SAS/Review Flashcards by Madeleine (she/her) Horvath

Which opioids affect serotonin levels?

Why is this important?

Tramadol, fentanyl

Patients on serotoninergic agents should not take!

Can lead to serotonin syndrome (altered mental status, autonomic dysfunction, neuromuscular abnormalities)

How well did you know this?

Not at all

Perfectly

What kind of defense mechanism:

A perosn is angry at their phsysician for cancelling their appointment. They end up cleaning their entire department to avoid thinking about being angry

Sublimation

Channeling anger, discomfort, unpleasant thoughts at productive activities

How well did you know this?

Not at all

Perfectly

Which cognitive domain will be affected first in Dementia with Lewy Bodies?

Attention/executive function, visuospatial reasoning

Will also have Parkinsonism

(Parietal lobe)

How well did you know this?

Not at all

Perfectly

Which side effect of first-generation antipsychotics is likely to present after decades of use?

Tardive dyskinesia

Due to long term dopamine blockade

chlorpromazine, fluphenazine, thioridazine, haloperidol

How well did you know this?

Not at all

Perfectly

Describe the general timeline of symptoms onset during alcohol withdrawal

6-48h: ANS hyperactivity
12-48h: Seizures
12-24h: Hallucinations
3-5+ days: Delirium Tremens

How well did you know this?

Not at all

Perfectly

Which cognitive domain will be affected first in Frontotemporal Dementia?

Personality changes, language deficits

(Frontal lobe)

How well did you know this?

Not at all

Perfectly

What are the risks associated with MAO inhibitors?

Serotonin Syndrome
- Altered Mental Status
- Autonomic Dysfunction
- Neuromuscular abnormalities
Hypertensive crisis
- Must avoid tyramine-rich foods
Severe interaction with meperidine

MAOi

Hydrazine

Tranylcypromine

Rasagiline

How well did you know this?

Not at all

Perfectly

Which drugs increase serum Lithium levels?

NSAIDs
Diuretics
- Thiazides, spironalactone, triamterene
ACE inhibitors
Ca2+ channel blockers
Metronidazole
Tetracycline

How well did you know this?

Not at all

Perfectly

What factors might precipitate delerium?

I-WATCH-DEATH

The slides specifically highlight factors in bold

Infection - pneumonia
Withdrawal
Acute metabolic
Trauma
CNS pathology
Hypoxia/hypercarbia - hypoxia
Deficiencies
Endocrine
Acute vascular
Toxins - diphenhydramine
Heavy metal

How well did you know this?

Not at all

Perfectly

What is the difference between schizoaffective disorder and schizophrenia?

Schizoaffective disorder:
- Mood symptoms regardless of whether psychotic symptoms are present or absent
Schizophrenia:
- Mood symptoms only present when psychotic symptoms are present

(Thank you @Nathan Shlobin!)

How well did you know this?

Not at all

Perfectly

Which area/circuit of the brain is impaired in Alzheimer’s Disease?

Limbic Network

How well did you know this?

Not at all

Perfectly

Abnormal eye movements (nystagmus) are characteristic of which drug intoxication?

Phencyclidine (PCP)

How well did you know this?

Not at all

Perfectly

Which antidepressants are contraindicated in patinets with current or history of anorexia nervosa or bulimia nervosa?

Bupropion

How well did you know this?

Not at all

Perfectly

Is this neurotransmitter associated with wakefullness or sleep?

Where is it secreted?

Serotonin

Wakefullness

Raphe nuclei (pons)

How well did you know this?

Not at all

Perfectly

Which antipsychotics are most likely to have side effects of involuntary facial movements, restlessness, and dystonia?

High-potency first-generation antipsychotics

Haloperidol
Fluphenazine
Trifluoperazine

How well did you know this?

Not at all

Perfectly

Hoover’s sign provides evidence for which disorder?

Functional Neurological Disorder (aka conversion disorder)

How well did you know this?

