General review form BV Flashcards
(227 cards)
1
Q
Antidepressants most likely to cause insomnia (3)
A
Fluoxetine, Bupropion and Sertraline
2
Q
mechanism of action of Carbamazepine
A
Blockade of Na gated channels
3
Q
Carbamazepine Cyp450 metabolizer
A
3A4
4
Q
Time to get stable levels of Carbamazepine in blood
A
3-5 weeks
5
Q
Neurobiological abnormalities associated with ASD
A
Decreased formation of Purkinje cells
6
Q
Head size in ASD is increased or decreased?)
A
increased
7
Q
Which Neurotransmitter synthesis is affected in ASD
A
Serotonin
8
Q
Brain structure affected in GAD
A
Amygdala (larger volume)
9
Q
EEG characteristic of CJD
A
Periodic sharp waves complexes
10
Q
Which drug should be used for agitation in PCP intoxication?
A
Benzodiazepines
11
Q
Which drugs should be avoided in PCP intoxication?
A
Phenothiazines and butyrophenones (haldol, thorazine)
12
Q
BPD is a disruption of which Mahler’s stage
A
Rapproachment
13
Q
Narcissistic PD is a disruption of which Mahler’s stage
A
Symbiosis (no soothing) and separation-individuation
14
Q
Antidepressant that increases cardiac malformations in 1st trimester
A
Paroxetine
15
Q
Pregabalin mechanism of action
A
Ca channel antagonist
16
Q
Disulfiram mechanism of action in liver and brain
A
inhibits Aldehyde dehydrogenase in liver
Blocks Dopamine dehydrogenase in brain
17
Q
Acamprosate mechanism of action
A
Blocks NMDA receptors
18
Q
Baclofen mechanism of action
A
GABA B receptor agonist
19
Q
Naltrexone mechanism of action
A
mu receptor antagonist
20
Q
Most common mood disorder comorbid with anorexia nervosa
A
MDD
21
Q
Class of antidepressant that Mirtazapine is in
A
Tetracyclic antidepressant
22
Q
Mirtazapine mechanism of action
A
Blocks presynaptic alpha 2 receptors , indirect 5HT1A activation increasing release of dopamine
23
Q
SSRIs FDA approved for GAD (2)
A
Paroxetine, escitalopram
24
Q
SNRI FDA approved for GAD
A
Venlafaxine, duloxetine
25
Buspirone mechanism of action
5-HT1A partial agonist at postsynaptic receptors
26
IQ to quailify as Intellectual disability
70 or less (2SD below average)
27
MAOI with the lowest incidence of sexual side effects
Tranylcipromine
28
Most effective treatment for social phobia
Phenelzine
29
ASD diagnostic criteria
Deficits in social communication and social interaction
| Restricted Repetitive behaviors, interests and activities
30
Time needed to elapse for disulfiram-alcohol reaction to disappear
2 weeks
31
Topiramate side effects that do not improve over time
cognitive slowing, weight loss, paresthesias
32
CYP450 predominantly present at birth
3A7
33
Mechanism of action of Modafinil
Histaminergic and increases dopamine by binding to the transporter
34
Mechanism of action of Atomoxetine
Norepinephrine reuptake inhibitor
35
Absolute contraindication of selegiline
surgery and pheochromocytoma
36
Suicide risk in BPAD
```
25%-50% will attempt
25% of all completed suicides
same suicide risk as MDD
10-25x higher than general population
10-15% will complete suicide
```
37
Best rating scale to differentiate delirium from dementia
Delirium Rating scale revised 98
38
FDA approved treatment of bulimia
Fluoxetine
39
main neurotransmitter associated with Panic disorder
GABA
40
selective mutism is this type of disorder in the DSM-V
Anxiety
41
MDD sleep changes
```
increase sleep onset latency
increased REM latency
increased number of REM sleep
Increased total awakenings
Decreased total sleep
decreased slow wave (stages 3-4)
```
42
Lesion to medial thalamus sxs
Medial: deficits in language
| Anterior and medial: mood and sleep-wake deficits
43
Lesions to lateral thalamus sxs
deficits in visual memory
44
Lesions to Amygdala
Hyperorality, hyperphagia, hypesexuality (Kluver bucy)
45
Lesions to mammilary bodies
Psychosis, memory deficits and confabulation (Kosarkoff)
46
%of children with ODD that will develop conduct disorder
30%
47
CJD CSF markers
14-3-3 and RT-QulC (latter is more specific)
48
CJD age of onset
50-70y/o
49
Drugs used to control aggressiveness in schizophrenia
lithium and beta blockers
50
Benzodiazepine that most rapidly absorbed when taken PO
diazepam
51
Benzodiazepines with rapid onset of action
Diazepam and clorazepate
52
Benzodiazepine with shortest half life
Triazolam (1-5h), followed by Alprazolam (6-20h)
53
Benzodiazepines with longest half lives (3)
Diazepam, Chlordiazepoxide, clorazepate
54
Jean Baker Miller theory
Relational theory- focused on real relation between therapist and patient
55
Carl Jung theory
Transpersonal psychology-archetypal phenomena of the collective unconscious
56
Heinz Kohut theory
self psychology-mirroring and idealization
57
Melanie Klein Theory
Objects relations-schizoid paranoid and depressive positions, true self and false self
58
Anna Freud theory
Ego theory, focused on ego defenses
59
What condition does the Maudsley model treat?
