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1.1 RC: Recall + Thea Gilks Review Decks > Gilks Deck 4: Neuro disorders + epidemiology review etc > Flashcards

Gilks Deck 4: Neuro disorders + epidemiology review etc Flashcards

(107 cards)

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1
Q

what disorders can be associated with pseudobulbar affect

A

ALS

MS

stroke

parkinsons

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2
Q

what is the treatment for pseudobulbar affect

A

either SSRIs or dextromethorphan+quinine

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3
Q

which type of seizure is associated with automatisms

A

focal impaired awareness (complex partial)

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4
Q

what % of epilepsy patients have psychiatric difficulties during course of illness

A

30-50%

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5
Q

what is the most common behavioural symptom in patients with epilepsy

A

personality change (i.e viscosity of personality)

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6
Q

what causes Balint and Gerstman syndromes

A

parietal lobe stroke

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7
Q

what causes hemi-spatial neglect

A

(usually) is neglect of LEFT visual field–> caused by injury to RIGHT PARIETAL lobe–> often due to RIGHT MCA stroke

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8
Q

why is right sided hemi-spatial neglect rare

A

because of REDUNDANT processing of the right space by both the left and right hemispheres–> in most brains, the left space is only processed by the right hemisphere

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9
Q

which hemisphere is non dominant

A

right

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10
Q

which hemisphere is dominant

A

left–> controls language

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11
Q

insult to which hemisphere results in greater risk of mania

A

right hemisphere insult

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12
Q

where was the stroke if you have APHASIA plus UNILATERAL motor deficits

A

LEFT/dominant MCA

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13
Q

what hemisphere of the brain controls/processes the following:

sensory stimulus from the right side of the body

A

left hemisphere

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14
Q

what hemisphere of the brain controls/processes the following:

spatial ability

A

right hemisphere

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15
Q

what hemisphere of the brain controls/processes the following:

time and sequencing

A

left hemisphere

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16
Q

what hemisphere of the brain controls/processes the following:

speech, language and comprehension

A

left hemisphere

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17
Q

what hemisphere of the brain controls/processes the following:

recognition of faces, places and object

A

right hemisphere

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18
Q

what hemisphere of the brain controls/processes the following:

recognition of words, letters and numbers

A

left hemisphere

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19
Q

what hemisphere of the brain controls/processes the following:

sensory stimulus from left side of the body

A

right hemisphere

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20
Q

what hemisphere of the brain controls/processes the following:

motor control of right side of the body

A

left hemisphere

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21
Q

what hemisphere of the brain controls/processes the following:

analysis and calculations

A

left hemisphere

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22
Q

what hemisphere of the brain controls/processes the following:

motor control of left side of the body

A

right hemisphere

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23
Q

what hemisphere of the brain controls/processes the following:

creativity

A

right hemisphere

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24
Q

what hemisphere of the brain controls/processes the following:

