Board Vitals Questions Flashcards

Question

Wernickes area

Answer 1

left temporal lobe receptive aphasia - unable to comprehend spoken language - can still speak fluently (doesn't make sense) language development comprehension of speech

Answer 2

caudate and putamen chromosome 4 CAG trinucleotide repeat anticipation huntington - synaptic vesicle-associated protein - accum. of intracellular toxic proteins - degeneration of striatum tx: tetrabenzazine haldol - chorea

Answer 3

Real Time Quaking Index Conversion (RT-QuIC) 6-9mth mortality CSF assay - tau proteins periodic sharp wave complexes (PSWCs) on EEG depression anxiety irritability insomnia

Answer 4

hearing naming visual recognition facial recognition (fusiform gyrus)

Answer 5

integrating sensory information IQ

Answer 6

primary visual cortex?

Answer 7

executive functioning social conduct judgment insight

Answer 8

dorsal columns untreated syphilis ``` sensory ataxia lightening pains urinary incontinence paresthesias diminished/absent reflexes hearing impairment ``` ``` (neurosyphilis) dementia personality change confusion irritability depression visual disturbance Argyll Robertson pupils (accommodate but don't react to light) ```

Answer 9

>70% blockage

Answer 10

``` megaloblastic anemia (MCV >100) GI sx neurologic sx -dementia -numbness -depression -muscle weakness ``` ``` pallor paresthesias decreased reflexes irritability poor concentration ``` posterior and lateral columns can be caused by nitrous oxide abuse

Answer 11

AIDS encapsulated organism India ink test Amphotericin B

Answer 12

medial temporal lobe

Answer 13

early sedative effect deep sleepiness for 3-4hrs increased wakefulness more restless sleep for several hrs

Answer 14

3-4Hz spikes and slow wave complexes

Answer 15

diffuse or anteriorly prominent theta and delta patterns

Answer 16

``` serotonin, NE, dopamine sexual side effects weight gain orthostatic hypotension edema insomnia ``` - ine (also TCAs) - ide (also TCAs) - id - ane - ole - one ``` hydrazine Isocarboxazid nialamide phenelzine hydracarbazine tranylcypromine bifemelane moclobemide pirlindole toloxatone rasagiline selegiline (MAOI-B - dopamine only) safinamide ```

Answer 17

earlier phases of sleep slow phase sleep 10-30% kids - sleep walk 50% kids w/sleepwalking or night terrors develop OSA

Answer 18

antibodies bloc, destroy or inactive postsynaptic neuromuscular acetylcholine receptors thymoma worsens w/exertion ``` diplopia dysarthria dysphagia fatigue muscle weakness ``` edrophonium chloride - Tensilon test (used to diagnose) ``` pyridostigmine plasmapheresis IVIG thymectomy steroids ```

Answer 19

impaired release of presynaptic acetylcholine repetitive muscle exertion may temporarily correct sx

Answer 20

impaired release of presynaptic acetylcholine botulism toxin blocks release of acetylcholine

Answer 21

15% Parkinsons 70% multiple system atrophy 85% Lewy body dementia

Answer 22

``` muscular dystrophy cataracts heart conduction defects endocrine changes myotonia hypersomnia frontal hair loss facial/temporal wasting problems w/executive functioning ``` involuntary contractions w/percussion of muscle ``` autosomal dominant trinucleotide repeat (CTG) ```

Answer 23

<2 hrs - activated charcoal >2hrs - IV sodium bicarbonate (never induce emesis) intubate IV fluids cardiovascular toxicity (widened QRS)

Answer 24

Anton's syndrome deny blindness despite clinical evidence bilateral occipital lobes

Answer 25

``` Alzheimers 60% vascular 15-30% Lewy body 4% frontotemporal 2% Parkinsons 2% all other causes 3% ```

Answer 26

dementia ``` 2 of the following: hypertension/vascular disease cerebral vascular disease subcortical dysfunction -neurogenic bladder -muscular rigidity -gait abnormalities bilateral abnormalities of MRI/CT syncope pseudobulbar palsy ```

Answer 27

``` hypochromic microcytic anemia (MCV <80) lead line in mucosa irritability seizures coma wrist-drop foot-drop peripheral neuropathies hypertension depression ```

Answer 28

smell | emotion

Answer 29

``` dementia amnesia decreased psychomotor movement magnetic gait incontinence ```

Answer 30

tightly blinking eyes grimacing botox injections

Answer 31

impaired visual memory (right) language deficits (medial) mood and sleep-wake-cycle (arterial and medial)

Answer 32

posterior diencephalon lesions: psychosis memory deficits confabulation

Answer 33

``` behavioral issues emotional issues hypersexuality hyperorality hyperplasia ```

Answer 34

``` mitosis (constricted pupils) dec respiration dec bowel sounds nausea vomiting severe itching ``` naloxone

Answer 35

catechol-O-methyltransferase (COMT) inhibitor helps prevent degradation/metabolism of levodopa and dopamine used in PD to reduce peripheral adverse effects of levodopa (has no actions by itself)

Answer 36

``` young males episodic 15 mins - 3hrs nocturnal retroorbital ipsilateral autonomic sx ``` pts prefer moving their head or pacing high flow oxygen triptans (abortive) corticosteroids (bridging) verapamil (prophylaxis)

Answer 37

absence seizures can cause hyperactivity reduces low threshold T-type calcium channels valproic acid is 2nd choice

Answer 38

``` 1% 10% suicide risk 80% 5yr relapse w/o meds 40% 1yr relapse on meds women:men 1:1 chromosome 22 ``` active phase 1mth late onset after 45

Answer 39

``` prolonged sleep latency inc wake time after sleep onset inc early morning awakenings dec total sleep time dec slow wave sleep dec slow wave sleep as % of total sleep time reduced REM latency prolongation of 1st REM sleep period inc REM activity inc REM sleep % ```

Answer 40

longer sleep latency inc freq of awakenings normal REM latency

Answer 41

(midbrain) dopamine production -substantia nigra

Answer 42

``` (interbrain) hypothalamus -control of hormone release -temperature regulation -sexual instincts -control of circadian rhythms (ventrolateral preoptic nucleus VLPO) -hydration ```

Answer 43

histamine arousal promoting itching

Answer 44

acetylcholine sweating

Answer 45

serotonin nausea

Answer 46

norepinephrine arterial vasoconstriction

Answer 47

substantia nigra | -dopamine

Answer 48

norepinephrine sympathetic hyperactivity urine vanillyl mandelic acid (VMA) urine metanephrines adrenal mass

Answer 49

young women follows flu-like illness ovarian teratomas paraneoplastic syndrome ``` psychosis anterograde amnesia hallucinations suicidal ideation dyskinesias autonomic instability ```

Answer 50

remove offending agent

Answer 51

Parkinsons multiple system atrophy Lewy body dementia

Answer 52

Alzheimers | Picks disease

Answer 53

reversible donepezil rivastigmine galantamine tacrine start early continue indefinitely may reduce rate of cognitive decline GI side effects - nausea - vomiting - diarrhea - abdominal cramping - improve w/time

Answer 54

conjugate eye movement

Answer 55

Hypobetalipoproteinemia (low cholesterol) Acanthocytosis (speculated red blood cells) Retinitis pigmentosa (pigment deposits on retina - loss of vision) Pallidal degeneration

Answer 56

slow spikes and waves | or polyspikes and waves

Answer 57

sleepiness despite 7 hrs in main sleep period at least 3x/wk for 3mths

Answer 58

moderate-severe dementia memantine

Answer 59

12-40% geriatric pts 10-15% all pts 37% post op pts 22-33% 3mth mortality rate generalized slow wave and theta/delta waves on EEG

Answer 60

adolescence - stage 3 and 4 peak newborns - 50% REM number of awakenings and amount of"light" stage 1 sleep inc in later adulthood

