Day 14

Question 1

Cortical vs. Subcortical Dementia (ex and presentation)

Answer 1

Cortical: AD, gradual cognitive decline with some specific higher order functional deficits
Subcortical: PD, movement and stuff like that, also more apathy/depression

Question 2

Nipples/Umbilicus Dermatomes

Answer 2

T4/T10

Question 3

Amoxapine

Answer 3

TCA with D2 antagonistic properties bc derivative of loxapine

Question 4

Fromm

Answer 4

Defined 5 character types common to Western culture

Question 5

Durham Rule

Answer 5

Cannot be held responsible if act was product of mental illness

Question 6

Most Common Neuropsychiatric SLE Sx (2)

Answer 6

Cognitive dysfunction + depression

Question 7

Fiduciary Duty

Answer 7

Obligation to work in patient’s best interests

Question 8

R MCA Stroke Sx (5)

Answer 8

Hemineglect
Visual and tactile extinction
Impaired prosody
Anosognosia
Behavioral problems

Question 9

Diabetic Third Nerve Palsy 3 Sx

Answer 9

Sudden onset unilateral eye pain, ptosis, diplopia

Question 10

Diabetic Third Nerve Palsy vs. ICA Post. Comm Aneurysm

Answer 10

Diabetic spares pupillary function, aneurysm will be dilated

Question 11

Shubo-kyofu

Answer 11

Japanese cultural syndrome similar to body dysmorphia, excessive fear of having a bodily deformity

Question 12

Optic Radiations Lesion (& Blood Supply) (2)

Answer 12

MCA:
Contralateral homonymous hemianopsia
or contralateral inferior quadrantanopia (“pie on the floor”)

Question 13

NE Neg Feedback R

Answer 13

presynaptic alpha 2

Question 14

CTE Presentation & Mech

Answer 14

Frontotemporal cognitive dysfunction from diffuse subcortical axonal shear that disrupts cortical + subcortical circuitry

Question 15

Genetic Predisposition to CTE

Answer 15

Carriers of Apo E4 on Ch 19 more susceptible

Question 16

4 FDA Approved SSRIs for OCD

Answer 16

Fluoxetine
Fluvoxamine
Sertraline
Paroxetine

Question 17

Most Serotonergic TCA

Answer 17

Clomipramine

Question 18

2 TCAs for Enuresis

Answer 18

Imipramine

Amitryptiline

Question 19

GABA R Channel Type

Answer 19

Chloride channel (opens, hyperpolarize cell)

Question 20

Abreaction

Answer 20

Freudian term for emotional release after recalling painful event. Freud thought this was what brought about cure for conversion disorder in psychodynamic

Question 21

2 Least Sedating TCAs

Answer 21

Desipramine and protryptiline

Question 22

3 Most Sedating TCAs

Answer 22

Amitryptiline
Trimipramine
Doxepin

Question 23

Clozapine + Carbamazepine Risk

Answer 23

Increases risk of bone marrow suppression

Question 24

IQ Calculation

Answer 24

(Mental Age / Chronological Age) x 100

Question 25

REM Disorder in Lewy Body Ds

Answer 25

Don’t get atonia during REM, so vocalize/thrash out/injure partner. Often precedes cognitive sx and is presenting sx in LBD.

Question 26

Lewy Body REM D/o Tx

Answer 26

Clonazepam

Question 27

TCA Antiarrhythmic Effect

Answer 27

Act as Class 1A Antiarrhythmics, so can terminate V Fib and increase collateral blood supply to ischemic cardiac tissue

Question 28

Transient Global Amnesia (what it is)

Answer 28

Attack of reversible anterograde and retrograde memory loss: can’t learn new info or recall any events during attack

Question 29

Transient Global Amnesia (retained)

Answer 29

Personal identiy; can carry along daily activities as usual

Question 30

TGA Duration

Answer 30

Acute, usually a few hours, almost always < 12 h

Question 31

TGA Trigger (3)

Answer 31

Often after physical exertion, sex, or extreme temps

Question 32

TGA Recurrence

Answer 32

Uncommon, no tx needed

Question 33

Topiramate Mech

Answer 33

Potentiates GABA-A R

Question 34

Lyme Agent & Vector

Answer 34

Spirochete Borellia burgdorferi, carried by deer tick (Ixodes)

Question 35

Lyme Dx Tests (2)

Answer 35

Initial: ELISA serologic screen, then Western blot for confirmatory

Question 36

Lyme Tx (2)

Answer 36

IV Ceftriaxone or PCN for 2-4 weeks

Question 37

RMSF Tx (2)

Answer 37

Oral or parenteral tetracyclines, or chloramphenicol + switch to PO doxy

Question 38

RMSF CNS & Ocular Sx

Answer 38

CNS: Meningoencephalitis
Ocular: Retinal vasculitis on fundoscopic