context/perception

A

right hemisphere

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25
what type of rhythm is present on EEG during wakefulness
"posterior dominant"
26
what stage of sleep makes up the largest portion of sleep
N2 (upt to 50%)
27
what stage of sleep is increased by benzos
N2
28
what is the relationship between SSRIs, REM and REM sleep behaviour disorder
despite suppressing REM, SSRIs can also exacerbate REM sleep behaviour disorder
29
how does clozapine affect REM sleep
patients on clozapine can spend up to 85% of sleep in REM and may complain of vivid dreams
30
how long does the typical sleep cycle last
90-120 minutes--> people go through multiple each night each progressive cycle has more REM and less N3
31
what would you see on EEG in hepatic encephalopathy
triphasic waves
32
what would you see on EEG in cerebral anoxia or CJD
periodic sharp waves
33
what would you see on EEG in diffuse atherosclerosis
slowed alpha and theta waves
34
what would you see on EEG in ADHD
increased slow waves
35
why does hyperventilation immediately before ECT stimulus application lead to a better seizure
depresses blood levels of carbon dioxide, which is an anticonvulsant
36
should you use unilateral ECT in a patient who has a hard time having seizures
no--> unilateral is for patients who have vigorous seizures
37
what medication can be given the night before ECT to help try and potentiate a seizure
sustained release theophylline at HS can give promethazine with it to help patient sleep without affecting the seizure
38
in which patients should you NOT use ketamine as anesthetic for ECT
those with epilepsy
39
list risk factors for ADHD
low birth weight/prematurity maternal smoking or alcohol in preg childhood adversity urban upbringing family history/genetics
40
what is the most commonly comorbid disorder wtih ADHD
ODD
41
list the most commonly comorbid conditions with ADHD
ODD > anxiety (47%) > learning disorder > mood disorder > conduct disorder > SUD > tics
42
what is the prevalence of ADHD in kids
5%
43
what is the prevalence of ADHD in adults
2.5%
44
what is the concordance of ADHD in monozygotic twins
70%
45
what is the prevalence of conduct disorder
4-10%
46
list risk factors for conduct disorder
genetics "difficult" temperament HYPOarousability birth complications parental rejection/neglect inconsistent parenting harsh discipline abuse lack of supervision parent criminality parental ASPD early institutional living peer rejection
47
what % of those with CD go on to develop ASPD
40%
48
what are the most commonly comorbid disorders with conduct disorder
ADHD SUD MDD anxiety learning disability (reading) intellectual disability TBI
49
list risk factors for autism
advanced parental age low birth weight fetal exposure to epival
50
what % of those with autism have at least one comorbidity
70%
51
what are the most commonly comorbid disorders with autism
any anxiety d/o (40%) > intellectual disability (30-40%) > ADHD (30-40%) > learning disorder, depression, OCD, ARFID, psychosis
52
what is the prevalence of autism
around 1%
53
list risk factors for SCZ
urban upbringing born in winter premature birth hypoxia at birth maternal diabetes advanced paternal age immigration 22q11 deletion family history of SCZ, bipolar
54
is low SES a RF for SCZ
no
55
what are the most commonly comorbid disorders with SCZ
SUD (above 50%) > anxiety (10-15%) > OCD, panic, medical comorbidity
56
what is the prevalence of SCZ
0.5%
57
what % of those with SCZ die by suicide
5%
58
what is the risk of relapse if someone with SCZ stops meds
90% risk within 1 yeart
59
list risk factors for bipolar d/o
early/rapid onset depression depression with PSYCHOMOTOR RETARDATION family hx of bipolar or schizophrenia
60
by how much does having bipolar disorder increase suicide risk
increased by 15x
61
what is the prevalence of bipolar I disorder
about 0.5%
62
what is the most heritable psych condition
bipolar I
63
what disorders are most commonly comorbid with bipolar I
any anxiety (75%) > SUD (56%)... esp. AUD > ADHD, eating disorders
64
list risk factors for depression
neuroticism/negative affectivity childhood adversity family hx pre existing psych and medical illness i.e BPD, CV disease
65
what are the most commonly comorbid disorders with MDD
anxiety (60%) > SUD (27-60%) > OCD, eating disorders, BPD
66
what is the lifetime prevalence of MDD
10% (1 year is 5%)
67
what % of those with an anxiety disorder also have a second anxiety disorder
50% (30% have 3+)
68
what is the lifetime prevalence of any anxiety disorder
30%
69
does having an anxiety disorder increase suicide risk
yes
70
