General review form BV Flashcards

1
Q

Antidepressants most likely to cause insomnia (3)

A

Fluoxetine, Bupropion and Sertraline

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2
Q

mechanism of action of Carbamazepine

A

Blockade of Na gated channels

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3
Q

Carbamazepine Cyp450 metabolizer

A

3A4

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4
Q

Time to get stable levels of Carbamazepine in blood

A

3-5 weeks

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5
Q

Neurobiological abnormalities associated with ASD

A

Decreased formation of Purkinje cells

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6
Q

Head size in ASD is increased or decreased?)

A

increased

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7
Q

Which Neurotransmitter synthesis is affected in ASD

A

Serotonin

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8
Q

Brain structure affected in GAD

A

Amygdala (larger volume)

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9
Q

EEG characteristic of CJD

A

Periodic sharp waves complexes

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10
Q

Which drug should be used for agitation in PCP intoxication?

A

Benzodiazepines

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11
Q

Which drugs should be avoided in PCP intoxication?

A

Phenothiazines and butyrophenones (haldol, thorazine)

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12
Q

BPD is a disruption of which Mahler’s stage

A

Rapproachment

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13
Q

Narcissistic PD is a disruption of which Mahler’s stage

A

Symbiosis (no soothing) and separation-individuation

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14
Q

Antidepressant that increases cardiac malformations in 1st trimester

A

Paroxetine

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15
Q

Pregabalin mechanism of action

A

Ca channel antagonist

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16
Q

Disulfiram mechanism of action in liver and brain

A

inhibits Aldehyde dehydrogenase in liver

Blocks Dopamine dehydrogenase in brain

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17
Q

Acamprosate mechanism of action

A

Blocks NMDA receptors

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18
Q

Baclofen mechanism of action

A

GABA B receptor agonist

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19
Q

Naltrexone mechanism of action

A

mu receptor antagonist

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20
Q

Most common mood disorder comorbid with anorexia nervosa

A

MDD

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21
Q

Class of antidepressant that Mirtazapine is in

A

Tetracyclic antidepressant

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22
Q

Mirtazapine mechanism of action

A

Blocks presynaptic alpha 2 receptors , indirect 5HT1A activation increasing release of dopamine

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23
Q

SSRIs FDA approved for GAD (2)

A

Paroxetine, escitalopram

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24
Q

SNRI FDA approved for GAD

A

Venlafaxine, duloxetine

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25
Q

Buspirone mechanism of action

A

5-HT1A partial agonist at postsynaptic receptors

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26
Q

IQ to quailify as Intellectual disability

A

70 or less (2SD below average)

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27
Q

MAOI with the lowest incidence of sexual side effects

A

Tranylcipromine

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28
Q

Most effective treatment for social phobia

A

Phenelzine

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29
Q

ASD diagnostic criteria

A

Deficits in social communication and social interaction

Restricted Repetitive behaviors, interests and activities

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30
Q

Time needed to elapse for disulfiram-alcohol reaction to disappear

A

2 weeks

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31
Q

Topiramate side effects that do not improve over time

A

cognitive slowing, weight loss, paresthesias

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32
Q

CYP450 predominantly present at birth

A

3A7

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33
Q

Mechanism of action of Modafinil

A

Histaminergic and increases dopamine by binding to the transporter

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34
Q

Mechanism of action of Atomoxetine

A

Norepinephrine reuptake inhibitor

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35
Q

Absolute contraindication of selegiline

A

surgery and pheochromocytoma

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36
Q

Suicide risk in BPAD

A
25%-50% will attempt 
25% of all completed suicides
same suicide risk as MDD
10-25x higher than general population
10-15% will complete suicide
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37
Q

Best rating scale to differentiate delirium from dementia

A

Delirium Rating scale revised 98

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38
Q

FDA approved treatment of bulimia

A

Fluoxetine

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39
Q

main neurotransmitter associated with Panic disorder

A

GABA

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40
Q

selective mutism is this type of disorder in the DSM-V

A

Anxiety

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41
Q

MDD sleep changes

A
increase sleep onset latency 
increased REM latency
 increased number of  REM sleep
Increased total awakenings
Decreased total sleep
 decreased slow wave (stages 3-4)
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42
Q

