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SPIEGEL > TEST ONE > Flashcards

TEST ONE Flashcards

1
Q

mood stabilizer that worsens acne?

A

lithium

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2
Q

side effects of lithium

A

cutaneous (worsens acne and PSORIASIS FLARES), tremors, hypothyroidism, diabetes insipidus (makes kidneys less sensitive to ADH), cardiac arrhytmia, GI complaints,

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3
Q

differences between attachment and bonding

A

attachment - emotional dependence of infant on mother, involves resources and security (infant depends on mother); developed by JOHN BOLBY

bonding - mother’s feelings for infant, DOES NOT INVOLVE RESOURCES AND SECURITY

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4
Q

test for CKJD?

A

CSF assay for 14-3-3 proteinase inhibitor proteins

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5
Q

difference between injuries at orbitofrontal lobe and medial frontal, left frontal, right frontal?

A

orbitofrontal - profane, irritable, irresponsible (PERSONALITY CHANGES)

medial frontal - apathy (limited spontaneous movement, gesture, speech)

left frontal - depression

right frontal - mania

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6
Q

difference between case control and cohort study

A

case control - START WITH DISEASE then see if there was exposure to risk factor

cohort - START WITH RISK FACTOR, and track over time to see who got the disease (retrospective, longitudinal)

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7
Q

Concept of good enough mothering?

A

WINNICOTT!!!

mother plays a role in bringing the world to the infant and offering empathic anticipation of infant’s needs; this will help baby develop healthy sense of self

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8
Q

Sensorimotor, preoperational, thought, concrete operations, formal operations?

A

Piaget stages of cognitive development

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9
Q

stages of separation-individuation; children develop identify separate from mothers

A

Mahler

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10
Q

Mahler stages?

A

normal autism, symbiosis, differentiation, practicing, rapprochement, object constancy

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11
Q

brain autopsy/imaging findings Wernicke’s

A

microhemorrhages of periventricular gray matter, around third and fourth ventricle

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12
Q

meperidine

A

opioid agonist used for pain; increases intrasynaptic SEROTONIN so don’t use with MAOIs

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13
Q

UMN vs LMN

A

UMN - mild muscle atrophy, hyperreflexia, hypertonia, POSITIVE babinski+hoffman (middle finger flick)+pronator drift, SPASTIC paralysis,

LMN - LOTS OF MUSCLE ATROPHY, hyporeflexia, hypotonia, absent babinski, flaccid paralysis, FASICULATIONS

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14
Q

Who invented positive/neg reinforcement in operant conditioning?

A

Skinner

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15
Q

Who invented social learning theory we learn through modeling others and through social interaction?

A

Bandura

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16
Q

ABCs of behavior

A

Antecedent (dog discovering lever releases food), then Behavior (dog keeps pushing lever), then Consequence (food keeps coming out)

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17
Q

Classical conditioning (US, UR, CS, CR)

A

unconditioned stimulus (food) -> unconditioned response (dogs salivating) -> neutral stimulus (bell) + exposure to uncontioned stimulus (food) = conditioned stimulus + conditioned response

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18
Q

Who developed learned helplessness? (doing nothing can influence environment)

A

Seligman

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19
Q

Who studied habituation/sensitization? (

A

Kandel

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20
Q

theory of behaviorism that environment can shape children; psychological care of infant and child

A

Watson

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21
Q

4 stages of Piaget

A 
sensorimotor (0-2y) - 5 senses, reflexes, habits, object permanence, WORKING MEMORY
pre operational (2-7y) - symbolism, play pretend, intuitive age (asking about everything)
concrete operational (7-11) - logic, sorting, inductive reasoning, conservation (fluids), empathy
formal operational  (12+) - abstraction, hypothesize, deductive reasoning
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22
Q

2nd line for absence siezure after ethosux?

A

VPA

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23
Q

NTs involved in aggression?

A

dopamine - initiates aggression
serotonin - decreases aggression (5-HIAA)
GABA - inhibits aggression

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24
Q

Why give positive reinforcement invariably and at different intevals?

A

prevents behavior from going EXTINCT!

