6 Flashcards
Trazodone is a substrate of which CYP
CYP 3A4
are carbamazepine and depakote approved for bipolar depression in addition to mania?
no just acute mania
Somnambulism (sleep walking) and night terrors happens in which stage of sleep?
Stage IV (slow wave)
obesity rates higher in men or women?
women
conduction aphasia symptoms
repetition impaired
but relatively normal spontaneous speech
conduction aphasia lesion site
arcuate fasciculus - superior temporal or inferior parietal region
where is gabapentin excreted?
renally - no hepatic metabolism
which nerve innervates thumb, forefinger, and middle finger
median nerve
can carpal tunnel create pain up the arm to the shoulder?
yes - referred pain
most common anxiety disorder
specific phobia
clinical triad for NF-1
cafe au lait spots
neurofibromas
Lisch nodules
Does NF-1 or NF-2 lead to behavioral or cognitive impairments?
NF-1
inheritance pattern for NF-1 and NF-2
automosomal dominant
variable episodes of abdominal pain + psych symptoms with +fam hx
acute intermittent porphyria
most likely side effect of ipecac
cardiomyopathy, inc. QTc, valve insufficiency
Binswanger’s disease
AKA subcortical arterioscleotic encephalopathy
vascular dementia + gait d/o + pseudobulbar
which cognitive test helpful at diagnosing right hemispheric disease?
judgement of line orientation test (match lines of same slope)
which neuro dz is this - spontaneous crying or laughter, lability
psuedobulbar palsy
which neuro dz is this - worries or surprised appearance with opthalmoplegia, rigidity, dementia
progressive supranuclear palsy
treatment for cervical dystonia or blepharospasm
botox
rolandic epilepsy
benign childhood epilepsy - stops in adolescence, doesnt require treatment
somatosensory distubance of mouth, preserve consciousness
mucus in stool but no blood is with what disorder
IBS
inclusion body myositis versus polymyositis - which one affects more proximal versus distal muscles?
inclusion body - more distal muscles
polymyositis - more proximal muscles
tuberoinfundibular pathway goes from what to what
hypothalamus to pituitary
nigrostriatal pathyway goes from what to what
substantia nigra to basal ganglia
mesolimbic pathway goes from what to what
ventral tegmental area to nucleus accumbens
most common mitochondrial disorder
mitochondrial encephalopathy lactic acidosis and stroke like episodes (MELAS)
botox MOA
blocks acetylcholine release from presynaptic vesicles
exclusions of tpa
major surgery in last 2 weeks
signs of brain bleed
BP>185/110
painless visual loss of one eye + white matter hyperintensities + vascular risk factors
anterior ischemic optic neuropathy (AION)
can alcohol, sedatives, and inhalants cause nystagmus?
yes
criteria for brain death
- apnea test - no breathing
- absence of brain stem reflexes (ie. gagging, corneal)
- isoelectric EEG
- absence of cerebral blood flow
- coma
- no reversible causes
brisk deep tendon reflexes suggestive of upper or lower motor neuron dz?
upper
older person gets focal seizure. from what most likely?
GBM
which med can help with chorea in Huntington’s?
haldol
triad of bacterial meningitis
fever, neck stiffness, headache
2 most common bacteria to cause meningitis
Strep pneumo, Neisseria meningitidus
most common pathogens for neonatal meningitis
Group B strep
E coli
Listeria
What does CSF look like for GBS?
elevated protein
normal WBCs
cause of olfactory aura caused by seizures from what brain area
medial temporal lobe
cause of gustatory aura caused by seizures from what brain area
insula
lorazepam, oxazepam, temazepam metabolized by what
hepatic glucuronidation (versus oxidation)
CBC monitoring frequency of carbamazepine for agranulocytosis or aplastic anemia
every 3 months the first year, then can decrease frequency
is carbamazepine’s side effects of agranulocytosis or aplastic anemia, steven johnson’s syndrome, hepatic failure, pancreatitis dose dependent?
no
can you take both carbamazepine and clozapine?
no! risk of agranulocytosis
most common side effects of donepezil
GI - nausea, abdominal cramping
clostridium tetani causes spasms and rigidty by
inhibiting release of GABA and glycine (inhibitory NTs) in brain stem and spinal cord –> contractions
which stage of sleep has sleep spindles and K complexes?
N2
which stage of sleep has slowing of alpha activity?
N1
which stage of sleep has slow wave delta?
N3
percent of REM in total sleep in neonate versus healthy adult
neonate - 50%
N3 - 25%
medication for hypertensive crisis from MAOIs and cocaine induced hypertension
phentolamine (alpha 1 blockade)
biggest risk factor for childhood abuse/neglect
low SES - financial stress
dissociative fugue
lasts min-months of sudden unexpected travel away from home with inability to recall one’s past/identity (typically triggered by trauma)
unaware
which mental disorder is predominantly women (10:1)
eating disorders
encopresis
repeated passage of feces into inappropriate places for >3 months
linked to sexual trauma
pathological gamblers have what neurochemical abnormalities?
low plasma MHPG concentrations
low platelet MAO concentrations –> serotonergic dysfunction –> impulse issues
for conduct disorder, symptoms have to be present before age
13
which analyst created concepts of archetypes, collective unconscious, introverts vs extroverts
Carl Jung
What is Eric Fromm known for?
creating five personality types
What concept is Kurt Goldstein known for?
Self-actualization
who proposed theories on an infant’s experience of pleasure and its effect on infant-mother relationship
Edith Jacobson
benzos in pregnancy are which category
D
what is the most common reason for psychiatric malpractice suits?
suicide
respondeat superior in legalese
person occupying a high position in hierarchy is responsible for those in lower positions
kappa is studying what
number for binary data that tell us if something is reliable
often measures degree of agreement between raters in a study
does libido decrease in women during pregnancy?
no - for many, it increases!
name of cognitive test where patient sees geometric figures for 10 sec and then asked to draw from memory
Benton visual retention test
anticipation defense mechanism
planning for future inner discomfort (mature)
which bipolar med associated with hyperparathyroidism
lithium
which med associated with eosinophilic colitis
clozapine
who came up with object relations theory
Melanie Klein
who used the term “epigenetic view of development?”
Erik Erikson
how long of worrying about future panic attack to meet criteria for panic disorder?
1 month
which recreational drug can cause severe hyperthermic syndrome that can progress to DIC, rhabdo, liver/kidney failure, death?
MDMA
for social anxiety, is combining CBT and SSRIs more effective than one alone?
no guess not
can nurses extend seclusion time if they feel patient is still agitated
no - only physician
Methadone is metabolized by CYP
3A4
what’s biggest risk factor that would lead to IP over OP detox
history of DTs
cyclothymic disorder criteria
hypomanic episodes + depressive symptoms but dont meet criteria for major depression
2 years
if someone has hypomanic episodes and no depressive symptoms they meet criteria for
other specific bipolar and related disorder
what is the correct action when patient is on clozapine and ANC is 500-999
stop clozapine
tried again when clozapine improves
monitor ANC daily until it’s over 1000
what is the correct action when patient is on clozapine and ANC is 1000-1499
switch to 3x/week monitoring until it’s back above 1500
what is the correct action when patient is on clozapine and ANC is <500
stop clozapine
only rechallenged after heme consult
psychological side effects of interferon
depression, SI, cognitive inefficiency