Lesion to medial thalamus sxs

A

Medial: deficits in language

Anterior and medial: mood and sleep-wake deficits

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43
Q

Lesions to lateral thalamus sxs

A

deficits in visual memory

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44
Q

Lesions to Amygdala

A

Hyperorality, hyperphagia, hypesexuality (Kluver bucy)

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45
Q

Lesions to mammilary bodies

A

Psychosis, memory deficits and confabulation (Kosarkoff)

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46
Q

%of children with ODD that will develop conduct disorder

A

30%

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47
Q

CJD CSF markers

A

14-3-3 and RT-QulC (latter is more specific)

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48
Q

CJD age of onset

A

50-70y/o

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49
Q

Drugs used to control aggressiveness in schizophrenia

A

lithium and beta blockers

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50
Q

Benzodiazepine that most rapidly absorbed when taken PO

A

diazepam

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51
Q

Benzodiazepines with rapid onset of action

A

Diazepam and clorazepate

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52
Q

Benzodiazepine with shortest half life

A

Triazolam (1-5h), followed by Alprazolam (6-20h)

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53
Q

Benzodiazepines with longest half lives (3)

A

Diazepam, Chlordiazepoxide, clorazepate

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54
Q

Jean Baker Miller theory

A

Relational theory- focused on real relation between therapist and patient

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55
Q

Carl Jung theory

A

Transpersonal psychology-archetypal phenomena of the collective unconscious

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56
Q

Heinz Kohut theory

A

self psychology-mirroring and idealization

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57
Q

Melanie Klein Theory

A

Objects relations-schizoid paranoid and depressive positions, true self and false self

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58
Q

Anna Freud theory

A

Ego theory, focused on ego defenses

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59
Q

What condition does the Maudsley model treat?

A

Anorexia

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60
Q

Prevalence of Paranoid Personality Disorder in inpatient

A

10-30%

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61
Q

Alzeimer’s Disease genetic mutations

A

Presenilin I, Presenilin II, APOE4, and amyloid precursor protein

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62
Q

4 main focus areas of interpersonal therapy

A
Complicated bereavement ( grief after loss of loved one)
Role dispute (conflict in significant relationships)
Role transitions (difficulties adapting to changes in relationships or life events)
Interpersonal deficits (difficulties stemming form isolation or lack of life events)
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63
Q

Lesion to this structure with result in prosopagnosia

A

Fusiform gyrus

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64
Q

Medications that should be taken on an empty stomach

A

Sedatives

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65
Q

Which SSRI have the lowest drug exposure during breastfeeding

A

Paroxetine and sertraline

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66
Q

SSRIs with higher drug exposure during breastfeeding

A

Fluoxetine, Citalopram

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67
Q

Which TCAs have the lowest drug exposure during breastfeeding

A

Nortriptiline and Imipramine

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68
Q

Interaction of valproate and lamotrigine

A

Valproate doubles lamotrigine half life

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69
Q

FDA approved treatment for cataplexy in narcolepsy

A

GHB, Sodium oxybate (Xyrem)

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70
Q

FDA approved medication for PTSD

A

Sertraline and Paroxetine

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71
Q

Peak prevalence of sleepwalking occurs at which age

A

8-12 years

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72
Q

Common disorder in patients with ASD

A

Anxiety

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73
Q

Desipramine should be used with caution in children and adolescents because of this side effect

A

sudden death

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74
Q

First line drug for ADHD with substance use, comorbid anxiety or tics

A

Atomoxetine (Norepinephrine reuptake inhibitor)