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25
Q

generalization in classical conditioning example

A

transfer of conditioned response from one stimlus to another?
ex: dog that salivates at bell starts salivating at cabinet

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26
Q

Discrimination in classical conditioning?

A

recogniing and responding to differences betwen different stimuli

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27
Q

neurofibromatosis 1 chromosome

A

17 (17 letters in von reckinghausen)

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28
Q

chromosome for neurofibromatosis 2 (vestibular schwannomas)

A

22 (chromosome 22 carries NF2)

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29
Q

What is Wisconsin Card sorting test and what does it test?

A

evaluates abstract reasoning and flexibility in problem solving; EXECUTIVE FUNCTION

trail making test also tests executive function

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30
Q

onset of puberty for girls and boys

A

11 - girls

13 - boys

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31
Q

contraindication sumitriptan

A

ischemic heart disesase

all drugs act as potent agonists 5ht 1 B and 5ht 1 D (blood vessels)

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32
Q

Which drugs iincrease serum concentration of TCAs?

A

antipsychotics, methylphenidate, thiazides, fluoxetine, sodium bicarb

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33
Q

Which drugs decrease TCA concentrations in blood?

A

CIGARETTE SMOKING, asorbic acid, lithium, barbituates, primidone

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34
Q

boundaries of parietal lobe

A

central sulcus - anterior boundary (touches frontal lobe)

lateral sulcus - inferior boundary (touches temporal lobe)

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35
Q

dorsal column carries…?

A

fine /discriminative touch, proprioception, vibration sense

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36
Q

spinothalamic trac carries

A

pain/temp, crude touch/pressure

goes from one side of body to contralateral side of somatosensory cortex

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37
Q

anterior cerebral artery supplies sensation to…

A

lower extremities (L part of homunculus)

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38
Q

MCA supplies sensation to…

A

contralateral upper extremity and head and neck

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39
Q

when someone can’t identify an object in their hand? term and lesion

A

asterognosis - parietal

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40
Q

pt unable to determine if finger is up or down/body part position?

A

astatognosis

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41
Q

when pt is unable to distinguish weight difference?

A

abarognosis - parietal lobe (somatoassociation); somatoassocation cortex

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42
Q

spatial coordination area?

A

parietal lobe

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43
Q

if you spill bottle of acid, what area helps coordinate sensory input from this and send it to motor cortex to make sure you move away and frontal to make sure you remember not to do ti again?

A

posterior association area parietal lobe (multimodal association area)

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44
Q

tetrad of Gerstmann syndrome?

A

acalculia
agraphia (without alexia) - inability to produce written language
R and L confusion
finger agnosia (inability to name fingers)

LESION IN ANGULAR GYRUS

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45
Q

acalculia

A

inabiliyt to perform simple arithmetic

lesion to PARIETAL

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46
Q

wernicke’s area on dominant or non dominant side?

A

dominant (typically left)

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47
Q

apraxia

A

inablity to perform routine motor tasks (non dominant parietal lobe)

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48
Q

where is gerstmann syndrome lesion?

A

dominant parietal lobe (usually left), AROUND ANGULAR GYRUS

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49
Q

sudden rampage (homicide/suicide) and ends in exhaustian and amnesia

A

AMOK (malaysian)

50
Q

delusion in Asian males who believe penis will disappear into abdomen?

A

Koro

51
Q

anxiety, depression, confusion, depersonalization, and derealization that ends in stuporous sleep and amnesia; seen in female eskimos of northern Greenland

A

Piblokto

52
Q

fear of being turned into a cannibal through posession of a demon (Native American)

A

Wihtigo

53
Q

vomiting, fever, restless sleep caused by “evil eye” (mediterannean)

A

Mal de Ojo

54
Q

hoffman’s sign

A

thumb adducts when middle or index finger of same hand is pushed down (CORTICOSPINAL TRACT LESION)

55
Q

palomental reflex

A

chin muscle contracts as thenar eminence of palm contralateral to brain lesion is stroked with blunt instrument (frontal lobe)

56
Q

loss of gag reflex (where is lesion?)

