MOC Exam#7 Flashcards

1
Q

Characteristics of Neurocognitive Disorder with Lewy Bodies

A
  • depression prior to onset of memory problems
  • fluctuating cognitive performance
  • visual hallucinations early in illness
  • Parkinsonian symptoms in 70-90%
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2
Q

fluctuating cognitive performance is associated with Parkinson’s disease, Alzheimer’s disease. TRUE or FALSE

A

FALSE

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3
Q

Bipolar disorder, hirsutism, __________

A

Valproic acid

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4
Q

The four elements that must be proven present for malpractice to be found

A

The 4 D’s:

  • duty
  • dereliction
  • damages
  • direct cause
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5
Q

The best pharmacological treatment of illness anxiety disorder

A
  • SSRI

- significant rates of remission

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6
Q

Hallmark symptoms of Lewy Body Disease

A
  • vivid visual hallucintations
  • fluctuations in levels of alertness (confusion)
  • spontaneous Parkinsonism
  • onset of cognitive symptoms within 1 year of motor symptoms
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7
Q

Hallmark of neurocognitive disorder due to frontotemporal lobar degeneratiion

A

-prominent behavioral problems

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8
Q

Rates of Alzheimer’s Disease with age

A
  • 5%-8% over age 65y
  • 15%-20% over age 75y
  • 25%-50% over age 85y
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9
Q

Association between depression and Alzheimer’s Disease

A
  • people with depression are more vulnerable to AD

- patients with AD tend to have fluctuation symptoms of depression unlike pts without AD

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10
Q

REM Sleep Behavior Disorder (RSBD)

A
  • often associated with “synucleinopathies, Parkinson’s Dz, Lewy Body
  • “acting out” on dreams due to lack of normal atonia associated with REM sleep
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11
Q

Features of neurocognitive disorder due to frontotemporal lobar degeneration (FTD)

A
  • apathetic, lacking initiative without reporting depressed mood or anhedonia
  • early changes in interpersonal and social behaviors without cognitive symptoms
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12
Q

Features of Creutzfeld-Jakob Disease

A
  • rapidly progressive neurocognitive disorder
  • caused by prion
  • “spongiform encephalopathy”
  • myoclonus
  • EEG PERIODIC SHARP WAVE COMPLEXES
  • MRI BASAL GANGLIA HYPERINTENSITIES
  • CSF positive for protein 14-3-3
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13
Q

Decreased ceruloplasmin levels

A
  • Wilson’s Dz

- disorder of copper metabolism causing hepatoxicity and neurotoxicity in young adults

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14
Q

Neurocognitive Disorders associations:

  • Motor Slowing
  • Constructional deficits
  • Benefit from structural support/cueing
  • Impaired semantic fluency and naming
  • Perseverative, imitative, utilization behaviors
A

-Motor Slowing: LEWY BODY
-Constructional deficits: LEWY BODY
-Benefit from structural support/cueing: VASCULAR
-Impaired semantic fluency and naming: ALZHEIMER’S DISEASE
-Perseverative, imitative, utilization behaviors:
FRONTOTEMPORAL

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15
Q

Characteristics of SIADH

A
  • normal to high blood volume
  • low serum sodium
  • inappropriate excretion of sodium
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16
Q

Psychotropic medications causing SIADH

A
  • Tegretol (Carbamazepine)
  • phenothiazines
  • TCA’s
  • MAOI’s
17
Q

Which SGA’s are dosage adjustment for renal function recommended?

A
  • Clozapine
  • Paliperidone
  • Risperidone
  • Lurasidone
18
Q

Which amyloid beta (Abeta) peptide is more pathogenic in Alzheimer’s disease?

A

Abeta1-42 is more proned to aggregation therefore more pathogenic

19
Q

Lifetime risk of Alzheimer’s Disease

A
  • at age 65y 9.1% for males, 17.2 % females
  • at age 75y 10.2%, 18.5%
  • at age 85y 12.1%, 20.3%
20
Q

Preferred mood stabilizer for rapid-cycling bipolar disorder

A

-Valproic acid

21
Q

Risk of SGA’s in elderly

A
  • sensitivity to EPS

- increased risk of stroke

22
Q

Changes in sleep/wake cylce associated with neurocognitive disorders

A
  • increased fragmentation of sleep
  • increased latency for onset of sleep
  • decreased sleep efficiency
  • decreased total sleep time
  • decreased slow-wave sleep
  • sleep cycle reversal
  • napping during the day
  • wandering
  • disorientation
  • sundowning
23
Q

The only FDA approved combined oral contraceptive pill for treatment of PMDD

A

Drospirenone/ethinyl estradiol

24
Q

Treatments for PMDD

A
  • SSRI’s

- Drospirenone/ethinyl estradiol

25
Q

Drowsiness the next day is a function of elimination half-life of sleep meds. List the elimination half-life of the following:

  • Zaleplon
  • Zolpidem
  • eszopiclone
  • Temazepam
  • Flurazepam
A
  • Zaleplon 1h
  • Zolpidem 2.6h
  • eszopiclone 6h
  • Temazepam 8-22h
  • Flurazepam 40-250h
26
Q

Time needed to clear all alcohol once drinking has stopped

A

12 h

27
Q

What are the maximum number of points on CIWA

A

67

28
Q

CIWA scores and levels of withdrawal

A

8 or less- mild
9 to 15- moderate
greater than 16- severe

29
Q

What are the single-day and weekly limits for alcohol use for a healthy adult male under 65 y

A

-no more than 4 drinks on any day and no more than 14 drinks per week

30
Q

What are the single day and weekly limits for alcohol use for healthy men and women over age 65y

A

-no more than 3 drinks on any day and 7 drinks per week