Neuroscience Quiz on Brain Lobes and Functions
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Questions and Answers

Which lobe of the brain is primarily responsible for processing auditory information?

  • Frontal
  • Parietal
  • Temporal (correct)
  • Occipital

Which of the following is NOT a function typically associated with the frontal lobe?

  • Motor function
  • Personality development
  • Receptive speech (correct)
  • Executive functions

Difficulties with reading and writing are most likely associated with damage to which area of the brain?

  • Frontal lobe
  • Temporal lobe
  • Occipital lobe
  • Parietal lobe (correct)

Which of the following is a primary function of the occipital lobe?

<p>Primary visual cortex (D)</p> Signup and view all the answers

A patient experiences visual hallucinations after a head injury. Which lobe is most likely affected?

<p>Occipital (B)</p> Signup and view all the answers

The Clock Drawing Test (CDT) is primarily used to assess which of the following?

<p>Executive function and cognitive dysfunction (C)</p> Signup and view all the answers

Which of the following functions is most closely associated with Broca's area?

<p>Expressive speech (D)</p> Signup and view all the answers

What does the acronym CRAFFT stand for in the context of adolescent risk screening?

<p>Car, Relax, Alone, Forget, Family/Friends, Trouble (A)</p> Signup and view all the answers

According to the provided information, what score on the 'cut down, annoyed, guilty, eye opener' questions indicates a high likelihood of alcohol or drug use?

<p>A score of 1 or above (C)</p> Signup and view all the answers

A person shows changes in personality after a brain injury. Which lobe would most likely be affected?

<p>Frontal lobe (A)</p> Signup and view all the answers

What is the primary purpose of the CRAFFT tool?

<p>To identify adolescents who may have high-risk alcohol or drug use disorders (C)</p> Signup and view all the answers

According to the CRAFFT screening, which of the following is NOT a focus of the questions asked?

<p>The socioeconomic status of the individual (D)</p> Signup and view all the answers

What does a clinically significant score of 2 or greater on 'cut down, annoyed, guilty, eye opener test' suggest?

<p>The individual likely has a problematic or concerning level of substance use. (C)</p> Signup and view all the answers

Which of the following best describes the concept of 'insight' in a mental health assessment?

<p>The patient's awareness and understanding of their own thoughts, feelings, and behaviors. (A)</p> Signup and view all the answers

When assessing a patient's 'judgment', a clinician would likely explore their ability to:

<p>Make sound decisions and anticipate consequences of their actions. (D)</p> Signup and view all the answers

What is the primary purpose of the Mini Mental Status Examination (MMSE)?

<p>To provide a quantitative evaluation of cognitive impairment and track changes over time. (D)</p> Signup and view all the answers

Which of these tasks is used to assess concentration/attention/calculation in the MMSE?

<p>Subtracting seven from 100 repeatedly, or listing all 12 months in reverse order. (A)</p> Signup and view all the answers

During an MMSE, if a clinician asks, What is the year? Season? Date? Day? and Month?, they are assessing:

<p>Orientation to time and place. (B)</p> Signup and view all the answers

Which question would be used to assess a patient's 'registration/ability to learn new material' during an MMSE?

<p>Can you repeat these three words: tree, flower, table? (B)</p> Signup and view all the answers

A patient who demonstrates 'poor insight' might display which behavior?

<p>Difficulty recognizing their own symptoms or any impact on their life. (C)</p> Signup and view all the answers

If a patient is asked 'What would you do if you found a wallet on the street?', what type of assessment is being performed?

<p>Assessing judgement. (B)</p> Signup and view all the answers

Which of the following is NOT a characteristic of subcortical dementia?

<p>Primary impact on the cerebral cortex structures. (B)</p> Signup and view all the answers

Which type of dementia is characterized by a step-like decline, often linked to cardiovascular issues?

<p>Vascular Dementia (C)</p> Signup and view all the answers

What is a common early clinical sign of dementia due to HIV disease?

<p>Motor abnormalities, such as lack of coordination. (D)</p> Signup and view all the answers

Which of the following is a key feature of frontotemporal dementia (Pick's disease) in its early stages?

<p>Personality, behavioral, and language changes. (C)</p> Signup and view all the answers

Which neurotransmitter decrease is associated with Dementia of Alzheimer's type (DAT)?

