AANPCB PMHNP-C flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

C-SSRS purpose

A structured interview that grades suicidal ideation from passive wishes to active intent with plan, plus suicidal behavior, to stratify risk and guide safety planning.

PHQ-9 severity cutoffs

Scores of 5-9 indicate mild, 10-14 moderate, 15-19 moderately severe, and 20 or higher severe depression; item 9 screens for suicidal thoughts.

CAM delirium criteria

Requires acute onset with fluctuating course plus inattention, and either disorganized thinking or altered level of consciousness, to identify delirium.

SIGECAPS mnemonic

Screens the nine depressive symptom domains: Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor changes, and Suicidal ideation, used to assess major depression.

AUDIT-C positive thresholds

A brief alcohol screen scored positive at 4 or more in men and 3 or more in women, indicating hazardous drinking that warrants further assessment.

Standard drink definition

Contains 14 grams of ethanol, equivalent to 12 ounces beer, 5 ounces wine, or 1.5 ounces distilled spirits, used to quantify alcohol intake.

GAD-7 scoring

Scores of 5-9 indicate mild, 10-14 moderate, and 15 or higher severe anxiety; a score of 10 or more often triggers treatment.

Mental status exam domains

Systematically covers appearance, behavior, speech, mood and affect, thought process and content, perception, cognition, insight, and judgment during assessment.

Major depressive episode criteria

Five or more of nine symptoms for at least two weeks, including depressed mood or anhedonia, causing clinically significant impairment or distress.

Manic episode duration

Elevated or irritable mood with increased energy lasting at least one week, or any duration if hospitalization is required, with three or more associated symptoms.

Hypomania definition

Distinctly elevated or irritable mood lasting at least four consecutive days without marked impairment, psychosis, or need for hospitalization, differentiating it from mania.

Schizophrenia core criteria

Two or more symptoms among delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms, with at least one from the first three.

ADHD adult symptom threshold

Requires at least five inattentive or hyperactive-impulsive symptoms, present before age 12, across two or more settings, with functional impairment.

Generalized anxiety disorder criteria

Excessive worry for six months or more that is hard to control, plus three of six symptoms such as restlessness, fatigue, concentration difficulty, irritability, tension, or sleep disturbance.

PTSD symptom clusters

Requires intrusion, avoidance, negative cognition or mood, and arousal or reactivity symptoms lasting more than one month after trauma exposure.

Panic attack definition

An abrupt surge of intense fear peaking within minutes with four or more of thirteen symptoms, such as palpitations, dyspnea, choking, or fear of dying.

Bipolar I vs bipolar II

Bipolar I requires at least one manic episode; bipolar II requires hypomania plus major depression without any full manic episode.

SSRI titration timeline

Start at a low dose, reassess after four to six weeks at an adequate dose, and allow four to eight weeks for full therapeutic response.

Serotonin syndrome triad

Mental status changes, autonomic hyperactivity, and neuromuscular abnormalities such as clonus and hyperreflexia; stop serotonergic drugs and give supportive care.

Bupropion contraindications

Avoid in seizure disorders, bulimia or anorexia nervosa, and abrupt alcohol or benzodiazepine withdrawal because it lowers the seizure threshold.

Lithium therapeutic range

Serum trough levels of 0.6 to 1.2 mEq/L are typical for maintenance; recheck levels five days after any dose change.

Antipsychotic metabolic monitoring

Obtain baseline weight, waist circumference, blood pressure, fasting glucose or A1c, and lipids, then repeat periodically to detect metabolic syndrome.

Benzodiazepine Beers caution

Older adults should generally avoid benzodiazepines due to increased risk of falls, fractures, cognitive impairment, and delirium.

Opioid use disorder first line

Buprenorphine or methadone maintenance is first-line pharmacotherapy; naltrexone is an alternative after detoxification and abstinence.

Treatment response vs remission

Response is at least a 50 percent reduction in symptom scale score; remission is near-absent symptoms, such as a PHQ-9 below 5.

Inadequate antidepressant response

After four to eight weeks at an adequate dose, confirm adherence and diagnosis before switching agents or augmenting therapy.

QTc risk thresholds

A QTc above 500 milliseconds or an increase over 60 milliseconds from baseline warrants stopping or changing the QT-prolonging medication.

Clozapine ANC monitoring

Absolute neutrophil count checks weekly for six months, then every two weeks for six months, then every four weeks thereafter.

Lithium adverse effect monitoring

Periodically check renal function, thyroid, and calcium; tremor, polyuria, and weight gain may signal adverse effects or toxicity.

Antidepressant activation monitoring

After starting an antidepressant, screen for emergent suicidality, agitation, or mania, especially in youth and young adults during early treatment.

Relapse prevention duration

Continue antidepressants for at least six to twelve months after remission, and longer for patients with recurrent or chronic episodes.

Naranjo adverse reaction scale

Estimates the probability that a symptom is drug-related; scores of 9 or higher are definite and 5 to 8 probable.