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75
Q

Part of the brain primarily responsible for smell

A

Olfactory cortex in LIMBIC system

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76
Q

Frontal lobe function

A

executive function
social conduct
judgement
some motor functions

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77
Q

Parietal lobe functions

A

sensory integration and somatosensory function

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78
Q

Temporal lobe function

A

hearing, naming and visual recognition

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79
Q

Anterior temporal lobe function

A

critical for semantic memory

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80
Q

MRI changes in schizophrenia

A
-Reduced volumen in:
prefrontal cortex
Medial temporal lobe
thalamus
hippocampus
superior thalamic gyrus
-Enlarged lateral and 3rd ventricles volume and basal ganglia
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81
Q

fMRI changes in schizophrenia

A

Reduced blood flow and metabolism in frontal lobes

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82
Q

Structures that arise from Diencephalon

A

Thalamus, hypothalamus, subtahlamus and optic vesicle

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83
Q

Structures that arise from Metencephalon

A

pons and cerebellum

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84
Q

Structures that arise from Myelencephalon

A

Medulla

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85
Q

Structures that arise from Telencephalon

A

brain hemispheres, limbic system and basal ganglia

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86
Q

Structures that arise from Mesencephalon

A

red nucleus, superior and inferior colliculi, substantia nigra and periaqueductal grey matter

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87
Q

Drug that cause false positive for PCP in Utox

A

Venlafaxine

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88
Q

Drug that cause false positive for LSD in Utox

A

Amitriptyline

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89
Q

Drug that cause false positive for barbiturates in Utox

A

Naproxen

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90
Q

Drug that cause false positive for benzos in Utox

A

Sertraline

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91
Q

Drug that cause false positive for amphetamines in Utox

A

Trazodone and selegiline

92
Q

Medication contraindicated in ECT

A

lithium, teophylline, hypoglycemics, bets blockers, lidocaine

93
Q

Kleine-Levin Syndrome

A
adolescent males
excessive day sleepiness
hyperphagia
apathy
hypersexuality
cognitive impairment
94
Q

Mechanism of action of ethosuximide

A

Reduces low threshold T-type Ca currents

95
Q

FDA approved drug to treat depression in children

A

Fluoxetine

96
Q

Mean age of onset of BPAD 1

A

18 y/o

97
Q

Adolf Mayer theory

A

genetic dynamic theory

98
Q

Harry Sullivan’s theory

A

interpersonal theory of psychopathology, focused in relationships rather than drives

99
Q

Karen Horney

A

actual self, idealized self, real self

100
Q

Antidepressant family that causes hyponatremia

A

SSRIs

101
Q

Depersonalization disorder common comorbidities

A

unipolar depression and anxiety disorders, uncommon in PTSD

102
Q

Brain structures affected in DID

A

smaller hipocampus, amygdala and medial prefrontal cortex

103
Q

Neuropeptide transmitters

A

somatostatin, enkephalins, opiates, endorphins

104
Q

Zaleplon half life

A

1-2h, can be given in the middle of the night

105
Q

Highly sensitive marker for NMS in acute phase of illness

A

low serum iron (leads to reduced dopamine receptor function), has low specificity

106
Q

selegiline mechanism of action

A

selective irreversible MAO B antagonist, acts on MAO A in high doses

107
Q

Prevalence of panic disorder in adults and adolescents

A

2-3%

108
Q

Lab tests altered in serotonin syndrome

A
hypocalcemia
hyponatremia
hypomagnesemia
leukocytosis
elevated CK
elevated LFTs
109
Q

