CNS II

1. List the three opioid receptor subtypes, the endogenous ligands for each receptor subtype, and the prototype exogenous opioid agonists that bind to each receptor subtype 2. List at least 8 important pharmacological effects produced by opioid agonists and name the receptor subtype that mediates each effect 3. Describe the differences in the pharmacology between full and partial opioid agonists 4. List the prototype opioid receptor antagonists, list which receptor subtype they bind to,

1. Describe the mechanism of action of aspirin, list its major side effects and signs associated with overdose, describe the treatment of aspirin overdose, and list the contraindications to the use of aspirin 2. Describe the major differences in duration of action, key uses and key side effects of aspirin, salicylic acid, diflunisal, indomethacin, ketorolac, ibuprofen, naproxen, meloxicam and celecoxib. 3. Describe the mechanism of action and special considerations for the use of colchicin

(PH-1) Describe rationale for and the mechanism of action of L-dopa and L-dopa plus carbidopa in the treatment of Parkinson disease, list their side effects, and describe the motor fluctuations observed in patients receiving these medications (PH-2) List the prototype indirectly-acting dopamine agonists used in the treatment of Parkinson disease, describe their mechanism of action, and list their major side effects (PH-3) List the prototype MAO and COMT inhibitors used in the treatment of Park

Define dementia. • Identify common types of dementia and their differential features. • Identify other clinical conditions on the differential diagnosis of dementia. • Identify helpful treatment interventions in dementia.

1. Understand the clinical definition, symptoms, and features of delirium. 2. Understand the medical factors that lead to delirium in vulnerable patients 3. Outline strategies for managing delirium

- Compare and contrast acute vs. chronic glaucoma (open angle vs. closed angle) - Define the following degenerative conditions of the eye: Arcus Senilis, Pterygium, Pinguecula, Macular degeneration (wet vs. dry), Cataracts - Describe the pathologic manifestations of diabetic retinopathy. - List the common causes of central retinal artery and vein occlusion. - Describe the clinicopathologic features of 2 common tumors of the eye (melanoma and retinoblastoma) - Define chalazion

• To define diagnostic characteristics and associated features of Impulse Control Disorders & distinguish Impulse Control Disorders from other disorders • To define diagnostic characteristics and associated features Dissociative Disorders & differentiate among them

Be able to choose the correct diagnosis of a specific somatoform disorder, factitious disorder or malingering from an NBME-style vignette Describe the general strategy for managing somatoform disorders in primary care List some assessments that can assist with making a diagnosis of factitious disorder (e.g., C peptide)

1. Describe the impact of substance use on individuals and society 2. Analyze a clinical scenario and choose the correct DSM IV diagnosis for substance abuse and dependence 3. Describe the basic neurobiology and neuroanatomy of reward/reinforcement pertinent to substance use disorders 4. Identify the effects of and treatment of nicotine dependence

1. Describe the impact of alcohol and sedative/hypnotic use on individuals and society 2. Analyze a clinical scenario and choose the correct treatment for alcohol and sedative/hypnotic withdrawal 3. Analyze a clinical scenario and choose the correct treatment for alcohol dependence

1. Describe the absorption, distribution and metabolism of ethanol and methanol. 2. List the pharmacological and toxic effects of ethanol and methanol and the mechanism of action for each effect. 3. Describe the tolerance and physical dependence that develops following chronic ethanol administration. 4. Describe the pharmacological approaches to the treatment of alcoholism. 5. Describe the pharmacological approaches to the treatment of methanol poisoning and the mechanism of action of the ag

• Analyze a clinical scenario and choose the correct diagnosis and/or treatment for Opioid intoxication • Analyze a clinical scenario and choose the correct diagnosis and/or treatment for Opioid withdrawal • Identify the rationale, appropriate patient population, and medication choices for Opioid maintenance treatment

1. Define Eating Disorders and their subtypes 2. Discuss clinical features of Eating Disorders in the framework of malnutrition 3. Discuss common medical complications and management issues of patients with Eating Disorders 4. Outline the risks, clinical manifestations and complications of refeeding syndome

1) Discuss important PE findings you should look for in evaluating patients for headache 2) Be able to identify different types of headache based on presentation: a) Migraine b) Cluster c) Tension d) Cervicogenic e) Rebound f) SOMETHING BAD: Intracranial mass/vascular event 3) be able to identify the red flags of headaches

1. List the prototype methylxanthines, describe their mechanism of action and pharmacological effects, and list their major side effects. 2. List the prototype psychomotor stimulants, cocaine, and nicotine, describe their mechanism of action and pharmacological effects, and list their major side effects. 3. Describe the pattern and nature of abuse observed with psychomotor stimulants, cocaine and nicotine, the degree of tolerance and dependence, and the treatment of the abuse. 4. Describe the

1. List the prototype methylxanthines, describe their mechanism of action and pharmacological effects, and list their major side effects. 2. List the prototype psychomotor stimulants, cocaine, and nicotine, describe their mechanism of action and pharmacological effects, and list their major side effects. 3. Describe the pattern and nature of abuse observed with psychomotor stimulants, cocaine and nicotine, the degree of tolerance and dependence, and the treatment of the abuse. 4. Describe the

1. Identify the signs of intoxication and withdrawal of these agents 2. Name the most prevalent hallucinogens, dissociatives, and novel agents of abuse 3. Describe emerging trends in substance abuse

1) Compare and contrast Partial sz vs Generalized sz 2) Describe the risk factors for developing seizures 3) Identify the conditions that can mimic seizures Describe the work up of new seizure and what labs and tests need to be done Recognize and classify different seizure types Identify common epilepsy syndromes Perform initial evaluation of seizure patients Discuss available treatment options for seizures

1. Analyze a clinical scenario related to an impaired physician and know what course of action to take. 2. Discuss the most common causes of Physician impairment 3. Outline the substances with the most potential for a fatal outcome in physicians.

1. List prototype drugs for the major classes of antiepileptic drugs, describe their mechanism of action, spectrum of antiepileptic activity, and list their major side effects. 2. Describe the metabolism and elimination of the prototype antiepileptic drugs and the possible drug interactions. 3. Describe the signs and symptoms of status epilepticus and its treatment.