A

stroke involving brainstem or complete brain death

57
Q

Gene’s associated with Alzheimers and locations

A 
Amyloid precursor protein (chromosome 21)
APO e4 (chromosome 19)
58
Q

missing sex chromosome, XO,= absent or minimal gonads

A

Turner’s syndrome

59
Q

female with no secondary sex characterisitcs/minimal gonad development

A

Turner’s

60
Q

extra chromsome XXY

A

Klinefelter’s snydrome

61
Q

male habitus but no strong male characteristics, small underdeveloped genitals, infertile, breast tissue during adolescence

A

Klinefelter’s

62
Q

how to make diagnosis of brain death

A

complete absence of brainstem reflexes (absent gag, fixed pupils, absent oculocephalic/oculuvestibular reflexes, absent corneal reflexes)

63
Q

difference between oculucephalic and oculuvestibular reflex

A

oculucephalic - eyes open and down then move as you turn head
oculuvestibular - caloric stimulation, cold water = nystagmus

64
Q

where is norepi produced/noradrenergic neurons?

A

locus cerelus (CEREBRUS)

65
Q

where are serotonergic neurons located?

A

raphe nucleis (SER RAPHAEL)

66
Q

what surgery good for myastehnia gravis sometimes

A

thymectomy (10% of MG associated with thymoma)

67
Q

what agent used to dx myasthenia gravis

A

edrophonium chloride (tensilon) - short acting cholinergic agent

68
Q

treatment options for MG

A

pyridostigmine, plasmapharesis, IV IG, thymetctomy

69
Q

EEG finding MG?

A

decerased amplitude (decrement) upon rapid repetitive muscle stimulation)

70
Q

newonset headache/worsening headache, fever, fatigue, myalgia, nightsweats, jaw claudication, VISION LOSS

A

temporal arteritis

71
Q

initial test of choice for tempral arteritis

A

ESR!…then can go to temporal artery biopsy if ESR is elevated

72
Q

treatment of temporal arteritis?

A

PREDNISONE

73
Q

concept that mental disorders have different outcomes?

A

emil KRAEPELIN (differentiated chronic schizophrenia and manic psychosis)

74
Q

who termed dementia praecox?

A

Kraeplin (borrowed from MOREL)

75
Q

concept of “transitional object”

A

WINNICOTT

76
Q

who wrote on narcicissim and self psychology

A

Kohut

77
Q

who formalized name schizohprenia and stressed that it need not have a deteriorating course?

A

Bleuler

78
Q

cluster headaches usually occur when?

A

nighttime, attacks of short duration (3 hours or less),, cyclical pattern mainly in spring and fall

79
Q

cluster headaches more common in males or females

A

males

80
Q

contraindications buproprion

A

HEAD TRAUAMA, seizure history, recent MAOI use (hypertensive crisis), anorexia

hypertension is NOT a contraindication

81
Q

what mood stbailizer can be given with MAOI

A

lithium

82
Q

which therapies can cause peripheral neuropathy?

A

vincristine (chemo) and isoniazid, excess b6 therapy

83
Q

neuro complication of EBV?

A

peripheral neuropathy

84
Q

sodium level in psychogenic polydipsia and diabetes insipidus

A

polydipsa - serum sodium is LOW (excess water into body from drinking)
DI - serum sodium is HIGH (water moved out of body via urine and not replaced, urine dilute, serum high with Na)

85
Q

progressive muscle weakness, generalized fatigue, red non pruitic rash on face/body (around knees and elbows)

A

dermatomyositis; CHECK FOR CANCER

86
Q

T/F: impairment in daily functioning needs to be present for diagnosis of delusional disorder

A

FALSE

87
Q

female orgasm increases with age

A

TRUE

88
Q

which anticonvulsant causes hirsutism, facial dysmorphism, and gingival hypertrophy?

