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Acute & Chronic II > Test 1 > Flashcards

Test 1 Flashcards

1
Q

s/s of generalized anxiety disorder

A

excessive worry, restlessness, irritability for at least 6 months

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2
Q

benzos work by increasing

A

GABA activity

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3
Q

typical pharm trx for GAD

A

antidepressant & benzo

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4
Q

risks of benzos

A

dependence, rebound insomnia

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5
Q

common side effects of antidepressants

A

weight gain and sexual dysfunction

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6
Q

complications of antidepressants in elderly

A

hyponatremia, hypercoagulation, osteoporosis, serotonin syndrome

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7
Q

buspirone is only approved for treatment of

A

generalized anxiety disorder

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8
Q

TCAs are not first line for generalized anxiety disorder because

A

high risk of cardiac dysrhythmias and lethal overdose

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9
Q

s/s of anxiety in children

A

diminished interest, social withdrawal

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10
Q

s/s of anxiety in adolescents

A

anger & obedience

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11
Q

characteristics of panic disorder

A

palpitations, shaking, sweating, SOB that peak in 10 minutes and then go away

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12
Q

characterized by excessive fears of scrutiny, embarrassment and humiliation in social or performance situations, leading to significant distress and/or impairment in functioning

A

social phobia

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13
Q

treatment for phobias

A

CBT, desensitization

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14
Q

A diagnosis of PTSD is made only after

A

a month has passed since traumatic event

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15
Q

treatment for OCD

A

CBT & SSRI

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16
Q

progressive cognitive decline mostly seen in those > 65

A

alzheimer’s dementia

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17
Q

dementia correlated with CVA

A

vascular dementia

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18
Q

dementia with fluctuating cognition associated with parkinsonism, hallucinations and delusions, gait difficulties, and falls.

A

Lewy body dementia

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19
Q

dementia with language difficulties, personality changes, and behavioral disturbances

A

frontotemporal dementia

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20
Q

these is no evidence that these prevent the onset of dementia

A

statins

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21
Q

rule these out when diagnosing alzheimer’s dementia

A

thyroid disease, vit B12 deficiency, depression

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22
Q

treatment for mild dementia

A

cholinesterase inhibitors

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23
Q

cholinesterase inhibitors

A

donepezil (Aricept) and rivastigmine (Exelon)

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24
Q

treatment for moderate to severe dementia

A

cholinesterase inhibitors, Namenda, or antipsychotics

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25
Q

Acute neurologic complication of illness and/or medication, especially common in older patients, manifested by new confusion and impaired attention.

A

delirium

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26
Q

difference between delirium and dementia

A

delirium is acute, dementia is chronic and progressive

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27
Q

characteristics of autism

A

ineffective social skills, inability to sustain conversation, repetitive behaviors

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28
Q

environmental need for autistic child

A

structured educational program with a routine.

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29
Q

early signs of autism are present by

A

18 months of age

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30
Q

red flags for autism are

A

don’t respond to name being called by 1 year old, no single word by 16 months

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31
Q

screen for autism in ALL children at

A

18-24 months of age

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32
Q

stages of grief

A

denial, anger, bargaining, depression, acceptance

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33
Q

low levels of this neurotransmitter is associated with depression

A

serotonin

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34
Q

dosage for escitalopram (Lexapro)

A

5-20 mg

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35
Q

dosage for citalopram (celexa)

A

10-40 mg

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36
Q

dosage for sertraline (zoloft)

A

50-200 mg

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37
Q

dosing for paroxetine (paxil)

A

20-60 mg

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38
Q

dosing for fluoxetine (prozac)

A

10-80 mg

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39
Q

SNRIs

A

venlaxafine (Effexor) and duloxetine (Cymbalta)

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40
Q

dosing for venlaxafine (Effexor)

A

75-373 mg

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41
Q

dosing for duloxetine (Cymbalta)

A

20-60 mg

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42
Q

dosing for buproprion (Wellbutrin)

A

200-450 mg

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43
Q

antidepressants should be continued for

A

6-9 months

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44
Q

lifelong trx of antidepressants are needed if

A

more than 3 depressive episodes

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45
Q

s/s of serotonin syndrome

A

confusion, hyperreflexia, fever, myoclonus

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46
Q

differences between depression and dementia

A

dementia has a slower decline in function; depression occurs more rapidly with a fluctuating course

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47
Q

suicide screening

A

o Thoughts of suicide
o Plan to commit suicide
o Means to complete the plan
o Intention to follow through with the plan

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48
Q

one or more manic or mixed episodes during a patient’s lifetime

A

bipolar I

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49
Q

at least one major depressive episode are met in addition to at least one hypomanic episode

