Studying Flashcards

Question

Carries a risk of permanent visual loss in 20-50% if untreated. Associated s/sx include polymyalgia rheumatica, headache (in 40% to 90%), weight loss (16% to 76%), scalp tenderness (28% to 91%), anorexia (14% to 69%), fever, leg claudication (2% to 43%), and jaw claudication (4% to 67%)

Answer 1

Giant Cell Arteritis

Answer 2

Alpha-2 adrenergic receptor antagonist -primary Serotonin 5HT2 antagonist. - Histamines receptor blockade (H1)—>sedation inc appetite. And weight gain

Answer 3

NE and DA reuptake inhibitor

Answer 4

D2 antagonists

Answer 5

LSD, psilocybin

Answer 6

Face sensory (somatic sensation for contralateral face and taste), projects to somatosensory cortex

Answer 7

Leg and arm sensory (somatic sensation to contralateral body), projects to somatosensory cortex Lateral-Leg and arm

Answer 8

Coordination and movement. Info from cerebellum and basal ganglia to motor cortex,

Answer 9

Vision (visual impulses/retina), to visual cortex

Answer 10

Hearing (auditory impulses) to primary auditory cortex.

Answer 11

Coordination and movement. Info from cerebellum and basal ganglia to motor cortex, .

Answer 12

: motor information about movement/tremor eg movement initiation. Basal ganglia to premotor cortex.

Answer 13

R parietal lobe

Answer 14

Gerstmann syndrome, L parietal lobe lesion

Answer 15

Mesial or hippocampal sclerosis

Answer 16

binds to dopamine transporter, inhibits dopamine reuptake. Also increases activity in the tuberomamillary nucleus (which is primarily histaminergic)

Answer 17

Adrenoleukodystrophy

Answer 18

Vision and hearing issues, hyperactivity, paralysis, seizures, muscle weakness, adrenal failure

Answer 19

X linked. So think if you see in males. Accumulation of very long chain fatty acids.

Answer 20

Lesch-nyhan syndrome, build up of Uric acid

Answer 21

Presents late in first year of life, psychomotor retardation, choreathetosis, spasticity and severe self injury

Answer 22

Slow spike and wave/ poly spike and wave

Answer 23

Long term potentiation

Answer 24

Inhibit Reuptake 5Ht and NE Also have: 1. Antihistaminic properties: sedation 2. Antimuscarinic: dry mouth, constipation, urinary retention, blurred vision, tachycardia 3. Antimuscarinic: Weight gain!

Answer 25

Serotonin, norepinephrine reuptake inhibitors.

Answer 26

Fluoxetine and Paroxetine

Answer 27

Paroxetine, due to more anticholinergic activity than others. Also more sedation.

Answer 28

Most SSRI: 2 weeks Fluoxetine: 5 weeks

Answer 29

CYP 2D6 inhibitor Leads to increased TCA levels (inc cardiac risk), benzos (inc sedation), Carbamazapine (inc toxicity), warfarin (inc toxicity), phenytoin (inc toxicity), warfarin (inc toxicity), bupropion (inc seizure risk)

Answer 30

Potent 1A2 inhibitor Moderate 2C19 inhibitor

Answer 31

SSRI more weight gain, SNRI hypertension

Answer 32

Serotonin syndrome

Answer 33

Chronic liver disease.

Answer 34

Duloxetine Venlafaxine more discontinuation syndrome

Answer 35

Block monoamine oxidase which leads to delaminating of 5ht, NE and DA - prevents their inactivation

Answer 36

MAO is in GI tract and prevents tyramine metabolism. Tyramine levels which are high lead to sever hypertension! Foods: aged/smoked things, soy, fave and broad beans

Answer 37

Meperidine (Demerol) Epinephrine Decongestants Anesthetics with sympathomimetrics

Answer 38

No dietary restrictions needed at low dose

Answer 39

Phentolamine

Answer 40

Selegiline, b/c more selective to MAO-B inhibition up to 10 mg

Answer 41

Buildup of stored catecholamines Hypertension, headache, diaphoresis, N.V, autonomic changes, chest pain, arrhythmia, death

