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Psychiatry > Pretest > Flashcards

Pretest Flashcards

1
Q

What is seen on EEG in a tonic clonic seizure?

A

Interictal epileptiform discharges

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2
Q

What is seen on EEG in hepatic encephalopathy?

A

Triphasic waves

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3
Q

What is seen on EEG in general toxic encephalopathy?

A

Diffuse slowing of background rhythms

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4
Q

What is seen on EEG in Creutzfeldt-Jakob disease?

A

Generalized periodic sharp waves

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5
Q

What is seen on EEG in opioid intoxication?

A

Decreased alpha activity and increased voltage of theta and delta waves

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6
Q

What is seen on EEG when a patient smokes marijuana?

A

Increased alpha activity in the frontal areas of the brain, but overall slows alpha activity

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7
Q

In what defense mechanism are socially unacceptable impulses transformed into acceptable ones?

A

Sublimation

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8
Q

What are the three defense mechanisms used in OCD?

A

undoing, isolation, and reaction formation

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9
Q

What is the protest phase of separation?

A

When the child is calling, crying and searching for the parent and upon the parent’s return the child is angry

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10
Q

What substance is used to assess dopamine activity in the CNS?

A

Homovanillic acid

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11
Q

What region of the brain is responsible for consolidation of immediate memory into long-term memory

A

Hippocampus is responsible for the consolidation of immediate memory into long-term

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12
Q

Dreaming is seen in what stage of sleep? What is seen on the EEG?

A

REM Sleep; characteristic low-voltage waves that are random, fast and sawtoothed

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13
Q

What are characteristics seen in REM sleep?

A

dreaming, lack of muscle tone (prevents from acting out dreams), increased heart rate, increased blood pressure, penile/clitoral nocturnal erections

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14
Q

What receptor is the target of the anti migraine drug sumatriptan?

A

serotonin receptor 5-HT1D

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15
Q

What serotonin subtype receptor is the target of risperidone?

A

5-HT6

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16
Q

What syndrome includes agraphia, acalculia, R to L disorientation, and finger agnosia?

A

Gerstmann

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17
Q

Affected patients and mother carriers of fragile X syndrome have higher incidence of what psychiatric disorders?

A

OCD, ADHD, persistent depressive disorder, anxiety, antisocial PD

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18
Q

A decreased latency of REM sleep is seen in what psychiatric disorder?

A

Major Depressive Disorder

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19
Q

Acute dystonic reactions are due to dopamine blockade in what neurologic pathway?

A

nigrostriatal

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20
Q

What medication can help relieve acute dystonic reactions from neuroleptic medications?

A

anticholinergics

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21
Q

What chromosome is presinilin 1 located on?

A

chromosome 14

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22
Q

During what stage of sleep do night terrors occur?

A

Non REM

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23
Q

Low levels of what neurotransmitter play a role in suicide behavior?

A

Serotonin; low concentrations the metabolite 5-HIAA have been associated with suicidal behavior

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24
Q

What neurotransmitter pathway has been implicated in the genesis of obsessive compulsive disorder?

A

Serotoninergic pathways; this is why SSRIs are helpful in treatment

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25
Q

What regions of the brain are damaged in thiamine deficiency?

A

dorsal medial nucleus of thalamus and mammillary bodies; structures are necessary for memory formation

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26
Q

A lesion to the right prefrontal region induces what kind of symptoms?

A

laughter, euphoria, tendency to make jokes/puns

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27
Q

A lesion to the left prefrontal region induces what kind of symptoms?

A

abolishes the normal mood elevating influences of this area and produces depression and uncontrollable crying

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28
Q

What region of the brain assigns emotional meaning to sensory experiences?

A

amygdala

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29
Q

If a person is unable to distinguish fear or anger from a person’s facial expression or voice, what region of the brain might have been damaged?

A

Amygdala

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30
Q

What psychiatric symptoms are seen in B12 def?

A

Apathy, depressed mood, confusion, memory deficits

31
Q

What is seen on the EEG in hepatic encephalopathy?

A

triphasic waves (in 50% of cases)

32
Q

90% of patients with CJD have what on the EEG?

A

Generalized periodic sharp waves are most common

33
Q

How long must symptoms for ADHD be present for the diagnostic criteria?

A

6 months

34
Q

What is the treatment choice for nocturnal enuresis?

A

classic conditioning with a bell or buzzer and pad

35
Q

What is the treatment choice for tourette’s?

A

neuroleptic or α2 agonists

36
Q

Why does one experience dizziness and perioral tingling/carpopedal spasm in hyperventilation?

A

Blow off CO2 —> cerebral vasoconstriction —> dizziness; hyperventilation —> low ionized calcium —> perioral tingling/carpopedal spasm

37
Q

How long must one experience excessive worry/anxiety to be diagnosed with GAD?

