5 Flashcards
myasthenia gravis pathophysiology
Acetylcholine receptor antibodies –> weaknesswh
What chromosome is the mutation in Huntington’s?
4
where is the atrophy in Huntington’s?
caudate and cerebral atrophy
Tobacco is an ____ (inducer or inhibitor) of CYP ____
inducer of CYP 1A2
Grapefruit juice is an ____ (inducer or inhibitor) of CYP ____
inhibitor of CYP 1A2/3A4
Fluvoxamine juice is an ____ (inducer or inhibitor) of CYP’s ____
inhibitor of CYP 1A2/2C19/3A4
order of top 5 solid tumors that metastasize to the brain
- lung
- breast
- melanoma
- GI
- kidney
what age do people learn to think abstractly
adolescence
what percent of the general population has a diagnosable personality disorder
10-15%
2 types of diseases that give ring enhancing lesions on brain imaging
toxoplasmosis and TB
what’s more affected with MCA stroke - broca or wernicke’s aphasias?
Broca
Lower extremities control is in which artery distribution
anterior cerebral artery
alexia without agraphia is a stroke in which artery distribution
posterior cerebral artery
what type of variables do each of these tests use (binary vs continuous): x squared, t test, ANOVA, correlation, regression analysis
Xsquared - 1 binary predictor, 1 binary outcome
t test - one binary predictor, 1 continuous outcome
ANOVA - 2 or more binary predictors, 1 continuous outcome
Correlation - 1 continuous predictor, 1 continuous outcome
Regression analysis - 2 or more continuous predictors, 1 continuous outcome
which childhood disorder is this - pectus excvatum, ocular lens dislocation, Marfans habitus, mental retardation, scoliosis, spasticity, seizures, high risk of stroke
homocystinuria
what is this childhood disorder - normal first 6 months, then becomes blind, deaf, unable to swallow, and eventually paralysis and death by age 4
Tay Sachs
Niemann-Pick disease is mutation in which enzyme
sphingomyelinase
Niemann-Pick symptoms
hepatosplenomegaly, thrombocytopenia, ataxia, dysarthria, dysphagia, supranuclear gaze palsy
amylase is test for
pancreatitis
William syndrome is deletion on which chromosome
7
is Marfan’s associated with mental retardation or autism, both, or neither?
Neither
what bleed causes brief loss of consciousness, followed by lucid period and then further deterioration
epidural hematoma
which artery torn in epidural hematoma
middle meningeal artery
Bupropion is an ______ (inhibitor or inducer) of ______ and a substrate of ______
inhibitor of CYP 2D6
substrate of 2B6
how do men and women metabolize alcohol differently?
women have less alcohol dehydrogenase in their gut so men metabolize more and women absorb more
“worst headache of my life” is problem where and from what
subarachnoid hemorrhage - from intracranial aneurysm or AVM of one of arteria that form Circle of Willis
1st neuropsychiatric symptom of Huntington’s is usually
depression
can you have bradykinesia in Huntington’s?
yes
what can be precipitated by chiropractic adjustments?
vertebral artery dissections
FDA treatment for postherpetic neuralgia
gabapentin
carbon monoxide poisoning affects which brain areas
cerebral cortex, hippocampus, cerebellar cortex, basal ganglia
Stiff person syndrome
persistent limb rigidity and spasms from autoantibodies against glutamic acid decarboxylase
cataplexy vs catalepsy
cataplexy - loss of muscle tone with strong emotions (narcolepsy)
catalepsy - posturing (catatonia)
mirtazapine MOA
5HT3 and alpha2 antagonism
what personality trait increases risk of cardiac disease in men
hostility
Prader Willi triad
hyperphagia, hypomentia, hypogonadism
Angleman’s syndrome
severe intellectual disability, microcephalous, laughter, seizures. rigidity, jerky movements
what is this - rapidly progressing dementia, exaggerated startle response, myoclonus
CJD
what is most common complication of pseudotumor cerebri
visual impairment from papilledema
does men’s sexual desire change as they get older?