Anorexia
60
Prevalence of Paranoid Personality Disorder in inpatient
10-30%
61
Alzeimer's Disease genetic mutations
Presenilin I, Presenilin II, APOE4, and amyloid precursor protein
62
4 main focus areas of interpersonal therapy
```
Complicated bereavement ( grief after loss of loved one)
Role dispute (conflict in significant relationships)
Role transitions (difficulties adapting to changes in relationships or life events)
Interpersonal deficits (difficulties stemming form isolation or lack of life events)
```
63
Lesion to this structure with result in prosopagnosia
Fusiform gyrus
64
Medications that should be taken on an empty stomach
Sedatives
65
Which SSRI have the lowest drug exposure during breastfeeding
Paroxetine and sertraline
66
SSRIs with higher drug exposure during breastfeeding
Fluoxetine, Citalopram
67
Which TCAs have the lowest drug exposure during breastfeeding
Nortriptiline and Imipramine
68
Interaction of valproate and lamotrigine
Valproate doubles lamotrigine half life
69
FDA approved treatment for cataplexy in narcolepsy
GHB, Sodium oxybate (Xyrem)
70
FDA approved medication for PTSD
Sertraline and Paroxetine
71
Peak prevalence of sleepwalking occurs at which age
8-12 years
72
Common disorder in patients with ASD
Anxiety
73
Desipramine should be used with caution in children and adolescents because of this side effect
sudden death
74
First line drug for ADHD with substance use, comorbid anxiety or tics
Atomoxetine (Norepinephrine reuptake inhibitor)
75
Part of the brain primarily responsible for smell
Olfactory cortex in LIMBIC system
76
Frontal lobe function
executive function
social conduct
judgement
some motor functions
77
Parietal lobe functions
sensory integration and somatosensory function
78
Temporal lobe function
hearing, naming and visual recognition
79
Anterior temporal lobe function
critical for semantic memory
80
MRI changes in schizophrenia
```
-Reduced volumen in:
prefrontal cortex
Medial temporal lobe
thalamus
hippocampus
superior thalamic gyrus
-Enlarged lateral and 3rd ventricles volume and basal ganglia
```
81
fMRI changes in schizophrenia
Reduced blood flow and metabolism in frontal lobes
82
Structures that arise from Diencephalon
Thalamus, hypothalamus, subtahlamus and optic vesicle
83
Structures that arise from Metencephalon
pons and cerebellum
84
Structures that arise from Myelencephalon
Medulla
85
Structures that arise from Telencephalon
brain hemispheres, limbic system and basal ganglia
86
Structures that arise from Mesencephalon
red nucleus, superior and inferior colliculi, substantia nigra and periaqueductal grey matter
87
Drug that cause false positive for PCP in Utox
Venlafaxine
88
Drug that cause false positive for LSD in Utox
Amitriptyline
89
Drug that cause false positive for barbiturates in Utox
Naproxen
90
Drug that cause false positive for benzos in Utox
Sertraline
91
Drug that cause false positive for amphetamines in Utox
Trazodone and selegiline
92
Medication contraindicated in ECT
lithium, teophylline, hypoglycemics, bets blockers, lidocaine
93
Kleine-Levin Syndrome
```
adolescent males
excessive day sleepiness
hyperphagia
apathy
hypersexuality
cognitive impairment
```
94
Mechanism of action of ethosuximide
Reduces low threshold T-type Ca currents
95
FDA approved drug to treat depression in children
Fluoxetine
96
Mean age of onset of BPAD 1
18 y/o
97
Adolf Mayer theory
genetic dynamic theory
98
Harry Sullivan's theory
interpersonal theory of psychopathology, focused in relationships rather than drives
99
Karen Horney
actual self, idealized self, real self
100
Antidepressant family that causes hyponatremia
SSRIs
101
Depersonalization disorder common comorbidities
unipolar depression and anxiety disorders, uncommon in PTSD
102