Answer 61

3x/wk for 3mths cataplexy and/or intrusion of REM sleep into transition between wake/sleep hypnopompic and hypnagogic hallucinations low levels CSF hypocretin (orexin) sodium oxybate (Xyrem) methylphenidate (Ritalin) modafanil (Provigil) structured napping times during the day

Answer 62

levodopa - converted to dopamine in CNS and peripherally carbidopa - reduces peripheral conversion into dopamine (reducing side effects) -inhibits DOPA decarboxylase

Answer 63

arousal sleep-wake cycles memory language

Answer 64

most common - non-small cell lung cancer greatest risk to metastasize - melanoma and small cell lung cancer breast (? 2nd) renal GI cancers

Answer 65

brief loss of vision black curtain coming down internal carotid artery

Answer 66

several headaches in 1 day short (2-30mins) lacrimation conjunctival inaction neck movements trigger episodes women responsive to indomethacin

Answer 67

more trinucleotide repeats = earlier age of onset of sx Huntingtons (CAG) Friedrich ataxia myotonic dystrophy

Answer 68

group A strep kids girls OCD traits irritability restlessness 20-30% pts rheumatic fever

Answer 69

SSRIs = safe | ``` bupropion venlafaxine TCAs? amoxapine clomipramine maprotiline ```

Answer 70

radiating jaw pain electric, shock like pain worsened by cold worsened by trivial stimuli (touching) carbamazepine phenytoin gabapentin (no NSAIDs)

Answer 71

``` 0-2 yrs trust vs mistrust 2-4 yrs autonomy vs shame/doubt (toilet training) 4-5 yrs initiative vs guilt (starting school) 5-12 yrs industry vs inferiority 13-19 yrs identity vs role confusion 20-39 yrs intimacy vs isolation 40-64 yrs generatively vs stagnation 65-death ego integrity vs despair ```

Answer 72

cognitive development birth-2 yrs sensorimotor -object permanence 2-6 yrs pre-operational - egocentrism - rules are fixed - ability to use symbols and language 7-11 yrs concrete operational - conservation of liquids - logic and objectivity - reversibility - transitivity - classification 11yrs-adult formal operations - abstract - hypothetical - major principles - motivations

Answer 73

naltrexoine fluoxetine SSRIs no meds FDA approved

Answer 74

positive reinforcement -add desirable stimulus to increase desired behavior positive punishment -add undesirable stimulus to decrease undesired behavior negative reinforcement -remove undesirable stimulus to increase desired behavior negative punishment -remove desirable stimulus to decrease undesired behavior

Answer 75

2 yrs - parallel play 3 yrs - associative play 4 yrs - cooperative play

Answer 76

``` birth-18 mths oral 18 mths-3 yrs anal 3-5 yrs phallic 5-12 yrs latency 12-15 yrs genital ```

Answer 77

``` haldol pimozide Abilify botox clonidine ``` Seroquel worsens tics

Answer 78

acute phase of Korsakoffs syndrome medical emergency thiamine deficiency confusion ophthalmoplegia ataxia nystagmus delirium amnesia microhemorrhages in periventricular grey matter around ventricles give thiamine BEFORE glucose to avoid worsening of sxs

Answer 79

autistic phase (first weeks) - total detachment - self-absorption symbiotic phase (until 5mths) - recognizes mother - lacks sense of individuality seperation-individuation - hatching (differentiation?) - shows increased interest in outside world - practicing (9-16mths) - develops ability to separate from mother - rapprochement (15-24mths) - explores outside world, but requires mother is present and able to support appropriately and emotionally in completing the task object constancy (2-5yrs)

Answer 80

3 levels of moral reasoning preconventional conventional postconventional

Answer 81

Connors Index Scale SNAP-IV Rating Scale-Revised Vanderbilt Diagnostic Rating Scale

Answer 82

pts w/conversion disorder exhibit sxs similar to someone important to them

Answer 83

subconscious 1-3% of pts w/neuro sis neurologic sxs not solely limited to pain ``` young females low SES rural areas not well-educated lack of concern about sxs ```

Answer 84

pt feigns sxs in order to seek the sick role

Answer 85

pt feigns sxs for secondary gain

Answer 86

cognition affectivity interpersonal functioning impulse control 15% population ``` antisocial - males (1% females) borderline - females histrionic - females dependent - female/neutral avoidant - female/neutral schizoid - male/neutral ```

Answer 87

pervasive pattern of detachment from social relationships restricted range of emotions

Answer 88

3% population pervasive pattern of social and interpersonal discomfort with and reduced capacity for close relationships cognitive or perceptual distortions and eccentricities relatives w/schizophrenia

Answer 89

how easily an individual acts on an initial, emotionally based evaluation of events and people foundation of conscientiousness

Answer 90

stable and realistic sense of self

Answer 91

means of interpreting social situations and understanding the relational motives and actions of others

Answer 92

capacity to observe the self as it relates to others

Answer 93

caused by inadequate soothing in Mahler's symbiotic phase (up to 5mths) and inadequate refueling during separation-individuation (6-24mths) psychoanalysis (Kohut, Kernberg) group therapy

Answer 94

2-3% population 12-15% clinical settings caused by disruption of Mahler's rapprochement (15-24mths) acting out splitting SSRIs antipsychotic mood stabilizer DBT mentalization based therapy

Answer 95

take negative stimulus and associated appropriate emotional response and instead convert negative response into a positive and often productive response

Answer 96

12-16 weeks relaxed/supportive beginning - 1-3 sessions (identify target diagnosis and interpersonal context in which it presents) middle (specific strategies) end - 1-3 sessions focuses on improving relationships in the present (not on what causes sxs) negative interpersonal experiences lead to depression induction of sick role explaining cause of pt's interpersonal problems (beginning phase) complicated bereavement -grief after loss of loved one role dispute -conflict in significant relationships role transition -difficulties adapting to change in relationships or life circumstances interpersonal deficits -difficulties stemming from social isolation or lack of life events (absence of one of the other 3)

Answer 97

focuses on unconscious motivations

Answer 98

using punishment to decrease target behavior

Answer 99

learning response that decreases over time as same stimulus is repeated

Answer 100

decrease in conditioned response due to lack of reinforcement

Answer 101

reward is given every time the target response occurs

Answer 102

responses that produce a satisfying effect in a particular situation are more likely to occur again in that situation response that produce a discomforting effect are less likely to occur

Answer 103

reducing a behavior by repeating the response intensely

Answer 104

behavior that is learned by watching others

Answer 105

individual psychotherapy not overly warm 10-30% psych inpatients

Answer 106

prevent deterioration or reduce complications of disease ACT metabolic monitoring intensive case management

Answer 107

detects diseases early when pts are asymptomatic HIV testing screening prodromal schizophrenia

Answer 108

keeps disease from occurring by removing its causes lifestyle changes immunizations suicide prevention programs

Answer 109

possessed by the individual patient, not the patient

Answer 110

aphasia - disturbance of language (cognitive function) dysarthria - disturbance of speech (motor function)

Answer 111

slurred speech with variable cadence and volume cerebellum

Answer 112

impaired ability to perform rapid, alternating movements cerebellar damage

Answer 113

sensation below umbilicus spastic leg weakness

Answer 114

depression frontal lobe tumor optic nerve compression optic atrophy papilledema

Answer 115

alzheimers disease | presenillin 2

Answer 116

von Hippel-Lindau syndrome

Answer 117

Huntington disease | Parkinson disease alpha-synuclein gene

Answer 118

infantile and juvenile spinal muscular atrophy | Werdnig-Hoffma and Kugelberg-Welander diseases

Answer 119

Creutzfeldt-Jakob disease Parkinson disease, Parkin spinocerebellar ataxia type 1

Answer 120

Williams syndrome

Answer 121

dystonia (early-onset primary dystonia - DYT1) Fredreich ataxia tuberous sclerosis complex 2

Answer 122

phenylketonuria

Answer 123

Wilson disease

Answer 124

Angelman syndrome dyslexia Prader-Willi syndrome Tay-Sachs (hexosaminidase A deficiency)

Answer 125

tuberous sclerosis complex 2

Answer 126

Charcot-Marie-Tooth disease frototemporal lobar degeneration Narcolepsy-cataplexy neurofibromatosis type I

Answer 127

apolipoprotein E familial hemiplegic migraine malignant hyperthermia susceptibility myotonic dystrophy

Answer 128

fatal familial insomnia

Answer 129

homocystinuria myoclonic epilepsy trisomy 21

Answer 130