Answer 42

Parathesias and weakness,

Answer 43

Agonist and partial agonist of presynaptic receptors 5HT-1A

Answer 44

Partial DA agonist, partial 5HT agonist

Answer 45

Anticholinergic, high Sedation, high EPS, none

Answer 46

Ppl taking antipsychotic for >2 yrs, more common in older women, or long term antipsychotic use

Answer 47

Mesolimbic

Answer 48

Mesocortical

Answer 49

DA pathway b/w ventral tegmental, nucleus’s accumbens, also includes the fornix, amygdala and hippocampus

Answer 50

Nigostriatal DA pathway

Answer 51

Tuberoinfundibular pathway (Hypothalamus to the anterior pituitary)

Answer 52

NE, DA reuptake inhibitor

Answer 53

Increased CPK, INc LFTS, leukocytosis

Answer 54

Fever Autonomic instability Lleukocytosis Tremor Elevated creatinine phosphokinase Rigidity Eexcessive sweating Delirium - will NOT HAVE hyperreflexia.

Answer 55

Initiation or rapid withdrawal

Answer 56

Dopaminergic agents Dantrolene Bromocriptine: D2 agonist AMantadine Benzos ECT Levodopa/Carbidopa

Answer 57

Sodium bicarbonate, lipid emulsion, plasmaphoresis in severe cases

Answer 58

Glutamate Antagonist (via NMDA receptors) Blocks glutamate transmission.

Answer 59

Renal issues

Answer 60

mu-opioid receptor antagonist.

Answer 61

Contraindicated in pts on opioids for pain, advanced liver disease, LFTS 3-5X over normal

Answer 62

Liver, can’t give if LFTS >3x expected

Answer 63

Kidney, contraindicated in severe renal disease

Answer 64

In liver blocks conversion of acetaldehyde to acetate by inhibiting aldehyde dehydrogenase so inc acetaldehyde levels. - leads to Hypotension, nausea and flushing. (for ETOH use disorder). - In brain Blocks dopamine-beta-hydroxylase—> catalyzes DA—> NE; modulates ratio of DA to NE and changes behavioral response to cocaine

Answer 65

Nicotine receptor partial agonist.

Answer 66

adrenergic agonist for helping SSRI induced sexual dysfunction but can lead to more anxiety

Answer 67

tetracyclic antidepressant. - Presynaptic alpha-2 adrenergic receptor antagonist. Serotonin 5HT2 antagonist. - H1 receptor blockade leads to sedation and weight gain

Answer 68

At least 3 non overlapping symptoms

Answer 69

Lead poisoning

Answer 70

Aka Methylbenzene Encephalopathy, cerebellar, brain stem, basal ganglia, and cranial nerve dysfunction In paint, adhesives, and pesticides.

Answer 71

Platinum drugs (cisplatin, —platin) Affect dorsal root ganglion, or large myelinated axons. Coasting symptoms worsen even after exposure.

Answer 72

Carbon Monoxide

Answer 73

Melanie Klein

Answer 74

theory of internal object relations based on instinctual drives in children. - Focus on Projection - The "bad mother" - "paranoid-schizopid position"- infant uses to conceptualize parts of the mother as all good or all bad - "depressive position: infant views mom as ambivalaent and having both positive and negative aspects - Developed analytic play therapy.

Answer 75

- infant uses to conceptualize parts of the mother as all good or all bad

Answer 76

Melanie Klein

Answer 77

: infant views mom as ambivalaent and having both positive and negative aspects Melanie Klein 1882-1960

Answer 78

Melanie Klein

Answer 79

genetic-dynamic approach to psychobiology- blend genetic and environmental - Emphasized social and interpersonal was most important locus of personas adaptation. - Chronological life chart with important bio and psychosocial evens, emphasized current events, and importance of human relationship b/w pt and therapist.