A

bipolar II

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50
Q

the onset of bipolar is at ages ____ with initial episodes of _____

A

15-30; depression

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51
Q

manic episode lasts usually

A

one week

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52
Q

people with bipolar have a high risk of

A

substance abuse and suicide

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53
Q

antidepressants in a bipolar patient can

A

cause them to switch from a depressed to manic mood

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54
Q

mood stabilizers for bipolar

A

lithium, lamotrigine, valproate

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55
Q

baseline lab before starting lithium

A

TSH and calcium

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56
Q

lamotrigine for bipolar has a high risk of developing

A

skin rash and SJS

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57
Q

complications of anorexia

A

hypotension, bradycardia, hypothermia, amenorrhea

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58
Q

heart complication d/t anorexia

A

mitral valve prolapse

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59
Q

ECG findings in anorexic patients

A

usually normal except for bradycardia

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60
Q

xerosis is seen in

A

anorexia (dry, scaly skin)

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61
Q

lab results in anorexia

A

leukopenia, high BUN, high cholesterol, low estrogen

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62
Q

med for anorexia

A

olanzapine

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63
Q

first line trx for anorexia

A

nutritional rehab and psychotherapy

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64
Q

complications of anorexia

A

high LFT, superior mesenteric artery syndrome, acute pancreatitis

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65
Q

anorexia has a ____ body weight and bulimia has a ____ body weight

A

low; normal

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66
Q

in anorexia, the HR is ____, in bulimia the HR is _____.

A

low; high

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67
Q

bulimia is characterized as binge-eating and compensatory behaviors at least

A

once a week for 3 months

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68
Q

s/s of bulimia

A

tachycardia, hypotension, parotid gland swelling, and dental erosion

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69
Q

bulimia has a high risk for

A

diabetes

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70
Q

first line therapy for bulimia

A

fluoxetine

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71
Q

this is contraindicated in both anorexia and bulimia as it can cause seizures

A

buproprion (wellbutrin)

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72
Q

mandatory reporting for

A

elder and child abuse/neglect`

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73
Q

Regardless of the gender identity of the patient, physical exams should be based on

A

the organs present.

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74
Q

In transgender patients, it is important to assess and treat for

A

cardiovascular disorders d/t hormone intake

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75
Q

annual screening should be done in men who have sex with men

A

HIV, syphilis, chlamydia, gonorrhea

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76
Q

treatment for those with hypoactive sexual disorder

A

testosterone patch for buproprion

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77
Q

meds that can cause erectile dysfunction

A

antihypertensives, antidepressants

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78
Q

PDE-5 inhibitors for ED are contraindicated in those

A

taking nitrates

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79
Q

PDE5 inhibitors

A

sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis)

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80
Q

teaching for sildenafil (Viagra) and vardenafil (Levitra)

A

effective for short periods and have to be taken on an empty stomach

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81
Q

patients with dysparenuria should have

A

a pelvic exam and pap

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82
Q

characterized by excessive daytime sleepiness and inappropriate manifestations of REM sleep.

A

narcolepsy

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83
Q

undesirable physical events or experiences that occur during entry in sleep.

A

parasomnias

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84
Q

one type of REM sleep parasomnia

A

REM sleep behavior disorder

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85
Q

when patient physically act out vivid, often unpleasant dreams with vocal sounds and sudden, often violent arm and leg movements during REM sleep

A

REM sleep behavior disorder

86
Q

REM sleep behavior disorder occurs in

A

men greater than 50

87
Q

inhalants cause

A

drowsiness, dizziness, slurred speech

88
Q

major hazard of nitrous oxide inhalation is

A

anoxia

89
Q

cocaine properties

A

CNS stimulant

90
Q

cocaine dependence can cause

A

seizures and arrythmias

91
Q

and increase in GABA causes

A

sedation

92
Q

intoxication is a BAC

A

greater than 0.10%

93
Q

DTs develop within ____hour of the last drink

A

24-72

94
Q

benzos facilitate the action of

A

GABA

95
Q

causes of carotid sinus syncope

A

tight collars, shaving, head turning

96
Q

causes of situational syncope

A

micturition, coughing, swallowing

97
Q

meds that can cause syncope

A

ACEI, beta blockers, sulfa, quinolones

98
Q

positive orthostatics if

A

more than 20 mmHg change in systolic, 10 mmHg change in diastolic, or more than 20 bpm in HR

99
Q

how to stabilize after syncope

A

place supine, loosen clothing, turn patient’s head to the side

100
Q

peripheral disorders that can cause dizziness

A

labryinthitis, benign positional vertigo, Meniere’s disease, any inner ear disorder

