Flashcards
(241 cards)
1
Q
White matter imaging
A
DTI
2
Q
High signal T1, low signal T2, low signal T3
A
fat
3
Q
Imaging modalities to differentiate different type of neurocognitive disorders
A
PET and SPECT
4
Q
2 cardiac things Lithum can cause
A
SA block and sick sinus syndrome
5
Q
Brain imaging findings of BPAD
A
enlarged amygdala; GP (globus pallidus) and putamen volume increase
6
Q
MR spectroscopy reveals increased choline in what brain areas in depression
A
BG (basal ganglia) and AC (anterior cingulate)
7
Q
Magnetoencephalography gets magnetic signals from what cells
A
pyramidal cells
8
Q
Depression has volume reduction in what brain structures
A
Prefrontal cortex, AC (anterior cingulate) cortex, caudate, putamen
9
Q
OCD has hypermetbolism in what areas
A
orbitofrontal cortex and anterior cingulum
10
Q
PTSD brain imaging findings
A
smaller hippocampal volume, smaller frontal volumes
11
Q
carbamazepine monitoring
A
CBC, LFTs, BUN/Cr
12
Q
Schizophrenia brain imaging findings
A
ventricular enlargement, enlarged caudate, smaller thalamus, smaller temporal lobes
13
Q
OCD associated with what structure
A
orbitofrontal cortex
14
Q
what condition can have a normal EEG
A
catatonia
15
Q
EKG findings of TCAs
A
prolonged PR, QRS, or QT intervals
16
Q
Nortriptyline therapeutic window
A
50 to 150 micrograms/mL
17
Q
how long for bleeding on CTH to become isodense with brain tissue?
A
2-6 weeks
18
Q
Huntington’s disease brain imaging findings
A
loss of caudate (next to ventricles)
19
Q
DAI best imaged by what modality
A
DWI MRI
20
Q
L’hermitte’s sign
A
electric shock down neck and to extremities with neck flexion
21
Q
best dural sinus imaging
A
MRV
22
Q
hyperintense T2 finding, round/ovoid mass, heterogenous
A
oligodendroglioma
23
Q
young pt, cystic mass
A
astrocytoma
24
Q
thick, irregular enhancing, edema
A
glioblastoma
25
CVA imaging after CTH
CTA head/neck
26
How to test color perception?
Hardy-Rand-Ritter test
27
Digital span is a measure of what?
working memory
28
CJD CSF findings
14-3-3 protein
29
MS CSF findings
myelin basic protein
30
SSPE CSF findings
IgG
31
Pronator drift tests for what
UMN lesion
32
CJD EEG findings
slow 1-2 Hz periodic sharp waves with generalized slowing
33
Toxic metabolic EEG findings
Triphasic waves on disorganized background
34
TIA best test to r/o
DWI MRI
35
Best lab test for heavy drinking
CDT (carbohydrate deficient transferrin)
36
ability to inhibit behavioral responses in adolescence is due to what
maturation of the prefrontal cortex
37
knowledge comes from sensory experiences
empiricism
38
least important thing in evaluating a cultural syndrome?
culture of the clinician
39
Who thought that development was made up of two positions, paranoid-schizoid position and depressive position?
Melanie Klein
40
Who thought that symbol creation was important in understanding human nature?
Carl Jung
41
Who developed hierarchal model of innate behavioral reactions of animals, that motivational impulses build up in the brain and are held in check by blocks?
Nikolaas Tinbergen
42
Who thought that newborn animals bond with the first moving stimulus it perceives?
Konrad Lorenz
43
Who revised Freud's drive theory?
Edith Jacobson
44
Who created orgone theory and cloudbusters?
Wilheim Reich
45
Who studied bees "waggle dance" regarding relaying information about more distant food sources?
Karl von Frisch
46
rates for anorexia and bulemia
are both increasing
47
secondary enuresis is most associated with what dx?