Answer 80

Interpersonal theory of psychopathology. Focus on relationships rather than drives (Freud) as important in human experience. - Healthy relationships needed for good mental health. - Anxiety passed from infant to mother, then pathological when manifest in other relationships. - Security operations: good me, bad me, not me. - Thought schizophrenia could be treated through repairing psychological relationships - Therapist was an active, "participant-observer"

Answer 81

Development of self and identity through social norms and biological drives. (blank) vs (blank)

Answer 82

1. Trust vs mistrust: birth to 18 mo 2. Autonomy vs shame : 18 mo-3 yrs 3. Initiative vs guilt: 3-6 yrs 4. Industry vs inferiority:6-12 yrs 5. Identity vs role confusion: 12-18 yr 6. Intimacy vs isolation: 18-35 yr 7. Generativity vs stagnation: 35-65 yr 8. Ego integrity vs despair: 65 to death

Answer 83

Birth to 18 mo - Basic trust

Answer 84

18 mo-3 yrs - Control and independence

Answer 85

3-6 yrs - Taking control of the environment, purpose

Answer 86

6-12 yrs - Confidence, competence, social skills

Answer 87

12-18 yr - Formation of identity, devotion

Answer 88

18-35 yr - Forming a relationship commitment

Answer 89

: 35-65 yr - Building a family, having productive career

Answer 90

: 65 to death - Viewing life as meaningful and fulfilling

Answer 91

: social and cultural influences on psychosexual development, differences in psychology bw men and women. - Bx caused by libidnal drives from childhood - Holistic psychology: person strives to be seen as a whole. - Actual self, real self, and idealized self. - Allow person to strive for self-realization by understanding distortions that prevent growth.

Answer 92

: person strives to be seen as a whole. Karen Horney 1885-1952

Answer 93

Karen Horney

Answer 94

Karen Horney

Answer 95

mu-opioid receptor antagonist. Long acting injection (vivitrol)

Answer 96

Disulfiram: In liver blocks conversion of acetaldehyde to acetate by inhibiting aldehyde dehydrogenase so acetaldehyde levels. Hypotension, nausea and flushing. (for ETOH use disorder). In brain Blocks dopamine-beta-hydroxylase—> catalyzes DA—> NE; modulates ratio of DA to NE and changes behavioral response to cocaine

Answer 97

1. Lorazepam- 2 mg 2. Clonazepam- 1 mg 3. Diazepam- 10 mg 4. Chlordiazepoxide- 25 mg 5. Phenobarbital- 30 mg

Answer 98

Abdominal pain, vomiting, confusion, depressed reflexes, hallucinations, and seizures

Answer 99

1. Non-fluent: difficult speech generation, esp articulation, grammar probs, impaired comprehension 2. Semantic: word finding difficulty, trouble naming, trouble understanding nouns.

Answer 100

Primary progressive aphasia, type of FTD This is non-fluent subtype

Answer 101

Reversible ACHesterase inhibitor

Answer 102

Watershed at border zones, high risk of infarcts at young age.

Answer 103

Globus Pallidus

Answer 104

Parkinson's

Answer 105

partial agonist 5ht-1A receptor

Answer 106

Temporal lobe

Answer 107

alpha-1 receptors but also DA blockade due to decreased sex drive

Answer 108

Agranulocytosis

Answer 109

interpersonal boundary issue

Answer 110

5HT-1D and 5HT1-B agonist

Answer 111

Partial D2 agonist 5HT1A partial agonist 5HT2A antagonist

Answer 112

corticosteroids

Answer 113

Group psychoeducation

Answer 114

Variable ratio

Answer 115

ADHD- 9.4% of ages 2-17

Answer 116

2 years in adults, 1 year in children and adolescents. cannot have met MDD or mania criteria

Answer 117

Karen horney

Answer 118

Li has insulin like effect that lowers blood sugar, and inc appetite and wt gain.

Answer 119

ictal PET or FMRI, SPECT

Answer 120

increase IR dose to 15%

Answer 121

obligation to help patients and relieve suffering.

Answer 122

duty to protect a patient's freedom to choose.

Answer 123

air distribution and application of services.

Answer 124

hypokalemic hypochloremic alkalosis

Answer 125

positive when cuts or scrapes to the backs of the hands are noted, which are a result of the teeth scraping the fingers while vomiting

Answer 126

natural environment animal blood-injection injury situation other

Answer 127

increased catecholamines d/t SNS hypervenitllation, leads to dec Co2 (hypocapnea, respiratory alkalosis),

Answer 128

>/= 4 depressive, manic or hypo manic episodes in past year, must have partial remission for at least 2 mo or switch directly to opposite type of mood

Answer 129

Low csf Hypocretin peptide aka orexin Low hypocretin/orexin in csf

Answer 130

chromosome 6 in narcolepsy-cataplexy in 90-1005 of ppl with narcolepsy but also 50% of ppl w/o.