101
Q

central disorders that can cause dizziness

A

TIA/CVA, multiple sclerosis, tumor

102
Q

hallmarks of a peripheral lesion r/t dizziness

A

nausea, normal neurologic exam, position related

103
Q

hallmarks of a central lesion r/t dizziness

A

abnormal neurologic exam

104
Q

clinical test for positional vertigo

A

HallPike-Dix

105
Q

caution with anticholinergics as it can cause

A

drowsiness, urinary retention, and confusion in elderly

106
Q

POUND with migraine

A 
pulsating or throbbing
one day duration 4-72 hours
unilateral
nausea
disturbance in everyday activities
107
Q

alleviating factors in migraine with/without aura

A

quiet room with eyes closed

108
Q

triggers to migraines

A

stress, weather, cheese, chocolate, alcohol, hormonal changes

109
Q

prodrome phase of migraines

A

irritability, fatigue, food cravings

110
Q

______ is common with migrainers

A

fibromyalgia

111
Q

when further investigation is needed for HA

A

age greater than 50, decreased DTR, personality change

112
Q

preventative therapy for migraines

A

anticonvulsant, CCB, beta blocker, antidepressant

113
Q

abortive therapy for migraines

A

triptans, NSAIDs, corticosteroids

114
Q

meds for abortive therapy for migraines should be limited to

A

use of 2 days or less as it can cause rebound headache.

115
Q

tension headache is described as

A

tight band around the head

116
Q

cluster headache characteristics

A

reaches intensity in 15 minutes, patient cannot sit still, severe pain

117
Q

those with cluster headaches have a high risk of

A

suicide

118
Q

other features that can occur with cluster headaches

A

ipsilateral conjunctival injection, lacrimation, rhinorrhea

119
Q

preventative therapy for cluster headaches

A

verapamil and lithium

120
Q

abortive therapy for cluster headaches

A

oxygen at 7L/min, triptans

121
Q

vasculitis of large and medium vessels

A

temporal arteritis

122
Q

risk factor for temporal arteritis

A

age greater than 50

123
Q

s/s of temporal arteritis

A

fever, weight loss, temporal headache, jaw pain, visual changes

124
Q

diagnostics for temporal arteritis

A

CRP and ESR

125
Q

treatment for temporal arteritis

A

glucocorticoids, baby ASA

126
Q

benign, chronic tremor of the upper extremities or head. The legs are NOT involved

A

essential tremor

127
Q

when the tremor is accentuated as the hand approaches a given target

A

essential tremor

128
Q

in essential tremor, the tremor disappears during

A

sleep or when drinking alochol

129
Q

trx for essential tremor

A

propranolol

130
Q

complication of essential tremor

A

alcoholism

131
Q

most common cause of resting tremor

A

parkinson’s

132
Q

resting tremor disappears when

A

movement is voluntary

133
Q

intention tremor is caused by

A

multiple sclerosis and stroke

134
Q

in intention tremor, the tremor increases as

A

it moves hand closer to target

135
Q

physical exam of tremor includes

A

when it’s fully supported at rest, when the limb is elevated against gravity, and during goal-directed movements.

136
Q

Wilson’s disease is

A

autosomal recessive

137
Q

Wilson’s disease is an impairment of

A

copper

138
Q

Wilson’s disease tremor

A

asymmetrical tremor

139
Q

partial seizures involve

A

only a portion of the brain

140
Q

when the patient has deja vu, hallucination, or activity of an arm or leg that doesn’t cause a loss of consciousness

A

simple partial seizure

141
Q

when the patient stares into space and either remains motionless or engages in repetitive behaviors (lip smacking, chewing, etc).

A

complex partial seizure

142
Q

generalized seizures involve

A

both hemispheres of the brain

143
Q

nonconvulsive generalized seizure

A

absence (petit mal)

atonic (drop attacks)

144
Q

convulsive generalized seizure

A

myoclonic

tonic-clonic

145
Q

caution with antiepileptic drugs as they have interactions with

A

warfarin, antibiotics, and oral contraceptives

146
Q

education with antiepileptics

A
  • don’t switch between brand name and generic

- can increase suicide thougts

147
Q

Most common neuro disorders in children with a systemic viral or bacterial infection.

A

febrile seizure

148
Q

risk factor for febrile seizure

A

age, viral infection, recent immunization

149
Q

simple febrile seizure

A

last less than 15 min once in a 24-hour period

150
Q

complex febrile seizure

A

last more than 15 min more than once in 24 hours

151
Q

Lumbar puncture in children with febrile seizures

A

unnecessary if the child returns to baseline

152
Q

Do not treat patients with febrile seizures with

A

antiepilectic drugs

153
Q

to obtain a driver’s license, there is no evidence of clinical seizures in a

A

3 month period prior to medical review

154
Q

is the doctor held liable for their recommendation on the patient for obtaining driver’s license?

