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

Lambert-Eaton - MOA - cause

- paraneoplastic abnormality of PREsynaptic ACh release, directed against voltage-gated channels - often ~ w/ small cell lung ca

ABPN Boards Flashcards by Lisa Rosenfeld

Lithium s/e’s

GI complaints, tremor, diabetes insipidus, hypothyroidism, weight gain, cardiac arrhythmia, edema, acne, follicular/maculopapular eruptions, psoriasis flares

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Lamotrigine s/e’s

SJS, anemia, thrombocytopenia, liver failure, pancreatitis

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Impact of risperidone on salivation?

Increased

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Oxcarbazepine s/e’s

SJS, leukopenia, thrombocytopenia

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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

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Genetic test used to test for trinucleotide repeats?

PCR

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What type of genetic defects can karyotyping detect?

deletions, translocations, trisomies

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How to diagnose CJD?

CSF assay for 14-3-3 proteinase inhibitor proteins

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Huntington’s genetics:

inheritance pattern
defect
chromosome

AD
trinucleotide repeats (CAG)
chromosome 4p16.3 (short arm)
anticipation: earlier from generation to generation

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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

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Winnicott is known for…

“good enough mother”

“transitional objects”

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Piaget’s stages of development

Degrees of abstraction:

sensorimotor
pre-operational
concrete operations
formal operations

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Freud’s stages of development

Oral
Anal
Phallic
Latency

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Mahler’s stages of development

Separation-individuation:

Normal autism (0-2m)
Symbiosis (2-5m)
Differentiation
Practicing
Rapprochement
Object constancy

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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

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MAO_A breaks down…

5-HT, NE, DA

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MAO_B breaks down…

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MAOi s/e’s

orthostatic hypotension, weight gain, edema, sexual dysfunction, insomnia

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Reversible MAOi’s

moclobemide

selegiline

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Lambert-Eaton

MOA
cause

paraneoplastic abnormality of PREsynaptic ACh release, directed against voltage-gated channels
often ~ w/ small cell lung ca

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What is Skinner’s theory of learning?

operant conditioning, positive and negative reinforcement (rewards)

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What is Bandura’s theory of learning?

social learning theory; we learn through modeling others and through social interaction

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Who came up with the concept of learned helplessness? What is it?

Seligman - model for depression; organism learns no behavior change can influence environment

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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

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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