Mental Health Unit 3: Neurocognitive Disorders & Psychopharmacology

Forty question-and-answer flashcards covering Alzheimer’s disease, neurocognitive disorders, somatic symptom disorder, defense mechanisms, psychopharmacology, and high-yield side effects.

What is the primary cause of Alzheimer’s disease?

A progressive neurodegenerative disorder that leads to a gradual decline in cognitive function, memory, and judgment.

Name the three clinical stages of Alzheimer’s disease.

Early (mild), Middle (moderate), and Late (severe).

List three major risk factors for developing Alzheimer’s disease.

Advanced age, APOE4 genetic variant, and head trauma or cardiovascular disease.

Which defense mechanism involves fabricating stories to fill memory gaps in Alzheimer’s patients?

Confabulation.

Which widely used screening tool assesses cognitive function in Alzheimer’s disease?

The Mini-Mental State Examination (MMSE).

What is the mechanism of action of cholinesterase inhibitors such as donepezil?

They increase acetylcholine by inhibiting acetylcholinesterase.

In which stages of Alzheimer’s disease are cholinesterase inhibitors most effective?

Mild to moderate stages.

Why must cholinesterase inhibitors be used cautiously in patients with asthma or COPD?

Because they can cause bronchoconstriction and worsen respiratory status.

Memantine belongs to which drug class and what is its mechanism of action?

It is an NMDA antagonist that blocks excessive calcium influx into neurons, slowing cell death.

What is the first and most important step in treating delirium?

Identify and treat the underlying cause.

Define Somatic Symptom Disorder (SSD).

Psychological distress expressed as physical symptoms without adequate medical explanation.

For how long must a patient be preoccupied with physical symptoms to meet criteria for SSD?

More than 6 months.

What is the first stage of Reattribution Treatment for Somatic Symptom Disorder?

Feeling understood—using active listening and empathy.

List the four stages of Reattribution Treatment.

Feeling understood, Broadening the agenda, Making the link, and Negotiating further treatment.

Which defense mechanism involves repeating phrases or behaviors to hide memory loss?

Perseveration.

How does the onset of delirium differ from the onset of a neurocognitive disorder (NCD)?

Delirium has an abrupt onset, whereas NCD develops gradually.

What is the prognosis for neurocognitive disorders such as Alzheimer’s disease?

They are progressive and irreversible, eventually requiring full-time care.

What is the mechanism of action of first-generation antipsychotics (FGAs)?

They block dopamine D2 receptors.

Name two hallmark extrapyramidal side effects associated with FGAs.

Dystonia and akathisia (others include Parkinsonism).

Which life-threatening reaction characterized by fever and rigidity can occur with FGAs?

Neuroleptic Malignant Syndrome (NMS).

What metabolic adverse effect is strongly associated with second-generation antipsychotics (SGAs)?

weight gain, hyperglycemia, and dyslipidemia.

Which neurotransmitters are primarily affected by SGAs?

They block both dopamine and serotonin receptors.

Describe the mechanism of action of Selective Serotonin Reuptake Inhibitors (SSRIs).

They inhibit serotonin reuptake, increasing synaptic serotonin levels.

What potentially fatal condition can result from excessive serotonergic activity?

Serotonin Syndrome.

Which antidepressant class can cause hypertensive crisis when combined with tyramine-rich foods?

Monoamine Oxidase Inhibitors (MAOIs).

What blood-pressure change is a key side effect of SNRIs such as venlafaxine?

Increased blood pressure.

Which antidepressant (NDRI) is contraindicated in patients with a seizure history?

Bupropion (Wellbutrin).

Name two common anticholinergic side effects of Tricyclic Antidepressants (TCAs).

Dry mouth and blurred vision (others include constipation).

What severe dermatologic reaction is associated with lamotrigine therapy?

Stevens-Johnson Syndrome.

State the therapeutic serum range for lithium used in bipolar disorder.

0.6–1.2 mEq/L.

List two early clinical signs of lithium toxicity.

Gastrointestinal upset and coarse tremor (others: confusion, seizures).

What hydration teaching is critical for patients taking lithium?

Maintain adequate fluid and consistent sodium intake; avoid dehydration and NSAIDs.

What serious withdrawal complication can follow abrupt cessation of benzodiazepines?

Seizures.

What is a major advantage of buspirone over benzodiazepines?

It does not cause sedation or dependence.

Give one example of a cholinesterase inhibitor used in Alzheimer’s disease.

Donepezil (others include rivastigmine and galantamine).

What nursing strategy is recommended for managing time spent on physical complaints in SSD?

Limit the time allotted to discussing physical symptoms while building rapport.

Which defense mechanism involves refusing to acknowledge memory loss?

Denial.

List three risk factors for Illness Anxiety Disorder.

Having a first-degree relative with the disorder, childhood trauma, and low self-esteem.

Define Factitious Disorder.

A condition in which a person intentionally produces or feigns symptoms for emotional attention without external gain; may involve self-injury or harming others (by proxy).

What key teaching should be given regarding discontinuation of antipsychotic medications?

Do not stop them abruptly; taper under medical supervision to avoid relapse or rebound psychosis.

Which screening tools are commonly used for both delirium and dementia assessment?

The Confusion Assessment Method (CAM) and the Mini-Mental State Examination (MMSE).