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Flashcards in Pretest Deck (74):
1

What is seen on EEG in a tonic clonic seizure?

Interictal epileptiform discharges

2

What is seen on EEG in hepatic encephalopathy?

Triphasic waves

3

What is seen on EEG in general toxic encephalopathy?

Diffuse slowing of background rhythms

4

What is seen on EEG in Creutzfeldt-Jakob disease?

Generalized periodic sharp waves

5

What is seen on EEG in opioid intoxication?

Decreased alpha activity and increased voltage of theta and delta waves

6

What is seen on EEG when a patient smokes marijuana?

Increased alpha activity in the frontal areas of the brain, but overall slows alpha activity

7

In what defense mechanism are socially unacceptable impulses transformed into acceptable ones?

Sublimation

8

What are the three defense mechanisms used in OCD?

undoing, isolation, and reaction formation

9

What is the protest phase of separation?

When the child is calling, crying and searching for the parent and upon the parent's return the child is angry

10

What substance is used to assess dopamine activity in the CNS?

Homovanillic acid

11

What region of the brain is responsible for consolidation of immediate memory into long-term memory

Hippocampus is responsible for the consolidation of immediate memory into long-term

12

Dreaming is seen in what stage of sleep? What is seen on the EEG?

REM Sleep; characteristic low-voltage waves that are random, fast and sawtoothed

13

What are characteristics seen in REM sleep?

dreaming, lack of muscle tone (prevents from acting out dreams), increased heart rate, increased blood pressure, penile/clitoral nocturnal erections

14

What receptor is the target of the anti migraine drug sumatriptan?

serotonin receptor 5-HT1D

15

What serotonin subtype receptor is the target of risperidone?

5-HT6

16

What syndrome includes agraphia, acalculia, R to L disorientation, and finger agnosia?

Gerstmann

17

Affected patients and mother carriers of fragile X syndrome have higher incidence of what psychiatric disorders?

OCD, ADHD, persistent depressive disorder, anxiety, antisocial PD

18

A decreased latency of REM sleep is seen in what psychiatric disorder?

Major Depressive Disorder

19

Acute dystonic reactions are due to dopamine blockade in what neurologic pathway?

nigrostriatal

20

What medication can help relieve acute dystonic reactions from neuroleptic medications?

anticholinergics

21

What chromosome is presinilin 1 located on?

chromosome 14

22

During what stage of sleep do night terrors occur?

Non REM

23

Low levels of what neurotransmitter play a role in suicide behavior?

Serotonin; low concentrations the metabolite 5-HIAA have been associated with suicidal behavior

24

What neurotransmitter pathway has been implicated in the genesis of obsessive compulsive disorder?

Serotoninergic pathways; this is why SSRIs are helpful in treatment

25

What regions of the brain are damaged in thiamine deficiency?

dorsal medial nucleus of thalamus and mammillary bodies; structures are necessary for memory formation

26

A lesion to the right prefrontal region induces what kind of symptoms?

laughter, euphoria, tendency to make jokes/puns

27

A lesion to the left prefrontal region induces what kind of symptoms?

abolishes the normal mood elevating influences of this area and produces depression and uncontrollable crying

28

What region of the brain assigns emotional meaning to sensory experiences?

amygdala

29

If a person is unable to distinguish fear or anger from a person's facial expression or voice, what region of the brain might have been damaged?

Amygdala

30

What psychiatric symptoms are seen in B12 def?

Apathy, depressed mood, confusion, memory deficits

31

What is seen on the EEG in hepatic encephalopathy?

triphasic waves (in 50% of cases)

32

90% of patients with CJD have what on the EEG?

Generalized periodic sharp waves are most common

33

How long must symptoms for ADHD be present for the diagnostic criteria?

6 months

34

What is the treatment choice for nocturnal enuresis?

classic conditioning with a bell or buzzer and pad

35

What is the treatment choice for tourette's?

neuroleptic or α2 agonists

36

Why does one experience dizziness and perioral tingling/carpopedal spasm in hyperventilation?

Blow off CO2 —> cerebral vasoconstriction —> dizziness; hyperventilation —> low ionized calcium —> perioral tingling/carpopedal spasm

37

How long must one experience excessive worry/anxiety to be diagnosed with GAD?

