First Aid Psychiatry: Neuro

Question 1

What is the ICU triad

Answer 1

delirium
pain
agitation

Question 2

is delirium a medical emergency

Answer 2

yes

Question 3

Most common precipitants of delirium in children are

Answer 3

febrile illness and medications

Question 4

EEG for delirium

Answer 4

diffuse slow EEG

Question 5

what does EEG show for delirium tremens

Answer 5

nothing

Question 6

quick bedside am for substance/medication intoxication

Answer 6

VALEUMS
vitals
alertness
Eyes
Urine 
mucous membrane
skin

Question 7

what happens to memory in delirium

Answer 7

deficits in recent memory

Question 8

What is used to rule diagnose delirium

Answer 8

Confusion Assessment Method

Question 9

How is delirium treated

Answer 9

treat the underlying cause

Question 10

drug of choice for Delirium

Answer 10

Haloperidol

Question 11

what drugs are contraindicated in delirium

Answer 11

second generation antipsychotics

Benzodiazepines (only used in alcohol delirium)

Question 12

Name 2 tests for diagnosis for neurocognitive disorder

Answer 12

Mini Mental State Exam

Mini-Cog

Question 13

how does hyperthyroidism show in the elderly

Answer 13

apathetic thyrotoxicosis: depression and lethargy

Question 14

Most common underlying etiology of major neurocognitive disorder

Answer 14

Alzheimer

Question 15

cognitive domains impacted by Alzheimer

Answer 15

memory
learning
language

Question 16

what is found in brain of Alzheimer

Answer 16

senile plaques and neurofibrillary tangles

• extraneural beta-amyloid plaques
• intraneural tau protein tangles

Question 17

how does Alzheimer start

Answer 17

gradual cognitive decline

Question 18

genes predisposing to Alzheimer

Answer 18

Amyloid precursor protein
presenilin 1
Presenilin 2
EPO4

Question 19

treatment for Alzheimer

Answer 19

1. Cholinesterase inhibitors
2. NMDA receptor antagonist
3. antipsychotics: increased mortality

Question 20

antipsychotics carry a black box warning for what in patients with dementia

Answer 20

increased risk of death

Question 21

how does vascular disease present

Answer 21

complex attention and executive function

• stepwise deterioation
• acute onset follow by partial improvement
• insidious onset with gradual decline

Question 22

core features of Lewy Body

Answer 22

1. waxing and waning of attention and alertness
2. visual hallucinations
3. extrapyramidal signs

Question 23

Suggestive features of Lewy body

Answer 23

• REM sleep behavior disorder

- antipsychotic sensitivity

Question 24

pathology of Lewy Body

Answer 24

Lewy bodies: alpha-synuclein
Lew Neurites
- both in basal ganglia

Question 25

treatment Lewy Body

Answer 25

1. cholinesterase inhibitor 2. Quetiapine or clazapine 3. levodopa/carbidopa 4. Melatonin/clonazepam

Question 26

clinical manifestation for Frontotemporal degeneration

Answer 26

cognitive deficits in attention, abstraction, planning, and problem solving - difficult speech and comprehension

Question 27

treatment for frontotermpaol degeneration

Answer 27

Serotnergic medications my help

Question 28

name an infection that can cause neurocognitive deficiency

Answer 28

HIV

Question 29

treatment of HIV

Answer 29

- Highly active antiretroviral therapy | - psychostimulants

Question 30

Triad of Huntington clinical manifestation

Answer 30

1. Motor: chore and bradykinesia 2. cognitive: executive function 3. psychiatric

Question 31

Treatment of Huntington

Answer 31

Tentrabenzine or atypical antipsychotics

Question 32

How is Parkinson's diagnosed

Answer 32

1. Bradykinesia : tremor or ridigity 2. asymmetry of motor symptoms 3. cognitive decline appears after onset of motor symptoms

Question 33

treatment for Parkinsons

Answer 33

1. carbidop/levodopa 2. cholinesterase inhibitor 3. Queitipine or clozapine (low dose)

Question 34

symptoms of Parkinson's disease can be exacerbated by what medication

Answer 34

antipsychotics

Question 35

pathology of prion disease

Answer 35

spongiform encephalopathy

Question 36

most common type of prion disease

Answer 36

Creutzfeldt-Jakob disease

Question 37

clinical features of prion diseae

Answer 37

- rapid progression - concentration, memory, and judgment first to go - myoclonus - ataxia, nystagmus, and hypokinesia

Question 38

EEG for prion disease

Answer 38

periodic sharp wave complexes

Question 39

lesions occur where in brain for prion disease

Answer 39

putamen or caudate nucleus

Question 40

what does lumbar puncture show for normal pressure hydrocephalus

Answer 40

- normal opening pressure | - elevation of CSF

Question 41

treatment for normal pressure hydrocephalus

Answer 41

shunt