list risk factors for ALL anxiety disorders
family hx personal hx childhood adversity female medical illness behavioural inhibition low education
71
list risk factors for GAD specifically
behavioural inhibition neuroticism harm avoidance family hx
72
what are the most commonly comorbid disorders with GAD
other anxiety disorders MDD medical conditions
73
what is the average age of onset of GAD
31
74
what is the lifetime prevalence of GAD
6-9%
75
list risk factors for OCD
social isolation physical and sexual abuse neuroticism family hx (esp for childhood onset)
76
what are the most commonly comorbid disorders with OCD
any anxiety (75%) > mood disorder (60%) > SUD (?) > OCPD (25%) > eating disorders, tics, somatic symptom disorder, body dysmorphic disorder
77
what is the SINGLE MOST COMMONLY comorbid diagnosis with OCD
MDD
78
what is the prevalence of OCD
1-2%
79
what % of those with OCD have OCPD
25%
80
what % of those with OCD attempt suicide
25%
81
which gender is more affected by childhood OCD
boys
82
list risk factors for PTSD
female chlidhood adversity pre existing psych illness low SES low IQ racial minority developing acute stress disorder = RF for PTSD
83
what % of those with PTSD have a comorbid disorder
75%
84
what are the most commonly comorbid disorders with PTSD
MDD ODD ADHD anxiety BPD TBI
85
what is the lifetime prevalence of PTSD
9%
86
list risk factors for all SUDs
male family hx early exposure to drugs pre existing psych illness high risk environment
87
what are the most commonly comorbid disorders with SUDs
MDD bipolar anxiety SCZ ADHD personality--esp ASPD PTSD eating disorder
88
what is the lifetime prevalence of all SUDs
22%
89
which is the most common SUD
AUD
90
list risk factors for anorexia
low self esteem female idealizing thinness perfectionism family history of MDD, anxiety, OCPD
91
what are the most commonly comorbid disorders with anorexia
MDD (50-65%) > anxiety disorders (50%)... esp GAD, social phobia > OCD, cluster C traits i.e rigidity, harm avoidance, perfectionism, obsessiveness
92
what are the most common anxiety disorders in AN
GAD, social phobia
93
what is the prevalence of AN
0.5%
94
what is the mortality rate for AN
5% per year total mortality 5-20%
95
what is the gender distribution of patients with AN
female: male 10:1 (same for BN)
96
list risk factors for bulimia nervosa
female low self esteem idealizing thinness impulsivity family history of MDD, anxiety, SUD, BPD
97
what are the most commonly comorbid disorders with bulimia nervosa
depression (over 50%) + anxiety (over 50%) > SUD (30%), bipolar, BPD, PTSD, impulsivity/risk taking
98
what is the prevalence of bulimia
1-1.5%
99
what is the yearly mortality of BN
2%
100
list risk factors for major NCD
age TBI vascular RFs depression (most significant?) hearing impairment low education (most significant?) HRT single fam hx, genetics MCI (10% convert per year)
101
list the impulse control disorders
DMDD (technically in mood but included here becuase can present similarly) IED ODD CD ASPD
102
what distinguishes DMDD from the other impulse control disorders
temper outburts out of proportion to provocation but NO VIOLENCE OR PROPERTY DAMAGE mood BETWEEN outbursts is persistently irritable/angry CANNOT COEXIEST with IED, ODD or bipolar
103
what distinguishes IED from the other impulse control disorders
failure to control aggressive impulses which are out of proportion to the provocation CAN involve physical/verbal AGGRESSION and property DAMAGE but it is NOT PREMEDITATED aggression in IED > than in ODD + provocation for outbursts is more broad/non specific
104
what distinguishes ODD from the other impulse control disorders
irritable mood, RESENTFUL, annoys others, easily ANNOYED, argumentative/DEFIANT, VINDICTIVE/SPITEFUL more likely to be provoked by AUTHORITY FIGURES
105
what distinguishes CD from the other impulse control disorders
DISREGARD for the basic rights of others, HARMFUL/DANGEROUS/evil behaviours i.e carrying weapon, setting fire, rape, theft NO mention of mood
106
what is the primary treatments for ODD/CD
primarily PSYCHOSOCIAL and based on CLINICAL EXPERIENCE --> multisystemic therapy --> parent management training --> family therapy --> CBT --> problem solving skills training
107
what is the focus of pharmacologic treatment of ODD/conduct
focused on treating COMORBIDITIES --> especially ADHD because as many as 70% of patients have comorbid ADHD use stimulants +/- alpha agonists for ADHD sx CAN use risperidone short term for significant disruptive/aggressive behaviours

1.1 RC: Recall + Thea Gilks Review Decks (13 decks)

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