A

no

155
Q

seizure free restriction of ____ months is needed to drive in Texas

A

6 months

156
Q

Chronic progressive inflammatory and neurodegenerative disease affecting the CNS.

A

multiple sclerosis

157
Q

s/s of multiple sclerosis

A

paresthesia, limb weakness, increased DTR, unsteady gait, nystagmus

158
Q

diagnostic of multiple sclerosis

A

MRI

159
Q

trx for multiple sclerosis

A

disease modifying therapy: interferons

160
Q

prognosis for multiple sclerosis

A

capable of living a regular life for 15-20 years

161
Q

clinical features of parkinson’s

A

resting tremor, bradykinesia, rigidity, postural instability

162
Q

parkinson’s is caused by

A

low dopamine

163
Q

the goal of trx for parkinson’s is to

A

maximize functional ability. you cannot slow the progression of the disease

164
Q

complications of parkinson’s

A

psychosis, dementia, depression

165
Q

TIAs are

A

acute ischemic deficits that last less than 24 hours

166
Q

most common causes of meningitis in adults and children

A

N. meningitides and Strep pneumoniae

167
Q

presentation of meningitis

A

fever, headache, stiff neck

168
Q

is present if the patient resists passive knee extension when the hip is fully flexed.

A

kernig sign

169
Q

present if a patient actively flexes the hips when the neck is passively flexed.

A

Brudzinski sign

170
Q

LP in meningitis shows

A

very high WBC and protein, high glucose, and positive gram stain

171
Q

encephalitis is caused by

A

herpes virus, west nile, adenovirus, enterovirus, mumps/measles

172
Q

difference b/t meningitis and encephalitis

A

normal mental status in meningitis; encephalitis has altered mental status

173
Q

LP in encephalitis

A

high WBC and protein, normal glucose, neg gram stain

174
Q

this has been effective in lowering in the meningitis rate

A

Hib vaccine

175
Q

when meningitis vaccine is given

A

11-12 and college freshman

176
Q

acute inflammation of the facial nerve

A

bell’s palsy

177
Q

goal of bell’s palsy trx

A

protection of the eye

178
Q

higher risk of bell’s palsy in

A

pregnancy

179
Q

bell’s palsy affects CN

A

VII

180
Q

trigeminal neuralgia affects CN

A

V

181
Q

trigeminal neuralgia characterisitscs

A

burning, sharp pain to one side of the face

182
Q

trigeminal neuralgia can be exacerbated by

A

chewing, talking, facial movement, weather

183
Q

trigeminal neuralgia trx

A

anticonvulsant

184
Q

Characterized by rapid, progressive, and symmetric loss of motor function

A

GBS

185
Q

causes of GBS

A

occurs 1-4 weeks after a URI and GI infection.

186
Q

characteristics of GBS

A

numbness/tingling in lower limbs that works up.

187
Q

complication of GBS

A

decline in respiratory status

188
Q

initial diagnostics for GBS

A

peak flow meter and pulse ox.

189
Q

hydrocele in an infant resolves at

A

1 year of age

190
Q

characteristics of muscle dystrophy

A

muscle weakness, normal intellect

191
Q

age when toddler should walk independently

A

12-14 months

192
Q

risk factors for hydrocephaly

A

prematurity, meningitis, intrauterine infection

193
Q

what child should do at 6-8 months

A

wave bye, sit up without support

194
Q

newborn jaundice that occurs less than 12 hours old indicates

A

ABO incompatibility

195
Q

how long should child remain in “time out”

A

1 min for each year of life

196
Q

should a 2 year old with asthma receive the Flu-mist vaccine?

A

no

197
Q

a child should not delay immunizations when

A

they are being treated with atbx

198
Q

anterior fontanel closes at

A

9-14 months

199
Q

the posterior fontanel closes at

A

4 months

200
Q

age to use “time out” as a discipline method

A

18 month-2 years

201
Q

a childhood immunization that is likely to cause a fever

A

pneumococcal

202
Q

at what age should a child be to ride a tricycle?

A

3 years old

203
Q

children should not receive tetracycline before

A

9 years of age

204
Q

when should children be able to tie their shoes?

A

6-7 years

205
Q

when should children be able to voice that they are hungry, cold, tired, etc

A

4 years old

206
Q

a newborn loses up to ___% of birth weight in the first week of life

A

10

207
Q

Fluoroquinolones should be not be given before

A

18 years of age

208
Q

sulfa drugs should not be prescribed before

A

2 months of age

209
Q

Wernicke encephalopathy is caused by

A

thiamine deficiency

210
Q

rotten teeth is associated with

A

methamphetamines

211
Q

alcohol withdrawal is associated with

A

clonidine

Acute & Chronic II (4 decks)

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