Not at all

Perfectly

Is this neurotransmitter associated with wakefullness or sleep?

Where is it secreted?

Orexin

Wakefulness

Lateral hypothalamus

How well did you know this?

Not at all

Perfectly

Is this neurotransmitter associated with wakefullness or sleep?

Where is it secreted?

Histamine

Wakefulness

Tuberomamillary nucleus (hypothalamus)

How well did you know this?

Not at all

Perfectly

What differentiates Bipolar I from Bipolar II?

Bipolar I
- At least 1 manic episode lasting 1+ weeks
Bioplar II
- Hypomania
  - Different from mania b/c does not cause marked impairment in social/occupational functioning, does not require hospitalization
- No manic episodes

How well did you know this?

Not at all

Perfectly

E - All of the above

Bupropion = atypical antidepressant (NE and DA reuptake inhibitor)
Clonidine, guanfacine = alpha-2 blockers
Atomoxetine = selective NE reuptake inhibitor

How well did you know this?

Not at all

Perfectly

Rapid withdrawal of what hormone can trigger migraine?

Estrogen

Rapid withdrawal occurs during the following times:
- Perimenopause
- Post-partum
- Perimenstruation

How well did you know this?

Not at all

Perfectly

What is the most consistent but non-specific neuroimaging finding in schizophrenia?

Enlarged ventricles

Almost always found in patients with schizophrenia
Not specific for schizophrenia

How well did you know this?

Not at all

Perfectly

Which seizure medications are prefered in women of childbearing age?

Study These Flashcards

Lamotrigine, levetiracetam

Sometimes carbamazepine

Avoid valproate, topiramate!!

What is the most effective treatment for insomnia?

Study These Flashcards

Cognitive behavioral therapy

Focuses on:

Sleep hygeine
Sleep restriction
- Bed is for sleeping and sex only!
- Wake up at the same time every day
Stimulus control
- Don’t sleep until you’re tired
- If you can’t fall asleep in 20 min, get out of bed and read
  - Avoid screens

What is the difference between schizotypal and schizoid personality disorders?

* Schizoid * Socially withdrawn * Desire to be left alone * Limited emotional expression * Schizotypal * Also socially withdrawn * Interpersonal awkwardness * Magical thinking, eccentricity

Which area/circuit of the brain is impaired in semantic aphasia/dementia?

Central pathway of vision (temporal lobe)

A set of sidely scattered but orchestrated crerebral areas that are activated by a specific task observed on neuroimaging is a... 1. State network 2. Attention network 3. Channel network 4. Default mode network

c. Channel network

Schizophrenia is a **[developmental/degenerative]** disorder What is the brain pathology?

Schizophrenia is a **developmental** disorder Results from abnormal neuronal migration during development

What are the classic features of MDD, melancholic subtype?

* Anhedonia and/or lack of reactivity * Early morning awakening * Significant anorexia or weight loss * Excessive or inappropriate guilt

A - Methylphenidate * Bupropion can also be used for ADHD, but not first line * Guanfacine is an alpha-2 agonist that is 2nd line or ad-junct to the stimulants * Tranylcypromine is a MAO inibitor - not indicated for ADHD

Which antipsychotic may cause neutropenia?

Clozapine * Atypical anti-psychotic * Blocks serotonin and norepinephrine * Used as a 3rd line agent * But must register in database * Track any neutropenia resulting so it is not prescribed in the future

What kind of seizure is associated wtih tongue biting?

Generalized tonic/clonic seizure

What time period constitutes persistent depressive disorder?

2+ years of depressed mood for most of the day, more days than not

Which area/circuit of the brain is impaired in Lewy Body Dementia?

Dorsal Pathway of Vision (parietal lobe)

What syndrome is associated with thamine deficiency? Which population is at particular risk?