Brain structures affected in DID
smaller hipocampus, amygdala and medial prefrontal cortex
103
Neuropeptide transmitters
somatostatin, enkephalins, opiates, endorphins
104
Zaleplon half life
1-2h, can be given in the middle of the night
105
Highly sensitive marker for NMS in acute phase of illness
low serum iron (leads to reduced dopamine receptor function), has low specificity
106
selegiline mechanism of action
selective irreversible MAO B antagonist, acts on MAO A in high doses
107
Prevalence of panic disorder in adults and adolescents
2-3%
108
Lab tests altered in serotonin syndrome
```
hypocalcemia
hyponatremia
hypomagnesemia
leukocytosis
elevated CK
elevated LFTs
```
109
varenicline mechanism of action
Full agonist alpha7, partial agonist alpha 4 and beta 2
110
Antidepressants safe in epilepsy
Mirtazapine, sertraline and citalopram
111
Antidepressants to avoid in epilepsy
Bupropion, fluoxetine, TCAs
112
Most anticholinergic TCAs
imipramine, clomipramine, doxepine
113
Amphetamines mechanism of action
Increases presynaptic release of dopamine and norepinephrine
114
Phenytoin side effects
```
hirsutism
gingival hyperplasia
diplopia
ataxia
neuropathy
```
115
Mechanism of action of Phenytoin
Blocks voltage gated Na channels
116
Weight gain mechanism of lithium
insulin like effect
117
Sumatriptan mechanism of action
5HT1B and 5HT1D agonist
118
Salvador minuchin
Structural family therapy
119
Tourette's neuroanatomical changes
frontal cortex, caudate nucleus, putamen and thalamus
120
ODD comorbidity with ADHD
50%
121
FDA approval for Vagus nerve stimulation
treatment resistant depression and epilepsy
122
Vagus nerve stimulation site of placement
carotid sheath
123
Mechanism of sexual side effects due to antipsychotic medication
Alpha 1
124
The dosage of ECT is changed by varying this aspect
Time of exposure to a fixed current
125
Neurological illness associated with REM Sleep Behavior Disorder
Parkinson's disease
126
Mechanism of action of valproic acid
blockade and prolonged recovery of active voltage gated Na channels, block T-type Ca channels and increases GABA activity
127
OCD SSRIs vs MDD SSRI
OCD may need 4x the amount of SSRIs for treatment
128
Disease mechanism in Narcolepsy
dysfunctional hypocretin/orexin pathway
129
Birth defects associated with topiramate
Cleft lip/palate, hypospadias
130
Medication effective to treat aggression in conduct disorder
antipsychotics
131
Neurotransmitter systems affected in Alzheimer's
Acetylcholine and Norepinephrine
132
Freudian stages
```
Oral-Birth to 18 m
Anal-18m to 3y
Phallic-3y to 6y (oedipal complex, castration anxiety and penis envy)
Latency-6y to puberty (around 12y/o)
Genital- puberty to death
```
133
Neurotransmitter increased 500x in delirium
Dopamine
134
APA guidelines for remission of actute pahse treatment in MDD
3 weeks of abscence of sad mood and decreased interest and 3 or less sxs of the major depressive episode remaining
135
NMDA R antagonist illicit drugs
PCP and ketamine, both are considered dissociatives
136
TCA that is not sedating
Proptryptiline
137
Drugs associated with depression
Propranolol, reserpine and alpha methyldopa
138
Laboratory changes in depression
```
increased CRP
increased CRH
increased cytokines
decreased BDNF
decreased leptin
dyslipidemia
```
139
Central venous thrombosis complications
blindness
herniation
hemorrhage (after treatment with anticoagulants)
140
Central venous thrombosis is more common in this population
Females
younger than 40 y/o
recent pregnancy, head trauma, coagulation disorders or infection
141
Binge eating disorder treatment
SSRIs
Amphetamines (Vyvanse is FDA approved)
CBT
142
inpatient management of anorexia nervosa with purging behavior
```
monitor for 2 h after meals
Frequent small meals
