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psychiatry Flashcards

1
Q

schizotypal personality disorder

A

eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness

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2
Q

differential diagnosis of DSM-5 psychotic disorders

A

brief psychotic disorder, schizophreniform disorder, schizophrenia, schizoaffective disorder, delusional disorder

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3
Q

brief psychotic disorder

A

> 1 day and < 1 mo. , sudden onset with full return to function

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4
Q

schizophreniform disorder

A

> 1 mo. and < 6 mo, same symptoms as schizophrenia, functional decline not required

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5
Q

schizophrenia

A

> 6 mo (includes > 1 mo of active sx, can include prodromal and residual periods), requires functional decline

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6
Q

schizoaffective disorder

A

concurrent mood episode, active-phase sx of schizophrenia + at least 2 week lifetime history of delusions or hallucination in the absence of prominent mood symptoms

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7
Q

delusional disorder

A

one or more delusions > 1 mo, no other psychotic symptoms, normal functioning apart from direct impact of delusions

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8
Q

how to distinguish b/w schizophreniform disorder and schizophrenia?

A

time! > 6 mo = schizophrenia

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9
Q

viral encephalitis

A

most commonly HSV

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10
Q

Lhermitte’s phenomenon

A

a shock-like sensation radiating to the feet with neck flexion, commly seen in MS

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11
Q

common presenting signs and sx of myasthenia gravis

A

ptosis, diplopia, dysarthria, dysphagia, and fatigable chewing

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12
Q

myasthenia is associated with which type of tumors?

A

thymoma

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13
Q

sporadic cancer

A

2 acquired mutations causing tumor formation

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14
Q

hereditary cancer

A

1 acquired and 1 inherited mutation causing tumor formation

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15
Q

hereditary retinoblastoma

A

germline mutations in one of the RB1 gene, associated with development of other primary tumors (such as osteosarcoma) later in life

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16
Q

septic arthritis

A

s. aureus

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17
Q

Failure of third and fourth pharyngeal arches

A

Di George Syndrome

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18
Q

What will CD3 and CD20 values be for a person with Di George?

A

CD 20 = B cells and will be normal, CD3 = T cells and is reduced! due to hypoplastic or absent thymus

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19
Q

CD3

A

B cells

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20
Q

CD 20

A

T cells

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21
Q

recurrent infections with catalase + organisms

A

NADPH oxidase deficiency causing CGD

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22
Q

metabolic derangements associated with DKA

A

metabolic acidosis, ketonemia, hyperglycemia, hyperkalemia, hyponatremia

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23
Q

why not use b-blockers for HTN control in setting of cocaine OD and pheochromocytoma?

A

unopposed alpha stimulation could cause hypertensive crisis

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24
Q

kernicterus

A

permanent neurological damage resulting from severe untreated hyperbilirubinemia in the neonatal period; grossly yellow discoloration of brain

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25
Q

ondansetron

A

anti-emetic used by patients undergoing chemotherapy

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26
Q

SE of cisplatin

A

ototoxicity

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27
Q

drugs that can cause interstitial lung disease

A

amiodarone, nitrofurantoin, methotrexate, bleomycin

28
Q

long-term prednisone associated with ___

A

cushing syndrome

29
Q

misoprostol

A

PGE1 analog that can be used to help prevent and treat NSAID induced peptic ulcers by stimulating gastric epithelial cell mucus production

30
Q

aspirin exacerbated airway disease

A

10% patients with asthma will develop nasal congestion or bronchospasm after ingesting aspirin or NSAIDs; increased diversion of AA down the 5-lipoxygenase pathway due to cyclooxygenase inhibition

31
Q

most head and neck CA are what?

A

squamous cell carcinomas

32
Q

what is this an example of: osteogenesis imperfecta can result from mutations affecting either of the genes coding for type 1 collagen

A

genetic heterogeneity

33
Q

what is this an example of: not all patients with BRCA gene mutations develop breast cancer

A

incomplete penetrance

34
Q

what is this an example of: family members affected by Marfan syndrome may present with a wide range of clinical symptoms despite harboring the same FBN1 gene mutation

A

variable expressivity

35
Q

nitrates MOA

A

anti-ischemic effects of nitrates is mediated by systemic vasodilation (predominately venodilation) with a decrease in LEDV and wall stress, result = decreased myocardial oxygen demand despite a reflexive increase in HR

36
Q

do nitrate directly affect cardiac chronotropy and/or inotropy?