``` metchromatic leukodystrophy neurofibromatosis type 2 velocardiofacial DiGeorge syndrome schizophrenia ```

Answer 131

``` adrenoleukodystrophy Duchenne muscular dystrophy Fragile X syndrome Lesch-Nyhan syndrome Rett syndrome ```

Answer 132

Fragile X syndrome x linked sex linked

Answer 133

Friedreich ataxia chromosome 9 autosomal recessive

Answer 134

Huntingtons disease - chromosome 4 - autosomal dominant spinocerebellar atrophies - autosomal dominant - type 1 (chromosome 6) - type 2 (chromosome 12) - type 3 (chromosome 14)

Answer 135

myotonic dystrophy chromosome 19 autosomal dominant

Answer 136

oculopharyngeal dystrophy chromosome 14 autosomal dominant

Answer 137

blocks cerebral acetylcholine receptors delirium amnesia anticholinergic effects

Answer 138

inhibit cholinesterase (irreversible) - increases acetylcholine - cholinergic toxicity postsynaptic dysfunction brief stimulation, then paresis of all muscles increased parasympathetic activity confusion seizures ``` Diarrhea Urination Miosis Bradycardia Emesis Lacrimation Salivation/sweating/secretion ``` tx: atropine + pralidoxime

Answer 139

``` weakness hyperreflexia tight muscles clonus Babinski sign ```

Answer 140

``` weakness areflexia paralysis atonia fasciculations ```

Answer 141

position and vibration fasciculus cuneatus fasciculus gracilis

Answer 142

pain and temperature

Answer 143

lack of self-awareness of deficit

Answer 144

neuropathy - damage to nerves outside the CNS myelopathy - damage to the spinal cord

Answer 145

executive functioning color, form, number

Answer 146

anomia (unable to recall names of everyday objects)

Answer 147

fixed-interval -reinforcement for response that occurs after set time fixed-time -reinforcement after fixed time, regardless whether behavior performed fixed-ratio -reinforcement every set number of responses variable interval - reinforcement for responses after varying amounts of time - response varies w/time (checking email throughout the day to monitor for important messages) variable ratio -reinforcement at a varying response rate (slot machines)

Answer 148

switched from high reward to low reward paradoxically weakens behavior more than simply receiving low reward all along

Answer 149

subject denies previously positive reinforcer is no longer valued and cannot be used to strengthen behavior any longer

Answer 150

partial agonist at alpha4beta2 full agonist at alpha 7 binds to receptors avidly, but stimulates receptors more weakly than nicotine, reducing cravings but also limiting the pleasurable effects of smoking

Answer 151

St. Johns Wart antidepressant anxiolytic no (serotonin syndrome) - SSRIs - MAOIs

Answer 152

improves memory | impairs anti platelet memory (causes bruising)

Answer 153

improves immune system

Answer 154

cerebellar damage diabetes insipidus - polyuria (single bedtime dose) - polydipsia (single bedtime dose) - hypernatremia - treat w/amiloride (K sparing diuretic) hyperparathyroidism - decrease lithium clearance - increase lithium levels - -lisinopril - -NSAIDs - -HCTZ - -low sodium diet - decrease lithium level - -high sodium diet level not affected by aspirin insulin-like effect reduces affect of ADH on kidney

Answer 155

``` carbamazepine oxcarbazepine phenobarbital/barbiturates phenytoin oxcarbazepine ethosuxamide steroids progesterone St. John's wort rifampin (lots of r's) ```

Answer 156

``` (lots more) valproic acid nefazodone fluoxetine sertraline fluvoxamine amiodarone cannabinoids diltiazem entacapone erythromycin grapefruit juice omeprazole ranitidine ketoconazole ```

Answer 157

fluoxetine sertraline paroxetine duloxetine

Answer 158

ends at T12-L1

Answer 159

hemitransection of thoracic spine (loss of pain sensation contralateral to paresis) ``` injury to lateral corticospinal tract= ipsilateral -leg paresis -hyperactive DTRs -Babinski sign ``` injury to posterior columns= ipsilateral -impairment in vibration and position sense (proprioception) injury to spinothalamic tract= contralateral -loss of temperature and pain sensation

Answer 160

``` I Olfactory II Optic III Oculomotor IV Trochlear V Trigeminal VI Abducens VII Facial VIII Vestibulocochlear (Acoustic) IX Glossopharyngeal X Vagus XI Spinal XII Hypoglossal ```

Answer 161

``` posterior column abnormalities (sensory loss) Babinski sign limb ataxia scanning speech pes cavus ``` trineucleotide repeat chromosome 6 autosomal recessive

Answer 162

(fastest to slowest) ``` tobacco cigarette spray (10-15mins) inhaler lozenge (20-30mins) gum (30-60mins) patch (2-9hrs) ``` short acting - 3mths

Answer 163

5-HT1A partial agonist at postsynaptic receptors 5-HT1A full agonist at presynaptic receptors mild-moderate presynaptic D2, D3, D4 antagonist partial alpha1 agonist

Answer 164

tetracyclic antidepressant - alpha-2 adrenergic antagonist - increases release of. norepinephrine - histaminic antagonism - -sedation - -inc appetite - -weight gain - 5-HT3 antagonist (anti-nausea) - (also 5-HT2 antagonist)

Answer 165

norepinephrine reuptake inhibitor

Answer 166

``` SIADH hyponatremia elevated LFTs hepatitis decreased WBCs agranulocytosis pancytopenia aplastic anemia Stevens-Johnson ``` check LFTs blockage of type 2 sodium channels

Answer 167

cleft lip cleft palate lower dose w/valproate

Answer 168

neural tube defect 20-30mg/kg loading dose increased by: - cimetidine - macrolide abx (erythromycin) - felbamate decreased by: - carbamazepine - phenytoin - primidone - phenobarbital ``` pancreatitis increased amylase tremor alopecia ankle swelling thrombocytopenia hepatic failure (BLACK BOX) ```

Answer 169

excitatory precursor to GABA learning memory receptors - AMPA - NMDA - kainate

Answer 170

``` confusion hallucinations flaccid paresis abdominal pain red urine ``` Watson-Schwartz test contraindicated (can precipitate/worsen attack) - barbiturates - phenytoin

Answer 171

dopamine-norepinephrine reuptake inhibitor

Answer 172

all typicals 5%/yr 10-20% treated for more than a year 20-40% hospitalized long term women children elderly brain damage less - seroquel - clozaril - geodon

Answer 173

buprenorphine - partial agonist at mu-opiod receptor - antagonist at kappa-opioid receptor naloxone -antagonist at mu-opiod receptor

Answer 174

shortest to longest ``` zaleplon (Sonata) ramelteon (Rozerem) zolpidem (Ambien) / triazolam (Halcion) eszopiclone (Lunesta) temazepam (Restoril) ```

Answer 175

valproate fluoxetine fluvoxamine sertraline

Answer 176

phenytoin carbamazepine phenobarbital rifampin

Answer 177

neutropenia myocarditis eosinophilic colitis fluvoxamine - inc clozapine levels dopamine, serotonin, alpha antagonist

Answer 178

narcolepsy GABA-B

Answer 179

``` venlafaxine - PCP amitriptyline - LSD naproxen - barbiturates sertraline - benzos trazodone - amphetamine ```