no
infantile secure attachment associated with what outcome
emotional and social competence
Kohut’s “bipolar self” composed of 2 systems of narcissistic perfection which are…
1) system of ambitions - the narcissistic self
2) system of ideals - idealized parental imago
brain areas for episodic memory
medial temporal lobe
anterior thalamic nuclei
mammillary bodies
fornix
prefrontal cortex
what does episodic memory remember
explicit, declarative awareness - eg. what you ate for a meal earlier that day, where you went on last vacation
brain areas of semantic memory
inferolateral temporal lobes
brain areas of procedural memory
basal ganglia, cerebellum, supplementary motor area
Area for TMS for depression
left dorsolateral prefrontal cortex
NeuroStar TMS can be indicated after youve failed how many trials of antidepressants?
one
how do atypical antipsychotics produce less EPS compared to first gen?
rapid dissociation from D2 receptors - low affinities and bind loosely and rapidly released
conversion disorder rates highest among which populations?
rural population
little education
low intelligence
low SES
military peeps with combat history
MDMA MOA
block reuptake of serotonin
induce massive release of serotonin from neurons
what damage does MDMA cause
damage to serotonergic nerve terminals
decreases in serotonin transporter binding
Minnesota Multiphasic Personality Inventory (MMPI) has three validity scales which are…
lie scale (L)
infrequency scale (F)
suppressor scale (K)
infrequency scale of MMPI useful at identifying
malingering, illiteracy, confusion, psychosis, panic
lie scale of MMPI useful at identifying
test if patient is being honest in answering questions
suppressor scale of MMPI useful at doing what
decreasing false positives and false negatives
T3 (triiodothyronine) should not be taken in which patients
patients with cardiac dz/acute MI/angina/HTN
thyrotoxicosis
adrenal insufficiency
T3 (triiodothyronine) drug interactions to watch out for
potentiate effects of warfarin
decrease insulin
decrease digitalis
watch thyroid levels if coadministered with SSRIs, TCAs, lithium, carbamazepine
does eszopiclone lead to dependence?
no
side effects of eszopiclone
hallucinations, sleep walking
how long after patient stopped drinking does GGT return to normal?
8 weeks
primary vs secondary vs tertiary causes of adrenal insufficiency areas
primary - adrenals
secondary - pituitary
tertiary - hypothalamus
psychiatric symptoms of adrenal insufficiency
depression, apathy, irritability, psychosis, delirium
what happens to concentrations of depakote and lamotrigine when taken together?
lamotrigine levels increase
depakote levels decrease
what happens to concentrations of carbamazepine and lamotrigine when taken together?
lamotrigine levels decrease
what happens to concentrations of carbamazepine and depakote when taken together?
carbamazepine levels increase
cerebellum forms at what age
1 year
myelnation of peripheral nerves completes at what age
2 years
fine pincer grasp develops around
9-12 months
ability to sit without support occurs at
6 months
clonazepam is slowly or rapidly absorbed?
rapidly
diazepam is slowly or rapidly absorbed?
rapidly
sex differences in rates of OCD?
equal among men and women
how long should IV/IM thiamine + dextrose be given in alcohol withdrawal?
3 days
elderly person on carbamazepine gets delirious. what happened?
hyponatremia from vasopressin effect
most antipsychotics metabolized through the liver except which one?
paliperidone
what type of validity is this - diagnosis based on general consensus among experienced clinicians?
face validity
what type of validity is this - diagnosis based on characteristic features that distinguish it from other disorders
descriptive validity
what type of validity is this - diagnosis will allow clinicians to accurately predict treatment response and clinical course
predictive validity
what type of validity is this - diagnosis based on an understanding of the underlying validity
construct validity
desvenlafaxine renally or hepatically excreted?
renally
Does desvenlafaxine also cause HTN like venlafaxine?
yes
blood levels of lithium at each level of toxicity (mild/moderate/severe)
mild: 1.5-2 mEq/L
moderate: 2-2.5
severe: >2.5
atomoxetine takes up to how many weeks to feel full effect?
10 weeks
Does duloxetine cause HTN like venlafaxine?
no
can patients on MAOIs consume vodka?
yes - small amounts of clear alcohol
but no rap beer, red wine, some white wines, and sherry
can patients on MAOIs consume smoked fish and caviar?
no
which drug of abuse causes perioral rash?
inhalants
REM latency increased or decreased in narcolepsy?
decreased
is risk of agranulocytosis in clozapine users dose related?
no
is risk of seizures in clozapine users dose related?
yes
are schizophrenic patients more likely to commit homicide?
no
most common form of dementia
Alzheimer’s (50-60% of dementias)
prevalence of Alzheimer’s in patients over 85
20-40%
does mirtazapine block serotonin or NE reuptake?
no