varenicline mechanism of action

A

Full agonist alpha7, partial agonist alpha 4 and beta 2

110
Q

Antidepressants safe in epilepsy

A

Mirtazapine, sertraline and citalopram

111
Q

Antidepressants to avoid in epilepsy

A

Bupropion, fluoxetine, TCAs

112
Q

Most anticholinergic TCAs

A

imipramine, clomipramine, doxepine

113
Q

Amphetamines mechanism of action

A

Increases presynaptic release of dopamine and norepinephrine

114
Q

Phenytoin side effects

A
hirsutism
gingival hyperplasia
diplopia
ataxia
neuropathy
115
Q

Mechanism of action of Phenytoin

A

Blocks voltage gated Na channels

116
Q

Weight gain mechanism of lithium

A

insulin like effect

117
Q

Sumatriptan mechanism of action

A

5HT1B and 5HT1D agonist

118
Q

Salvador minuchin

A

Structural family therapy

119
Q

Tourette’s neuroanatomical changes

A

frontal cortex, caudate nucleus, putamen and thalamus

120
Q

ODD comorbidity with ADHD

A

50%

121
Q

FDA approval for Vagus nerve stimulation

A

treatment resistant depression and epilepsy

122
Q

Vagus nerve stimulation site of placement

A

carotid sheath

123
Q

Mechanism of sexual side effects due to antipsychotic medication

A

Alpha 1

124
Q

The dosage of ECT is changed by varying this aspect

A

Time of exposure to a fixed current

125
Q

Neurological illness associated with REM Sleep Behavior Disorder

A

Parkinson’s disease

126
Q

Mechanism of action of valproic acid

A

blockade and prolonged recovery of active voltage gated Na channels, block T-type Ca channels and increases GABA activity

127
Q

OCD SSRIs vs MDD SSRI

A

OCD may need 4x the amount of SSRIs for treatment

128
Q

Disease mechanism in Narcolepsy

A

dysfunctional hypocretin/orexin pathway

129
Q

Birth defects associated with topiramate

A

Cleft lip/palate, hypospadias

130
Q

Medication effective to treat aggression in conduct disorder

A

antipsychotics

131
Q

Neurotransmitter systems affected in Alzheimer’s

A

Acetylcholine and Norepinephrine

132
Q

Freudian stages

A
Oral-Birth to 18 m
Anal-18m to 3y
Phallic-3y to 6y (oedipal complex, castration anxiety and penis envy)
Latency-6y to puberty (around 12y/o)
Genital- puberty to death
133
Q

Neurotransmitter increased 500x in delirium

A

Dopamine

134
Q

APA guidelines for remission of actute pahse treatment in MDD

A

3 weeks of abscence of sad mood and decreased interest and 3 or less sxs of the major depressive episode remaining

135
Q

NMDA R antagonist illicit drugs

A

PCP and ketamine, both are considered dissociatives

136
Q

TCA that is not sedating

A

Proptryptiline

137
Q

Drugs associated with depression

A

Propranolol, reserpine and alpha methyldopa

138
Q

Laboratory changes in depression

A
increased CRP
increased CRH
increased cytokines 
decreased BDNF
decreased leptin
dyslipidemia
139
Q

Central venous thrombosis complications

A

blindness
herniation
hemorrhage (after treatment with anticoagulants)

140
Q

Central venous thrombosis is more common in this population

A

Females
younger than 40 y/o
recent pregnancy, head trauma, coagulation disorders or infection

141
Q

Binge eating disorder treatment

A

SSRIs
Amphetamines (Vyvanse is FDA approved)
CBT

142
Q

inpatient management of anorexia nervosa with purging behavior

A
monitor for 2 h after meals
Frequent small meals
Daily weight after voiding
Eat 500 calories more than needed to maintain weight per day
Daily i/o
143
Q

Morphine metabolism

A

Does not get metabolized by CYP

Glucuronidated

144
Q

Mechanisms of opioid induced hyperalgesia

A

Increased release of substance P
Increased dorsal horn spinal cord activity
Sensitization of primary afferent neurons

145
Q

CYP involved in Methadone metabolism

A

CYP3A4

146
Q

Valproic acid CYP interaction

A

2C9 and 2A6

147
Q

Gabapentin mechanism of action

A

Voltage gated Ca channel blocker

148
Q

Treatment of visual hallucinations in Lewy Body dementia (LBD)

