lange qbank review Flashcards

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1
Q

Cotard syndrome content of delusion

A

Nihilistic, rejecting all religious and moral principles in the belief that life is meaningless or that their body is no longer in existence, can feel like they are rotting.

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2
Q

Capgras syndrome content of delusion

A

People familiar to pt have been replaced by exact look alike

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3
Q

Delusional disorder

A

Non bizarre delusions.

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4
Q

Postpartum psychosis

A

Characterized by depression, mood lability, delusions, and a hallucinations. Most cases are a result of bipolar disorder.

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5
Q

Sleep disturbance associated with depression

A

Early morning waking.

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6
Q

Cortisol and catecholamine levels in depression

A

Increased cortisol levels.

Decreased catecholamines.

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7
Q

Cyclothymia

A

Cycling between hypomania and dysthymia.

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8
Q

Double depression

A

MDD superimposed on dysthymic disorder.

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9
Q

Psychotic presentation with abdominal pain

A

Porphyria.

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10
Q

Kluver-Bucy syndrome

A

Presents with docility, lack of fear response, anterograde amnesia, hyperphagia and hypersexuallity.
Due to severe damage to or disconnection of the amygdala bilaterally

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11
Q

Punchdrunk syndrome

A

Acquired movement disorder associated with traumatic damage to the substantia nigra.

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12
Q

Treatment of choice for Panic Disorder with or without agoraphobia

A

Fluoxetine (SSRI)

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13
Q
Common side effects of 
TCA
SSRI
MAOI
Li
Depakote
A

TCA: dry mouth, dizziness (associated w/ hypotension), and urinary hesitancy (due to anticholinergic blocking).
SSRI: GI upset, sexual dysfunction, and agitation.
MAOI: hypotension (less likely to have anticholinergic effects)
Li: (DI),polyuria, polydipsia, tremor and mental confusion at higher doses.
Depakote: GI upset, sedation, and tremors

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14
Q

What differentiates dependence from abuse?

A

Pt’s inability to quit drinking regardless of a desire to quit or knowledge of its negative aspects best differentiates dependence from abuse.

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15
Q

Lab findings in alcoholic pts

A

Elevated GGT
AST>ALT (both elevated)
Increased uric acid (thus increase risk of gout)
Macrocytic anemia
Increased serum triglycerides (part of liver dz)

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16
Q

ECT treatment by the numbers

A

2-4 for Catatonia
6-12 for Major Depression
>20 for Psychosis or mania

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17
Q

Frotteurism

A

Sexual arousal by touching or rubbing up against a nonconsenting person.

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18
Q

Fetishism

A

Sexual arousal connected to nonliving objects.

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19
Q

Stigmata of narcolepsy

A

HYPERSOMNIA
CATAPLEXY
SLEEP PARALYSIS
HYPNAGOGIC HALLUCINATIONS (vivid dream like hallucinations during wake sleep transition).

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20
Q

Cataplexy

A

a sudden and transient episode of muscle weakness accompanied by full conscious awareness, typically triggered by emotions such as laughing, crying, terror, etc.

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21
Q

Negative prognostic factors in schizophrenia

A

Early onset, poor premorbid social and work functions, withdraw/autistic behavior, positive family hx, poor social support, negative symptoms, neurologic symptoms and hx of perinatal trauma.

22
Q

Suicide risk in depression

A

10-15%

23
Q

Pharmacological treatment of PTSD

A

SSRI

24
Q

Factitious disorder vs malingering

A

In factitious disorder the secondary gain is to assume the sick role.
In malingering the secondary gain is a material financial or material.

25
Q

Left frontal hemisphere infarct vs right frontal hemisphere infarcts

A

Left frontal hemisphere -> depression.

Right frontal hemisphere -> euphoria, inappropriate indifference, or mania.

26
Q

Rates of schizophrenia w/ 1 affected parent vs 2 affected parents

A

One parent = 12% risk of developing schizophrenia.

Two parents = 40% risk of developing schizophrenia

27
Q

Schizophrenia rates amongst twins

A

50% monozygotic
12% dizygotic
8% siblings

28
Q

Neurologic signs associated with schizophrenia

A

Short term memory deficits.
Unstable smooth pursuit of eye movements
Sensory gating abnormalities (habituation to repeated sensory stimulus).

29
Q

Haptic hallucinations

A

Tactile hallucination, pt feels as if they are being touched.

30
Q

Hypnagogic vs Hypnopompic hallucinations

A

Hypnagogic occur as you fall asleep

Hypnopompic occur as you wake up

31
Q

Difference between localized amnesia and selective amnesia

A

Localized amnesia involves a discrete period of time where all memories are lost.
In selective amnesia, parts/aspects of the memory are blocked,

32
Q

Sleep pattern changes in depressed pt

A

Increased sleep latency (hard to fall asleep).
Increased REM latency (harder to reach REM sleep).
Early morning awakening.
Increased wakefulness.
REM sleep mostly in first half of the night.

33
Q

Areas of brain affected by OCD

A

Increased activity (metabolism) in the caudate nucleus, frontal lobes, and cingulum.

34
Q

Examples of culture bound delusions

A

Koro: worry that penis is shrinking into abdomen, found in south east asia.
Zar: delusions of possession by spirit.
Taijin Kyofusho: belief that body is offensive to others.

35
Q

Ideas of reference

A

Delusion that others are focusing on you in some positive or negative way. Commonly seen in paranoid schizophrenia. Eg. TV is speaking to pt, parents are trying to kill pt.

36
Q

Locus Ceruleus

A

Alarm center of the brain, it is hyperactive in agitated states (tachycardia, diaphoresis, dilated pupils).

37
Q

Serotonin syndrome cause and presentation

A

Pt on MAOI, then takes an SSRI, TCA, Buspirone, Venlafaxine. Results in dysautonomia, flushing, fever, and myoclonic jerks.

38
Q

Where is serotonin synthesized?

A

Dorsal and medial raphe nucleus

39
Q

Where is NE synthesized?

A

Locus Ceruleus

40
Q

Conversion disorder

A

Sudden onset of singular neurologic deficit, often in setting of stress.

41
Q

Hallmark of hypochondriasis

A

Belief that pt has illness.

42
Q

Dangerous withdrawals drugs

A

Benzodiazepines and alcohol.

43
Q

Treatment for panic disorder with agoraphobia

A

SSRI - specially Paroxetine and Sertraline

44
Q

Effect of stimulants such as methylphenidate on tics

A

They can make them worst.

45
Q

Treatment of Tics and Tourette’s

A

Haloperidol or Pimozide (D2 receptor antagonist, Typical antipsychotics)

46
Q

Describe Tardive Dyskinesia

A

Consists of a number of abnormal and involuntary movements such as lip smacking, facial grimacing, and dance like movements of limbs and trunk.

47
Q

Treatment of GAD

A

Immediate relief with Benzos - Alprazolam. Long term relief with Buspirone (5HT1A partial agonist). It takes 2 weeks to kick in.

48
Q

Pharmacological intervention for BPD

A

SSRI and antipyschotics

49
Q

SSRI discontinuation syndrome

A

Occurs 1-3 days after stopping SSRI. Most commonly manifest as dizziness, nausea, vomiting and flu like symptoms.

50
Q

ECG changes associated with lithium

A

Inverted T-waves.

51
Q

Drugs that increase/decrease lithium levels

A

Increase: Thiazide diuretics, K sparing diuretics, NSAIDS (excepts ASA) and metronidiazole.

52
Q

Most effective treatment of OCD

A

Clomipramine (TCA with serotonin re-uptake inhibition)