passmed questions Flashcards
18 year old sprinter, loss of sensation below knee. doesn’t fit a dermatome?
conversion disorder. not feigning, but functional. physical symptoms which keep changing. don’t accept test results
19 year old with panic attacks. first line tx?
paroxetine
schiz patient on clozapine. comes in with weight gain and feeling unwell. what investigation is important to do?
FBC for agranulocytosis. could be unwell due to infection. weight gain is normal in atypical antipsychotics
what is neuroleptic malignant syndrome?
pyrexia and muscle stiffness
what are first rank symptoms in schizophrenia? (4)
Schneider’s first rank symptoms may be divided into auditory hallucinations, thought disorders, passivity phenomena and delusional perceptions (bonny ton)
which drugs are used to treat mild to moderate symptoms in alzheimers?
donepezil, rivastigmine and galantamine (acetylcholine esterase inhibitors)
where does the hypothalamus receive inputs from?
septal area (boots september ends), somatosensory afferents (wall), visceral afferents, hippocampus
what is the septal area responsible for?
basic emotional drive
which circuit must be intact in at least 1 hemisphere in order for new memories to be acquired?
circuit of papez
what part of the memory is involved in facts?
semantic memory
is this declarative memory or non declarative?
declarative
what is the other part of the declarative/explicit memory?
episodic (events)
what part of the memory is involved in non declarative/implicit?
emotional memory, conditioned reflexes, skills and habits
learning an association between face and a name requires an intact ?
hippocampus
which type of amnesia can you get in benzo use? retrograde or anterograde
anterograde
what is required for recalling a memory for a time after its required?
hippocampus
role in evaluating significance of environmental events and association of environmental events and reinforcement
amygdala
5 neurotransmitters involved in memory?
5HT, catecholamines, glutamate, acetyl choline
which part of the brain is involved in remembering emotional responses? (think PTSD and unable to remember)
amygdala
skeletal musculature memory (motor habits)? boxing and bike
cereBellum
which glutamate receptor is key in long term potentiation?
NMDA (slower to work but lasts for longer) rel
phosphorylation of tau, is this a good thing or a bad thing?
bad
why?
phosphorylated tau cannot bind to tubulin, micro tubular integrity suffers
why is e4 bad?
cannot inhibit the phosphorylation of tau, and you need to do this
why do NMDA antagonists impair learning and memory?
glutamate is a neurotransmitter involved in memory
AMPA kines, what do these do to memory?
improve
which functional disorder is related to somatic and sensory loss that doesn’t fit a dermatome? not feigning?
conversion disoder. big H with m and s (motor and sensory)
someone who keeps returning with changing physical symtoms (changing mural/wall), refusing to accept negative test results has what?
somatisation disorder
which 3 areas are critical in acquisition, consolidation and expression of drug stimulus learning?
hippocampus, striatum and amygdala
if you have low DRD2, you are at higher risk of what?
addiction
acute stress and dopamine release…what can this motivate in susceptible individuals?
drug taking
if CIWA ar score is more than 8 in alcohol withdrawal, what should chlordizepoxide be switched to?
diazepam
what kind of drug is buprenorphine?
partial opiate antagonist
when do you give lorazepam in delirium?
parkinsons, lewy body dementia and neuroleptic sensitivity
mean duration of delirium?
1-4 weeks
buzzwords for delirium?
rapid, transient, lucid intervals, sundowning, persecutory delusions, visual hallucinations, disorientated, fear. post surgery
side effects of first line treatments in ADHD
sleep and appetite changes, DAT - dysphoria, anxiety, tics
2nd line treatment ADHD?
atomoxetine