A

cholinesterase inhibitors

149
Q

Ch inhibitor with most evidence for cognitive impairment in LBD

A

Rivastigmine

150
Q

Treatment of depression in LBD

A

ECT or TMS

151
Q

Disorder comorbid with body dysmorphic disorder

A

Social phobia

152
Q

Deep brain stimulation placement for OCD

A

It’s FDA approved

Ventral anterior limb of the internal capsule and adjacent striatum

153
Q

Malan’s model of therapy

A

triangle of conflict

154
Q

Sifneo’s model of therapy

A

Anxiety provoking, therapist acts as teacher

155
Q

Davanloo model of therapy

A

Short term dynamic psychotherapy

156
Q

Mann’s model of therapy

A

Existential therapy, therapist acts as empathic figure

157
Q

EEG typical in Lennox Gestaut Syndrome

A

Slow spikes and waves

158
Q

Mainstray treatment for TCA cardiotoxicity

A

IV sodium bicarbonate

159
Q

Number of symptoms required for a diagnosis of panic attack

A

4, need to be present for >1 month to diagnose panic disorder

160
Q

Solitary tract is critical for this part of sleep

A

Non REM

161
Q

Primary prevention

A

Keeps disease from occurring: ex: counseling, immunizations and suicide prevention programs

162
Q

Secondary prevention

A

Detects diseases when patients are asymptomatic and addresses treatment: HIV test, depression screening, Utox screen, identifying prodromal schizophrenia and nutrition and exercise screening

163
Q

Tertiary prevention

A

Activities that reduce complications or prevent deterioration after the disease onset: Metabolic screening in patient taking psychotropics, ACT team and intensive care management

164
Q

Tourette’s diagnosis

A

Symptoms may wax and wane but must be present for >1 year
Symptoms onset before age 18
Multiple motor and 1 or more vocal tics

165
Q

Type of amnesia in Kosarkoff’s

A

Anterograde and retrograde

166
Q

Type of amnesia in dementia

A

anterograde

167
Q

Type of amnesia after ECT

A

Anterograde and retrograde

168
Q

Type of amnesia in Transient Global amnesia

A

Anterograde and retrograde

169
Q

Methanol intoxication MRI findings

A

Infarct or Hemorrhage in the putamen

170
Q

Kleptomania pharmacological treatment

A

Naltrexone and SSRIs, no FDA approved drugs

171
Q

% of death of people with serotonin syndrome that develop seizures

A

~40% will die

172
Q

Personality disorder comorbid with anorexia

A

OCPD

173
Q

Mirtazapine most serious side effect

A

Agranulocytosis

174
Q

Antidepressant that improves nausea

A

Mirtazapine (5HT3 blockade)

175
Q

Most common etiological factor associated with temporal lobe epilepsy

A

Prolonged febrile convulsions of childhood

176
Q

Infection related to PANDAS

A

Strep A

177
Q

PANDAS symptoms

A

Rapid onset of OCD and/or tics and neuropsychiatric sxs following group A strep infection

178
Q

Most prominent comorbidities with Fragile X

A

ADHD and social anxiety

179
Q

Most common mutation in Fragile X

A

FMR1

180
Q

fMRI findings during AH

A

overactivation of temporoparietal cortex

181
Q

FDA approved treatment of social phobia

A

Paroxetine, sertraline and long acting venlafaxine

182
Q

Most common personality disorder in bulimia nervosa

A

Borderline PD

183
Q

Medications that exacerbate Acute intermittent porphyria

A

Seizure medication

184
Q

FDA approved medications for treatment of tics

A

haloperidol, aripiprazole and pimozide

185
Q

% of patients with BPAD that have recurrence of mania

A

> 90%

186
Q

Prazosin mechanism of action for nightmares

A

Blockade of norepinephrine at postsynaptic alpha 1 receptors

187
Q

Selegiline effect on weight

A

no weight gain

188
Q

Metabolite of Oxycodone detected in urine

A

Oxymorphone

189
Q

Gastaut-Gestschwind syndrome

A
occurs mostly in left temporal seizures 
hyperreligiosity
hypergraphia
hiper morality
hyposexual
Circumstantiality
190
Q

