DB1: 400 words without references included. 2-3 references peer review articles within 5 years of publications in the U.S.A. 1. Describe the function and characteristics of each neurotransmitter. 2. What signs/symptoms and diseases occur with an increase and a decrease with each neurotransmitter? DB2: 400 words without references included. 2-3 references peer review articles within 5 years of publications in the U.S.A. For this discussion board please refer to the Case Study: 1. What is the most likely diagnosis for this young boy? (References) 2. Discuss how to use the DSM 5. What are other diagnostic tools you can use? How would you explain to a patient how you arrived at their diagnosis? 6 y/o male HISTORY OF PRESENT ILLNESS A 6 y/o boy, usually in good health, is brought in by his mother because of several recent episodes in which the child suddenly began to screaming in his sleep. The episodes occurred approximately 90 min. after the child had gone to bed and lasted anywhere from 1 minute to 7 minutes. The parents attempted to soothe the child but to no avail. The child was inconsolable, and they had great difficulty comforting him. When the child finally calmed down, he looked around the room, asked where he was, and went back to sleep. The parents thought he has simply suffered from a severe nightmare and were thus quite surprised in the morning when they discovered that he did not remember anything of the previous night’s events and claimed that he did not dream. The next four nights were uneventful and the child slept well. However, similar episodes on the fifth and sixth nights, with a single enuretic episode on the 6th night, prompted the current evaluation. The pediatrician deemed the child physically healthy and subsequently referred him to you. The boy lives with his parents and 2 yr. old brother. The family moved from the Midwest to the East Cost 3 months ago. The boy recently started the 1st grade in public school and has been doing well academically but reportedly has difficulty making friends and is frequently picked on by some of his peers. PAST HX: The parents describe the boy as a colicky baby for the first 6 months of life, with subsequent frequent frequent nighttime awakenings. From the age of 6 months until recently he has slept well. The child had met all developmental milestones on time. He has been toilet trained since the age of 3 with occasional and infrequent nocturnal enuresis. Speech is of normal volume, rate and rhythm. The patient describes his mood as “OK”, but his affect appears mildly dysphoric. Thought processes are logical and goal directed. He denies any suicidal or homicidal ideation. He also denies hallucinations, and there is no evidence of paranoid ideation. His concentration and memory are normal. Insight is fair and judgment is good. DIAGNOSTIC TESTING: The parents used a camcorder to document the episodes . Nighttime polysomnography was not indicated at this time. EEG was not currently indicated. What is your diagnosis? What are the differential diagnosis? DB3: 400 words without references included. 2-3 references peer review articles within 5 years of publications in the U.S.A. Please answer the following questions: (Please provide references to support all responses) Discuss components of suicide. What is your responsibility as a PMHNP as their care provider? What are the legal ramifications? What are some cultural considerations?
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