ADHD
48
CBT is most useful for which aspect of anorexia treatment?
relapse prevention
49
something uncommon to pica
leaves
50
enuresis requires what age as part of criteria
that child be at least 5 years old
51
which type of disorders in childhood predict obesity later in life?
depressive
52
bulimia associated with which personality disorder
borderline personality disorder
53
pica is normal below age what
1
54
rumination disorder is seen in what age range
3 months to 1 y/o
55
primary nocturnal enuresis treatment
DDVAP
56
encorpresis dsm frequency
once a month for 3 months
57
mortality rate of anorexia
5%
58
cause of death of anorexia
suicide and MODS
59
most common eating disorder
binge eating disorder
60
pica in adults occurs with what time of disorders
learning disabilities
61
eating disorder with lowest female to male ratio
binge eating disorder
62
medication most useful for binge/purge behaviors in bulemia
fluoxetine
63
substance that causes relaxed/tranquil then drowsiness, dizziness, nausea
GHB
64
substance causing RTA along with diffuse brain atrophy
toluene (inhalants)
65
what class of medications potentiates the effect of inhalants?
benzodiazepines
66
BAL level with ataxia, nystagmus, slurred speech
100-200
67
describe reward circuit
VTA to nucleus accumbens via dopaminergic neurons
68
vertical nystagmus, which substance use?
PCP
69
caffeine has antagonism at what receptor
adenosine
70
gambling disorder is associated with which personality disorder
paranoid personality disorder
71
gambling affects how many people in the US
1 million
72
herbal incense acts on which receptor
cannabinoid
73
insight oriented therapy in a gambler after how long duration?
3 months
74
ingestion of what gives false positive for BZD?
sertraline
75
opiates inhibit cAMP-dependent phosphorylation where?
locus ceruleus
76
pathological gambling most associated with which axis I disorder?
MDD
77
testosterone above what dose increases mania risk?
300 mg
78
stimulant-induced craving for drugs medicated by which neurotransmitter?
glutamate
79
lowest dose of methadone to induce cross tolerance blockade of opiates?
80-120 mg
80
last area to be affected for physician with a substance use disorder
job performance
81
what substance increases muscle mass by increasing growth hormone?
GHB
82
substance that has most reinforcing effect?
cocaine
83
is loss of a parent before 15 y/o a risk factor for gambling disorder?
yes
84
initial treatment for PCP intoxication?
urine acidifcation (remember RTA)
85
withdrawal of what substance gives vivid and unpleasant dreams?
strimulants
86
how do amphetamines exert their effect?
by releasing catecholamines from the neuron
87
"how many drinks can you hold" test
TWEAK
88
highest sensitivity test for assessing alcohol use disorder?
TWEAK
89
which personality disorder: projection, withdrawal, and controlling behavior
paranoid PD
90
which personality disorder: fantasy and withdrawal
schizoid PD
91
which personality disorder: idealism, omnipotence, rationalization
narcissistic PD
92
which personality disorder: repression, dissociation, externalization of emotion
histrionic PD
93
Kohut's theory of personality is based on believing what?
that an individual has need for empathic interaction with self-objects
94
Kernberg's theory of personality believed what?
idealization is a defense against rage, envy, contempt, and devaluation
95
Person who created interpersonal circumplex or interpersonal circle
Timothy Leary
96
Five-factor model of personality?
NEOAC
97
What percent of pts have a PD?
30-50%
98
Most prevalent PD?
antisocial
99
How heritable is BPD?
68% (nice)
100
Lifetime suicide risk in BPD?
5-10%
101
Personality disorder with highest reliability with regard to diagnosis?
antisocial
102
Personality disorder not in ICD-10
schizotypal
103
three personality disorders that can be associated with psychotic sx
paranoid, schizotypal, and borderline
104
which personality disorder has diagnostic feature of interpersonal exploitativeness?
narcissistic
105
which personality disorder most associated with alcohol?
antisocial
106
which personality disorder has a high percentage of female relatives with somatization disorder?
antisocial
107
somatization disorder most seen with which PD?
histrionic
108
how do PDE5 inhibitors work?
increase NO leads to increased cGMP which leads to smooth muscle relaxation and increased blood flow
109
which neurochemicals involved in ability to have orgasm?
dopamine and serotonin
110
how does serotonin affect sexual function?
it inhibits it by vasoconstricting cavernosal vessels (5HT1D)
111
what dopamine agonist has been used to treat erectile dysfunction
apomorphine
112
which 5HT receptor serves sexual function?
5HT1A
113
which factor argues against female orgasmic disorder?
IPV
114
what is not a risk factor for ED over age 40?
fatigue
115
libido, arousal, and pleasure mediated by which neurotransmitter?
dopamine
116
in ED, what are testosterone and LH levels?
testosterone low; LH high
117
which CYP metabolizes PDE-5 inhibitors?
