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MP422 > CNS DISORDERS > Flashcards

CNS DISORDERS Flashcards

1
Q

what treatment should be considered before medication?

A

‘talking therapies’
such as CBT (cognitive behavioural therapy) AND medication

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2
Q

what type of disorder is AUTISM SPECTRUM DISORDER and symptoms

A

neurodevelopmental disorder
- repetitive behaviours - hand flapping/spinning
- communication deficits
- social interaction deficits

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3
Q

severe form ASD symptoms

A

language regression
seizures
low measured IQ

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4
Q

how to notice ASD in babies

A

slow to reach baby and toddler developmental milestones in motor skills and language

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5
Q

likelihood of co-morbidities with ASD and what are they

A

70%
anxiety
depression
epilepsy
ADHD

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6
Q

what is pathological demand avoidance (PDA)

A

describes features presented in many children diagnosed with ASD: resisting and avoiding everyday demands of life, mood swings, procrastinating, lacking social understanding

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7
Q

non-pharmcological treatment for ASD

A

support/care/management of child and family
environmental modification: efforts to increase sensory stimuli
psychological intervention: communication and interaction

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8
Q

only recommended medication for ASD

A

antipsychotic
risperidone in low doses in children with severe irritability/aggression (up to 2mg daily in children weighing up to 45kg, and up to 3.5mg daily in those weighing over 45kg)

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9
Q

what does ADHD stand for

A

ATTENTION DEFICIT HYPERACTIVITY DISORDER aka hyperkinetic disorder

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10
Q

3 main symptom categories of ADHD

A

inattention
hyperactivity
impulsivity

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11
Q

non-pharmacological intervention in ADHD

A
  1. group treatment: coping strategies/developing control/developing social skills
  2. cognitive behavioural therapy
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12
Q

considerations when prescribing for ADHD

A
  • issues with side effects
  • problems with medication at school
  • risk of misuse of drug
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13
Q

Methylphenidate moa

A

PSYCHOSTIMULANT
(potential cognitive enhancer)

blocks the dopamine transporter and norepinephrine transporter, leading to increased concentrations of dopamine and norepinephrine within the synaptic cleft

increased receptor binding > increased neuronal activity

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14
Q

drug classification of methylphenidate

A

schedule 2 controlled drug
not licensed for use in children under 6 years old

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15
Q

why do CNS drugs prevent release NT from being cleared from the synapse?

A

synaptic concentration increased > greater stimulation of post-synaptic neutron through receptors

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16
Q

chief symptom of Tourette’s syndrone

A

tics
can be vocal (sounds) or physical (movements)

17
Q

underlying problem in Tourette’s syndrome

A

lies in the basal ganglia, which is part of the brain that controls motor learning, executive functions/behaviours, and emotions

18
Q

non-pharmacological treatment of Tourette’s syndrome

A
  • habit reversal therapy
  • exposure with responsive prevention (ERP)
19
Q

habit reversal therapy

A

trying to identify and stop feelings/sensations that trigger a tic

20
Q

exposure with responsive prevention (ERP)

A

involves increasing exposure to the urge to tic leads to suppression of the tic response for longer

21
Q

medicating tourette’s

A

antipsychotics/neuroleptics (risperidone, olanzapine), clonidine, topiramate

22
Q

issue with Tourette’s and ADHD medication

A

thought to exacerbate tics, atomoxetine does not have this effect

23
Q

an obsession

A

an obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters a person’s mind, causing feelings of anxiety, disgust or unease

24
Q

obsessive-compulsive disorder (OCD)

A

an anxiety disorder characterised by unwanted repetitive thoughts (obsession) and/or actions (compulsions)

25
Q

a compulsion

A

a repetitive behaviour or mental act that some feel they need to carry out to try to temporarily relieve the unpleasant feelings brought on by the obsessive thought

26
Q

OCD - mild functional impairment

A

obsessive thinking and compulsive behaviour <1hr/day

27
Q

OCD - moderate functional impairment

A

obsessive thinking and compulsive behaviour 1-3 hours/day

28
Q

OCD - severe functional impairment

A

> 3 hours/day

29
Q

OCD presentation

A
  • fear of deliberately harming yourself or others
  • fear of harming yourself or others by mistake or accident
  • fear of contamination by disease, infection or an unpleasant substance
30
Q

body dysmorphic disorder (BDD)

A

fears about physical appearance that go beyond self-esteem: a functional impact on life

31
Q

BDD presentation

A
  • constantly comparing looks
  • spend a long time concealing what they believe is a defect
  • feel anxious around people
  • reluctant to seek help (feel seen as vain/self-obsessed)
  • excessively dieting and exercise
32
Q

OCD and BDD treatment

A

CBT + sertraline or fluvoxamine

except if co-morbid with depression then fluoxetine

33
Q

anorexia nervosa (eating disorder)

A

when a person tries to keep their weight as low as possible (by starving themselves or exercising excessively)

34
Q

bulimia (eating disorder)

A

when a person goes through periods of binge eating and is then deliberately sick or uses laxatives to try to control their weight

35
Q

binge eating disorder (BED)

A

when a person feels compelled to overeat large amounts of food in a short space of time

36
Q

non-pharmacological treatment of eating disorders

A
  • CBT
  • interpersonal psychotherapy
  • dietary counselling
37
Q

cautions with prescribing for anorexia

A

heart is weakened by emaciation, SSRIs often prescribed

38
Q

bulimia medication

A

SSRIs (fluoxetine) prescribed generally at higher doses than for depression

39
Q
A

MP422 (17 decks)

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