<p>Decreased Acetylcholine and Norepinephrine. (A)</p> Signup and view all the answers

Which of the following is a characteristic of Lewy body disease?

<p>Recurrent visual hallucinations, and Parkinsonian symptoms. (A)</p> Signup and view all the answers

In late-stage HIV related dementia, which cluster of symptoms is likely to be observed?

<p>Global cognitive impairment, mutism, and seizures. (C)</p> Signup and view all the answers

Which of the following statements is true regarding the use of medications in treating psychosis or agitation related to dementia?

<p>Atypical antipsychotics should be used as first-line agents, starting at a low dose. (A)</p> Signup and view all the answers

Which of the following is considered a key factor in the development of vascular dementia?

<p>Preexisting cardiovascular risk factors, such as hypertension. (B)</p> Signup and view all the answers

Which type of dementia has a higher incidence of depression and psychosis?

<p>Huntington's disease. (C)</p> Signup and view all the answers

Which laboratory test is crucial to perform before initiating lithium therapy due to the potential for lithium to cause hypothyroidism?

<p>Thyroid panel (TSH) (D)</p> Signup and view all the answers

A client with bipolar disorder is being started on lithium therapy. Which baseline lab result would be of most concern to the nurse?

<p>Serum creatinine of 2.4 mg/dL (D)</p> Signup and view all the answers

Why is an electrocardiogram (ECG) recommended before lithium initiation for clients over age 50?

<p>To identify potential cardiac side effects of lithium (D)</p> Signup and view all the answers

A client on lithium presents with a maculopapular rash and pruritis. Which body system is most likely affected?

<p>Dermatological (B)</p> Signup and view all the answers

What effect can NSAIDs have on lithium levels?

<p>Increase lithium levels (C)</p> Signup and view all the answers

A client taking lithium is experiencing severe nausea, vomiting, diarrhea, and confusion. What is the priority action by the nurse?

<p>Hold the lithium dose and check serum lithium level (D)</p> Signup and view all the answers

A client on lithium has developed polyuria. This can potentially lead to what other side effect?

<p>Polydipsia (C)</p> Signup and view all the answers

What is the primary reason why a pregnancy test is done before starting a female client on lithium?

<p>Lithium can cause congenital heart defects (C)</p> Signup and view all the answers

Which of the following is NOT a common side effect of lithium therapy?

<p>Weight loss (B)</p> Signup and view all the answers

A client is prescribed an MAOI. Which of the following should the client be educated to avoid while taking this medication to prevent a hypertensive crisis?

<p>Foods high in tyramine (C)</p> Signup and view all the answers

Which of the following medications when taken with an MAOI can cause a hypertensive crisis?

<p>Meperidine (B)</p> Signup and view all the answers

A client prescribed lithium is also taking an ACE inhibitor for hypertension. What is the priority nursing action related to lithium levels?

<p>Monitor for signs of lithium toxicity (B)</p> Signup and view all the answers

Which finding indicates lithium toxicity rather than a common side effect of lithium?

<p>Coarse hand tremors (B)</p> Signup and view all the answers

Which of the following best describes the neuroprotective effect of lithium in bipolar disorder?

<p>Lithium helps stabilize mood and protect against neuronal damage (C)</p> Signup and view all the answers

A client on lithium has developed leukocytosis. What would this be categorized as?

<p>Hematological effect (C)</p> Signup and view all the answers

Which of the following best describes the primary goal of using affirmations in motivational interviewing?

<p>To build a strong therapeutic relationship by validating the patient's strengths and efforts. (D)</p> Signup and view all the answers

A client states, 'I've tried to cut back before, but it never lasts.' Which response exemplifies a simple reflection?

<p>You've tried before but it hasn't worked out. (B)</p> Signup and view all the answers

Why is it important to use reflections in motivational interviewing?

<p>To help the client feel heard, fostering deeper self-exploration and understanding. (A)</p> Signup and view all the answers

What is the primary purpose of using summaries during a motivational interviewing session?

<p>To condense the key points of the discussion, promote mutual understanding, and allow for client reflection. (A)</p> Signup and view all the answers

Which response best illustrates a complex reflection to the statement, 'I know I should exercise, but I just can't seem to get motivated'?

