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ROSH Review > WEEK 4 > Flashcards

WEEK 4 Flashcards

1
Q

how long to be diagnosed for persistent depressive disorder?

A

depressed mood with two other symptoms of depression for majority of days for at least 2 CONSECUTIVE YEARS

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2
Q

first line rx pyromania

A

CBT

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3
Q

how many instances of deliberate fire setting required for pyromania dx?

A

at least 2 (more than 1)

can’t be due to monetary gain, politics, conceal criminal activity, express anger/vengenace, to improve one’s living circumstances

needs to be due to curiosity…get tense before act and relief after act

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4
Q

imaging for tourette’s

A

reduced caudate volume (issue with cortico-striatal-thalamo-cortical circuitry)

cortical thinning in frontal and parietal lobes

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5
Q

which personalities inc risk for suicide?

A

CLUSTER B!!!, BPD the worst but don’t forget narcissistic, antisocial

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6
Q

rx for female orgasmic disorder

A

behavioral exercises like masturbation w/ kegel exercises

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7
Q

proposed mechanism for cluster headaches

A

calcitonin gene-related peptide released from tigeminal nerve which causes pain (vasodilator), subsequent parasympathetic activiation with vasodilation implicated as well

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8
Q

what is the only medication approved by FDA for treatment of schizoaffective d/o?

A

paliperidone

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9
Q

Mechanism fragile X

A

expansion of cytosine-guanine-guanine (CGG) trinucledotide repeats on FMR1 gene

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10
Q

GGA un intron 1 of both alleles of frataxin gene

A

fredreich ataxia (most common hereditary ataxia)

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11
Q

what should NF1 pts be screened for?

A

AUTISM (high association)

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12
Q

FDA approved medication for alcohol withdraawal that is associated with reduced risk of recurrent withdrawal symptoms/seizures

A

chlordiazepoxide
diazepam

LONG ACTING AGENTS better if you can

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13
Q

another name for essential tremor?

A

familial tremor (autosomal dominant)

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14
Q

target for DBS for essential tremor?

A

ventral intermediate nucleus

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15
Q

which substance intoxication can cause hyperacusis?

A

PCP

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16
Q

Two scales for stratifying depression symptoms severity

A

HAM-D (hamilton)
MADRS (Montgomery Asberg)

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17
Q

MADRS < 7?

A

normal range, no depression

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18
Q

MADRS > 35?

A

Severe depression

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19
Q

How long to fear something to meet criteria for specific phobia?

A

6 months

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20
Q

difference between aripiprazole and risperidoen @ dopamine receptor?

A

Abilify - partial agonist
Risperdal - antagonist

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21
Q

treatment to reduce apneic episodes in central sleep apnea?

A

oxygen therapy

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22
Q

delusion where you’re convinced something awful/catastrophic might happen

A

nihilistic

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23
Q

pt with MDD only wanting psychotherapy; how long to determine “adequate trial” of psychotherapy?

A

8-16 weeks to see a response

(wait 8 weeks)

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24
Q

Which has greater risk for precipitating mania (SSRIs or SNRIs)

A

SNRIs

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25
Q

14-3-3 protein in CSF?

A

CKJD

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26
Q

med for rapid eye movement disorder in pt with LBD?

A

memantine

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27
Q

PTSD with dissociative symptoms = what to risk of suicide?

A

increase!!! compared to without dissociative

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28
Q

1st line therapy for specific phobia?

A

exposure based therapy (type of CBT)

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29
Q

incidence vs prevalence

A

incidence = rate of NEW CASES of a disease occuring in specific population over particular period of time

prevalance = the NUMBER OF CASES of a disease in a specific population at a particular time point (point prevalance) or period of time (period prevalence)
# cases at one time / total population at same point in time

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30
Q

Which CN is affected by increased ICP from psedutumor cerebri and what is effect?

A

CN VI (abducens)
Double vision ensues

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31
Q

if doing association or correlational studies to match stressors with symptom clusters, what are you trying to increase?

A

SPECIFICITY

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32
Q

gorssly normal psychomotor development in first 6 months followed by period of regression

A

Rett’s syndrome

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33
Q

gait abnormalities, partial/complete loss of language, sterotypic hand movements, loss of hand skills; infant

A

Rett syndrome (x-linked)

decelerated head growth can happen but not required for dx

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34
Q

how to clarify whether a learning disability is present that is interfering with learning particular subject?

A

psychoeducational testing/intelligence and achievement testing

never use continuous performance testing for ADHD

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35
Q

environmental exposures assocaited with Parkinson’s?