Daily weight after voiding
Eat 500 calories more than needed to maintain weight per day
Daily i/o
```
143
Morphine metabolism
Does not get metabolized by CYP
| Glucuronidated
144
Mechanisms of opioid induced hyperalgesia
Increased release of substance P
Increased dorsal horn spinal cord activity
Sensitization of primary afferent neurons
145
CYP involved in Methadone metabolism
CYP3A4
146
Valproic acid CYP interaction
2C9 and 2A6
147
Gabapentin mechanism of action
Voltage gated Ca channel blocker
148
Treatment of visual hallucinations in Lewy Body dementia (LBD)
cholinesterase inhibitors
149
Ch inhibitor with most evidence for cognitive impairment in LBD
Rivastigmine
150
Treatment of depression in LBD
ECT or TMS
151
Disorder comorbid with body dysmorphic disorder
Social phobia
152
Deep brain stimulation placement for OCD
It's FDA approved
| Ventral anterior limb of the internal capsule and adjacent striatum
153
Malan's model of therapy
triangle of conflict
154
Sifneo's model of therapy
Anxiety provoking, therapist acts as teacher
155
Davanloo model of therapy
Short term dynamic psychotherapy
156
Mann's model of therapy
Existential therapy, therapist acts as empathic figure
157
EEG typical in Lennox Gestaut Syndrome
Slow spikes and waves
158
Mainstray treatment for TCA cardiotoxicity
IV sodium bicarbonate
159
Number of symptoms required for a diagnosis of panic attack
4, need to be present for >1 month to diagnose panic disorder
160
Solitary tract is critical for this part of sleep
Non REM
161
Primary prevention
Keeps disease from occurring: ex: counseling, immunizations and suicide prevention programs
162
Secondary prevention
Detects diseases when patients are asymptomatic and addresses treatment: HIV test, depression screening, Utox screen, identifying prodromal schizophrenia and nutrition and exercise screening
163
Tertiary prevention
Activities that reduce complications or prevent deterioration after the disease onset: Metabolic screening in patient taking psychotropics, ACT team and intensive care management
164
Tourette's diagnosis
Symptoms may wax and wane but must be present for >1 year
Symptoms onset before age 18
Multiple motor and 1 or more vocal tics
165
Type of amnesia in Kosarkoff's
Anterograde and retrograde
166
Type of amnesia in dementia
anterograde
167
Type of amnesia after ECT
Anterograde and retrograde
168
Type of amnesia in Transient Global amnesia
Anterograde and retrograde
169
Methanol intoxication MRI findings
Infarct or Hemorrhage in the putamen
170
Kleptomania pharmacological treatment
Naltrexone and SSRIs, no FDA approved drugs
171
% of death of people with serotonin syndrome that develop seizures
~40% will die
172
Personality disorder comorbid with anorexia
OCPD
173
Mirtazapine most serious side effect
Agranulocytosis
174
Antidepressant that improves nausea
Mirtazapine (5HT3 blockade)
175
Most common etiological factor associated with temporal lobe epilepsy
Prolonged febrile convulsions of childhood
176
Infection related to PANDAS
Strep A
177
PANDAS symptoms
Rapid onset of OCD and/or tics and neuropsychiatric sxs following group A strep infection
178
Most prominent comorbidities with Fragile X
ADHD and social anxiety
179
Most common mutation in Fragile X
FMR1
180
fMRI findings during AH
overactivation of temporoparietal cortex
181
FDA approved treatment of social phobia
Paroxetine, sertraline and long acting venlafaxine
182
Most common personality disorder in bulimia nervosa
Borderline PD
183
Medications that exacerbate Acute intermittent porphyria
Seizure medication
184
FDA approved medications for treatment of tics
haloperidol, aripiprazole and pimozide
185
% of patients with BPAD that have recurrence of mania
>90%
186
Prazosin mechanism of action for nightmares