<p>It sounds like you're experiencing a conflict between your goals and your current lack of initiative. (B)</p> Signup and view all the answers

If a therapist says, 'you've described some real challenges you've faced and yet you are still hoping to make changes,' this is an example of:

<p>An affirmation (A)</p> Signup and view all the answers

What is the benefit of reflecting back the client's words during a motivational interview?

<p>It prompts the client to feel heard, understood, and explored in their own thoughts. (C)</p> Signup and view all the answers

At the end of a session, the therapist reviews key topics, discussing both reasons for and doubts about changing. Which motivational interviewing technique is this best described as?

<p>Summarising (C)</p> Signup and view all the answers

Flashcards

Frontal Lobe: Executive Functions

The frontal lobe is responsible for complex cognitive functions, including planning, decision-making, and personality.

Broca's Area: Expressive Speech

Broca's area, located in the frontal lobe, is crucial for producing speech.

Temporal Lobe: Language & Memory

The temporal lobe processes auditory information, plays a role in memory, and is essential for understanding language.

Wernicke's Area: Receptive Speech

Wernicke's area, part of the temporal lobe, is responsible for understanding language.

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Occipital Lobe: Vision

The occipital lobe is responsible for visual processing, including interpreting what we see.

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Parietal Lobe: Sensory Processing

The parietal lobe is involved in sensory processing, including touch, taste, and spatial awareness.

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Clock Drawing Test (CDT)

A simple test used to assess cognitive function, often used to screen for neurological problems like dementia.

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CDT: Executive Functions

The CDT assesses a person's executive functions, which are cognitive abilities that regulate, control, and manage other cognitive processes.

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Hallucinations

Perceiving things that are not actually there, such as hearing voices or seeing objects that don't exist.

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Insight

A patient's awareness and understanding of their own thoughts, feelings, behaviors, and the presence of any mental health symptoms or conditions.

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Judgement

The ability to make sound decisions, evaluate situations, and anticipate the consequences of actions, considering social norms, cultural values, and personal goals.

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Mini-Mental Status Examination (MMSE)

A screening tool to assess cognitive impairment in adults, used to identify dementia and track its progression.

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Concentration/Attention/Calculation (MMSE)

A component of the MMSE that evaluates attention, concentration, and basic arithmetic skills.

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Orientation (MMSE)

A component of the MMSE that evaluates a person's awareness of time and place.

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Registration/Learning (MMSE)

A component of the MMSE that assesses the ability to learn and retain new information.

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Recall (MMSE)

A component of the MMSE that evaluates the ability to repeat a sequence of words or numbers.

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CRAFFT Screening Tool

A screening tool used to assess adolescents' risk for alcohol and drug use disorders. Consists of 6 questions, each with a 'yes' or 'no' answer.

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Have you ever ridden in a CAR driven by someone (including yourself) who was high or had been using alcohol or drugs?

This question assesses whether the adolescent has used alcohol or drugs in a situation where their judgment might be impaired, such as driving a car.

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Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in?

This question explores whether the adolescent uses alcohol or drugs to cope with emotions or for social pressure.

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Do you ever use alcohol or drugs while you are by yourself ALONE?

This question assesses whether the adolescent uses alcohol drugs alone, suggesting potential dependence or isolation.

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Scoring & Interpretation of CRAFFT

Each 'yes' answer on the CRAFFT questionnaire scores 1 point. A total score of 1 or higher suggests a high probability of alcohol or drug use disorder.

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Subcortical Dementia

A type of dementia affecting subcortical structures, leading to a mix of cognitive and motor issues.

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Cortical Dementia

A type of dementia primarily affecting the cerebral cortex, often with gradual onset and progressive decline in cognitive function.

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Alzheimer's Disease

Most common type of dementia, classified as cortical dementia, featuring gradual cognitive decline and hallmark amyloid deposits and neurofibrillary tangles.

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HIV Dementia

Subcortical dementia associated with HIV infection, characterized by cognitive decline, motor problems, and behavioral changes.

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Lewy Body Disease

A type of dementia caused by Lewy bodies (protein clumps) in the brain, known for visual hallucinations and Parkinson-like symptoms.

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Vascular Dementia

Second most common dementia, often caused by vascular disease with step-type cognitive decline.