Answer 131

Meds: methylphenidate (daytime sleepiness-FDA), adderall (daytime sleepiness -FDA), modafinil, amodafonil (nuvigil). For cataplexy sodium oxybate (xyrem)

Answer 132

Cataplexy in 30-70% often in strong emotion

Answer 133

childhood maltreatment 90%

Answer 134

Substance use disorder 11 total criteria Mild= 2-3, moderate= 4-5, severe=6

Answer 135

CBT can reduce Sx SSRI tx for irregular menses b/c symptoms hard to predict.

Answer 136

need 5/11 symptoms in final week before menses.

Answer 137

clear and convincing evidence

Answer 138

malpractice suit

Answer 139

Guilt beyond a resonance doubt:

Answer 140

Substantial evidence:

Answer 141

on the stand, specialized knowledge, if court order waiver of privilege is implied. If conflict of interest must identify to the court.

Answer 142

a witness with knowledge about the case, do not offer opinions

Answer 143

legal rule that protects certain info from being shared, the individual has privilege not the physician

Answer 144

60-80% are male (reading, writing, or math), not attributable to ID

Answer 145

- Nicotine leads to release of ADH, which fuels thirst, so more likely in heavy cigarette smokers - Severe hyponatremia <130mmol/L can occur and h2o intoxication. —>? Leads to cerebral edema, delirium, seizure, coma, and death. - Tx: Na replacement and water restriction

Answer 146

Beriberi": neuropathy, weakness, muscle wasting, cardiomegaly, ophthalmoplegia, confabulation

Answer 147

Niacin Pellagra Pigmented rash of sun-exposed areas, disorientation, and problems with memory, diarrhea, memory problems, bright red tongue

Answer 148

Seborrhoeic dermatitis, inflamed tongue, neuropathy, confusion, depressed mood, microcytic anemia

Answer 149

Folate Shrunken and inflamed tongue, megaloblastic anemia, high homocysteine

Answer 150

Cobalamin Dorsal column loss of vibratory and position sense, ataxic gait, dementia, loss of control of bowels, erectile dysfunction, megaloblastic anemia

Answer 151

1. rapid sodium replacement in hyponatremia is This can result in a clinical transection of the pons and a locked-in syndrome. 2. ventral pontine infarct as a consequence of basilar artery thrombosis

Answer 152

Arachnoid (pacchionian) granulations:

Answer 153

clean up cells (macrophages)

Answer 154

glial cells responsible for development and framework of neurons.

Answer 155

insulate axons, provide myelin sheath

Answer 156

: line ventricles, produce CSF

Answer 157

primary progenitors

Answer 158

myelinate the PNS

Answer 159

- Telencephalon- cerebral hemispheres, lateral ventricles - Diencephalon- Thalamus, hypothalamus, epithalamus, retina, pineal gland, third ventricle

Answer 160

- Mesencephalon: midbrain, cerebral aqueduct

Answer 161

- Metencephalon: pons, cerebellum, upper part of 4th ventricle - Myelencephalon: medulla, lower part of 4th ventricle.

Answer 162

cerebral hemispheres, lateral ventricles

Answer 163

Thalamus, hypothalamus, epithalamus, retina, pinela gland, third ventricle

Answer 164

midbrain, cerebral aqueduct

Answer 165

pons, cerebellum, upper part of 4th ventricle

Answer 166

medulla, lower part of 4th ventricle.

