SPMM Flashcards by Matthew Cohen

After individuals with bulimia stop purging what may they get?

Parotitis - often painless

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When can a child copy a circle, square and triangle?

Circle - aged 3

Square - aged 4

Triangle - aged 5-6

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When can a child build blocks of 2, 3, 6-7, 9-10

2 - 15 months

3 - 18 months

6-7 - 2 years

9-10 - 3 years

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How should one switch from a TCA to SSRI?

Half dose of TCA start the SSRI and slowly withdraw the TCA

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How should you switch from Trazodone to another anti-D (not MAOI)?

Cross-taper cautiously

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In CJD what are the initial symptoms?

Often cerebellar or visual:
- Ataxia, clumsiness, dysarthria
- Diplopia, distorted vision, blurred vision, field defects, changes in colour perception, visual agnosia

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Name some changes to the cerebellum?

Hypoplasia of the cerebellar vermis
Reduced Purkinje cell count of the cerebellum

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Lesion in which artery of the brain is most likely to produce akinetic mutism?

Anterior cerebral artery

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Does Lewy Body Dementia showed reduced acetylcholine counts?

Yes - that’s why acetylcholine-esterases are used in these conditions

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What is the cerebral torque?

Opposing right-left asymmetry of frontal and parietal-occipital regions - may be disturbed in psychosis

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What anti-depressants perinatally have been linked to cleft palate in neonates?

SSRIs

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MAOI > other anti-depressants for which condition?

Social phobia

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What measures may improve lithium induced tremor?

Taking smaller, more frequent doses
Propanolol

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How long does persistent delusional disorder need to last?

1 month

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In grief attentional bias to objects belonging to the dead person is known as?

Incentive salience

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What is interoception?

Awareness of one’s physiological state

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What is the most long lasting cognitive effect after ECT?

Retrograde amnesia for autobiographical memory

Confusion and disorientation usually resolves within 24-48 hrs
Anterograde amnesia resolves in

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What is the most long lasting cognitive effect after ECT?

Retrograde amnesia for autobiographical memory

Confusion and disorientation usually resolves within 24-48 hrs
Anterograde amnesia resolves in

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What is the most long lasting cognitive effect after ECT?

Retrograde amnesia for autobiographical memory

Confusion and disorientation usually resolves within 24-48 hrs
Anterograde amnesia resolves within the first few weeks

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Does high EE affect men or women more with regards to risk of relapse post psychotic episode?

Men

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What is the primary ego defence?

Repression

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Is the risk of Clozapine induced agranular cytosis dose dependent?

Afro-Caribbean, young and low baseline count are risk factors
First 6 months of treatment risk is highest

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Name antipsychotics high risk of weight gain?

Clozapine
Olanzapine

Moderate:
- Risperidone
- Quetiapine
- Palliperidone
- Chlorpromazine

Others are generally low risk inc. Zuclopenthixol, Haloperidol. Sulpride, Amilsulpride, Aripiprazole etc

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Which anti-dementia drug undergoes minimal hepatic involvement for breakdown and is metabolised by choline-esterase itself?

Rivastigmine

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Are there interactions between OCP and Sodium Valproate?

Which cells promote clearance from the synapse?

Stellate cells

Which cells link the cortex to the spinal cortd for motor transmission?

Betz cells

Name a common defence mechanism seen in Naricssism?

Projection

How may extraversion, neuroticism and psychoticism change in age?

All decrease in both males and females

How long does puberty tend to last for boys?

2-3 years

What is the most common feature in Parkinson's?

Unilateral resting tremor

Describe features of late onset Schizophrenia?

Predominantly female Less negative symptoms Less thoughts disorder Prominent hallucinations visual Social isolation Sensory impairment Premorbid paranoid personality traits

In psychopathology the tendency to feel inappropriately euphoric is known as?

Moria

What does the Stanford Binet test assess for?

Intelligence

In extroverts how does the ascending reticular activating system act?

Under-active --> therefore seek out social contact Introverts --> may be over active and want alone time

Name some mechanisms that account for sexual dysfunction with antipsychotics?

Alpha - 1 - antagonism - erectile dysfunction (also known to attribute to priapism for chlorpromazine, thioridazine and trazadone) D2 blockade - hyperprolactinaemia or reduced drive H1 blockade - sedation Anticholinergic blockade - Reduced peripheral vasodilation

Which anti-depressants are most/least associated with sexual dysfunction?

Mirtazapine Moclobemide Vortioxetine Reboxetine Buproprion Agomelatine Those with a lot: - SSRI - SNRI (Venlafaxine > Duloxetine) - Tricyclics

What is the inheritance pattern of Fragile X

X-linked dominant

How does Flumazenil work?

Competitive inhibition at GABA-A receptor

Which TCA is the a) Most serotenergic b) Most noradrenergic c) Most histaminergic c) Least anticholinergic

a) Clomipramine - best for OCD b) Desipramine - most noradrenergic (secondary amine) c) Doxepin d) Secondary amines - Nortriptyline, Desipramine, Amozapine

What are the ECG in myocarditis?

Saddle shaped ST elevation - if pericardial involvement Tachycardia Prolongation of PR interval Diffuse TWI

What can acetylcholine-esterase inhibitors do to ECG?

Bradycardia and PR prolongation

Lhermitte's sign is seen in which condition?