A

6 months

38
Q

If garlicky break is smelt on a patient, ingestion of what should be suspected?

A

Arsenic

39
Q

What is the potential toxicity of tacrine?

A

Hepatotoxicity

40
Q

What is the typical presentation of DTs in a post-op patient?

A

3-4 days Post op; elevated BP, tachycardia, elevated temperature

41
Q

What is dementia pugilistica?

A

“Boxer’s dementia;” cognitive decline accompanied by parkinsonian symptoms

42
Q

What is the treatment of neuroleptic malignant syndrome?

A

Dantrolene followed by bromocriptine

43
Q

What neuroleptics are more likely to cause tardive dyskinesia?

A

Typicals; specifially high potency

44
Q

Why use high potency antipsychotic with a benzo in acute psychotic setting?

A

Antipsychotic treats psychosis, benzo helps reduce the amount of antipsychotics needed and protects against dystonic reactions

45
Q

What is an erotomanic delusion?

A

The delusion of having a special relationship with someone, often famous

46
Q

What is persecutory delusional disorder?

A

Individual thinks they are being harassed or harmed by others

47
Q

What is Capgras syndrome?

A

Individual believes familiar people have been replaced by imposters

48
Q

What is lycanthropy?

A

Delusion that a person is a werewolf or another animal

49
Q

What predominant symptom is seen in autoscopic psychosis?

A

Hallucination of transparent phantom of one’s own body

50
Q

In what psychotic disorder does one develop psychotic disorder similar to those that his/her long-term partner has been experiencing?

A

Folie a deux

51
Q

What is first line treatment for acute mania?

A

Valproic acid (use to be lithium)

52
Q

What is the difference in diagnosing persistent depressive disorder in adolescents vs. adults?

A

1 year of symptoms for adolescents; 2 years of symptoms for adults

53
Q

What labs should be done for a patient on lithium?

A

Thyroid functioning tests, creatinine, urinalysis, lithium level

54
Q

What are the atypical features in major depressive disorder with atypical features?

A

Mood reactivity (certain events “lift” the depression), self pity, excessive sensitivity to rejection, increased appetite, increased sleeping, reversed diurnal mood fluctuations (better in morning, worse at night)

55
Q

What drugs can be used to treat sex addiction in men?

A

SSRIs or medroxyprogesterone acetate

56
Q

What is the initial dose of naloxone administered in opioid overdose?

A

0.8 mg IV

57
Q

What medication can be used for the rapid relief of hallucinogen intoxication?

A

Benzos; otherwise low stim environment with reassurance is good too

58
Q

What receptors does PCP act on?

A

NMDA - agonist

59
Q

If a patient is on clozapine and has a WBC of 3000-3500, what should the clinician do?

A

Whether symptomatic or not, check labs 2x a week

60
Q

If a patient is on clozapine and has a WBC of 2000 to 3000, what should the clinician do?

A

Check CBC daily and stop clozapine; clozapine may be restarted after WBC normalizes.

61
Q

In uncomplicated agranulocytosis due to clozapine, what should the clinician do?

A

Patient should be placed on protective isolation, clozapine d/c’d, and bone marrow specimen may be needed

62
Q

What is the most common side effect of Ramelteon?

A

Headache

63
Q

What is St. John’s Wort used for?

A

Antidepressant, sedative, anxiolytic

64
Q

How is neuroleptic malignant syndrome treated?

A

Neuroleptic stopped, patient cooled and hydrated; dantrolene (IV) and/or bromocriptine (po) may be given

65
Q

How should acute dystonia from a neuroleptic be treated?

A

Benztropine or diphenhydramine; antipsychotic decreased

66
Q

What sedative hypnotics are known to cause a dissociative state?

A

Zolpidem and zoleplon

67
Q

What drug is helpful at treating akathisia?

A

Beta blockers (propranolol)

68
Q

What effect do TCAs and SSRIs have on sleep?

A

Reduce REM sleep

69
Q

What is the preferred treatment of psychotic symptoms in a patient with Parkinsons disease?

A

Quetiapine

70
Q

When does lithium reach steady state?

A

5-7 days

71
Q

Which antipsychotics are least likely to cause postural hypotension?

A

Haloperidol and fluphenazine

72
Q

Which SSRIs are more likely to cause discontinuation syndrome?

A

Paroxetine and sertraline (shorter half lives)

73
Q

Which SSRI can be stopped abruptly without problems (ie no discontinuation syndrome)?

A

Fluoxetine

74
Q

How are dystonic reactions to neuroleptics treated?

A

IM diphenhydramine or benztropine

Psychiatry (3 decks)

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