First line agent for impulsivity and behavioral dyscontrol in personality disorders

A

mood stabilizers

191
Q

Depakote absolute contraindications

A

pregnancy
PCOS
hepatic disease
urea cycle disorders

192
Q

FDA approved medication for bipolar depression

A

quetiapine, symbiax, lurasidone

193
Q

Sleep cycle phase when most parasomnias take place

A

early phase

194
Q

illness associated with parasomnias

A

50% children who sleepwalk or have night terrors have OSA

195
Q

Intervention needed before administrating ECT to child/ adolescent

A

2 child psychiatrists that are not the primary treaters should independently agree

196
Q

Diagnostic criteria for TGA

A
Attack must be witnessed
No loss of biographical information
No alterationin consciousness
No cognitive impairment
No recent hx of trauma or seizures
must resolve within 24 h
Other causes of amnesia must be excluded
197
Q

Panic disorder most common comorbid condition

A

Agoraphobia

198
Q

FDA approved antidepressants for tretament of panic disorder

A

Fluoxetine, Paroxetine, Sertraline and venlafaxine

199
Q

Time needed to elapse to diagnose PTSD with delayed onset

A

6 months

200
Q

Mean age of onset of mood disorders

A

18y/o

201
Q

MRI findings in methyl alcohol intoxication

A

Putamen hemorrhage

202
Q

Topiramate mechanism of action

A

inhibits Na channels
Enhances GABA A receptors
Antagonizes AMPA and kainate subtypes of glutamate receptors

203
Q

Gene commonly mutated in Wilson’s disease

A

ATP7B

204
Q

Meige’s syndrome characteristics

A

Sore jaw, increased blinking, jaw clenching, lip pursing, and occasionally tongue protrusion

205
Q

Cause Akinetic mutism

A

tumors of the upper brainstem

206
Q

Leading cause of paraneoplastic syndrome

A

small cell carcinoma of the lung

207
Q

Medical conditions that cause ASD

A

<5% of ASD cases have a medical condition. These are:Fragile X syndrome, Rett syndrome, tuberous sclerosis, abnormalities in chromosome 15

208
Q

Mechanism of action of memantine

A

NMDA R antagonist

209
Q

Medication that increase depression and suicide in depressed Epilepsy

A

Barbiturates and vigabatrin

210
Q

Number of non overlapping symptoms necessary to diagnose BPD with mixed features

A

3

211
Q

Morel

A

First used the work dementia precox

212
Q

Most common EPS side effect of Clozapine

A

Akathisia

213
Q

Hypersomnolence disorder diagnosis criteria length

A

present for >3months

214
Q

Most specific test to diagnose Lewy body disease

A

PET scan

215
Q

Antidepressant with fastest onset of action on GAD

A

Nortriptiline

216
Q

TCA with highest levels in infant after breastfeeding

A

Doxepine

217
Q

Antidepressants that can cause insomnia

A

Fluoxetine, sertraline and bupropion

218
Q

Definition of agoraphobia

A

Fear of being in places or situations difficult to escape from, usually accompanied by fear of having a panic attack.

219
Q

Most prevalent childhood psychiatric disorder

A

ADHD

220
Q

Side effect of Depakote that increases suicide risk in females

A

PCOS

221
Q

Right parietal lobe damage

A

Left hemisensory deficits

Left neglect

222
Q

Antidepressant that decreases prolactin

A

Aripiprazole

223
Q

Benefit of transdermal methylpheidate

A

Avoids first pass in liver, requires less dosage

224
Q

Monitoring of lithium in pregnancy

A

Beginning at week 34, weekly monitoring is necessary

225
Q

Paraneoplastic cerebellar degeneration primary tx

A

Small cell ca of lung, ovary, hodgkin, breast

226
Q

MEdication used to improve loss of appetite 2/2 stimulants

A

cyproheptadine

227
Q

Trazodone mechanism of action

A

metabolite and inhibiting serotonin reuptake in presynaptic neurons