ABPN Boards Flashcards
Lithium s/e’s
GI complaints, tremor, diabetes insipidus, hypothyroidism, weight gain, cardiac arrhythmia, edema, acne, follicular/maculopapular eruptions, psoriasis flares
Lamotrigine s/e’s
SJS, anemia, thrombocytopenia, liver failure, pancreatitis
Impact of risperidone on salivation?
Increased
Oxcarbazepine s/e’s
SJS, leukopenia, thrombocytopenia
Who is the founder of attachment theory?
Definition of attachment and bonding?
John Bowlby
Attachment: emotional dependence of infant on mother
Bonding: mother’s feeling toward infant
Genetic test used to test for trinucleotide repeats?
PCR
What type of genetic defects can karyotyping detect?
deletions, translocations, trisomies
How to diagnose CJD?
CSF assay for 14-3-3 proteinase inhibitor proteins
Huntington’s genetics:
- inheritance pattern
- defect
- chromosome
- AD
- trinucleotide repeats (CAG)
- chromosome 4p16.3 (short arm)
- anticipation: earlier from generation to generation
Brain region involved in:
- personality changes
- executive fxn changes
- apathy
- depression
- mania
- personality changes: frontal
- executive fxn changes: frontal
- apathy: medial frontal
- depression: left frontal
- mania: right frontal
Winnicott is known for…
“good enough mother”
“transitional objects”
Piaget’s stages of development
Degrees of abstraction:
- sensorimotor
- pre-operational
- concrete operations
- formal operations
Freud’s stages of development
- Oral
- Anal
- Phallic
- Latency
Mahler’s stages of development
Separation-individuation:
- Normal autism (0-2m)
- Symbiosis (2-5m)
- Differentiation
- Practicing
- Rapprochement
- Object constancy
Erikson’s stages of development
- Trust vs mistrust
- Autonomy vs shame/doubt
- Initiative vs guilt
- Industry vs inferiority
- Identity vs role diffusion
- Intimacy vs self-absorption
- Generativity vs stagnation
- Integrity vs despair/isolation
MAO_A breaks down…
5-HT, NE, DA
MAO_B breaks down…
DA
MAOi s/e’s
orthostatic hypotension, weight gain, edema, sexual dysfunction, insomnia
Reversible MAOi’s
moclobemide
selegiline
Lambert-Eaton
- MOA
- cause
- paraneoplastic abnormality of PREsynaptic ACh release, directed against voltage-gated channels
- often ~ w/ small cell lung ca
What is Skinner’s theory of learning?
operant conditioning, positive and negative reinforcement (rewards)
What is Bandura’s theory of learning?
social learning theory; we learn through modeling others and through social interaction
Who came up with the concept of learned helplessness? What is it?
Seligman - model for depression; organism learns no behavior change can influence environment
Who came up with classical conditioning? What is it?
Pavlov: neutral stimulus is paired w/ one that evokes a response so that neutral stimulus comes to evoke the same response
Absence seizures
- EEG correlate
- 1st and 2nd-line tx
- Contraindicated tx
- EEG: 3Hz spike and wave pattern
- 1st line: ethosuximide
- 2nd line: VPA
- contraindicated: carbamazepine (can worsen sz)
CSF findings in narcolepsy?
decreased hypocretin (orexin)
Tuberous sclerosis
- inheritance pattern
- sxs
- AD
- neurocutaneous: tumors, seizures, MR, behavioral problems
Rett’s syndrome
- inheritance pattern
- sxs
- X-linked dominant; only in girls
- deceleration in growth and developmental regressions starting at 5mo; +sz
Neurofibromatosis type 1
- inheritance
- chromosome
- AD
- chromosome 17q
Neurofibromatosis type 2
- inheritance
- chromosome
- AD
- chromosome 22
- note: few cutaneous lesions; frequently bilateral acoustic schwannomas
Williams’ syndrome
- inheritance
- chromosome
- physical sxs
- psych sxs
- AD
- chromosome 7q11-q23 (hemizygous deletion including elastin locus)
- short, elfin; thyroid, renal, CV abnormalities
- MR, anx, hyperactivity, hypermusicality
Tacrine MOA?
