passmed questions Flashcards

1
Q

18 year old sprinter, loss of sensation below knee. doesn’t fit a dermatome?

A

conversion disorder. not feigning, but functional. physical symptoms which keep changing. don’t accept test results

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2
Q

19 year old with panic attacks. first line tx?

A

paroxetine

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3
Q

schiz patient on clozapine. comes in with weight gain and feeling unwell. what investigation is important to do?

A

FBC for agranulocytosis. could be unwell due to infection. weight gain is normal in atypical antipsychotics

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4
Q

what is neuroleptic malignant syndrome?

A

pyrexia and muscle stiffness

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5
Q

what are first rank symptoms in schizophrenia? (4)

A

Schneider’s first rank symptoms may be divided into auditory hallucinations, thought disorders, passivity phenomena and delusional perceptions (bonny ton)

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6
Q

which drugs are used to treat mild to moderate symptoms in alzheimers?

A

donepezil, rivastigmine and galantamine (acetylcholine esterase inhibitors)

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7
Q

where does the hypothalamus receive inputs from?

A

septal area (boots september ends), somatosensory afferents (wall), visceral afferents, hippocampus

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8
Q

what is the septal area responsible for?

A

basic emotional drive

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9
Q

which circuit must be intact in at least 1 hemisphere in order for new memories to be acquired?

A

circuit of papez

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10
Q

what part of the memory is involved in facts?

A

semantic memory

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11
Q

is this declarative memory or non declarative?

A

declarative

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12
Q

what is the other part of the declarative/explicit memory?

A

episodic (events)

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13
Q

what part of the memory is involved in non declarative/implicit?

A

emotional memory, conditioned reflexes, skills and habits

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14
Q

learning an association between face and a name requires an intact ?

A

hippocampus

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15
Q

which type of amnesia can you get in benzo use? retrograde or anterograde

A

anterograde

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16
Q

what is required for recalling a memory for a time after its required?

A

hippocampus

17
Q

role in evaluating significance of environmental events and association of environmental events and reinforcement

A

amygdala

18
Q

5 neurotransmitters involved in memory?

A

5HT, catecholamines, glutamate, acetyl choline

19
Q

which part of the brain is involved in remembering emotional responses? (think PTSD and unable to remember)

A

amygdala

20
Q

skeletal musculature memory (motor habits)? boxing and bike

A

cereBellum

21
Q

which glutamate receptor is key in long term potentiation?

A

NMDA (slower to work but lasts for longer) rel

22
Q

phosphorylation of tau, is this a good thing or a bad thing?

A

bad

23
Q

why?

A

phosphorylated tau cannot bind to tubulin, micro tubular integrity suffers

24
Q

why is e4 bad?

A

cannot inhibit the phosphorylation of tau, and you need to do this

25
Q

why do NMDA antagonists impair learning and memory?

A

glutamate is a neurotransmitter involved in memory

26
Q

AMPA kines, what do these do to memory?

A

improve

27
Q

which functional disorder is related to somatic and sensory loss that doesn’t fit a dermatome? not feigning?

A

conversion disoder. big H with m and s (motor and sensory)

28
Q

someone who keeps returning with changing physical symtoms (changing mural/wall), refusing to accept negative test results has what?

A

somatisation disorder

29
Q

which 3 areas are critical in acquisition, consolidation and expression of drug stimulus learning?

A

hippocampus, striatum and amygdala

30
Q

if you have low DRD2, you are at higher risk of what?

A

addiction

31
Q

acute stress and dopamine release…what can this motivate in susceptible individuals?

A

drug taking

32
Q

if CIWA ar score is more than 8 in alcohol withdrawal, what should chlordizepoxide be switched to?

A

diazepam

33
Q

what kind of drug is buprenorphine?

A

partial opiate antagonist

34
Q

when do you give lorazepam in delirium?

A

parkinsons, lewy body dementia and neuroleptic sensitivity

35
Q

mean duration of delirium?

A

1-4 weeks

36
Q

buzzwords for delirium?

A

rapid, transient, lucid intervals, sundowning, persecutory delusions, visual hallucinations, disorientated, fear. post surgery

37
Q

side effects of first line treatments in ADHD

A

sleep and appetite changes, DAT - dysphoria, anxiety, tics

38
Q

2nd line treatment ADHD?

A

atomoxetine