6 months

38

If garlicky break is smelt on a patient, ingestion of what should be suspected?

Arsenic

39

What is the potential toxicity of tacrine?

Hepatotoxicity

40

What is the typical presentation of DTs in a post-op patient?

3-4 days Post op; elevated BP, tachycardia, elevated temperature

41

What is dementia pugilistica?

“Boxer’s dementia;” cognitive decline accompanied by parkinsonian symptoms

42

What is the treatment of neuroleptic malignant syndrome?

Dantrolene followed by bromocriptine

43

What neuroleptics are more likely to cause tardive dyskinesia?

Typicals; specifially high potency

44

Why use high potency antipsychotic with a benzo in acute psychotic setting?

Antipsychotic treats psychosis, benzo helps reduce the amount of antipsychotics needed and protects against dystonic reactions

45

What is an erotomanic delusion?

The delusion of having a special relationship with someone, often famous

46

What is persecutory delusional disorder?

Individual thinks they are being harassed or harmed by others

47

What is Capgras syndrome?

Individual believes familiar people have been replaced by imposters

48

What is lycanthropy?

Delusion that a person is a werewolf or another animal

49

What predominant symptom is seen in autoscopic psychosis?

Hallucination of transparent phantom of one’s own body

50

In what psychotic disorder does one develop psychotic disorder similar to those that his/her long-term partner has been experiencing?

Folie a deux

51

What is first line treatment for acute mania?

Valproic acid (use to be lithium)

52

What is the difference in diagnosing persistent depressive disorder in adolescents vs. adults?

1 year of symptoms for adolescents; 2 years of symptoms for adults

53

What labs should be done for a patient on lithium?

Thyroid functioning tests, creatinine, urinalysis, lithium level

54

What are the atypical features in major depressive disorder with atypical features?

Mood reactivity (certain events “lift” the depression), self pity, excessive sensitivity to rejection, increased appetite, increased sleeping, reversed diurnal mood fluctuations (better in morning, worse at night)

55

What drugs can be used to treat sex addiction in men?

SSRIs or medroxyprogesterone acetate

56

What is the initial dose of naloxone administered in opioid overdose?

0.8 mg IV

57

What medication can be used for the rapid relief of hallucinogen intoxication?

Benzos; otherwise low stim environment with reassurance is good too

58

What receptors does PCP act on?

NMDA - agonist

59

If a patient is on clozapine and has a WBC of 3000-3500, what should the clinician do?

Whether symptomatic or not, check labs 2x a week

60

If a patient is on clozapine and has a WBC of 2000 to 3000, what should the clinician do?

Check CBC daily and stop clozapine; clozapine may be restarted after WBC normalizes.

61

In uncomplicated agranulocytosis due to clozapine, what should the clinician do?

Patient should be placed on protective isolation, clozapine d/c’d, and bone marrow specimen may be needed

62

What is the most common side effect of Ramelteon?

Headache

63

What is St. John’s Wort used for?

Antidepressant, sedative, anxiolytic

64

How is neuroleptic malignant syndrome treated?

Neuroleptic stopped, patient cooled and hydrated; dantrolene (IV) and/or bromocriptine (po) may be given

65

How should acute dystonia from a neuroleptic be treated?

Benztropine or diphenhydramine; antipsychotic decreased

66

What sedative hypnotics are known to cause a dissociative state?

Zolpidem and zoleplon

67

What drug is helpful at treating akathisia?

Beta blockers (propranolol)

68

What effect do TCAs and SSRIs have on sleep?

Reduce REM sleep

69

What is the preferred treatment of psychotic symptoms in a patient with Parkinsons disease?

Quetiapine

70

When does lithium reach steady state?

5-7 days

71

Which antipsychotics are least likely to cause postural hypotension?

Haloperidol and fluphenazine

72

Which SSRIs are more likely to cause discontinuation syndrome?

Paroxetine and sertraline (shorter half lives)

73

Which SSRI can be stopped abruptly without problems (ie no discontinuation syndrome)?

Fluoxetine

74

How are dystonic reactions to neuroleptics treated?

IM diphenhydramine or benztropine