Disorder
A 44-year-old female came to the clinic today brought in by her husband. He notes that she has been with various states of depression and irritability over the past 3 months with extreme fatigue, has lost 20 pounds and has insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity.
DIAGNOSIS: bipolar type 2 disorder.
Question
1. How does genetics play in the development of bipolar 2 disorders?
Selected Answer:
Bipolar disorder is a mental health disorder, The mood can swing between negative and positive moods, which can occur quickly. The cause is unknown. Most of the time genetics have a major role major role disorder, like a family with hx of the disorder,but other predisposing factors trigger could the disorder, changes of the brain structure like traumatic brain injuiiry and concussion, environmental factors like stressful events that could be related to work or personal life, seasonal factors like change of weather from winter to spring,
Correct Answer:
The pathophysiology of bipolar disorder, or manic-depressive illness (MDI), has not been fully identified, and there are no objective biologic markers that correspond definitively with the disease state. Twin, family, and adoption studies all indicate that bipolar disorder has a significant genetic component. Firstdegree relatives of a person with bipolar disorder are approximately 7 times more likely to develop bipolar disorder than the rest of the population, and the heritability of bipolar I disorder (BPI) has recently been estimated at 0.73. Bipolar individuals, who may exhibit psychotic behavior, have deficits in reelin expression linked to genetic loci located on the chromosome 22, which confers susceptibility to schizophrenia. Given that, there still are large variations in clinical symptoms suggests that developmental and environmental factors are as important as genetic factors in contributing to the etiology of mood disorders.
Response Feedback:
[None Given]
| Scenario 2: Bipolar Disorder
A 44-year-old female came to the clinic today brought in by her husband. He notes that she has been with various states of depression and irritability over the past 3 months with extreme fatigue, has lost 20 pounds and has insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. DIAGNOSIS: bipolar type 2 disorder. Question 1. How does genetics play in the development of bipolar 2 disorders? |
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