Answer 167

diencephalon

Answer 168

telencephalon (part of the cerebral hemispheres)

Answer 169

Myelencephalon

Answer 170

telecephalon (part of the cerebral hemispheres)

Answer 171

Metencephalon

Answer 172

Substantia Nigra

Answer 173

Raphe Nucleus (brain stem) Part of reticular formation

Answer 174

Locus Ceruleus - nucleus in the pons, blue colored

Answer 175

Nucleus Basalis of Meynert

Answer 176

Nicotinic, Muscarinic

Answer 177

AMPA, NMDA, Kainate

Answer 178

GABA-A: benzos, GABA-B: GHB

Answer 179

H1- histamine receptor

Answer 180

5ht-3 receptor antagonist, Anti nausea effect

Answer 181

Tyrosine hydroxylase

Answer 182

NMDA (glutamate, excitatory)

Answer 183

Glutamate, leads to excessive CA++ and cell death

Answer 184

decreased hippocampal volumes, smaller anterior cingulate cortex volume.

Answer 185

Pseudotumor cererbri

Answer 186

benign intracranial hypertension

Answer 187

lumbar puncture with measurement of the opening pressure, which is elevated over 20 cm H2O.

Answer 188

acetazolamide or with prednisone. Can do lumbar punctures to siphon off fluid to maintain normal CSF pressure. Surgery: ventriculoperitoneal shunting, or lumboperitoneal shunting if the ventricles are too small, and optic nerve sheath fenestration, which can siphon off CSF.

Answer 189

Trigeminal nerve (CNV)

Answer 190

15min-3 hrs

Answer 191

At least 5 lasting 4-72 hrs

Answer 192

Two of the following characteristics: 1 unilateral location, 2 pulsating quality, 3 moderate or severe intensity, or 4 aggravated by walking stairs or similar routine physical activity. During the headache at least one of the two following symptoms occurs: phonophobia and photophobia, nausea and/or vomiting.

Answer 193

ON usually presents with eye pain that increases with eye movement followed by central visual loss (scotoma) in the affected eye. is a common sign of MS and is frequently the cause of initial presenting symptoms.

Answer 194

Globes pallidus, Caudate, putamen, substantia nigra, Subthalamic nucleus

Answer 195

Arousal, sleep/wake cycles

Answer 196

- 2-30 min duration, can happen multiple times per day. Autonomic symptoms (lacrimation, conjunctival injection, and Horner syndrome), Neck movement trigger episodes.

Answer 197

Giant Cell Arteritis

Answer 198

Vision loss d/t central retinal artery occlusion

Answer 199

Golds standard: temporal artery biopsy Screen: elevated ESR

Answer 200

Neurosyphillis: progressive dementia, dysarthria, tremors, and hypotonia.

Answer 201

Caudate nucleus

Answer 202

Temporal, inferomedial temporal lobes

Answer 203

Periodic lateralized epileptiform discharges (PLEDs)

Answer 204

IV acyclovir

Answer 205

Methadone most extensively studied Buprenoprhine also okayed

Answer 206

milnacipran (SNRI), duloxetine, and pregabalin.

Answer 207

pain for greater than 3 months or more without another identified cause. Although widespread tenderness is present, there is a lack of joint swelling or inflammation. Often soft tissue sites are more painful than joints. In addition, fatigue, waking unrefreshed, and cognitive symptoms are also included criteria.

Answer 208

- more REM episodes noted. - REM episodes are shorter -less total REM sleep. - NREM sleep there is a decreased amplitude of delta waves. -lower percentage of N3 sleep. - higher percentage of N1 and N2 sleep. - increased awakening after sleep onset.

Answer 209

At least 3 mo

Answer 210

Examining a situation from distance and more objectively. Associated with mindfulness

Answer 211

MD1- trinucleotide repeat in DMPK, chromosome 19 MD2- tetranucleotide repeat in zinc finger protein 9 gene (ZNF9 or CNBP) chromosome 3

Answer 212

Decreased glucose uptake on affected side

Answer 213

Behavioral syndrome: hyperreligiosity, circumstantiality, hyper graphic, hypo sexuality and intense emotional response Associated with temporal lobe seizures, particularly complex partial seizures

Answer 214

Prolonged febrile convulsions of childhood, or anoxia at birth (Of note less common are tumors (eg astrocytomas), and infections (eg herpes)

Answer 215

Astrocytoma

Answer 216

Glioblastoma and anaplastic astrocytoma

Answer 217

Benign rolandic seizures

Answer 218

Most outgrow by adulthood

Answer 219

Benign rolandic seizures Involvement of tongue and possible respiratory spasm

Answer 220

Stenosis of subclavian near the vertebral artery, more common on the L b/c branc from aorta. Leads to vertebrobasilar insufficiency due to decreased/reversal fo blood flow See l arm cluadication, numbness, down L arm, dec BP/HR in L arm Neuro sx: Dizziness, double vision, dysphasia, numbness of ipsilateral face and contra lateral limbs.