Answer 180

1mth sertraline fluoxetine paroxetine CBT

Answer 181

carbamazepine - dec OCPs oxcarbazepine - dec OCPs topiramate >200mg

Answer 182

``` bupropion clozapine theophylline clomipramine clozapine ``` alcohol cocaine stimulants

Answer 183

inc risk of bleeding - reduction of serotonin in plts GI SEs most common in sertraline and fluvoxamine (5HT-3) CNS activation (anxiety, restlessness, tremor, insomnia) most common in fluoxetine sedation most common in paroxetine SIADH most common in fluoxetine akathisia/EPS rare - most common in sertraline

Answer 184

venlafaxine paroxetine escitalopram duloxetine

Answer 185

can interact with - phenelzine - lithium - neuroleptics can cause - irritability - insomnia - mania

Answer 186

vit B6 deficiency - MAOIs - isoniazid (INH)

Answer 187

black box warning - liver failure - suicidality hypotension bradycardia

Answer 188

sedative anesthetic consumed as a beverage should not be used w/benzos, alcohol or barbiturates liver toxicity

Answer 189

dexamethasone | rifampicin

Answer 190

behavioral exchange communication training problem solving

Answer 191

communication analysis - (identify maladaptive communication patterns to help pt communicate effectively) construct a timeline - understand relationship between depression and interpersonal experiences treats depression focuses on current relationships 4 core issues - grief - role transition - role dispute - interpersonal deficits

Answer 192

working through - identify patterns of defense mechanisms and object relations - make the subconscious conscious

Answer 193

``` most widely used depression anxiety schizophrenia not personality disorders ``` identification of dysfunctional cognitions role playing thought mood logs automatic thoughts exposure and response therapy

Answer 194

assumes pts are doing the best they can, and they need to do even better chain analysis patient capabilities group skills training individual therapy phone consultations consultation team

Answer 195

self exploration self instruction self correction self rehearsal

Answer 196

``` hypokalemia elevated BUN hypercholesteremia hyperamylasemia hypomagnesemia hypophosphatemia ``` cardiac arrhythmias osteoporosis lanugo female adolescent perfectionistic

Answer 197

phenothiazine typical antipsychotic nausea vomiting vertigo

Answer 198

Lunesta short acting daytime sleepiness fatigue taste disturbance

Answer 199

relational theory

Answer 200

structural theory

Answer 201

ego psychology | defense mechanisms

Answer 202

transpersonal psychology analytic psychology growth of personality

Answer 203

object relations theory bad mother tension between true and false self paranoid-schizoid position - parts of mother as all good or all bad depressive position - mother ambivalent, having both positive and negative aspects

Answer 204

Kohut (self psychology) - self-object - supportive - transference - -mirroring (affirming/positive responses used to see positive responses in self) - -idealization (calm and soothing other provides comfort when unable to do so for self) Kernberg - confronting - defenses - -splitting - -projectice identification - -primitive idealization

Answer 205

reduce symptoms improve self-esteem and functioning therapist makes suggestions and gives advice

Answer 206

first rank symptoms

Answer 207

coined the term schizophrenia ``` the 4 As loose Associations Affective flattening Autism Ambivilance ```

Answer 208

used the term dementia praecox (created by Morel) classified schizophrenia as a physical disease differentiated schizophrenia from manic-depressive illness

Answer 209

behavioral therapy avoidant personality disorder

Answer 210

unconscious conflict between opposing wishes or between wishes and prohibitions

Answer 211

process that occurs when repressed memory and associated affect is brought into consciousness

Answer 212

contemporary and friend of Freud helped develop theory of hysteria

Answer 213

structural family therapy

Answer 214

apathy | limited spontaneous movement, gesture, speech

Answer 215

depression Broca's area?

Answer 216

dread of cats

Answer 217

follow population over period of time longitudinal study

Answer 218

retrospective | examines persons without a particular disease

Answer 219

some patients get treatment another group does not assigned randomly goal to determine effectiveness of treatment

Answer 220

describe prevalence in a population at a particular point in time

Answer 221

variation of double-blind | placebo and treatment groups switch at some point

Answer 222

good enough mothering transitional object

Answer 223

14 day washout | 28 day for fluoxetine

Answer 224

ideas that are unacceptable to the pt are prevented from reaching awareness

Answer 225

acute inflammatory demyelinating polyneuropathy (AIDP) campylobacter jejnui ascending pain paralysis seonsory loss loss of DTRs in extremities IVIG plasmapheresis

Answer 226

inflammatory disease of the muscle

Answer 227

upper and lower motor neurons damage to anterior horn cells progressive muscle weakness fasciculations wheelchair bound

Answer 228

social learning theory learn through modeling others and social interaction

Answer 229

learned helplessness organism learns that no behavioral change can influence the environment organism becomes depressed and apathetic

Answer 230

difficulty initiating or maintaining sleep 3x/wk for 3 maths

Answer 231

major inhibitory neurotransmitter chloride ion channel

Answer 232

inhibitory

Answer 233

autosomal dominant seizures mental retardation behavioral problems cutaneous lesions facial angiofibromas shagreen spots (irregularly shaped skin lesions on back and flank) retinal haratomas

Answer 234

girls only ``` deceleration of head growth loss of purposeful hand skills stereotyped hand movements loss of social engagement acquired impairments in expressive and receptive language skills seizures ```

Answer 235

trail making test | Wisconsin card sorting test

Answer 236

prolactinomas | NMS

Answer 237

``` delusions obsession compulsions phobias suicidality homicidality neologisms depersonalization derealization ```

Answer 238

``` racing thoughts circumstantial tangential clang associations perseveration word salat goal directed ideas ```

Answer 239

hallucinations

Answer 240

Malaysa sudden rampage homicide/suicide ends in exhaustion/amnesia

Answer 241

Asian delusion penis will disappear into abdomen and cause death

Answer 242

female Eskimos ``` anxiety depression confusion depersonalization derealization ending in stuporous sleep/amnesia ```

Answer 243

Native Americans delusional fear of being turned into a cannibal through possession by a supernatural monster (the Wihtigo)

Answer 244

Mediterranean vomiting fever restless sleep caused by the evil eye

Answer 245

flick middle finger + if other fingers/thumb involuntarily flex + = upper motor neuron damage

Answer 246

+ when chin muscle contracts when thenar eminence contralateral to brain lesion is stroked upper motor neuron damage

Answer 247

devastating stroke to brain stem | brain death

Answer 248

glabeller reflex repeated blinking when tapping on forehead possible Parkinsons

Answer 249

absence of brain stem reflexes - absent gag - fixed pupils - absent oculocephalic reflex - absent oculovestibular reflex - absent corneal reflex eyes can be open or closed EEG doesn't have to be flat line (it's all about the brain stem)

Answer 250

relationship dissolution criticism defensiveness contempt stonewalling

Answer 251

actual self real self idealized self social and cultural influences on psychosexual development

Answer 252

family based therapy | anorexia

Answer 253

taking a small detail out of context and using it to make an entire experience negative

Answer 254

coming to an incorrect conclusion based on a previous experience

Answer 255

all or none | black or white

Answer 256

coming to a generalized conclusion based on a single experience

Answer 257

making events more/less signification based on a negative interpretation

Answer 258

socially unacceptable desire is consciously transformed into a socially acceptable one

Answer 259

Open ended questions Affirmations Reflective listening Summaries expression of empathy rolling with the resistance developing discrepancy supporting self-efficacy

Answer 260

group therapy | behavior therapy

Answer 261

multi systemic therapy family focused community based

Answer 262

obtains sexual arousal from an inanimate object at least 6 months

Answer 263

sexual arousal from crossdressing (not just underwear, full outfits) usually heterosexual men

Answer 264

brief, sharp pain worsened by cold unilateral carbamazepine oxcarbazepine

Answer 265

women: men 3:1 ``` elderly headache fever fatigue myalgia night sweats weight loss jaw claudication ``` irreversible and sudden vision loss ESR sed rate elevated prednisone

Answer 266

pt believes they have a specific serious disease despite negative (or "a serious dx") 6mths 1-5% population chronic waxing/waning

Answer 267

pt has one or more somatic symptoms that are distressing and disrupt daily life not intentionally produced not explained by medical dx (sx can be associated w/another medical condition) 6mths ``` lower level of edication lower SES female older age unemployed ``` tx: therapy only (group and individual)

Answer 268

shortest half life SSRI

Answer 269

autoimmune disease of skin and muscles skin rash on face, eyelids, elbows, knees carcinoma

Answer 270

acute onset mood disorder sx family hx of mood disorders positive sx

Answer 271