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Pick's Disease

Also known as frontotemporal dementia, more common in men, with early personality, behavioral and language changes.

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Huntington's Disease

A subcortical type of dementia, with prominent motor abnormalities, psychomotor slowing, and high incidence of depression and psychosis.

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Dementia Etiology

The cause of dementia, often including brain degeneration and chemical imbalances like decreased acetylcholine.

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Dementia Psychosis/Agitation Treatment

Treatment approaches for managing psychosis and agitation in patients with dementia, often prioritizing non-pharmacological therapies and atypical antipsychotics.

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Affirmations in Motivational Interviewing

Positive statements that acknowledge and appreciate the patient's effort and strengths during the change process.

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Reflections in Motivational Interviewing

Reframing or re-stating what the patient has said to show understanding and help them explore their thoughts and feelings.

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Summarizing in Motivational Interviewing

Summarizing key points and themes of the conversation to help the patient see the bigger picture, identify patterns, and gain insight.

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Empathy in Motivational Interviewing

The ability to listen, understand, and respond to the patient's thoughts, feelings, and values in a non-judgmental way.

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Motivational Interviewing (MI)

A communication style that supports the patient's own motivation for change instead of imposing external pressure.

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Eliciting Change Talk in Motivational Interviewing

Helping the patient discover their own reasons for change and explore the benefits and challenges.

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Responding to Resistance in Motivational Interviewing

Acknowledging the patient's resistance to change without judgment or confrontation but using empathy and understanding.

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Patient Agency in Motivational Interviewing

The patient's internal motivation and commitment to change, which is a key factor in successful outcomes.

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What is the gold standard treatment for manic episodes in bipolar disorder?

Lithium is the gold standard treatment for manic episodes in bipolar disorder. It helps stabilize mood swings and reduces the risk of future episodes.

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Does lithium have any anti-suicidal effects?

Studies suggest that lithium may have anti-suicidal effects, potentially by reducing impulsivity and improving cognitive function.

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What is the neuroprotective treatment of choice for bipolar disorder?

Lithium is considered the neuroprotective treatment of choice for bipolar disorder. It helps protect brain cells from damage, potentially reducing the risk of cognitive decline.

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What baseline lab tests are required before initiating lithium?

Before starting lithium treatment, it is crucial to check thyroid function to rule out hyperthyroidism, which can mimic manic symptoms, and to monitor for potential hypothyroidism caused by lithium.

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Why is serum creatinine checked before lithium initiation?

Checking serum creatinine levels before starting lithium is essential to assess kidney function and ensure safe dosage. Lithium is excreted by the kidneys, and impaired kidney function can increase lithium levels in the body.

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What is the role of BUN in lithium initiation?

Blood urea nitrogen (BUN) levels are another indicator of kidney function assessed before lithium initiation. It helps evaluate the body's ability to filter waste products, crucial for lithium safety.

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Why is a pregnancy test required before lithium therapy?

A pregnancy test is mandatory before starting lithium treatment because lithium can cause serious birth defects, including congenital heart defects.

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Who should undergo an ECG before lithium therapy?

Electrocardiogram (ECG) is recommended for clients older than 50 years before starting lithium therapy. This helps identify any pre-existing heart conditions, as lithium can cause cardiac side effects.

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What is a common endocrine side effect of lithium?

Weight gain is a common side effect of lithium due to its effects on energy metabolism and appetite. Monitoring weight changes is important to ensure overall well-being.

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How does lithium influence thyroid function?

Lithium can interfere with thyroid function, leading to both impaired thyroid function and hypothyroidism. Monitoring thyroid hormone levels is crucial to adjust treatment appropriately.

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What is a common neurological side effect of lithium?

Fine hand tremors are a common side effect of lithium, particularly at higher doses. These tremors usually subside with lithium dose adjustment or treatment with beta-blockers.

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What are the signs of lithium toxicity?

Lithium toxicity can manifest as severe nausea, vomiting, diarrhea, confusion, convulsions, drowsiness, blurred vision, slurred speech, muscle weakness, heart palpitations, coarse hand tremors, and unsteadiness. This necessitates immediate medical attention.

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How does hyperkalemia affect lithium levels?