A

herbicide/pesticide

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36
Q

sensitivity formula

A

TP / (TP + FN)

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37
Q

specificity formula

A

TN / (TN + FP)

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38
Q

PPV formula

A

true positive / all the positives
TP / (TP+ FP)

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39
Q

Negative predictive value formula

A

true negative / all the negatives

TN / (FN + TN)

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40
Q

utility of mannitol

A

lowers ICP; good for subdural hematoma)

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41
Q

mechanism lurasidone

A

blocks both dopamine and serotonin receptors

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42
Q

2nd line phrmacotherapy for MG

A

immunomdulating medications azathioprine, mycophenolate, cyclosporine

use only if pyridostigmine (ACHE inhibitor) and steroids ineffective

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43
Q

typical age of onset for persistent depressive disorder (dysthymia)

A

EARLY
(childhood, adolescence, early adulthood)

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44
Q

earliest time that clinical anxiety and depressive disorders can arise?

A

3 years old

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45
Q

irreversible severe antero+retrograde amnesia, confabulation, lack of insight, apathy

A

Korsakoff syndrome (untreated Wernicke’s encephalopathy, didn’t get thiamine)

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46
Q

injury in Korsakoff syndrome location

A

anterior nuclei of thalamus

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47
Q

how to optimize external validity?

A

random selection from population of interest

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48
Q

When to complete M-CHAT for autism?

A

16-30 months (less than 3 yo)

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49
Q

therapy for encopresis?

A

BEHAVIORAL THERAPY
laxatives

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50
Q

when to diagnosis learning disorder?

A

ONLY AFTER formal education has begun

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51
Q

gender difference in prevlance of bipolar disorder

A

equal between men and women

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52
Q

what are good prognostic factors for schizophrenia/schizophreniform?

A
  • CONFUSION OR PERPLEXITY
  • onset of symptoms within 4 weeks of noticeable change in behavior/functionig
  • normal range of affect
  • good pre morbid functioning
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53
Q

effectiveness of SSRIs in specific phobia?

A

mixed evidence, conflicting

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54
Q

difference in eating between binge-eating disorder and Prader willi

A

binge eating - distinct episodes of uncontrolled eating, loss of control, distress

Prader Willi - PERSISTENT overeating

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55
Q

dopamine and glutamate in delirium?

A

INCREASED

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56
Q

which hormone can be used to decrease inflammation and reduce brain swelling?

A

estrogen

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57
Q

crescent shaped collection on CT that crosses cranial sutures but not midline

A

subdural

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58
Q

convex, lense shaped pattern on non contrast CT 2/2 skull fracture

A

epidural hematoma

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59
Q

typical mechanism of injury in subdural hematomas

A

shearing force that results in tearing of bridging veins leading to subdural hematoma

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60
Q

Commonly inmvolved artery in epidural hematoma

A

middle meningeal artery (usu. torn by fractured temporal bone)

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61
Q

thunderclap headache, sudden onset, photphobia/nausea

A

subarachnoid hemhorrage;

more risk with berry aneurysms/vascular malformations

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62
Q

two types of therapy for binge eating disorder

A

CBT
INTERPERSONAL PSYCHOTHERAPY

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63
Q

most specific tool for diagnosis PTSD

A

clinician administered PTSD scale (CAPS-5)

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64
Q

FDA approvals for MDD in over 8 and over 12?

A

over 8 - prozac
over 12 - prozac, lexapro

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65
Q

difference between IED and DMDD

A

IED - episodes of outbursts
DMDD - PERSISTENT irritability or angry mood

66
Q

receptor involved in pimavanserin?

A

serotonin receptors
(inverse agonist and antagonist at 5ht2a receptors)

67
Q

why is pimavanserin useful in Parkinson’s psychosis

A

parkinsons = loss of serotonin neurons leads to upregulation of 5ht2a eceptors causing excessive stimulation of receptors leading to psychosis….pimavanserin blocks these excessively stimulated 5ht2a receptors and decreases psychotic symptoms

68
Q

which neurotransmitter system implicated in ADHD?

A

noradrenargic

69
Q

tract involved in OCD

A

cortico-striato-thalama-cortical circtui (CSTC)

70
Q

mechanism atmoxetine

A

selective NE reuptake inhibition

71
Q

circadian rhythm sleep wake, advanced sleep phase

A

sleeping TWO OHOURS EARLIER and waking TWO HOURS EARLIER

72
Q

most common chromosomal cause of ID

A

Down syndrome

(fragile x is most INHERITED cause of ID)

73
Q

size of prefrontal cortex in schizophrenia patients?

A

reduced, smaller

74
Q

when is the earliest you can get trauma focused CBT for PTSD?

A

6 yo

75
Q

how long symptoms needed to dx ODD? conduct?

A

6 months for ODD
1 year for conduct disorder

76
Q

which atypical needs dose increase in cigarette smoking?