``` male no precipitating factors withdrawn family hx of schizophrenia negative sx neurological sx hx of perinatal trauma no remissions in early years many relapses hx of assaultiveness ```

Answer 272

clonidine phentolamine (HTN) dicyclomine (Bentyl)

Answer 273

preponderance of the evidence 50% - civil cases, competency reasonable medical certainty 50.1% - more likely than not - expert witness clear and convincing 75% - civil commitment beyond a reasonable doubt greater than 90% - criminal cases

Answer 274

2yrs - gender constancy 3yrs - gender identity 5-7yrs - rigid/inflexible

Answer 275

triangle of conflict defense work forming a portrait to resolve dynamic pathologic defenses

Answer 276

anxiety provoking therapy | therapist acts as a teacher

Answer 277

intensive short-term dynamic psychotherapy

Answer 278

existential therapy | therapist acts as empathetic helper

Answer 279

oralism paraphilia only aroused by/can only achieve orgasm through a single type of sexual contact

Answer 280

paraphilia sexual arousal from enemas

Answer 281

sexual identity patter of a person's biological sexual characteristics (usually no doubt about male vs female) gender identity a person's sense of maleness or femaleness sexual orientation who someone is attracted to sexually (male vs female vs both) sexual behavior who someone actually has sex with (male vs female vs both)

Answer 282

girls 8-10yrs | boys slightly older

Answer 283

Korea similar to somatization do middle aged females psychosocial stress

Answer 284

desipramine imipramine nortriptyline all are cyp 2D6 substrates

Answer 285

CBT more common in women 7.8% lifetime prevalance >1mth no way to predict who gets it no improvement w/debriefing decreased hippocampal volume FDA: sertraline paroxetine 2nd generation antipsychotics venlafaxine? other SSRIs? Benzos slow recovery rate

Answer 286

risk factors - childhood neglect - abuse family hx - OCD - mood dos tx: - SSRIs - MAOIs - TCAs chronic body part may change

Answer 287

trisomy 21 - most common fragile X - 2nd most common, most common heritable

Answer 288

blocks dopamine reuptake dopamine and NE reuptake inhibition increases dopamine?? ``` hyper sexuality shower of lights tactile hallucinations (coke bugs) hyperthermia (OD) hypertension (phentolamine) ``` crack coca freeze girl happy dust

Answer 289

can treat Parkinson's pergolide bromocriptine pramipexole ropinirole buspirone - partial agonist (???)

Answer 290

inhibits serotonin and norepinephrine reuptake 5-HT agonist

Answer 291

partial dopamine D2 agonist partial 5-HT 1A agonist 5-HT 2A antagonist (as are all atypicals)

Answer 292

lesion to left - depression lesion to right - mania

Answer 293

autosomal recessive chromosome 13 incorporation of copper into ceruloplasmin diminished biliary excretion of copper excessive deposition of copper in the brain -basal ganglia serum ceruloplasmin ``` Parkinsonism flapping tremor ataxia dystonia dysphagia dysarthria liver failure ```

Answer 294

reward center | also VTA

Answer 295

null hypothesis rejected when it should have been retained

Answer 296

null hypothesis retained when it should have been rejected

Answer 297

probability of finding the difference between two samples probability of rejecting the null hypothesis when it should be rejected

Answer 298

``` cocaine - 8hrs alcohol - 12hrs amphetamine - 48hrs heroin - 72hrs PCP - 8days cannabis - 4wks ```

Answer 299

grinding teeth amphetamines MDMA (ecstasy)

Answer 300

``` reddened conjunctivae tachycardia dry mouth orthostatic hypotension anxiety panic attacks ```

Answer 301

bruxism dilated pupils tenting of skin serotonin reuptake inhibitor ``` ecstasy Adam club drug disco biscuits love drug ```

Answer 302

mild 2-3 moderate 4-5 severe 6

Answer 303

encephalopathy ataxia visual loss tachypnea hemorrhage of putamen

Answer 304

alcohol withdrawal with AVH | clear sensorium

Answer 305

``` N/V/D yawning perspiration runny nose dilated pupils twitching muscles ```

Answer 306

``` alcohol cannabis opioids inhalants benzos ```

Answer 307

amphetamine | cocaine

Answer 308

LSD MDMA cannabis

Answer 309

PCP | ketamine

Answer 310

opioid antagonist

Answer 311

NMDA antagonist structurally resembles GABA reduces EtOH cravings tid dosing give after ~1wk no EtOH

Answer 312

aldehyde dehydrogenase inhibitor if drink EtOH, N/V/HTN/HA/flushing must abstain from alcohol for several days - 1 week prior to use (minimum 12hrs) 500mg qd x1-2wks then 250mg qd

Answer 313

increased body temp tachycardia hypertension dilated pupils

Answer 314

``` nystagmus agitation hypertension tachycardia diminished pain slurred speech ataxia muscle rigidity seizures hyperacusis (inc sensitivity to certain frequencies) catatonia ``` angel dust belladonna black whack use benzos for agitation NMDA antagonism

Answer 315

``` crank crystal ice speed crystal meth ```

Answer 316

``` cat valium special K vitamin K kit kat honey oil ``` derivative of PCP

Answer 317

women - lower adjusted body water - higher fat content - lower alcohol dehydrogenase in gastric mucosae

Answer 318

initial dose 10-20mg | goal dose 60-100mg

Answer 319

glue inhalant glue-sniffer neuropathy similar to Guillain-Barre sx bluish discoloration decrease temperature extremities facial numbness vision loss

Answer 320

masturbation | coitus interuptus

Answer 321

psychotic sx with 4wks of noticeable changes confusion good fx prior to sx absence of flat affect

Answer 322

thalamic nucleus | visual/retina

Answer 323

thalamic nucleus | face sensory

Answer 324

thalamic nucleus | leg and arm sensory

Answer 325

thalamic nucleus | cerebellar

Answer 326

thalamic nucleus | auditory

Answer 327

treats anticholinergic toxicity similar to NMS/serotonin syndrome lack of diaphoresis

Answer 328

``` prenatal malnutrition radiation during 1st trimester maternal influenza during pregnancy family childhood stress winter/spring births ```

Answer 329

men (mean 20-28) -10-25 women (mean 26-32) - early 20s - early 30s - early 60s

Answer 330

high antipsychotic doses moderate anticholinergic doses extended hospitalization nicotine

Answer 331

first 1 mth fever flu like sx never rechallange

Answer 332

first coined dementia praecox

Answer 333

suppress information

Answer 334

pt feels like he/she is dead (or a zombie)