CYP 3A4
118
CYP 3A4 inhibitors
ketoconazole, ritinovir, erythromycin, (fluoxetine)
119
what is testosterone used as a treatment for in men?
male hypoactive sexual desire disorder
120
which paraphilia has latest age of onset?
pedophilia
121
paraphilia with earliest age of onset?
transvestitism
122
most pedophiles are homosexual or heterosexual?
heterosexual
123
medication for treating paraphilia
medroxyprogesterone
124
percent of people with pedophilia who are homosexual?
50%
125
most common paraphilia among women
sexual masochism disorder
126
autoerotic asphyxiation most common in what group?
adolescent boys
127
according to psychoanalytic models, paraphilias arise from what
a failure to complete the process of genital adjustment
128
what is the difference between women and men with regard to Alzheimer's and neurofibrillary tangles?
in women, each neurofibrillary tangle unit equals 3-fold increase in women but 20-fold increase in men
129
most specific factor in shaping gender identity?
androgen
130
genital self-stimulation begins at what age
15 to 19 months
131
sexual orientation recognized at what age?
school age
132
what percent seek gender reassignment surgery?
10%
133
gender dysphoria associated with what disorder?
anxiety disorders
134
at what age does one have a gender identity
2-3 years old
135
75% of boys begin cross dressing before what age
4 years old
136
ependymoma most likely to cause head size increase in what demographic?
babies
137
chorioid plexus carcinoma in what demographic?
children with HA
138
opsoclonus-myoclonus paraneoplastic; characterized by what?
antibodies against postsynapatic neurons
139
paraneoplastic limbic encephalitis; two characteristics
voltage gated K channels; hyponatremia
140
hallmark of paraneoplastic cerebellar degeneration
loss of Purkinje cells
141
brain tumor type that develops from embryonic fetal tissue?
medulloblastoma
142
types of cancer with paraneoplastic association
small cell cancer, breast/gyn cancer, Hodgkin's lymphoma
143
largest association btwn paraneoplastic disorder and what?
thymoma
144
GBM associated with amplification of what gene
EGFR gene
145
paraneoplastic stiff-person syndrome associated with which gene
anti-amphiphysin
146
hemangioblastoma; what condition?
von Hippel Lindau syndrome
147
CrAg screening at what CD4 cutoff
100
148
variant CJD, what is seen on light microscopy?
florid plaques
149
sporadic CJD, what is seen on light microscopy?
spongiform degeneration and astrocytic gliosis
150
mosquitoes transmit epidemic encephalitis via what vector?
arbovirus
151
ataxia, tremors, choreoathetosis, Papua New Guinea
Kuru
152
most common signs and symptoms of poliomyelitis
none
153
brain abscess from sinus or dental infection due to what organism
anaerobic strep
154
flu like symptoms, then encephallitis sx, temporal lobe involvement
HSV-1 encephalitis
155
complication of rheumatic fever
Sydenham's chorea
156
2 things about fatal familial insomnia
thalamus atrophy; PRNP gene
157
GSS syndrome related to CJD but different how?
amyloid plaques of abnormally folded protein
158
lobe with AH
temporal lobe
159
lobe with VH
occipital lobe
160
best imaging modality to look at the dural sinuses
MRV
161
pathological laughing and crying: name 3 step pathway
frontal cortex, pons, cerebellum
162
akinetic mutism can result from b/l infarctions of what
anterior cingulate gyrus
163
where is Broca's area located?
dominant frontal lobe
164
fear/anxiety center, startle
amygdala central nucleus
165
which area of the PFC is most involved with anxiety?
medial or orbitofrontal cortex
166
CSF produced by what
choroid plexus
167
what are cortical columns used for
functional units for information processing
168
exposure to light helps entrain the circadian rhythm by activating nonvisual photoreceptors that project where?
suprachiasmatic nucleus (which is located in the anterior hypothalamus)
169
gustatory special sensory seizures (auras) localize to what brain structure
insula
170
purpose of pineal gland
production of melatonin
171
risk taking behavior mediated by what structure?
orbitofrontal cortex
172
neuroplasticity is based on what changing?
dendritic spikes
173
CNS neurons derive from
ectoderm to form the neural tube
174
PNS neurons derive from
the neural crest
175
appetite and thirst regulation
hypothalamus
176
storing and retrieving long term memories happens in which brain region
temporal lobe
177
basal ganglia derived from what embroyonically
telencephalon
178
DLPFC functions for what
working memory
179
hippocampus located in what region
temporal lobe
180
foramen of Monro
communication between lateral ventricles with third ventricle
181
medulla oblongata derives from what embryonically
myelencephalon
182
mesolimbic pathway connects ventral tegmental area to what
ventral striatum (which includes the nucleus accumbens)
183
what does the middle frontal gyrus contain
frontal eye field
184
where does the spinal cord end?