Multiple sclerosis - it is the presence of brief shock like sensations starting in the neck and radiating down the body towards the limbs

How is subclinical hypothyroidism managed in a patient taking Lithium?

Initially monitored

Are perceptual abnormalities seen in parkinson's?

Yes - 40% Commonly perception of a person next to them - 25% Sometimes formed visual hallucinations - 22% Can be auditory hallucinations - 9.7%

Shenjing Shuairuo is a culture bound illness from which country?

China - it means weak nerves Symptoms similar to chronic fatigue/fibromyalgia - Multiple somatic complaints - Dizziness, headaches, chronic pain, fatigue

The social acceptance of individuals with learning disabilities without devaluation is known as?

Social role valorisation

Name a new mental disorder in ICD-11

Prolonged grief disorder

In ICD-11 can all disorders be diagnosed at any age?

Yes

What anti-D is associated with a lower risk of manic switch?

SSRI

Clonidine is a....

Alpha-2-adrenergic agonist - it's effects are typically act on presynaptic alpha 2 adrenergic receptors this reduces the release of noradrenaline - on cessation there may be rebound hypertension - Clonidine is used for tics and tourettes and also ADHD Side effects; - dizziness - sedation - orthostatic hypotension - dry mouth - depression

Which oral benzodiazepine has the shortest onset of action?

Diazepam

How does reserpine work?

It prevents the storage and synthesis of NA from axon terminals

What is a haptic hallucination?

Other name for tactile hallucination

What is the most common obsession in OCD?

Fear of contamination

In Minuchin's study of families of patients with anorexia nervosa what behaviours did he find?

Overprotectiveness Rigidity Poor resolution conflict resolution skills Emneshment

How does vision develop in the neonate?

Birth - track objects, bright light perception, can fixate on objects at 20cm, figure-ground perception 1 month - discriminate faces 2 months - prefers 3D > 2D and depth perception 4 months - colour vision and accommodation 6 months - adult acuity

Name a neurochemical theory for tardive dyskinesia?

High D-2 sensitivity (supersensitivty)

What muscarinic receptor blockade is most likely to lead to anti-cholinergic effects in TCAs?

Name some neurological conditions associated with autism?

Tuberous sclerosis Neurofibromatosis

What are the hold tests in the WAIS?

Information Object assembly Picture completion Vocabulary - these are meant to be resistant to brain damage Non-hold tests are block design, digit span, digit symbol, similarities

What is the risk of alcoholism in close relatives?

3-4 x more likely

What is the increased risk of inheriting panic disorder in close relatives compared to the general population?

6 - 17% 4 - 8 x more likely

The isoforms of MAO A/B are encoded on which chromosome?

X chromosome

What scan would differentiate Parkinson's from drug induced Parkinson's

Beta-CIT-SPECT or FP-CIT (DATscan)

Techtineum-HMPAO-SPECT (99mTc) assess for?

Indirectly assess blood flow

What stage of sleep are saw tooth waves seen?

REM sleep Also low voltage mixed frequency alpha and theta waves seen

Are dystonias dose dependent?

Yes

How does Mianserin work?

Alpha-2 antagonism and weak alpha-1 antagonism - prevents the uptake of Na mainly, some Serotonin Can be delivered OD due to half life 10-29 hours Sedative and weak antimuscarinic effects

What are phase 1 and phase 2 reactions?

Phase 1 - oxidation, reduction, hydrolysis Phase 2 - conjugation, methylation, n-acetylation, glucuronidation

What can SSRI's cause?

Nocturnal myoclonus

The MOHOST is a scale that assesses?

ADL functioning

Capgras syndrome is what type of delusion?

Reduplicative paramnesia - the sense that a place, person has been duplicated and the person is simultaneously experiencing it

What personality traits was Jung associated with?

Introversion/Extroversion

Restless leg syndrome may be treated with what type of drug?

Dopamine agonist carbi/levo-dopa Prameprixole

Restless leg syndrome may be treated with what type of drug?

Dopamine agonist: - carbi/levo-dopa - pramiprexole - rapinirole Clonazepam 2nd line

Fronto-striatal executive dysfunction is a neuropsychological theory for which condition?

ADHD

What type of chromosome is formed by Robertsonian translocation?

Metacentric - p arms get discarded

The health of nations outcomes scale assess for?

Assess recovery and clinical outcomes

Name a non-clinical administered scale fully structured interview used in epidemiological studies to identify a lifetime diagnosis?

Diagnostic interview schedule

Pimozide and Carbamezepine are broken down by BLANK enzymes

CYP3A4 - grapefruit juice, paroxetine, fluvoxamine and fluoxetine are inhibitors

Name some antipsychotics with prominent orthostatic hypotension?

Clozapine & Risperidone - due to alpha-1-adrenergic blockade

Which anti-epileptic is associated with motor disturbances?

Vigabatrin

Name some indications for Tetrabenazine?

- Huntington's - Tardive Dyskinesia - Tourette's

What is a hygric hallucination?

A feeling of fluid

Name some defence mechanisms used in OCD?

Undoing, reaction formation and isolation

When is the steady state of clozapine/sodium valproate reached?

2-3 days

What has been previously referred to as bodily distress disorder?

Neurasthenia

SPMM Flashcards

(88 cards)