Answer 335

erotomania

Answer 336

1% population 2.8-8.2% 1st degree relative 13% parent (10x) 40% monozygotic twin

Answer 337

``` dec blood flow to frontal lobes brain volume deficit increased vol of lateral and 3rd ventricles and basal ganglia smaller hippocampus decreased activity in frontal lobes ```

Answer 338

7-17% psychosis | 13-31% mood disorders

Answer 339

Stelazine | atypical antipsychotic

Answer 340

treat w/bromocriptine/dantrolene (if not responding to supportive care within 24-48hrs) increased muscle tone hyperthermia elevated CPK

Answer 341

schizoaffective disorder

Answer 342

less than 1 month

Answer 343

more than 1 month | less than 6 months

Answer 344

misinterpretations of actual stimuli hear a dog barking, but interpret it as a person saying something

Answer 345

abnormal postures difficulty talking drooling

Answer 346

no difference in rates of hospitalizations and EPS between meds olanzapine highest metabolic effects clozapine most effective discontinuation rates all similar (longest was olanzapine, but most side effects) no difference between 1st and 2nd generation meds risperidone quetiapine ziprazidone perphenazine

Answer 347

higher in women

Answer 348

higher in postmenopausal women normal in men lower in premenopausal women

Answer 349

1,500 begin daily ANC monitoring until >1,000 (may then consider restarting)

Answer 350

male:female 3:1

Answer 351

dopamine prolactin amenorrhea galactorrhea hypothalamus to anterior pituitary

Answer 352

anxiety disorders

Answer 353

at least 5 ``` preoccupation w/gambling gambling increased sums of money attempts to quit gambling to escape dysphoric mood lying to SOs about gambling loss of important relationships illegal acts to be able to gamble relying on others to pay bills desire to keep going back to break even ```

Answer 354

MS | medial longitudinal fasciculus

Answer 355

experience of unreality, detachment or feeling like an outside observer to your own body, actions, sensations, thoughts or feelings

Answer 356

experience of unreality or detachment to you own surroundings experienced as unreal, dream-like, foggy, lifeless or visually distorted

Answer 357

inability to recognize neurological deficit occurring in oneself

Answer 358

most common inflammatory demyelinating disease onset 15-50yrs optic neuritis - eye pain increased w/movement - central visual loss (scotoma) - afferent pupillary defect (Marcus Gunn pupil) (swinging flashlight test) internuclear ophthalmoplegia fever worsens sxs (Uhthoff's phenomenon) fatigue Lhermitte's sign - electric shock down spine w/neck flexion steroids interferon

Answer 359

calluses on the back of the hands due to self induced vomiting bulimia

Answer 360

``` six cafe-au-lait spots axillary/inguinal freckling optic glioma 2 or more neurofibromas 1st degree relative w/NF1 2 or more Lisch nodules (hamartomas of the iris) bony lesions ```

Answer 361

bilateral acoustic schwannomas

Answer 362

vitamin B1

Answer 363

1/3 - fetal alcohol syndrome inc risk of ADHD small for gestational age

Answer 364

extroverted SSRIs stimulants CBT

Answer 365

ANC 1,000-1,499 - inc freq of monitoring to 3x/wk until 1,500 - then restart at last normal dose/ANC monitoring level ANC 500-999 - interrupt clozapine until level resolves - daily ANC until 1,000 - 3x/wk until 1,500 - then check weekly x4wks - then restart at last normal dose/ANC monitoring level ANC below 500 - stop clozapine - daily ANC until 1,000 - 3x/wk until 1,500 - may rechallange if ANC recovers (consider risks/benefits) - resume as new pt ``` baseline ANC ANC every wk x6mths ANC every 2wks x6mths ANC every mth forever ANC every wk x4wk after stopping ```

Answer 366

central pontine myelinolysis acute locked in syndrome

Answer 367

``` black fat fertile 30s OCPs tetracycline ``` visual field defects headaches waxing/waning lumbar puncture opening pressure over 20 acetazolamide

Answer 368

within 3hrs of stroke exclusion criteria - seizure - hemorrhage - major surgery past 3mths - glc abnormalities - recent MI - anticoagulants - thrombocytopenia

Answer 369

ropinirole (Requip) | dopamine agonist

Answer 370

decreased levels of serotonin in CSF dopamine - inc aggression serotonin/NE/GABA - dec aggression

Answer 371

``` autosomal recessive chromosome 22 deficiency in arylsulfatase A (ASA) lysosomal storage disease death by age 5 ``` ``` gait disorder hypotonia lower limb areflexia dementia behavioral problems ```

Answer 372

not in DSM (with season pattern specifier in DSM) sx must remit during other seasons light therapy tx - carb cravings - most effective in AM - can precipitate hypomania

Answer 373

cytomegalovirus

Answer 374

AIDS ``` clumsiness progressive weakness visual changes speech changes personality changes ```

Answer 375

uncontrollable, excessive talking

Answer 376

difficulty recognizing and describing one's emotions

Answer 377

``` constipation anticholinergic sxs orthostatic hypotension sedation tremor prolonged QTc & PR tachycardia ```

Answer 378

L1/L2/L3 - hip flexion L3/L4 - leg extension L5 - foot flexion S1 - foot extension, ankle jerk

Answer 379

internal capsule lacunar stroke

Answer 380

internal capsule

Answer 381

weight gain | sedation

Answer 382

``` constipation blurred vision dry mouth drowsiness urinary retention cognitive dysfunction ```

Answer 383

orthostatic hypotension | drowsiness

Answer 384

antipsychotic effects EPS prolactin elevation

Answer 385

contralateral subthalamus

Answer 386

``` dopamine epinephrine NE acetylcholine serotonine histamine ```

Answer 387

production -choroid plexus drainage into blood -arachnoid granulations

Answer 388

measles ``` personality changes myoclonic seizures choreoathetoid movements difficulty swallowing death - 12mths ``` CSF assay (measles Ab) EEG brain biopsy

Answer 389

x-linked recessive self-mutilation

Answer 390

contraindicated in liver disease withdrawal sx fibromyalgia

Answer 391

mania/hypomania screener

Answer 392

bimodal 15-24 45-54

Answer 393

bipolar disorder

Answer 394

depression psychosis hypothyroidism

Answer 395

mania | mercury intoxication

Answer 396

amoxapine (D2 antagonist) maprotiline mirtazapine

Answer 397

``` port-wine nevus brain angioma ipsilateral to skin nevus contralateral hemiparesis MR homonymous meiagopia glaucoma seizures ```

Answer 398

``` erythromycin clarithromycin alprazolam diazepam midazolam cyclosporine diltiazam nifedipine amlodipine verapamil atorvastatin simvastatin aripiprazole buspirone haloperidol tamoxifen trazodone propranolol zolpidem zaleplon methadone OCPs progesterone testosterone fentanyl ```

Answer 399

lowers levels of ``` amitriptyline fluvoxamine clozapine olanzapine haloperidol imipramine ```

Answer 400

``` postpartum pituitary hemorrhage chiasmal compression bitemporal hemianopsia severe headache ``` failure to lactate

Answer 401

adrenocorticotropic hormone pituitary gland dexamethasone suppression test

Answer 402

propranolol primidone benzodiazepines botox

Answer 403

AMPA kainate NMDA

Answer 404

elderly | female

Answer 405

25% 6mths 30-50% 2yrs 50-75% 5yrs

Answer 406

I - duty to warn | II - duty to protect

Answer 407

not criminally responsible if act was product of mental illness or defect

Answer 408

desipramine protriptyline nortriptyline

Answer 409

ptosis diplopia inability to adduct eye diabetes (benign) -pupil spared internal carotid artery aneurynm (potentially fatal) -dilated pupil