A

olanzapine

77
Q

melatonin agonist helpful in sleep wake cycle disorder

A

ramelteon

78
Q

mechanism Fabry disease

A

deficincy in lysosomal enzyme alpha-galactosidase A

79
Q

dopamine pathway responsible for positive symptoms

A

mesoLIMBIC (omggg did i grow another limb?!?!)

80
Q

dopamine pathway for negative symptoms

A

mesocortical

81
Q

location of episodic memory

A

MEDIAL TEMPORAL LOBES (hippocampus, entorhinal cortex, perihinal cortex, parahippocampal cortex)

82
Q

how to dx mitochondrial myopathy?

A

subsarcolemmal accumulation of mitochondria on Gomori trichome stain of muscle biopsy

83
Q

muscle biopsy shows antisynthetase antibodies…dx?

A

polymyositis

84
Q

what part damaged in frontotemporal dementia?

A

frontal lobes (fronto insular region, ANTERIOR temporal lobes, ANTERIOR cingulate and cingulate cortex

85
Q

which antidepressant liquid formulation (non tablet) contains alcohol and contraindicated with disulfiram?

A

sertraline

86
Q

what is partialism?

A

sexual arousal from NONGENITAL body part (hair, feet, toes); seen in fetish disorder

87
Q

symptoms of Bell’s palsy

A

decreased tearing, hyperacusis, decreased taste sensation of anterior 2/3rds of tongue, acute onset one-sided facial weakness involving BOTH UPPER AND LOWER part of face; can also have BELL PHENOMENON (eye tursn up vertically when attempts to close eye on paralyzed side of face)

88
Q

besides amyloid beta plaques and neurofib tangles, what other things can be found in Alz?

A

LEWY BODIES

89
Q

FDA approved med for seasonal affective d/o

A

buproprion (dual norepi/dopamine reuptake inhibition)

90
Q

lab markers for ongoing alcohol use or to assess for abstinence? also good to identify chronic alcohol use disorder

A

CDT (carbohydrate-deficient transferrin)
GGT (gamma glutamyl transferase)
ethyl glucoronide (heavy alcohol use within past 5 days; helpful for relapse)

91
Q

mode of inheritance Wilson/s dx?

A

autosomal recessive

92
Q

what does kappa statistic measure?

A

test-retest reliability, inter-rater reliability, and intra-rater reliability are most commonly measured by the Cohen kappa statistic. Reliability refers to the degree that two measurements agree with each other.

93
Q

timeline for Persistent complex bereavement disorder (how long after loved one passes away)

A

at least 12 months

94
Q

what kind of study reports prevalence or incidence of disease at a specific point or period of time and may also report associated factors such as demographics, exposures, and risk factors

A

cross sectional study

95
Q

what kind of study is retrospective

A

case control (starts with disease and people without disease, retrospects to see who had risk factor)

96
Q

first line treatment for acute mania in adolescents

A

olanzapine (or atypical like risperidone)

97
Q

What medication may improve cognitive function and apathy in patients who have major neurocognitive disorder with Lewy bodies?

A

rivastigmine

98
Q

contraindications stimulant

A

EATING DISRODER

99
Q

contraindications stimulant

A

EATING DISRODER

100
Q

What antidepressant may be less likely to precipitate hypomanic or manic symptoms?

A

which is a norepinephrine and dopamine reuptake inhibitor.

101
Q

how to tell prion disease from other major NCDs?

A

insidious and RAPID ONSET
MOTOR deficits including ataxia/myoclonus

102
Q

timeline for partial and sustained remission for tobacco use disorder

A

partial - no symptoms in 3 months
sustained - no symptoms in 12 months

103
Q

difference in criteria for MDD and persistent depressive (dysthymia)

A

MDD = 2 weeks 5 symptoms
dysthymia = 2 years persistent symptoms, does not usually reach 5 SIGECAPS

104
Q

hallucinogen persisting perception disorder (i.e. after LSD)

A

high potency benzo like CLONAZEPAM

105
Q

which stage theta waves? (sleep)

A

N1

106
Q

not accomplishing initiative vs guilt stage can result in what?

A

inhibition, phobia, or psychosomatic symptoms and conversion disorder

107
Q

anxiety does what to medial prefrontal cortex

A

decreased activity

108
Q

stimulation of medial prefrontal cortex does what to fear response?

A

diminishes; also reduces anxiety

109
Q

Kluver-Bucy syndrome results from lesions to what area?

A

bilateral amygdala

110
Q

where does jacksonian march affeect?

