3 Flashcards
best treatment for manic pregnant person
ECT
most common symptom for narcoleptics
sleep attacks
which neurotransmitter works as an adjunct for glutamate and as an independent inhibitory neurotransmitter
glycine
trauma to which vessel causes epidural hematoma
middle meningeal artery
what is the characteristic EEG pattern in CJD?
periodic sharp wave complexes
stages of Mahler’s separation-individuation
1) autism
2) symbiosis
3) differentiation
4) practicing
5) rapprochement
6) object constancy
Mahler stage of autism - time and characteristic
birth to 2 months
more time asleep
Mahler stage of symbiosis - time and characteristic
2-5 months
distinguish from inner and outer world while perceiving itself as part of single entity with mother
Mahler stage of differentiation - time and characteristic
5-10 months
begin to distinguish self from mother
Mahler stage of practicing - time and characteristic
10-18 months
move independently and explore outside world
Mahler stage of rapprochement - time and characteristic
18-24 months
independence vacillate with need for its mother
Mahler stage of object constancy - time and characteristic
2-5 years
understand permanence of other people even when not present
skin manifestations of arsenic poisoning
keratosis, melanosis, malignancies, Mees lines of fingernails (white striations)
symptoms of arsenic poisoning
central - N/V/D, hypotension, tachy, encephalopathy
peripheral- neuropathy, skin manifestations
lead poisoning in children vs adult manifestation
children - encephalopathy
adults - neuropathy
mercury poisoning
psych/neuro - irritability, personality changes, confusion, stupor
tremors, weakness, visual dist. ataxia
organophosphate poisoning mechanism
inhibits acetylcholinesterases –> cholinergic toxicity
person who coined the name schizophrenia
Eugen Bleuler
which toxin causes blue line at the gingival margin
lead
manganese poisoning manifestation
Parkinsonian features, behavioral/cognitive changes, cock walk
which NT is derived from serine
glycine
where is glycine most concentrated in
spinal cord
what are people studying glycine as treatment for
neg symptoms of schizophrenia
which child abuse most lethal
shaking baby –> subdural hematomas
can there be preserved eye tracking and swallowing in persistent vegetative state?
yes
can there be preserved response to noxious stimulation in persistent vegetative state?
no
what is the most common typical effect of depression on nocturnal sleep
early morning awakening
antidote to benzo overdose
flumazenil
antidote to organophosphate OD
atropine
antidote to lead poisoning
dimercaprol
Papez circuit involves which parts
hippocampus, thalamus, cortex, mammillary bodies
PKU manifestation
microcephaly, mousy odors, infantile spasms, light hair/skin
internal carotid stenosis should be treated surgically if stenosis is symptomatic and above what percent
70%
which solid tumor metastasizes most frequently to the brain
lung
most useful treatment for post-LP HA
repeat LP with blood patch - inject some blood to increase the pressure from the CSF leak
compression of which peripheral nerve causes meralgia paresthtica
lateral femoral cutaneous - pain in anterior thigh
wear looser pants
week after having a baby, she gets headache, behavioral changes, irritability, seizures, dipolopia. what is it?
cerebral venous thrombosis - hypercoagulable state from pregnancy
most common congenital viral infection in newborns
CMV
most common myopathy in patients over 50
inclusion body myositis
when is sleep apnea pathological
more than 5 episodes (>10 sec each) per hr or >30 episodes in a night
what is rate limiting step in dopamine synthesis
tyrosine hydroxylase turning L-tyrosine –> L-DOPA
lethal level of lithium is above
4
IQ associated with which lobe
parietal
Ganser’s syndrome
dissociative disorder where you voluntarily talk past the point or give approximate answers (variant of malingering)
how does ibuprofen affect lithium levels?
increases
how does aspirin affect lithium levels?
no effect
how do diuretics affect lithium levels?
increases
Todd’s paralysis
brief period of transient hemiparesis after a seizure
tropical spastic paraparesis is a
chronic progressive myelopathy caused by HTLV-1
battle sign indicative of
basilar skull fracture
(mastoid hematoma)
whats best treatment to treat ADHD in a patient with Tourettes
atomexetine
side effects of depakote
common - weight gain, tremor, thinning of the hair, ankle swelling
GI distress, sedation, pancreatitis, pancytopenia, hepatotoxicity
teratogenic
amphetamines can be detected on UDS for how long
48 hrs
alcohol can be detected on UDS for how long
12 hours
Kluver Bucy syndrome is destruction of the
amydgala bodies bilaterally and inferior temporal cortex
can addicts use patient controlled analgesia
yes
surgery option for OCD
cingulotomy
most useful long term treatment setting for noncompliant schizophrenic patient with hx of vioence
outpatient commitment program
can MAOIs be mixed with meperidine
NO
can MAOIs be mixed with anesthetics?
NO
can MAOIs be mixed with asthma medication?
NO
can MAOIs be mixed with dextromethorphan?
NO
can MAOIs be mixed with stimulants?
NO
what is the term of a psychiatrist’s right to maintain a patient’s secrecy in the face of a subpoena
privilege
dif between privilege and confidentiality
privilege - legal protection
confidentiality - ethical standard
WBC frequency for clozapine
1) Baseline before treatment
2) 1st 6 months - weekly
3) 2nd 6 months - biweekly
4) after 12 mo - monthly
5) tx stopped - weekly for 4 weeks
sleep changes in people >65 y/o
- more REM episodes
- REM shorter
- less total REM sleep
- NREM decreased delta wave amplitude
- lower percentage of N3 sleep
- higher % N1 and N2 sleep
interaction between clozapine and SSRIs, TCAs
increase clozapine level
interaction between clozapine and cimetidine
increase clozapine level
interaction between clozapine and carbamazepine
decrease clozapine level
interaction between clozapine and depakote
increase clozapine level
risk of combined use of clozapine and alcohol, benzos
CNS depression
risk of combined use of clozapine and lithium
increase risk of NMS, movement d/os, seizures, confusion
most widely used substance among US high school students
cannabis (tho I’m not sure this is right based on other studies)
Beck’s cognitive triad of distorted thoughts in depression
- I am worthless
- The world is self-defeating
- Expectation of continued hardship/failure
alogia is
poverty of speech and thought content
how many mood episodes in 12 months to meet criteria for rapid cycling
4
what type of reinforcement underlies gambling
random reinforcement
dif between primary and secondary refinforcement
primary - unlearned (ie. hunger)
secondary - learned (ie. reward)
schizophrenia late onset is considered after what age
45 yo
three essential stages by Bowlby and Roberston when children separated from parents
1) protest
2) despair
3) detachment upon her return
usual and accepted length of period of grief after death of loved one is
12 months (1-2 months can return to acute functioning)
which sleep agent with long half life
lunesta eszopiclone