High potassium (hyperkalemia) can interfere with the body's ability to excrete lithium, leading to increased lithium levels in the blood. It is crucial to monitor potassium levels during lithium therapy.

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How does hyponatremia influence lithium levels?

Low sodium (hyponatremia) can also lead to elevated lithium levels in the blood. This is because the kidneys try to conserve water, inadvertently trapping lithium in the body.

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What is a hypertensive crisis?

Hypertensive crisis can occur when monoamine oxidase inhibitors (MAOIs) are combined with foods high in tyramine, a dietary precursor to norepinephrine. Tyramine can cause a surge in blood pressure and heart rate.

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What are the consequences of hypertensive crisis?

Hypertensive crisis is a serious medical emergency caused by the interaction of MAOIs with tyramine-rich foods or certain medications. It can lead to stroke, heart attack, and even death.

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Study Notes

Test Taking Strategies

  • Carefully read the entire question, focusing on keywords
  • Avoid assumptions or adding extra info
  • Narrow down answer options, look for opposites, or similar wording
  • Prioritize patient needs using Maslow's hierarchy (physiological, safety)
  • Patient safety is paramount, prioritize it before assessment
  • Culture is important in nursing care
  • Critical thinking and rationale are essential
  • Collaboration with other healthcare professionals is encouraged

Lithium

  • Toxicity occurs with levels of 1.5 mEq/L or higher, normal 0.6-1.2 mEq/L
  • Gold standard for treating manic episodes
  • Evidence for anti-suicidal effects
  • Neuroprotective for bipolar disorder
  • Baseline labs are crucial for lithium initiation
  • Lithium can cause hypothyroidism
  • Hyperthyroidism symptoms can mimic mania
  • Serum creatinine: 0.6-1.2 mg/dL

Side Effects of Lithium

  • Clinical Findings: weight gain, impaired thyroid function, fine hand tremors, fatigue, mental cloudiness, etc.
  • Endocrine, Central nervous system, Dermatological, Gastrointestinal, Renal, Cardiac, Hematological
  • Kidney disease and drugs that reduce renal clearance can increase Lithium serum concentration.
  • Signs of Lithium toxicity: severe nausea, vomiting, diarrhea, confusion, convulsions, drowsiness, blurred vision, slurred speech, muscle weakness, heart palpitations, coarse hand tremors, ataxia

Hypertensive Crisis

  • Occurs when MAOIs are taken with foods that contain tyramine
  • Symptoms include: blood pressure >180/120 mmHg, sudden headache in occipital region, elevated blood pressure, facial flushing, palpitations, urinary dilation, etc
  • Treatment includes discontinuing MAOI, giving phentolamine, stabilizing fever, and reevaluating medication guidelines

Teratogenic Risks

  • Benzodiazepines: Floppy baby syndrome, cleft palate
  • Buspar, SSRIs: safer in pregnancy
  • Carbamazepine: Neural tube defects
  • Lithium: Epstein anomaly
  • Lamotrigine: safer in pregnancy
  • Divalproex: Neural tube defects, spina bifida, atrial septal defect, cleft palate, and potential long-term developmental defects

Stevens Johnson Syndrome (SJS)

  • Rare, potentially life-threatening immune reaction
  • Common with anticonvulsant use
  • Symptoms include fever, facial swelling, tongue swelling, macules, papules, skin sloughing, prodromal headache, malaise, arthralgia, painful mucous membranes

Clozaril and Carbamazepine

  • Risk of neutropenia is monitored by ANC (absolute neutrophil count) instead of total WBC count
  • Normal ANC is between 2,500-6,000
  • Monitoring for Clozaril: during the first 6 months, weekly; during the second 6 months, every two weeks; then monthly if ANC is normal
  • Discontinue Clozaril/Carbamazepine when ANC is less than 1000 mm3 or WBC is 2000-3000
  • Monitor for signs of infection (sudden fever, chills, sore throat, weakness)

Bulimia and Anorexia Nervosa

  • Individuals may be within normal weight range
  • Symptoms of Bulimia: erosion of dental enamel, Russel’s sign, hypertrophy of salivary glands, rectal prolapse
  • Symptoms of Anorexia: Low BMI, amenorrhea, emaciation, bradycardia, hypotension, ECG changes, inversion of T-waves, ST-segment depression, prolonged QT interval, hypothermia, yellow skin