Wernicke-Korsakoff Syndrome People with alcohol-use disorder * Wernicke * Ataxia, abnormal eye movmement * Korsakoff * Amnesia, poor judgement, confabulation, spurious answers to questions

Automatisms and aura of a funny taste in one's mouth before a seizure are characteristic of which kind of epilepsy?

Temporal lobe epilepsy Automatism = fumbling with clothing/button, cannot stop

Which type of reinforcement schedule has the fastest extinction? Which types have the slowest extinction?

Fastest extinction = continuous (also has fastest learning) Slowest extinction = variable interval or variable ratio (Fixed interval and fixed ratio have the fastest conditioning)

Which antipsychotics are likely to cause abnormal lactation?

* Low-potency first-generation * Chlorpromazine * Thioridazine * Second-generation - lower risk than FGA, but can still happen * Quetiapine * Olanzapine * Risperidone * Aripiprazole * Ziprasodone * Clozapine

List the parts of the Papez circuit, in order

* Entorhinal cortex (anterior part of the parahippocampal gyrus) * Via perforant (through dentate) or alvear pathways to the... * Hippocampus * Fornix * Mammillary bodies (hypothalamus) * Via mammilothalamic tract to the... * Anterior thalamic nuclei * Via internal capsule to the... * Cingulate * Back to the parahippocampal gyrus

What kind of medication is cyclobenzaprine?

Muscle relaxant

Which sleep disorder is associated with low orexin levels in the CSF? Describe 3 associated symptoms

Narcolepsy * Cataplexy * Knees buckle in response to emotion * Vivid dreams * Sleep paralysis

Which area/circuit of the brain is impaired in frontal type dementia?

Frontal cortex

What kind of defense mechanism: ## Footnote **A perosn is angry at their psysician for cancelling their appointment. Next time they see their physician, they compliment the physician on their shirt**

Reaction formation | (Doing the opposite of what you feel)

Which class of antidepressants is most likely to have cardiac effects? What are the effects?

TCAs Long QT -\> Torsades (potentially fatal arrhythmia) * Amitriptyline * Nortriptilyine * Desipraime * Amoxapine * Imipramine * Clomipramine * Doxepin

How is lithium metabolized?

Excreted unchanged by the kidney (No hepatic metabolism)

Which cognitive domain will be affected first in Alzheimer's Disease?

Memory | (Limbic system)

What are the indications for haloperidol in a patient with delerium?

* Psychosis * Hallucinations * Agitation But remember, the focus of the treatment should always be the underlying cause!!

What further testing is indicated when a child presents with signs and symptoms of autism spectrum disorder?

* **Genetic testing** * **Lead levels (if reasonable environmental risk)** * **EEG** * Hearing and vision * Wood's lamp (for Tuberous Sclerosis)

How are abscence seizures differentiated from focal seiziures without loss of consciousness?

No post-ictal period (confusion) after abscence seizure

According to Robins and Guze (1970), what 5 steps can help achieve diagnostic validity for psychiatric disorders?

1. Clinical description 2. Delimitation from other disorders 3. Follow-up study (including treatment response) 4. Family study 5. Laboratory studies

Which kind of reinforcement schedule results in the fastest conditioning?

Fixed schedules - type of partial reinforcement (Continuous reinforcement has the fastest _learning_)

What are the classic features of MDD, atypical subtype?

* Mood reactivity * Significant weight gain * Hypersomnia * Leaden paralysis

Is this neurotransmitter associated with wakefullness or sleep? Where is it secreted? **Norepinephrine**

Wakefulness Locus ceruleus (pons)

Which medication can be used to augment the effects of SSRIs and is known for reducing the risk of suicide?

Lithium

Is this neurotransmitter associated with wakefullness or sleep? Where is it secreted? **GABA**

Sleep Ventrolateral peroptic nucleus (VLPO)

What is a "homeopathic" treatment?

Like treating like Ex: using seizures in ECT to help treat patients with seizures

SAS/Review Flashcards

(56 cards)