L1
185
uncinate fasciculus connects what to what
anterior temporal lobe to ventral prefrontal region (like OFC)
186
CN 8 exits at what level
level of the pons
187
visual information through optic tract to where (x2)
lateral geniculate body to primary visual cortex
188
Wernicke's speech area located where
superior temporal gyrusd
189
parasympathetic innervation to ciliary muscles and iris sphincter muscles from where?
Edinger-Westphal nucleus
190
brain structure that provides pain, touch, temperature
thalamus
191
brain cells that provide nutrients to nerve cells and control chemical composition
astrocytes
192
saltatory conduction via nodes of Ranvier via what kind of channels
Na channels
193
upbeating nystagmus, lesion where?
medulla
194
L cerebellar lesion affects which side and what?
L side, skilled movements
195
default mode network of the brain does what
involved in reprocessing previously experienced stimuli
196
what is the roof of the 4th ventricle?
cerebellum
197
diencephalon is composed of what two structures?
thalamus and hypothalamus
198
what forms the lenticular nucleus?
globus pallidus and putamen
199
what forms the striatum?
caudate and putamen
200
third ventricle walls are made up of what
thalamus and hypothalamus
201
SIADH, hyponatremia due to which MAOI?
tranylcypromine
202
MAOI with least likelihood for HTN crisis?
selegeline
203
phenelzine is a strong MAOI, what are contraindications to it?
liver disease, CHF, pheochromocytoma
204
which SNRI/SSRI highest risk in pregnancy?
Paxil
205
which SSRI with most norepi reuptake inhibition?
Paxil
206
majority of neurotransmitters mediate their effects via
G protein coupled receptors
207
receptors with intrinsic enzyme activity
tyrosine kinase and phosphatase
208
LSD acts on which 5HT receptor to cause psychomimetic sx?
5HT2
209
dopamine to norepinephrine via what enzyme?
dopamine hydroxylase
210
rate limiting enzyme for norepinephrine synthesis
tyrosine hydroxylase
211
norepinephrine to epinephrine via what enzyme?
phenylethanolamine NMT
212
rate limiting enzyme for serotonin synthesis
tryptophan hydroxylase
213
serotonin to 5-hydroxyindoleacetic acid via what enzyme
MAO
214
measurement of dopamine degradation
homovanillic acid
215
end-stage metabolite of norepinephrine
VMA vanillylmandelic acid
216
tyrosine to dopamine via what enzyme
tyrosine hydroxylase
217
products of choline acetyltransferase
aceteylcholine and coenzymeA
218
rate limiting step of acetylcholine synthesis
active transport of choline uptake into the presynaptic nerve
219
MAO located where
OAM outer area of mitochondria
220
calmodulin, protein kinase C bind what?
calcium
221
brussel sprouts are a *** and will affect the metabolism of ***
1A2, clomipramine
222
venlafaxine is metabolized by *** and these are *** inducers
2D6; dexamethasone and rifampin
223
methadone metabolized by what, and what is an inhibitor of this?
3A4; clarithromycin
224
how do carbamazepine and St. John's wort act, and can affect what medication?
2C9 inducer; glyburide
225
rifampin inhibits or induces?
induces a lot
226
NSAIDs and what, via what? need to monitor
fluconazole; 2D9
227
fluoxetine is what kind of inducer/inhibitor
potent 2D6 inhibitor
228
sertraline induces 3A4 and inhibits everything but what
1A2
229
SSRI with most norepinephrine reuptake inhibition?
Paxil
230
worst SSRI in pregnancy
Paxil
231
most common side effect of Wellbutrin
dry mouth
232
mirtazapine what type of AD
noradrenergic and specific serotonergic
233
medications FDA approved for PTSD
sertraline, paroxetine
234
antidepressant not associated with weight gain
duloxetine
235
ciprofloxacin inhibits or induces duloxetine metabolism
inhibits metabolism A12
236
shortest half life BZD
triazolam
237
high potency BZDs
triazolam, alprazolam, clonazepam
238
BZDs act on what channel
GABA-A chloride
239
what teratogenic effect of BZD
oral cleft
240
Buspar mechanism
full agonist pre, partial agonist postsynaptic 5HT1A
241
Buspar affected by what med?
ritinovir, 3A4