Blockade of norepinephrine at postsynaptic alpha 1 receptors
187
Selegiline effect on weight
no weight gain
188
Metabolite of Oxycodone detected in urine
Oxymorphone
189
Gastaut-Gestschwind syndrome
```
occurs mostly in left temporal seizures
hyperreligiosity
hypergraphia
hiper morality
hyposexual
Circumstantiality
```
190
First line agent for impulsivity and behavioral dyscontrol in personality disorders
mood stabilizers
191
Depakote absolute contraindications
pregnancy
PCOS
hepatic disease
urea cycle disorders
192
FDA approved medication for bipolar depression
quetiapine, symbiax, lurasidone
193
Sleep cycle phase when most parasomnias take place
early phase
194
illness associated with parasomnias
50% children who sleepwalk or have night terrors have OSA
195
Intervention needed before administrating ECT to child/ adolescent
2 child psychiatrists that are not the primary treaters should independently agree
196
Diagnostic criteria for TGA
```
Attack must be witnessed
No loss of biographical information
No alterationin consciousness
No cognitive impairment
No recent hx of trauma or seizures
must resolve within 24 h
Other causes of amnesia must be excluded
```
197
Panic disorder most common comorbid condition
Agoraphobia
198
FDA approved antidepressants for tretament of panic disorder
Fluoxetine, Paroxetine, Sertraline and venlafaxine
199
Time needed to elapse to diagnose PTSD with delayed onset
6 months
200
Mean age of onset of mood disorders
18y/o
201
MRI findings in methyl alcohol intoxication
Putamen hemorrhage
202
Topiramate mechanism of action
inhibits Na channels
Enhances GABA A receptors
Antagonizes AMPA and kainate subtypes of glutamate receptors
203
Gene commonly mutated in Wilson's disease
ATP7B
204
Meige's syndrome characteristics
Sore jaw, increased blinking, jaw clenching, lip pursing, and occasionally tongue protrusion
205
Cause Akinetic mutism
tumors of the upper brainstem
206
Leading cause of paraneoplastic syndrome
small cell carcinoma of the lung
207
Medical conditions that cause ASD
<5% of ASD cases have a medical condition. These are:Fragile X syndrome, Rett syndrome, tuberous sclerosis, abnormalities in chromosome 15
208
Mechanism of action of memantine
NMDA R antagonist
209
Medication that increase depression and suicide in depressed Epilepsy
Barbiturates and vigabatrin
210
Number of non overlapping symptoms necessary to diagnose BPD with mixed features
3
211
Morel
First used the work dementia precox
212
Most common EPS side effect of Clozapine
Akathisia
213
Hypersomnolence disorder diagnosis criteria length
present for >3months
214
Most specific test to diagnose Lewy body disease
PET scan
215
Antidepressant with fastest onset of action on GAD
Nortriptiline
216
TCA with highest levels in infant after breastfeeding
Doxepine
217
Antidepressants that can cause insomnia
Fluoxetine, sertraline and bupropion
218
Definition of agoraphobia
Fear of being in places or situations difficult to escape from, usually accompanied by fear of having a panic attack.
219
Most prevalent childhood psychiatric disorder
ADHD
220
Side effect of Depakote that increases suicide risk in females
PCOS
221
Right parietal lobe damage
Left hemisensory deficits
| Left neglect
222
Antidepressant that decreases prolactin
Aripiprazole
223
Benefit of transdermal methylpheidate
Avoids first pass in liver, requires less dosage
224
Monitoring of lithium in pregnancy
Beginning at week 34, weekly monitoring is necessary
225
Paraneoplastic cerebellar degeneration primary tx
Small cell ca of lung, ovary, hodgkin, breast
226
MEdication used to improve loss of appetite 2/2 stimulants
cyproheptadine
227
Trazodone mechanism of action
metabolite and inhibiting serotonin reuptake in presynaptic neurons