Answer 410

post traumatic dementia apo E4 chromosome 19

Answer 411

``` clomipramine fluoxetine fluvoxamine paroxetine sertraline ``` med+CBT

Answer 412

involves relaxation techniques

Answer 413

carried out in real situation

Answer 414

CBT pt is encouraged to consider possible alternate causes for events

Answer 415

desipramine protriptyline (myoclonic twitches)

Answer 416

no absolute contraindications ``` brain tumors aneurysms recent MI increased ICP uncontrolled HTN ```

Answer 417

OCPs MAOIs clozapine (bone marrow suppression)

Answer 418

bell pad imipramine desmopressin

Answer 419

- reversible anterograde and retrograde amnesia - inability to learn new info - retain personal info/identity ask same question repeatedly men 50s or older acute several hours

Answer 420

borrelia burgdorferi ixodes dammini ixodes pacificus mimics neuro conditions - meningitis - Bell's palsy - Guillain-Barre rash

Answer 421

middle meningeal artery temporal or parietal areas LOC then lucid younger

Answer 422

meningeal bridging veins crescent shape older alcoholics

Answer 423

marked lymphocytosis increased protein decreased glucose

Answer 424

mild-mod lymphocytosis normal-mild inc protein normal glucose

Answer 425

mees lines -white lines in finger nails N/V/D hypotension tachycardia tx: chelation

Answer 426

compares two groups and determines if the differences are due to experimental influence or chance multiple binary predictor variables one continuous outcome variable

Answer 427

uses data to predict the value of one variable in relation to another two continuous or binary variables one continuous outcome variable

Answer 428

depression ``` suicidality worthlessness anger/ambivalence toward deceased social contacts don't help person isolates others find depressed person irritating/annoying ``` bereavement pt evokes sympathy from others

Answer 429

autosomal recessive chromosome 12 phenylalanine hydroxyls deficiency ``` mousy odor microcephaly infantile spasms light hair/skin MR ```

Answer 430

parkinsonian sxs EPS sxs substantia nigra to basal ganglia

Answer 431

negative sxs ventral tegmental area to frontal cortex

Answer 432

positive sxs ventral tegmental area to nucleus accumbent

Answer 433

measurement of direction and strength of relationship between 2 variables

Answer 434

tyrosine hydroxylase -rate limiting step dopamine - NE - epinephrine

Answer 435

malingering prison giving approximate answers believes sxs are real

Answer 436

brief postictal paralysis 48hrs contralateral to sz focus

Answer 437

triphasic waves - EEG | asterixis

Answer 438

alpha 2 agonist | decreases NE released

Answer 439

amygdaloid bodies hyper sexuality hyperoralitu placidity

Answer 440

comorbid - fire setting - substance use - eating disorders tx: - mood stabilizers - SSRIs - TCAs

Answer 441

immobile position constantly maintained (catatonia)

Answer 442

repetitive fixed pattern of movement or speech

Answer 443

ration of incidence in those with risk factors to the incidence in those without risk factors

Answer 444

absolute incidence in pts exposed to condition that can be attributed to exposure

Answer 445

``` lower % stage 3 sleep decreased delta waves more stage 1/2 sleep less total REM sleep more REM episodes shorter REM episodes increased awakenings ```

Answer 446

increases NMS

Answer 447

poverty of speech and thought content

Answer 448

separation from mother protest despair detachment/denial of affection

Answer 449

oral - dependency anal - obsessive compulsive phallic - poor resolution of Oedipal complex

Answer 450

``` animal natural enviornment blood injection injury situational other ```

Answer 451

glioblastoma multiforme

Answer 452

most common CNS cancer - lymphoma - -Epstein Barr most frequent CNS opportunistic infection -toxoplasmosis most common spinal cord pathology -vacuolar myelopathy

Answer 453

hypokalemia hyperchloremia pancreatic inflammation esophageal erosion

Answer 454

prion disease | endemic to cannibalistic Fore people

Answer 455

herpes simplex virus facial nerve palsy steroids acyclovir

Answer 456

breast lung prostate

Answer 457

Young Mania Rating Scale

Answer 458

relapsing-remitting -sxs clear, then return primary-progressive -sxs do not clear, new ones appear secondary-progressive -initial relapsing-remitting course, then new sxs

Answer 459

``` dysphagia dysarthria ptosis diplopia urinary retention ``` ``` infants/honey weak cry lethargy floppiness poor suck constipation ```

Answer 460

pt does not give effort in unaffected leg when asked to push down with affected leg (feigning)

Answer 461

carbamazepine SSRI decreased urine output

Answer 462

TCAS venlafaxine bupropion nefazodone

Answer 463

niacin deficiency vitamin b3 dementia dermatitis diarrhea

Answer 464

tics - Tourettes dopamine antagonist

Answer 465

psychosis | schizophrenia

Answer 466

``` Mellaril retrograde ejaculation low EPS anticholinergic orthostatic hypotension ```

Answer 467

granulomatous disease multiple organs peripheral neuropathy facial nerve palsy

Answer 468

``` isolation of affect undoing reaction formation intellectualization rationalization ```

Answer 469

propranolol | alpha-methyldopa

Answer 470

no antipsychotics cholinesterase inhibitor lower dose of antiparkinson med

Answer 471

at least 3 somatic sxs - restlessness - fatigue - difficulty concentrating - irritability - muscle tension - sleep disturbance excessive worry multiple events 6mths

Answer 472

OCD | specific phobia

Answer 473

substance use

Answer 474

NMS - muscle rigidity - high CPK serotonin syndrome - clonus - GI sx - hyperreflexia

Answer 475

visual hallucinations fluctuating cognition Parkinsonism REM sleep behavior do neuroleptic sensitivity low uptake in basal ganglia

Answer 476

obligation to work in pts best interest

Answer 477

help pts and relieve suffering

Answer 478

cerebellar atrophy truncal ataxia (vermis) gait unsteadiness wide-based gait

Answer 479

one binary predictor variable | one continuous outcome variable

Answer 480

one binary predictor variable | one binary outcome variable

Answer 481

two possible values yes/no positive/negative female/male

Answer 482

falls somewhere on a range height weight age

Answer 483

one continuous predictor variable | one continuous outcome variable

Answer 484

``` pectus excavatum ocular lens dislocation Marfan's habitus mental retardation scoliosis ``` error of amino acid metabolism

Answer 485

displacement | repression

Answer 486

hypochondriasis | introjection

Answer 487

thalamic lesions/strokes | posterior cerebral arteries

Answer 488

``` difficulty w/attention and concentration bradyphrenia (slowed thought) social withdrawal apathy depression fatigue ``` gait incoordination rigidity slowness of gait fine and skilled hand and finger movements affected

Answer 489

- depigmentation and neuronal loss of substantial nigra - presence of Lewy bodies - dopaminergic under activity in the striatum - 60-85% of stratal dopamine neurons must be lost before sxs - asymmetrical early in disease - bilateral later in course - levodopa-carbidopa mainstay tx - dopamine agonists - MAOIs - anticholinergics

Answer 490

``` fatigue agitation depression delirium dementia psychosis paranoia ```

Answer 491

heavy alcohol use women childhood trauma perception of an external locus of control (natural cause) (not human cause) borderline personality do paranoid dependent antisocial very old very young

Answer 492

increase carbamazepine levels

Answer 493

deep, burning pain worsened by light touch follows herpes zoster (shingles) gabapentin

Answer 494

women continuous headache indomethacin

Answer 495

Creutzfeld-Jakob disease kuru (New Guinea) Gerstmann-Straeussler-Scheinker syndrome fatal familial insomnia

Answer 496

declarative memory recall of personal facts what you ate for dinner what you did on vacation

Answer 497

declarative memory recall of general facts who was 1st president difference between bus/train

Answer 498

how to drive | how to type

Answer 499

retention and recall of facts semantic episodic

Answer 500

women higher than men OCD equal

Answer 501

slow sustained twisting movement of the limbs, trunk, neck | tardive dyskinesia - choreoathetoid movement, involuntary, irregular

Answer 502

dx based on general consensus among clinicians and researchers

Answer 503

dx based on characteristic features that distinguish it from other disorders

Answer 504

dx will allow clinicians to accurately predict tx response and clinical course

Answer 505

dx based on understanding of underlying pathophysiology

Answer 506

SSRIs SNRIs atomoxetine

Answer 507

positive and negative sx scale psychosis

Answer 508

onset within 4wks

Answer 509

repetition of one's own speech

Answer 510

GB -lower motor neuron signs TM - upper motor neuron signs - loss of bowel/bladder control

Answer 511

lamotrigene

Answer 512

valproic acid | carbamazepine

Answer 513

A- studies show no human risk B- animal studies show no risk C- animal studies show risk D- human fetal risk seen (may use in life-threatening situations) E- proved fetal risk (no indication even in life-threatening situations)

Answer 514

specific phobia also most common mental disorder among women 2nd most common in men (after substance use)

Answer 515

correlates with ethnicity set of meanings, norms, beliefs, values, behavior patterns shared by a group of people taught, passed on way of life/customs

Answer 516

people grouped based on outer appearance biologic and genetic underpinnings

Answer 517

subjective sense of belonging to a group of people with a common national or regional origin shared believes, value and practices, including religion common heritage, ancestry, history

Answer 518

reabsorbed in proximal tubules w/Na ``` decrease Na (low Na diet, HCTZ) increase reabsorption ```

Answer 519

heart probs tachycardia inc LFTs skeletal muscle atrophy

Answer 520

logical, analytical

Answer 521

creative, emotional, intuitive

Answer 522

epigenetic principle each stage must be properly resolved for development to proceed normally

Answer 523

inclusion body myositis - men - worse on one side - most common polymyositis - women - symmetrical - follows flu like illness dermatomyositis -women -skin involvement symmetrical

Answer 524

bradycardia insomnia 4 sxs w/in 24 hours - DSM

Answer 525

within 3 hours of sx onset - neuro deficit - no hemorrhage on CT exclusion: - improving neuro deficit - seizure - prior intracranial hemorrhage - blood glc high or low - GI or GU bleed in past 3wks - recent MI - anticoagulants - thrombocytopenia - major surgery past 3mths - stroke/head injury past 3mths - arterial puncture past 7days - BP over 185/110

Answer 526

PCP inhalants alcohol sedative hypnotics

Answer 527

- coma (may retain spinal reflexes) - no spontaneous respirations - absence of brain stem reflexes (pupillary, oculocephalic, corneal, gag) - EEG silence (isoelectric not mandatory) - absence of cerebral blood flow - absence of reversible causes - positive apnea test (necessity)

Answer 528