A

phenytoin (can also cause cerebellar atrophy)

89
Q

R writ and fingers weak, weakness when tries to extend arm, trouble turning farm over when palm is on flat surface

A

saturday night palsy (RADIAL NERVE COMPRESSION)

90
Q

elbow injury causing weakness in hand muscles and 4th/5th finger flexor weakness

A

ulnar nerve compression

91
Q

hand paresthesias, thenar atrophy, and positive Tinel sign (percussion of nerve over wrist causes numbness)

A

carpal tunnel…MEDIAN NERVE PALSY

92
Q

manuever to flex hand at wrist for 1 minute which can elicit numbness

A

Phalen’s manuever for dx carpal tunnel

93
Q

diagnostic test of choice for carpal tunnel syndrome

A

needle EMG and nervce conduction studies

94
Q

weakness in biceps and brachialism

A

musculocutaneous nerve injury

95
Q

treatment for cataplexy assocaited with narcolepsy

A

sodium oxybate (GHB)

96
Q

decline in energy with no clear cause; diagnosed 6 months after severe fatigue

A

chronic fatigue syndrome

97
Q

what Piaget stage does child develop idea that objects can change but also maintain characteristics that allow them to be the same

A

CONSERVATION IS SEEN IN CONCRETE OPERATIONS stage

reversiblity also in this stage

98
Q

face of fragile X

A

long ears, narrow face, short stature, hyperextendable joints, ARCHED PALATE, macro-orchidism

99
Q

what mood stabilizer is the classic inhibitor of cyp 3a4

A

VPA! causes inhibition of clearance of lamotrigine)

100
Q

which MAOI selectively in hibits MAO B at lower doses

A

selegiline

101
Q

which substance when abused long term can lower dopamine transmission/lead to hypodopaminergic state?

A

cocaine (blocks dopamine reuptake from synapctic cleft leading to increased levels in short term but chronically can lead to depletion of dopamine)

102
Q

list dopamine agonists

A

PERGOLIDE
BROMOCRIPTINE
PRAMIPEXOLE
ROPINIROLE (restless legs)

103
Q

what is the one atypical antipsychotic that inhibits serotonin and norepi reuptake?

A

ziprasodone!! (inhibits 5ht1a receptor too when all the other atypicals bloc 5ht2a and dopamine d2 rceptors)

104
Q

which atyphical works as partial dopamine agonist at D2 receptor?

A

aripiprazole (also works as partial agonist at 5ht1a receptor and blocker at 5ht2a receptor)

105
Q

which is the only ligand gated serotonin receptor (others are G protein coupled)

A

5ht3

106
Q

which serotonin receptors are inhibitory

A

5ht1 and 5ht5

107
Q

which serotonin receptors are excitatotry

A

5ht2,4,6,7

5ht3 also excitatotory but also remember it’s ionotropic/igand gated NOT metabotropic/g-protein

108
Q

wing flapping coarse tremor of upper extremity, ataxia, rapidly progressing confusional state developing over several months

A

WILSONS! dx with serum ceruloplasmin level and rx with pencillamine (cooperchelator)

109
Q

which test has high reliability?

A

Wechsler adult intellligance scale (results conssitent throughout lifetime and repeatable)

110
Q

null hypothesis rejected (there is a change) when it should’ve been retained (there actually isn’t a change)

A

type I error

111
Q

null hypothesis retained (there is no difference) when it should have been rejected (there really is a difference)

A

type II error

112
Q

randomization protectes against what kind of bias?

A

selection bias

113
Q

increasing power of a study does what to error

A

lowers type II error

114
Q

the probability of finding a true difference between samples

A

power (rejecting null hypothesis when it should be rejected, type II error)

115
Q

number of people who have a disorder at a specified point in time

A

point prevalance (number of people who have disorder divided by number of people in population at that time)

116
Q

how long can each susbtance be detected in urine? PCP, cannabis, cocaine, heroin

A

PCP - 8 days
cannabis - 4 weeks
cocaine - up to 8 hours
heroin - up to 72 hours

117
Q

hemotologic effect of carbamazepine

A

leukopenia, agranulocytosis, pancytopenia, aplastic anemia!!!
get CBC if concerned

118
Q

eye findings schziophrenia

A

abnormal smooth pueruist and saccades

119
Q

pathologic gambling most associated with what comorbid psych disorder?

A

mood! particularly MDD

120
Q

with internuclear ophthalmoplegia (abnormal horizontal ocular movements with delayed adduction of ipsilateral eye), often seen in MS, where is the lesion?

A

medial longitudinal fasciculus (MLF)

SPIEGEL (3 decks)

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