MOC Exam#8 Flashcards
ECT is safe in the presence of which cardiac illnesses
- ischemic heart disease
- heart faillure
- heart transplants
ECT is a strong contraindication in the setting of which heart diseases
- acute myocardial infarction
- malignant tachyarrhythmias
Which psychiatric disorder has the highest all cause mortality rate?
Anorexia nervosa
- medical comorbidities: cardiac arrhythmia, electrolyte imbalances
- suicide
- all-cause mortality rate of 5.9
Compare the all-cause mortality rates of :
- anorexia nervosa
- schizophrenia
- major depressive disorder
- bipolar disorder
- bulimia nervosa
- anorexia nervosa: 5.9
- schizophrenia: 2.5
- major depressive disorder: 1.6
- bipolar disorder: 2.2
- bulimia nervosa: 1.9
The best strategies for preventing relapse of MDD after successful course of ECT:
- maintenance ECT
- Venlafaxine + Lithium
Anti-dopaminergic medications (SGA’s) should be continued when catatonia is identified. TRUE or FALSE
FALSE
-stop antipsychotics and give LORAZEPAM
CSF findings in vCJD
- elevated tau protein levels
- lower levels of 14-3-3 protein
Effects of in utero exposure to cannabis, alcohol, nicotine
- increased prevalence of ADHD and aggression in children
- cannabis transfers into breast milk in very high concentrations
- compared to alcohol concentration in breast milk which is low
- nicotine transfers at a higher rate in breast milk than transplacentally
Potential adverse effects of Valproic acid
- hepatic dysfunction
- hemorrhagic pancreatitis
- teratogenic effects
- polycystic ovarian syndrome
- thrombocytopenia (especially in the elderly)
Lithium and hypernatremia
- most common drug cause of hypernatremia
- most common cause of nephrogenic diabetes insipidus
Risperidone is metabolized only by CYP
2D6
Fluoxetine inhibits which of the CYP
1A2, 2C, 2D6, 3A4
Which chromosome is involved in the development of frontotemporal neurocognitive disorder?
Chromosome 17 (FTP-17) -neuronal and glial inclusions that stain positive for MAP-T
Chromosomal involvement of Alzheimer’s Disease
- Chromosome 19 (for early onset)
- Chr 1 (presenillin 2)
- Chr 14 (presenillin 1)
- Chr 21 (APP)
Bipolar disorder is a consistent risk factor for postpartum psychosis. TRUE or FALSE
TRUE
Factor that predicts worsening mood/depression following bariatric surgery
-post-operative weight gain
best factor predicting worsening mood symptoms in bariatric surgery pt
What are Lewy Bodies made of?
- alpha synuclein
- ubiquitin
All patients with neurocognitive impairment should be screened for
DRIVING SAFETY
Korsakoff’s syndrome
- thiamine deficiency in the setting of malnourishment
- potentially reversible with IM or IV injections of 100 mg thiamine
- associated with ophthalmlplegia, cerebellar ataxia, confusion (Wernicke’s encephalopathy)
What is clorazepate?
long acting benzodiazepine
What is CAM?
- the Confusion Assessment Method
- 4-item screening questionnaire for delirium
Strategies for pharmacologic management of severe OCD
- SSRI
- SSRI + atypical (response 40-50%)
- SSRI + CBT
- switch SSRI
- SSRI + Clomipramine
- Deep brain stimulation
Most appropriate test for assessing delirium
Digit span- assess for attention deficits
Delirium is most highly associated with which neurotransmitter
Acetylcholine
Best treatment for tardive dyskinesia
reduction of dose or discontinuation of antipsychotic medications
- BENZTROPINE IS NOT EFFECTIVE FOR TARDIVE DYSKINESIA
- ECT treatment for TD has response rate of 39%
Contraindications for Galantamine use
- severe renal and hepatic impairment
- metabolic disorders of galactose metabolism
