Mock 1 Flashcards
(52 cards)
Frontal syndromes
o Medial prefrontal syndrome poverty of speech, paucity of spontaneous behaviour
o Orbitofrontal : poor impulse control, explosive outburst
o Dorsolateral: executive dysfunction, diminished planning.
Regarding trail making tests
trial making B has numbers and letters, A just numbers.
How does TdP present
o Torsades does not necessitate collapse. However is rarely asymptomatic.
risk significantly increased above Qtc 500ms
Cube Towers
15 months Tower of 2 cubes
18 months Tower of 3-4 cubes
2 years Tower of 6 cubes
3 years Tower of 8-9 cubes
Shapes copying
1- scribble
2- line
3- circle
4- square
5 triangle
Dementia drugs MoA:
o Donepezil – selective and reversible ACHEI
o Rivastigmine – pseudoirreversible ACHEI, butrylcholinesterase inhibitor
o Galantamine - Nicotinic R modulator, selective and reversible ACHEI
o Memantine - non-competitive NMDAR, 5Ht3 antagonist
only galantamine is COMPETITIVE of the ACHEIs
Antidepressant switching rules
tranylcypromine - stop and wait 2 weeks
mecoblomide - stop and wait 24h
Taper TCAs to half and then cross taper
otherwise for the most part cross taper cautiously and start new drug low
switching to mirtazapine just cross taper
Read the question?
read the question
abnormal neurological findings and dementia with normal MRI and CSF
CJD
Startle response in neurological disease
CJD
Underdeveloped area in ASD
cerebellar vermis
Brain area in thermal regulation
pre-optic area (hypothal)
Which 5HTR is involved in auto-regulation/somatodendritic inhibition and where does this happen?
5HT1A (a for autoreceptor) in Raphe N.
5HTRs inhibitory/excitatory?
5HT1 - Gi (decrease cAMP) inhibitory
5HT2 - Gq (increase IP3) excitatory
5HT3 - ligand gated ion channel
5HT4 - Gs (increase cAMP) excitatory
5HT5 - Gi (decrease cAMP) inhibitory
5HT6 - Gs (increase cAMP) excitatory
5HT7 Gs (increase cAMP) excitatory
HIV which cell type not infected?
neurons
HIV which CNS cell types most infected?
macrophage, microglia
Brain perfusion in schizophrenia
o Hypoperfusion – frontal lobes, PFC, cingulate gyri, parietal lobes
o Hyperperfusion – cerebellum, brainstem, thalamus
which disease is hypothesised as an absence of cerebral torque? and by whom?
psychosis, torque is L-R asymmetry, by Crow
What has a glucocorticoid R antagonist effect?
mifepristone
EEG findings in seizure types
Absence
atypical absence
Focal
Myoclonic
generalised TC
Atonic
Typical absence (aka petit mal) Generalised 3 Hz spike-wave
Atypical absence Slow (<2.5 Hz) generalized spike-and-wave
Focal (previously known as partial) Focal spikes
Myoclonic Generalized 3-6 Hz polyspike and wave discharge
Generalised tonic-clonic EEG often obscured by artifact (movement). Generalized fast rhythmic spikes are seen in the tonic stage. Bursts of spikes and after-coming slow waves are synchronous with clonic jerks. A postictal period of irregular slow activity follows
Atonic (drop attack) Generalized spike-and-wave is typical, with atonia at the time of the slow wave
Which ion is highest in axon terminal before depolarisation
potassium
REM in psychiatric disorders?
REM latency typically shortened in ALL disorders
medications can ‘suppress’ REM latency meaning longer time to REM and less intense REM
Rebound effects when stopping can be seen
myocarditis symptoms
fever, chest pain, SOB
do a trop for clozapine (although this is obviously useless and bad medicine)
When does NMS present?
90% within 10d