Pharmacological Management

  • Medication management as adjunctive therapy for anorexia nervosa, and Bulimia nervosa
  • Fluoxetine is FDA-approved for Bulimia
  • SSRIs and TCAs are effective in reducing binging and purging

Psychotherapeutic Interventions

  • Individual psychotherapy
  • Behavioral therapy
  • CBT
  • Family therapy
  • Group therapy

Inducers and Inhibitors

  • Enzyme Inducers*: decrease the serum level of other drugs
  • Examples*: tobacco, carbamazepine, hypericum (St. John's Wort), phenytoin, phenobarbital, tobacco.
  • Enzyme Inhibitors*: increase the serum level of other drugs
  • Examples*: bupropion, clomipramine, cimetidine, clarithromycin, fluoroquinolones, grapefruit juice, ketoconazole, nefazodone

Neurotransmitters

  • Norepinephrine (Noradrenaline): attention, mood, sleep, and memory. Imbalances can contribute to anxiety and depression
  • Serotonin: mood, appetite, sleep, memory, and learning. Imbalances linked with disorders like depression, anxiety, and OCD
  • Dopamine: reward, pleasure, motivation, movement. Imbalances linked with psychosis, addiction, and depression
  • Acetylcholine: memory, learning, and muscles. Deficits linked to Alzheimer's disease and dementia

Lobes of the Brain

  • Frontal Lobe (Thinking, planning, problem-solving, emotions, behavioral control, decision-making)
  • Temporal Lobe (Memory, language, facial recognition, hearing)
  • Parietal Lobe (Perception, sensory information, language comprehension, vision and touch)
  • Occipital Lobe (Vision, visual processing, color identification)
  • Cerebellum (Motor skills, hand-eye coordination)
  • Brainstem (Temperature regulation, heart rate, swallowing)
  • Cerebrum (Largest part of the brain, divided into two hemispheres, responsible for most functions)

Clock Drawing Test

  • Used to assess executive function and cognitive dysfunction, often as an indicator for dementia or Alzheimer's Disease

Hypothalamus and Thalamus

  • Hypothalamus: regulates satiety, appetite, thirst, water balance, circadian rhythm, body temperature, libido, and hormonal regulation
  • Thalamus: sensory relay station, modulates flow of sensory information, regulations emotions, memory, and affective behaviours

Neuroleptic Malignant Syndrome (NMS)

  • Rare, potentially life-threatening
  • Caused by typical and atypical antipsychotics
  • Symptoms include: mutism, hypotension, extreme muscle rigidity, hyperthermia, tachycardia, diaphoresis, coma

Dementia types

  • Alzheimer's disease
  • Frontotemporal dementia
  • Primary progressive aphasia
  • Parkinson's disease dementia
  • Huntington's disease
  • Vascular dementia
  • Dementia type due to HIV disease

Suicide Assessment

  • Risk factors: Ages ≥ 45/55, divorced/separated, living alone, white, psychiatric disorder, physical illness, substance abuse, previous suicide attempt, recent loss, male gender

Therapeutic Relationship

  • Genuineness, acceptance, nonjudgment, empathy, authenticity, respect, professional boundaries, open-ended questions

Screening Brief Intervention Referral to Treatment (SBIRT)

  • Brief intervention for alcohol
  • FRAMES*: Feedback, Responsibility, Advice, Menu, Empathy, Self-efficacy

CAGE-AID

  • Screening tool for alcohol or substance abuse
  • A positive response to at least one question warrants further assessment

CRAFFT (Car)

  • Screening tool to detect teens/young adults misuse.
  • Questions to use to determine if adolescents require interventions.

Motivational Interviewing

  • Focused, goal-directive therapy that builds on the Transtheoretical Model of Change
  • Non-confrontational, empathetic, client-centered, and empowering strategies such as ask open-ended questions, reflections, summarizing and affirmations.

Action Steps

  • Provide information
  • Offer feedback
  • Do not give prescriptive advice

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Description

Test your knowledge on the functions of various brain lobes with this engaging quiz. Discover how different areas of the brain relate to behaviors, cognitive functions, and assessments like the CRAFFT tool. This quiz is perfect for students studying neuroscience or psychology.

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