Answer 221

Eye Opening Response • Spontaneous--open with blinking at baseline 4 points • To verbal stimuli, command, speech 3 points • To pain only (not applied to face) 2 points • No response 1 point Verbal Response • Oriented 5 points • Confused conversation, but able to answer questions 4 points • Inappropriate words 3 points • Incomprehensible speech 2 points • No response 1 point Motor Response • Obeys commands for movement 6 points • Purposeful movement to painful stimulus 5 points • Withdraws in response to pain 4 points • Flexion in response to pain (decorticate posturing) 3 points • Extension response in response to pain (decerebrate posturing) 2 points • No response 1 point

Answer 222

CES1A1 by ritalinic acid in the liver

Answer 223

Decreased formation of Purkinje cells in cerebellum

Answer 224

Diabetic peripheral neuropathy Fibromyalgia

Answer 225

Depression

Answer 226

Tuberomamillary nucleus

Answer 227

Can cause decreased night vision and corneal opacities

Answer 228

Autosomal dominant Trinucleotide CTG repeat in DMPK (Dystrophia myotonica protein Kinase gene) >100,000s repeated vs normal 5-35 Chromosome 19

Answer 229

More severe (aka Steinert’s Disease) DISTAL weakness/wasting Percussion grip myotonia, muscle weakness of face, neck, forearm, and hand and foot dorsiflexors. Muscle pain dysphasia, respiratory muscle involvement, dysarthria Cataracts cardiac conduction issues infertility, insulin resistance

Answer 230

Autosomal Dominant Tetranucleotide repeat CCTG on zinc finger protein 9 gene (ZNF9 or CNBP genes); 75-11,000 repeats vs 11-26 normal Chromosome 3

Answer 231

PROXIMAL weakness Milder, grip and percussion myotonia (tap on the air emenance leads to thumb abduction and slow relaxation) and weakness in neck flexors elbow extensors, finger flexors, and hip flexors

Answer 232

X linked disorder with accumulation of very-long-chain fatty acids

Answer 233

Sx: vision and hearing impairment, aphasia, hyperactivity, paralysis, seizures, muscle weakness, adrenal failure, and coma

Answer 234

Dystrophiniopathy- lack dystrophin X-linked

Answer 235

Gower maneuver Most commoon childhood childhood muscular dystrophy Diminished DTR, muscle weakness proximal>distal Elevated Creatinine phosphokinase (CPK) ID in 1/3 cases Enlarged muscles (fat infiltration) esp calves

Answer 236

Chromosome 7q

Answer 237

Microdeletion of 7q, loss of elastin gene, AD inheritance Hemizygous deletion including the elastin locus on chromosome 7q11–q23.

Answer 238

Short stature, unusual facial features that include depressed nasal bridge (an upturned nose), broad forehead, widely spaced teeth, broad forehead, full/wide lips, and elfin-like facies, as well as thyroid, renal, and cardiovascular anomalies. Psychiatric symptoms include anxiety, hyperactivity, and hypermusicality.

Answer 239

FMR1 gene, most common form inherited ID. Males more impaired than females. The chromosomal anomaly lies at Xq28 Trinucleotide repeat

Answer 240

moderate to severe MR, macro-orchidism, prominent jaw, large ears, narrow face, arched palate, autistic features and high-pitched speech. Hyperactivity and inattention are characteristic in affected males with fragile X syndrome.

Answer 241

Fragile X-associated tremor/ataxia syndrome: Progressive neurological decline. FMR1 gene at Xq27.3 on southern blot or PCR. MRI:generalized cortical and cerebellar atrophy with increased signal intensity. Jacksonian March: type of focal seizure. Begins in finger or toe or corner of mouth the. Spreads to ipsilateral area of body

Answer 242

Trisomy 21

Answer 243

deletion at the short arm of chromosome 5p15.2.

