Neuro/psych Flashcards
Name some positive symptoms of schizophrenia
Thought disorder
Auditory hallucinations
Delusions
How long does a section 3 enable inpatient admission for?
6 months
What is agoraphobia?
Fear of being in enclosed spaces where escape may be difficult
Name a nicotinic receptor partial agonist
Varenicline
What is Charles Bonnnet syndrome?
Temporary visual hallucinations in those with visual impairment
How do you treat TCA overdose?
Lavage, emesis followed by activated charcoal in the first 12 hours of ingestion
How long is a section 5(2) valid for?
72 hours
Name the clinical features of myotonic dystrophy
Facial weakness
Ptosis
Hollowing of temples
Atrophy of jaw muscles
Early frontal balding
Name a useful screening tool for eating disorders
SCOFF
What is Uhthoff’s phenomenon?
A temporary worsening of neurological signs when the body is overheated
What is Lhermitte’s sign?
An electric shock like sensation radiating down the spine when the neck is flexed
What can be used for cluster headache prophylaxis?
Verapamil
Prednisolone
What is Fregoli syndrome?
Where familiar people are falsely identified in strangers
What is Othello syndrome?
A delusion of infidelity in partners
What is Ekbom’s syndrome?
A delusion of infestation with insects
Name some pharmacological treatments for ADHD
Methylphenidate
Dexamphetamine
Atomoxetine
When should lithium levels be checked?
12 hours after the dose
What is the therapeutic range for lithium?
0.5-1.2 mmol/l
Name some ECG changes seen in lithium toxicity
Inversion of T waves
Isoelectricity
Reversible flattening
Explain the pathophysiology of DMD
No dystrophin is produced
What is the prognosis in DMD?
Affected boys are confined to a wheelchair by age 12 and tend to die of CV or respiratory complications by age 20-30
What is the MOA of mirtazapine?
Noradrenergic and specific serotonergic antidepressant
Name some SEs of clozapine
Neutropaenia
Agranulocytosis
Seizures
Myocarditis
Cardiomyopathy
What is somatisation disorder?
Multiple somatic complaints
No organic pathology
Symptoms have persisted for several years
Onset usually before the age of 30
What is the triad of normal pressure hydrocephalus?
Dementia
Abnormal gait
Urinary incontinence
What is Munchausen’s syndrome characterised by?
- Simulated illness
- Pathological lying
- Wandering from place to place
Which drug is first line for generalised tonic clonic seizures?
Sodium valproate
What is hemiballismus?
Involuntary flinging motions of the extremities due to infarction/haemorrhage in the contralateral subthalamic nucleus
What does a section 2 enable?
Compulsory assessment for an assessment for a period of up to 28 days
What is the treatment for TB without CNS involvement?
RIPE for 2 months followed by a further 4 months of RI
What is the triad in serotonin syndrome?
Neuromuscular excitation, autonomic effects, altered mental status
Name some SSRI discontinuation symptoms
increased mood change
restlessness
difficulty sleeping
unsteadiness
sweating
gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting
paraesthesia
What does a section 4 entail?
72 hour assessment order
used as an emergency, when a section 2 would involve an unacceptable delay
a GP and an AMHP or NR
often changed to a section 2 upon arrival at hospital
Name some extrapyramidal side effects
Parkinsonism
acute dystonia
sustained muscle contraction (e.g. torticollis, oculogyric crisis)
may be managed with procyclidine
akathisia (severe restlessness)
tardive dyskinesia (late onset of choreoathetoid movements, abnormal, involuntary, may occur in 40% of patients, may be irreversible, most common is chewing and pouting of jaw)
Name some features of MND
fasciculations
the absence of sensory signs/symptoms*
the mixture of lower motor neuron and upper motor neuron signs
wasting of the small hand muscles/tibialis anterior is common
Other features
doesn’t affect external ocular muscles
no cerebellar signs
abdominal reflexes are usually preserved and sphincter dysfunction if present is a late feature
Name some cutaneous features of tuberous sclerosis
depigmented ‘ash-leaf’ spots which fluoresce under UV light
roughened patches of skin over lumbar spine (Shagreen patches)
adenoma sebaceum (angiofibromas): butterfly distribution over nose
fibromata beneath nails (subungual fibromata)
café-au-lait spots* may be seen
Name some neurological features of tuberous sclerosis
developmental delay
epilepsy (infantile spasms or partial)
intellectual impairment
Name some other features of tuberous sclerosis
retinal hamartomas: dense white areas on retina (phakomata)
rhabdomyomas of the heart
gliomatous changes can occur in the brain lesions
polycystic kidneys, renal angiomyolipomata
lymphangioleiomyomatosis: multiple lung cysts
Which cranial nerves can be affected in vestibular schwannomas?
cranial nerve VIII: vertigo, unilateral sensorineural hearing loss, unilateral tinnitus
cranial nerve V: absent corneal reflex
cranial nerve VII: facial palsy