Cholinesterase inhibitor (used to tx dementia)
Donepezil MOA?
Cholinesterase inhibitor (used to tx dementia)
Galantamine MOA?
Cholinesterase inhibitor (used to tx dementia)
Rivastigmine MOA?
Cholinesterase inhibitor (used to tx dementia)
Memantine MOA?
NMDA antagonist, slows Ca2+ influx into cells, halts cell destruction (cytotoxicity)
What does the Halstead-Reitan battery test for?
Location of brain lesions; series of 10 tests; distinguishes between brain damage and neurologically intact
Triptan receptor profile?
- Potent agonists of 5-HT_1B & 1D
- Mostly on intracranial blood vessels, but also on coronaries; hence contraindicated in pts w/ CAD and uncontrolled HTN
Impact of antipsychotics on TCA concentration?
Increased
Impact of methylphenidate on TCA concentration?
Increased
Impact of acetazolamide on TCA concentration?
Increased
Impact of aspirin on TCA concentration?
Increased
Impact of cimetidine on TCA concentration?
Increased
- cimetidine = antacid
Impact of thiazides on TCA concentration?
increased
Impact of fluoxetine on TCA concentration?
increased
Impact of sodium bicarb on TCA concentration?
Increased
- sodium bicarb txs heartburn
Impact of cigarettes on TCA concentration?
Decreased (P450 1A2)
Impact of ascorbic acid on TCA concentration?
Decreased (P450 1A2)
Impact of lithium on TCA concentration?
Decreased (P450 1A2)
Impact of barbiturates on TCA concentration?
Decreased (P450 1A2)
Impact of primidone on TCA concentration?
Decreased (P450 1A2)
- primidone = anticonvulsant
What sort of lesion causes alexia without agraphia?
corpus callosum
What is Gerstmann’s syndrome?
L parietal lobe (L angular gyrus) lesion
Sxs: acalculia, agraphia, R/L confusion, finger agnosia
What sort of lesion causes acalculia, agraphia, R/L confusion, finger agnosia?
L parietal lobe (L angular gyrus) lesion
aka Gerstmann’s syndrome
Med used to tx pituitary adenoma?
Bromocriptine (after removing offending agent)
Glutamate
- effect: inhib vs excit?
- receptor profile
- involved in…?
- precursor to…?
- major excitatory NT
- works on NMDA receptors
- very important in learning and memory; involved in theory of cytotoxity; understimulation by glutamate ~ psychosis
- precursor to GABA
Major inhibitory NT’s?
GABA, glycine
Alzheimer’s genetics
Chromosome 21: amyloid precursor protein
Chromosome 19: Apo E4
Definition of brain death?
Absence of brain-stem reflexes
Main location of NE neurons? Clinical association?
locus ceruleus; poor regulation ~ anxiety
Main location of serotonergic neurons? Clinical association?
raphe nuclei in the pons; ~depression
Myesthenia gravis
- MOA
- Clinical findings
- Dx
- Tx
- Autoantibodies against postsynaptic nicotinic ACh receptors on muscles
- Deep tendon reflexes typically preserved
- Edrophonium chloride (Tensilon) used to diagnoses the dz
- Pyridostigmine (Mestinon) used to tx the dz; Also tx w/ steroids, plasmapheresis, ivig, immunosuppressants (Imuran)
3Hz spike and wave pattern
Absence sz
Frontocentral beta activity
normal adult drowsiness
Posterior alpha rhythm
eyes closed, but awake
Right temporal spikes
seizure focus
Delta waves when pt is awake
c/f structural lesion
Gower’s maneuver
using hands to get up from chair; bedside indicator of muscular dystrophy or mypoathy
Duchenne’s muscular dystrophy
- inheritance
- defect
- s/s
- autosomal recessive
- lack of dystrophin
- proximal > distal, decreased DTRs (except Achilles), elevated CPK, MR in 1/3 cases, enlarged muscles (esp calves) d/t fat infiltration
What are the MOST sedating TCAs?
amitriptyline, doxepin, trimipramine
What are the LEAST sedating TCAs?
desipramine, protriptyline
