Flashcards in Pretest Deck (74):
What is seen on EEG in a tonic clonic seizure?
Interictal epileptiform discharges
What is seen on EEG in hepatic encephalopathy?
What is seen on EEG in general toxic encephalopathy?
Diffuse slowing of background rhythms
What is seen on EEG in Creutzfeldt-Jakob disease?
Generalized periodic sharp waves
What is seen on EEG in opioid intoxication?
Decreased alpha activity and increased voltage of theta and delta waves
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
In what defense mechanism are socially unacceptable impulses transformed into acceptable ones?
What are the three defense mechanisms used in OCD?
undoing, isolation, and reaction formation
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
What substance is used to assess dopamine activity in the CNS?
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
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
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
What receptor is the target of the anti migraine drug sumatriptan?
serotonin receptor 5-HT1D
What serotonin subtype receptor is the target of risperidone?
What syndrome includes agraphia, acalculia, R to L disorientation, and finger agnosia?
Affected patients and mother carriers of fragile X syndrome have higher incidence of what psychiatric disorders?
OCD, ADHD, persistent depressive disorder, anxiety, antisocial PD
A decreased latency of REM sleep is seen in what psychiatric disorder?
Major Depressive Disorder
Acute dystonic reactions are due to dopamine blockade in what neurologic pathway?
What medication can help relieve acute dystonic reactions from neuroleptic medications?
What chromosome is presinilin 1 located on?
During what stage of sleep do night terrors occur?
Low levels of what neurotransmitter play a role in suicide behavior?
Serotonin; low concentrations the metabolite 5-HIAA have been associated with suicidal behavior
What neurotransmitter pathway has been implicated in the genesis of obsessive compulsive disorder?
Serotoninergic pathways; this is why SSRIs are helpful in treatment
What regions of the brain are damaged in thiamine deficiency?
dorsal medial nucleus of thalamus and mammillary bodies; structures are necessary for memory formation
A lesion to the right prefrontal region induces what kind of symptoms?
laughter, euphoria, tendency to make jokes/puns
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
What region of the brain assigns emotional meaning to sensory experiences?
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?
What psychiatric symptoms are seen in B12 def?
Apathy, depressed mood, confusion, memory deficits
What is seen on the EEG in hepatic encephalopathy?
triphasic waves (in 50% of cases)
90% of patients with CJD have what on the EEG?
Generalized periodic sharp waves are most common
How long must symptoms for ADHD be present for the diagnostic criteria?
What is the treatment choice for nocturnal enuresis?
classic conditioning with a bell or buzzer and pad
What is the treatment choice for tourette's?
neuroleptic or α2 agonists
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
How long must one experience excessive worry/anxiety to be diagnosed with GAD?
If garlicky break is smelt on a patient, ingestion of what should be suspected?
What is the potential toxicity of tacrine?
What is the typical presentation of DTs in a post-op patient?
3-4 days Post op; elevated BP, tachycardia, elevated temperature
What is dementia pugilistica?
“Boxer’s dementia;” cognitive decline accompanied by parkinsonian symptoms
What is the treatment of neuroleptic malignant syndrome?
Dantrolene followed by bromocriptine
What neuroleptics are more likely to cause tardive dyskinesia?
Typicals; specifially high potency
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
What is an erotomanic delusion?
The delusion of having a special relationship with someone, often famous
What is persecutory delusional disorder?
Individual thinks they are being harassed or harmed by others
What is Capgras syndrome?
Individual believes familiar people have been replaced by imposters
What is lycanthropy?
Delusion that a person is a werewolf or another animal
What predominant symptom is seen in autoscopic psychosis?
Hallucination of transparent phantom of one’s own body
In what psychotic disorder does one develop psychotic disorder similar to those that his/her long-term partner has been experiencing?
Folie a deux
What is first line treatment for acute mania?
Valproic acid (use to be lithium)
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
What labs should be done for a patient on lithium?
Thyroid functioning tests, creatinine, urinalysis, lithium level
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)
What drugs can be used to treat sex addiction in men?
SSRIs or medroxyprogesterone acetate
What is the initial dose of naloxone administered in opioid overdose?
0.8 mg IV
What medication can be used for the rapid relief of hallucinogen intoxication?
Benzos; otherwise low stim environment with reassurance is good too
What receptors does PCP act on?
NMDA - agonist
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
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.
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
What is the most common side effect of Ramelteon?
What is St. John’s Wort used for?
Antidepressant, sedative, anxiolytic
How is neuroleptic malignant syndrome treated?
Neuroleptic stopped, patient cooled and hydrated; dantrolene (IV) and/or bromocriptine (po) may be given
How should acute dystonia from a neuroleptic be treated?
Benztropine or diphenhydramine; antipsychotic decreased
What sedative hypnotics are known to cause a dissociative state?
Zolpidem and zoleplon
What drug is helpful at treating akathisia?
Beta blockers (propranolol)
What effect do TCAs and SSRIs have on sleep?
Reduce REM sleep
What is the preferred treatment of psychotic symptoms in a patient with Parkinsons disease?
When does lithium reach steady state?
Which antipsychotics are least likely to cause postural hypotension?
Haloperidol and fluphenazine
Which SSRIs are more likely to cause discontinuation syndrome?
Paroxetine and sertraline (shorter half lives)
Which SSRI can be stopped abruptly without problems (ie no discontinuation syndrome)?