``` phase II (phase I = oxidation/cyp) ``` lorazepam oxazepam temazepam

Answer 529

50% - affective dos (MDD, bipolar) 25% - substance abuse 5% - personality dos 4-10% borderlines complete 5% antisocials complete 5-10% schizophrenics complete affective dos 30x risk

Answer 530

agranulocytosis ``` carbamazepine phenytoin propylthiouracil sulfonamides captopril ```

Answer 531

pheochromocytomoa cocaine hypertension MAOI hypertensive crisis

Answer 532

``` poverty psychosocial stress less parental education underemployment poor housing single parenting welfare reliance many children physical handicap MR prematurity parental mental illness parents substance abuse social isolation domestic violence ```

Answer 533

substitutes both/and for either/or sees truth as an evolving product of the opposition of different views seeking synthesis between seemingly contradictory ideas and emotions

Answer 534

perpetration at least 16 at least 5yrs difference prepubescent child (13 or younger) do not include late adolescent w/12yo or 13yo

Answer 535

at least 4yo at least monthly x3mths more common in boys correlates with: sexual abuse maternal hostility punitive/harsh parenting

Answer 536

pregnancy category D

Answer 537

quantifies degree of agreement between two raters in a study tells whether test produces reliable/reproducible results

Answer 538

- communicate a choice - understand info presented - understand how info related to own circumstances - reason in logical manner (even if most people wouldn't agree w/decision)

Answer 539

planning for future inner discomfort mature defense

Answer 540

indulging in autistic-like retreat to resolve conflict interpersonal intimacy avoided by driving others away w/eccentricity immature defense

Answer 541

depression psychosis mania OCD?

Answer 542

making something unconscious conscious links feeling, thought, behavior, symptom to its unconscious meaning

Answer 543

reformulating what pt has said to create coherent view of what has been communicated

Answer 544

hypomania depressive sxs that do not meet criteria for MDD at least 2yrs

Answer 545

fear of being in places or situations that may be difficult to escape from

Answer 546

learn to avoid certain painful stimuli by avoiding certain behaviors dont go to crowded mall lobby bc it causes panic attacks variation of negative reinforcement

Answer 547

DBT mentalization therapy transference-focused psychotherapy (Kernberg)

Answer 548

1 intrusion sx (nightmares) 1 avoidance sx (restricted affect?) 2 increased arousal sxs 2 negative cognition/mood sxs

Answer 549

neutral stimulus (conditioned) (chainsaw) paired with a stimulus that evokes a response (unconditioned) (fire) in time, neutral stimulus elicits same response as as unconditioned stimulus

Answer 550

voluntary behavior is modified as pt actively tries different behaviors to see which will deliver desired reward

Answer 551

behavior engaged in at high frequency (things we like to do) can be used to reinforce behavior that occurs at a low frequency (things we don't like to do)

Answer 552

``` CBC CT (suspicion of sx or tumor) EKG CXR? dental exam in elderly spine X-ray (if spinal disease) ```

Answer 553

most common: methohexital (Brevital) don't use due to inc sz threshold: propofol

Answer 554

glioma cushings disease MS

Answer 555

``` isoniazid cimetidine metoclopramide steroids bronchodilators antidepressants anticonvulsants stimulants barbiturates drugs of abuse ```

Answer 556

using verbal and nonverbal cues to encourage pt to keep talking

Answer 557

tries to get more details about what the pt has already said

Answer 558

- early age of onset - lack of guilt/shame - high frequency of acts - substance use - no coitus w/paraphilic act - low IQ - personality dos - lack of attachment/relationships - axis I do - multiple paraphilias

Answer 559

- CBT - insight-oriented psychotherapy - anti androgens - twelve step programs - sex therapy

Answer 560

wish to have body of another sex

Answer 561

in between genders; both genders; neither gender

Answer 562

competence to be executed

Answer 563

unintelligible jargon that has meaning to the speaker but not the listener

Answer 564

meaningless and stereotyped repetition of words or phrases

Answer 565

reduction in quality of spontaneous speech

Answer 566

pt believes reality of fantasies and acts on them

Answer 567

BMI 17 mild 16 moderate 15 severe <15 extreme

Answer 568

nighttime panic attacks

Answer 569

head banging during sleep

Answer 570

5-HT 2A antagonism help w/negative sxs

Answer 571

``` SLE temporal lobe epilepsy neurosyphilis Wilsons disease AIDS B12 deficiency heavy metal poisoning delirium dementia Huntingtons pellagra tumor stroke/bleed herpes encephalitis autism ```

Answer 572

``` past violent behaviors battered, underprivileged child low education poor family supports unstable housing unemployed poor coping skills lack of resources ```

Answer 573

hypersomnia increased appetite weight gain (= reversed vegetative sxs) tx: MAOIs

Answer 574

CBT | graded exercise therapy

Answer 575

``` pulse BP height weight physical exam ``` EKG only if concern for cardiac issues

Answer 576

Vyvanse - prodrug, not active is snorted, crushed, injected Concerta, Metadate ER - extended release

Answer 577

``` age over 70 male alcohol abse smoking recent surgery brain damage/disease diabetes cancer blindness malnutrition intoxication/withdrawal ```

Answer 578

``` narcotic painkillers steroids anesthetics antineoplastic agents anticholinergics antibiotics antifungals antiviral agents ```

Answer 579

reticular formation (attention and arousal) dorsal tegmental pahtway mesencephalic retircular formation - tectum and thalamus

Answer 580

NE (inc) serotonin acetylcholine (dec) glutamate

Answer 581

delirium - background slowing triphasic waves - hepatic encephalopathy PLEDs - herpes simplex virus encephalitis temporal lobe spikes - temporal lobe epilepsy hypsarrhythmia - infantile spasms

Answer 582

torsades de pointes

Answer 583

depression | PTSD

Answer 584

conversion do - neuro sxs (motor or sensory) - la belle indifference - acute/pts recover somatic sx do - somatic/physical sxs and maladaptive thoughts - histrionic about sxs - chronic/relapsing-remitting - both involuntarily produced - both could involve pain

Answer 585

5 days after short acting narcotic 10 days after long acting narcotic

Answer 586

buprenorphine/naloxone 8/4, 2/0.5 typical maintenance doses: 4-16mg qd

Answer 587

``` insomnia irritability restlessness depression nervousness anxiety muscle twitches sweating ```

Answer 588

5 sxs | 1 must be depressed mood or loss of interest

Board Vitals Questions Flashcards

(633 cards)