A

distal limb all the way to ipsilateral face (on same side as injury to primary motor cortex)

111
Q

body integrity identity disorder vs body dysmorphic

A

body integrity - would rather live without ear
body dysmorphic - don’t like how my ear works, i’d rather have another hear

112
Q

friedrich ataxia gene

A

9, trinucleotide repeat GAA

113
Q

CSF guillan barre

A

elevaed protein, normal WBC (cytoalbuminologic dissociation)

114
Q

NMS without muscle rigidity or tremors what can cause

A

clozapine (atypical NMS)

115
Q

tetrabenazine

A

insomnia, akathisa,

116
Q

hypersomnia, always eating (hyperphagia), irritbaility, loss of sexual inhibitions

A

Klein Levin syndrome (resolves itself)

117
Q

mechanism grave’s disease

A

stimulation of thyroid gland but autobodies to thyrotropin receptor = inc secretion of T4, T3

118
Q

blepharospasm (blinking), mouth jerking, almost TD like

A

Meige’s syndrome; rx with botulinum toxin

119
Q

rx TMJ

A

mouth guard/splint alignment

120
Q

three alpha saynuclein opathies

A

LBD
parkinson’s
multiple system atrophy

121
Q

klismaphilia

A

sexual arousal from enema

122
Q

when a patient feels that they are dead or a zombie (severely depressed)

A

cotard syndrome

123
Q

belief is soul is gone after being frightened

A

susto

124
Q

psychological distress after losing semen

A

dhat syndrome

125
Q

in vivo CKJD, (not eating cow), what chromosome?

A

short arm chromosome 20

126
Q

what causes denaturing during spongiform enceph

A

alpha helix turning into beta sheets

127
Q

de clarambault syndrome

A

erotomania

128
Q

triad of Horner’s syndrome

A

miosis
anhydrosis
ptosis

129
Q

weird words but intact intonation and rhythm

A

wernicke’s aphasia

130
Q

raaaaare side effect mirtazapine

A

agranulocytosis

131
Q

Internuclear ophthalmoplegia is associated with a lesion in which anatomical site

A

MLF (medial longitudinal fasciculus)

132
Q

personality disorder with temporal lobe abnoramility, difference corpus collosum

A

schizotypal

133
Q

PET scan during and after a seizure (post ictal)

A

during - metabolism increased, will light up
after (post ictal) - low metabolism of glucose at origin of seizure

134
Q

antipsychotics most likely to cause seizure

A

chlorpromazine
clozapine

135
Q

relational model, relationships are central to life

A

Miller

136
Q

interpersonal psychology, focus on relationships rather than drive

A

Sullivan (Harry

137
Q

object relations theory, paranoid schizoid (all good or all bed), depressed position (ambivalent towards mom)

A

Melanie klein

138
Q

who termed hysteria/anti woman

A

Breuer and Freud

139
Q

4 As of schizophrenia, theorist

A

Bueler

140
Q

who coined term schizophrenia

A

Bueller (blew bugle with name of schizophrenia)

141
Q

Kraeplin terms

A

dementia praecox
bipolar

142
Q

4 As of Bueler

A

loosening Associations
blunted Affect
Ambivalence
Autism (loss of awareness of external events, preoccupation with internal thoughts)

143
Q

who coined first break symptoms of schizohprenia

A

Snyder (1st Rank nazi)

144
Q

genetic diad theorist (genetics and environment play a role, nature nurture)

A

Adolf Meyer

145
Q

H A R P syndrome

A

congenital issue causing neurology

146
Q

which serotonin receptor upregulation causes sexual side effects

A

5HT2A (2A bad for sex)

147
Q

Why does mirtazapine good for sexual side effects

A

blocks 5ht2a

148
Q

yohimbe good for what not so good for what

A

good for sexual side effects but bad for anxiety (ANXIOGENIC)

149
Q

pure motor hemiparesis; location lesion?

A

internal capsule

150
Q

receptor assocaited with constipation, blurred vision, dry mouth, drowsiness

A

M1 / muscarininc

151
Q

L hemiballismus, location of lesion?

A

RIGHT/CONTRALATERAL subthal nucleus

152
Q

what are the sex biogenic amine NTs?

A

dopamine
epinephrine
norepi
ach
histamine
serotonin

153
Q

what structure mediates drainage of CSF into blood?

A

arachnoid granules

154
Q

what is a duct for substances in subarachnoid space to enter brain?

A

virchow-robin

155
Q

method of predicting value of one varibale in relation to another variable?

A

regression analysis

156
Q

personality/cognitive changes in child , myoclonic seizures, chorea, leading to coma and death; rare complication of what disease

A

subacute sclerosing panencephaliits (SSPE)
rare severe complication of MEASLES

157
Q

deficiency in hypoxanthine-guanine phosphoribosyltransferace

A

Lesch-Nyhan (hyperuricemia)

158
Q

deficiency in hexosaminidase A

A

Tay Sachs (AR, chromosome 15)

159
Q

deficiency in lysosomal enzyme galactocerbroside B galactosidase

A

Krabbe disease

160
Q

deficiency in B-glucosidase, chromosome 1

A

Gaucher’s disease

ROSH Review (4 decks)

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