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Child Psychiatry Boards > Neuro/somatic symptom/sleepwake > Flashcards

Neuro/somatic symptom/sleepwake Flashcards

1
Q

What is the most effective treatment for primary enuresis?

A

enuresis alarm

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2
Q

What is the level of control and motivation in these 3 disorders? (conscious vs unconscious)
1. Somatic symptom disorders
2. Factitious disorders
3. Malingering

A
  1. Somatic symptom disorders: unconscious control, unconscious motivation
  2. Factitious disorders: conscious control, unconscious motivation
  3. Malingering: conscious control, conscious motivation
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3
Q

Compare children’s sleep to adults.
__ REM (more/less)
__ REM (earlier/later)
__ REM (more frequent, less frequent)
__ total hrs of sleep

A

More REM
Earlier REM
More frequent REM
More total hrs of sleep

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4
Q

Which nucleus of the hypothalamus regulars sleep?

A

Suprachiasmatic nucleus

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5
Q

Which part of sleep do you see the following activity on EEG?
A) alpha activity, vertex waves
C) K complexes w/sleep spindles or bundles
D) high amplitude delta (slow) waves
E) saw tooth waves

A

A) N1 sleep & when awake with eyes closed, drowsy twilight sleep
C) N2 sleep (light NREM sleep)
D) N3 sleep (deep, slow wave NREM sleep)
E) REM sleep

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6
Q

What is the progression of sleep cycle over 90 mins?

A

N1 –> N2 –> N3 –> N2 —> REM

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7
Q

Multiple sleep latency test is useful to assess for what dx?

A

Narcolepsy

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8
Q

Are Zolpidem and Zaleplon for sleep initiation or sleep maintenance?

A

sleep initiation

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9
Q

Is Suvorexant for sleep initiation or sleep maintenance?

A

sleep maintenance

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10
Q

What hormone secreted by pineal gland regulates circadian rhythm?

A

Melatonin

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11
Q

Psychostimulants such as Dextroamphetamine, Methylphenidate, Modafinil, Armodafinil and Selegiline are used to tx what sleep disorder?

A

hypersomnolence disorder and narcolepsy in daytime

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12
Q

Low hypocretin-1 (aka orexin) in the CSF is found in what sleep disorder?

A

Narcolepsy

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13
Q

REM latency < 15mins, mean sleep latency <8mins and 2 or more sleep onset REM periods found on nocturnal sleep polysomnography is aligned with what sleep d/o?

A

narcolepsy

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14
Q

Which sleep medication is contraindicated in narcolepsy b/c it is a orexin receptor antagonist?

A

Suvorexant

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15
Q

Narcolepsy has ___ % monozygotic twin concordance?

A

30%

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16
Q

What hypnotic can you give in the nighttime for tx of narcolepsy?

A

sodium oxybate: CNS depressant that increases N3 sleep

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17
Q

Sodium oxybate activates what receptor?

A

GABA-B receptor

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18
Q

For what category of sleep disorders are Modafinil and armodafinil helpful with? (3 disorders)

A

promoting daytime wakefulness

Narcolepsy
OSA
Shift work sleep disorder

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19
Q

What is the pharmacologic tx for delayed sleep phase tx?

A

Melatonin

20
Q

Sleep phase chronotherapy is indicated for what sleep disorder?

A

Delayed sleep phase

21
Q

What are the 2 Non-REM sleep arousal disorder specifiers in which no imagery is recalled and amnesia largely present?

A
  1. sleep-walking type
  2. sleep terror type
22
Q

What stage does sleep walking occur in and does it begin before or after puberty?

A

N3
begings before puberty

23
Q

Nightmare disorder occurs during which part of sleep. Patients have memory of these dreams and are easily awakened.

A

REM SLEEP

24
Q

Image rehearsal therapy is beneficial effects for what sleep issue?

A

Nightmares

develop an alternative script to the nightmare

25
Q

What is the first line pharmacologic agent for tx of RLS?

A

dopamine agonists:
Ropinirole, Pramipexole, Rotigotine

26
Q

Most common pediatric chronic illness.

A

Asthma

27
Q

Infants younger than _____ months, require virologic assays that directly detect HIV due to presence of maternal HIV antibody.

A

18 months

28
Q

What is a common side effect of phenobarbital seen in kids?

A

Kids become hyperactive after

29
Q

Jerky mgmt of upper body followed by seizure, normal IQ

A

Juvenile myoclonic epilepsy

30
Q

Child presents with restlessness, irritability, stiffness, seizures, peripheral neuropathy starting at 6 months of age due to issues with myelin production. What AR disorder are we concerned this child has?

A

Krabbe’s disease
Deficiency of galactocerebrosidase

31
Q

Children with metachromatic leukodystrophy, whcih is due to demyelination of white matter/central and peripheral NS due to deficiency in arylsulfatase A typically come to psychiatry for what presentation?

A

Psychosis

32
Q

Huntington’s disease affects what part of brain?

A

Basal ganglia

33
Q

What is tx for WIlson’s dx?

A

Penicillamine (chelating agent)

34
Q

what is difference between NF1 & NF2 (presentation and genes)

A

NF1 has cutaneous lesions, nerve lesions, neurofibromas & schwannomas, lisch nodules (pigmented iris harmartomas) and MR

NF2 has been/l vestibular (nerve 8) schwannomas

35
Q

Hypo-pigmented spots (ash leaf spots), seizures, aggression and AD inheritance is likely what dx?

A

Tuberous sclerosis

36
Q

Facial port-wine in trigeminal nerve, glaucoma, seizures, MR is likely what d/o?

A

Sturge-Weber syndrome

37
Q

Problems with coordination starting around age 4, child can’t break focus unless they move their head, have a red eye and highly sensitive to UV light along with cognitive deterioration is indicative of what d/o?

A

Ataxia-telangectasia

Cerebellar degenerative disease

38
Q

what is treatment for Guillain-Barré syndrome?

A

Plasmapheresis or IVIG

39
Q

How is Duchenne muscular dystrophy inherited?

A

X-linked recessive

40
Q

which muscular dystrophy presents as progressive, symmetrical muscle weakness affecting hips/pelvic/thighs and shoulders and may see enlarged calves due to absence of dystrophin starting around 2-6y/o?

A

Duchenne muscular dystrophy

41
Q

In a pt with Huntington’s dx which brain region on MRI is most likely to show b/l atrophy?

A

Head of the caudate nucleus

42
Q

_______ syndrome presents as beginning in childhood or adolescence and is characterized by periods of hypersomnolence and altered behaviors during wakefulness.

A

Kleine-Levin syndrome

43
Q

This disorder typically occurs in healthy children who begin to lose expressive and receptive language skills most commonly between the ages of 4 and 7 years, although children at both younger and older ages may manifest initial symptoms. Concurrent with the development of aphasia, paroxysmal epileptiform EEG changes and, in many cases, seizures occur.

A

Landau-kleffner syndrome (aka acquired epileptic aphasia)

44
Q

What is the most common type of childhood brain cancer? Of note, in boys>girls and arises in posterior fossa w/complication of hydrocephalus.

A

Medullosblatomas

45
Q

Do males or females have more cases of juvenile myasthenia gravis?

A

females (2-6x more)

Child Psychiatry Boards (12 decks)

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