Answer 244

Cri-du-chat syndrome

Answer 245

Fetal alcohol syndrome:

Answer 246

Fetal alcohol syndrome:

Answer 247

TSC1 or TSC2 gene Tuberous sclerosis is an autosomal dominant neurocutaneous d/o

Answer 248

Tuberous sclerosis:

Answer 249

Tuberous sclerosis:

Answer 250

(irregularly shaped, often raised or textured skin lesion on the back or flank). Tuberous sclerosis

Answer 251

Chromosome 3

Answer 252

chromosome 6

Answer 253

Chromosome 19

Answer 254

Myasthenia Gravis

Answer 255

Pyridostigmine

Answer 256

Rett syndrome

Answer 257

mutation of the 60-exon NF1 gene on chromosome 17q

Answer 258

café au lait spots [six or more to make the diagnosis], subcutaneous neurofibromas, axillary freckling, Lisch nodules [pigmented iris hamartomas], optic nerve glioma, neurofibromas, and schwannomas) any two of the following seven criteria to carry the diagnosis: six or more café au lait spots and over 15 mm if after puberty, axillary or inguinal freckling, optic glioma, two or more neurofibromas or one plexiform neurofibroma, a first-degree relative with NF1, two or more Lisch nodules (hamartomas of the iris), and characteristic bony lesion such as thinning of long bones or sphenoid dysplasia.

Answer 259

mutation of the NF2  gene on chromosome 22.

Answer 260

Metachormoatic leukodystrophy:

Answer 261

Chromosome 22q13

Answer 262

Myelin disorder, deficiency in arylsulfatase A Chromosome 22q13 Inheritance is autosomal recessive. Leads to progressive demyelination

Answer 263

Tay Sachs:

Answer 264

AR HEXA gene on chromosome 15

Answer 265

Krabbes disease: (aka globoid cell leukodystrophy)

Answer 266

autosomal recessive deficiency in galactocerebrosidase beta-galactosidase. Chromosome 14q31

Answer 267

Chromosome 14q31

Answer 268

Krabbes disease (aka globoid cell leukodystrophy)

Answer 269

Fabry disease:

Answer 270

Structural family therapy, roll of structural family imbalances

Answer 271

Unified detachment: examining problem from an emotional distance with greater objective focus. Comes from mindfulness, immersion in the present moment. Empathic joining: evocation of strong emotions in the dyad Tolerance building: helping dyad become more tolerant of upsetting behaviors

Answer 272

looks at the past, and how causing present problems. Multigenerational transmission and encourages change through insight.

Answer 273

Structural: looks at blueprint of ”healthy” family, well defined subsystems, clear boundaries, and parents in charge. Minuchin

Answer 274

Strategic: change that interrupts maladaptive bx sequences

Answer 275

Experiential: focuses on the present and encourages change through growth experiences

Answer 276

Systemic: change occurring due to changes beliefs.

Answer 277

: diagnosed narcissistic personality based on self object transference of mirroring and idealization. Self-psychology.

Answer 278

more confrontational to defenses. Dx of narcissism based on defenses pt uses. Main defenses are Splitting, projective identification, and primitive idealization. Borderline and narcissistic share borderline personality structures. Narcissistic ppl suffer from pathological fusion of aspects of ideal self, real self and idealized objects.

Answer 279

9 dimensions of temperament

Answer 280

Activity level: how physically active a person is Biological rhythms: regularity of someone’s internal drives, like eating, sleeping and toileting. Sensitivity: How children react to their environment, inc sensory Intensity of reaction: how strongly they react to situations Adaptability: how easily someone can adjust to change or new situations. Approach/withdrawal: how quickly and easily a person adjusts to changes or new situations. Persistence: how long you are able and willing to stick to a task, even when it is challenging Distractibility: how easily someone is distracted by their environment. Mood: overall tone of a person’s feelings, interactions and behaviors.

Answer 281

transactional theory of stress and coping. Stress is a product of person and environment.

Answer 282

: personality style and hardiness (good health under stress)

Answer 283

primary and secondary appraisal. One is stress a threat, second evaluating coping skills during stress.

