Personality Disorders/Sleep/Somatic Symptom/sex Flashcards
Which personality disorder presents as being a loner, restricted range of emotions, no pleasure in activities and no close friends?
Schizoid personality disorder
REM sleep behavior disorder (acting out dreams but don’t have absence of muscle tone) is highly associated with development of what type of dementia?
Lewy body dementia
What is the progression of sleep cycle over 90 mins?
N1 –> N2 –> N3 –> N2 —> REM
Which part of sleep do you see the following activity on EEG?
A) alpha activity, vertex waves
B) theta activity (rhythmic activity b/w 5-8 Hz)
C) K complexes w/sleep spindles or bundles
D) high amplitude delta (slow) waves
E) saw tooth waves
A) N1 sleep & when awake with eyes closed
B) N2 sleep
C) N2 sleep
D) N3 sleep
E) REM sleep
RLS is a sensory-motor disorder with 4 cardinal features:
1) uncomfortable sensation to move the legs
2) discomfort worse in _________ (day OR night?)
3) discomfort worse at rest
4) discomfort improves with mvmt of affected limbs
NIGHT (can also disrupt sleep)
What is the only drug approved for treatment of non 24-hr sleep wake disorder often experienced by blind patients?
Tasimelteon (melatonin receptor agonist)
A man comes for a sleep study and you see increased beta activity on EEG. What medication is he likely taking?
Benzos
What rare neurological condition starts in adolescence where they have hypersomnia (sleeping all the time), aggressive, and over-sexual behavior. There is no definitive tx for it outside of stimulants to increase period of wakefulness.
Kleine-Levin syndrome
What are the biologic features of Borderline PD?
1. Decreased ________ (NT)
2. _______ lobe dysfunction
- Serotonin
- frontal
What psychiatric illness has highest rate of comorbidity with Borderline PD?
MDD
Antisocial and narcissistic personalities share the characteristics of being manipulative, self-serving and lacking empathy however, what differentiates them?
narcissistic personalities are not impulsive and aggressive
What is the common reason for primary enuresis?
delayed bladder maturation (haven’t achieved control of their bladder yet)
small functional bladder capacity, high nocturnal urine production, increased detrusor activity, diminished vasopressin release, poor arousal from sleep
What length of time must continence must have been maintained prior to incontinence to be deemed secondary nocturnal enuresis?
at least 6 months of continence prior to incontinence
Which etiology theory claims somatic symptom disorder is caused by:
A) disrupted childhood attachment
B) compromise formation: expressing something that is repressed but camouflaged
C) amplification hypothesis: pts amplify and misinterpret (catastrophize) normal physiologic functions, may overly attend to interoceptive cues OR somatization is culturally acceptable communication OR somatization is reinforced
A) Attachment theory
B) Psychodynamic theory
C) Learning theory
When wold you use a PHQ-15?
Suspicion of somatic symptom disorder b/c it measures somatic symptoms
Ppl with somatic symptom disorder have a higher rate of _______ personality d/o seen in their male relatives.
Anti-social PD
ACCEPTS model of treatment is used for what psychiatric illness?
Factitious disorder imposed on another
Multiple sleep latency test is useful to assess for what dx?
Narcolepsy
Which Z drug for sleep has the shortest half-life resulting in least daytime grogginess?
Zaleplon
You should avoid giving Ramelteon in pts with severe _________ dx?
liver
For what category of sleep disorders are Modafinil and armodafinil helpful with?
promoting wakefulness
ie hypersomnolence disorder, narcolepsy
Sodium oxybate’s (activates GABA receptor) FDA indications are for what 2 things?
Cataplexy AND excessive daytime sleepiness
Modafinil and Armodafinil FDA indications are to do what?
reduce excessive daytime sleepiness from
-narcolepsy
- OSA
- shift work sleep d/o
What is best tx for REM sleep behavior disorder?
Clonazepam
What medical condition can cause RLS?
Iron deficiency anemia
What are first line agents for tx of RLS?
dopamine agonists
- Ropinirole, pramipexole
What is the first line medication for treatment of premature (early) ejaculation in men, after trying behavioral techniques ( ie squeeze method, start and stop)?
Paxil(paroxetine) daily or as needed
What personality disorder has the following MOA: Hyper-reactivity in amygdala during reappraisal tasks
Avoidant PD
heightened amygdala activity in anticipation of receiving negative social stimuli shows their tendency for anxiety in social settings.
Sleep disturbances that are typically seen in ________ disorder include a decrease in the duration of deep sleep, a decrease in total sleep time, an increase in rapid-eye movement (REM) sleep, and decreased REM latency (time between sleep onset and the first REM cycle).
depressive
Which personality disorder often coexists in bulimic patients?
Borderline PD