A

NO

37
Q

what is the role of CFTR in sweat glands?

A

reabsorb chloride from sweat fluid and enhance sodium reabsorption by ENaC; mutate this and more sodium and chlorine is found in sweat

38
Q

CFTR is respiratory epithelium

A

secrete chloride into the lumen, inhibiting ENaC and decreasing luminal sodium absorption, result = hydrated mucous

39
Q

mutated CFTR in respiratory epithelium

A

destroys electrolyte balance that normally keeps mucosal cells hydrated, result = thick, viscid secretion both low in sodium and chloride

40
Q

Albright hereditary osteodystrophy

A

pseudohypoparathyroidism associated with short stature and short metacarpal and metatarsal bones

41
Q

what is this an example of: all 3 patients have disease X but 3 different mutations of the same gene are identified that cause the disease

A

allelic heterogenity

42
Q

epistasis

A

interactions between multiple genes that combine to create a new phenotype or mask/modify the phenotype of one of the gene

43
Q

what is this an example of: patients with sickle cell anemia who also have a mutation causing persistence to high fetal hemoglobin levels often have a less severe clinical course

A

epistasis

44
Q

indomethacin

A

to close PDA as it antagonized prostaglandin E2

45
Q

leukotriene D4

A

made by eosinophils and mast cells; important role in bronchial asthma pathogenesis by inducing bronchospasm and increasing bronchial mucus secretion; anti-leukotriene rx like montelukast anatagonizes leukotriend D4

46
Q

sx of ACTH dependent Cushing’s syndrome

A

HTN, central obesity, thinning of the skin, moon facies

47
Q

sx of Addison’s disease (primary adrenal insufficiency)

A

elevated ACTH, hypoTN, hypolglycemia, hyponatremia, hyperkalemia

48
Q

menkes disease

A

increased serum copper

49
Q

hemochromatosis sx

A

liver disease with hepatomegaly, DM secondary to pancreatic islet destruction, arthropathy, pituitary hormone deficiencies, hyperpigmentation, and cardiomyopathy; dx > 40 y/o once accumulated enough iron

50
Q

what organ can be affected by portal HTN?

A

spleen! since portal venous system is valve-less, blood flows back into splenic vein and congests red pulp or spleen leading to splenomegaly

51
Q

most common causes of impetigo

A

s. aureus and GAS

52
Q

bullous impetigo

A

s. aureus infection with toxin production

53
Q

intraabdominal abscesses following abdominal trauma, surgery, gynecologic procedures

A

bacteroides fragillis

54
Q

how may bacteria move abx out of cell?

A

efflux pumps paired with protons

55
Q

gain of function point mutation of FGFR3 mutation making its inhibitory function constituitively active

A

achondroplasia; chromosome 4

56
Q

COL1A1 gene mutation

A

osteogenesis imperfecta, defect in type 1 collagen and short stature; blue sclerae

57
Q

FGFR3

A

achondroplasia

58
Q

bruton agammaglobulinemia

A

intracellular messaging abnormality that results in recurrent infections; defective gene on X chromosome

59
Q

androgen binding protein (ABP)

A

synthesized by Sertoli cells of seminiferous epithelium and secreted into the seminiferous tubule lumen; ABP maintains high local concentration of testosterone necessary for normal sperm production and maturation

60
Q

LH

A

stimulate leydig cells to secrete testosterone

61
Q

sertoli cells

A

stimulated by FSH to release APB which binds testosterone to keep testosterone local for promotion of spermatogenesis

62
Q

how does glucagon confer message?

A

binds Gs GPCR on hepatocyte to increase cAMP which activates protein kinase A, which leads to activation of key enzymes involved in glycogenlysis and gluconeogenesis

63
Q

red safranin O

A

colors cartilage, mast cell granules and mucin red

64
Q

sphingomyelin

A

classically found in myelin sheath around nerve; neimann pick = defective degradation

65
Q

connects the ovary to the wall of the pelvis

A

suspensory ligament

66
Q

wide fold of peritoneum that connects the uterus to the pelvis

A

broad ligament

67
Q

what are some structures included in the broad ligament?

A

round ligament, ovarian ligament, fallopian tube

neuro (34 decks)

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