Answer 284

triangle of conflict and triangle of persons theory

Answer 285

anxiety provoking therapy, therapist acts as teacher

Answer 286

intense short term dynamic psychotherapy

Answer 287

Existential Therapy, therapist as empathic helper

Answer 288

Winnicot, reminds of mother

Answer 289

mother plays a vital role in bringing the world to the infant and offering empathic anticipation of the infant's needs. If she does these things well enough the baby will move toward the development of a healthy sense of self.  Good enough

Answer 290

developed stages of separation–individuation to describe how children develop identity that is separate from their mothers. Her stages were normal autism, symbiosis, differentiation, practicing, rapprochement, and object constancy. 

Answer 291

 Learned helplessness is a model for depression developed by Seligman, in which an organism learns that no behavioral change can influence the environment.

Answer 292

social learning theory, which says we learn through modeling others and through social interaction

Answer 293

habituation and sensitization in snails. Habituation theory says that an animal can learn to stop responding to a repeated stimulus. 

Answer 294

developed classical conditioning. In classical conditioning, a neutral stimulus is paired with one that evokes a response so that eventually the neutral stimulus comes to evoke the same response.

Answer 295

classical psychoanalysis, drive theory. Libido and aggression. Four parts of the drive: Source: where it comes from in the body Impetus: amount or intensity of drive Aim: action that discharges tension Object: target of the action

Answer 296

birth-1, erogenous zone=mouth primary source of interaction occurs through the mouth, ex rooting and sucking reflex is especially important. derives pleasure from oral stimulation through gratifying activities such as tasting and sucking. infant is entirely dependent upon caretakers (who are responsible for feeding the child), the child also develops a sense of trust and comfort through this oral stimulation. primary conflict: weaning process--the child must become less dependent upon caretakers. If fixation occurs at this stage, issues with dependency or aggression. Oral fixation can result in problems with drinking, eating, smoking, or nail-biting.

Answer 297

1-3 years, erogenous zone: bowel and bladder control Focus of libido controlling bladder and bowel. Conflict: toilet training- learnt o control bodily needs Achieving leads to accomplishment and independence If parents take an approach that is too lenient, Freud suggested that an anal-expulsive personality could develop in which the individual has a messy, wasteful, or destructive personality. If parents are too strict or begin toilet training too early, Freud believed that an anal-retentive personality develops in which the individual is stringent, orderly, rigid, and obsessive.

Answer 298

2-6, genitals Difference b/w male and female Oedipal complex boys see fathers as rivals, for moms affection Electra complex for girls

Answer 299

6 to puberty, sexual feelings inactive Ego and Super ego develops and ids energies are suppressed Children develop social skills, values and relationships with peers and adults outside of the family. stage is important in the development of social and communication skills and self-confidence. Fixation at this stage can result in immaturity and an inability to form fulfilling relationships as an adult.

Answer 300

puberty to death, maturing sexual interests onset of puberty causes the libido to become active once again. The goal of this stage is to establish a balance between the various life areas.

Answer 301

Avoid with anti-platelets and anticoagulants. Can take with SSRI for sexual side effects (largely anecdotal data). blood flow and cognitive enhancement.

Answer 302

anti inflammatory. No known drug intxns. Avoid in immune related conditions

Answer 303

Aka Hypericum perforatum : herbal TX for depression, CYP induction and lowers levels of many drugs, including warfarin and digoxin. RCT showed some effectiveness in somatoform d/os. SSRI effects so can lead to serotonin syndrome.

Answer 304

aka piper methysticum sedative, and anesthetic qualities in beverages. Some use in helping with anxiety and adjustment disorders in a RCT. Acts on GABA receptors. Can lead to liver toxicity in long-term use. Don’t take with ETOH, be so, or barbituates due to GABA effects

Answer 305

(Garlic) mild cholesterol lowering effects. Should be used cautiously with anti platelet and anticogulants. Avoid in warfarin duper to risk of bleeding.

Answer 306

can cause insomnia, mania, and irritability. People take to improve mental and physical performance.

Answer 307

(omega 3 FA): adjunctive tx for depression

Answer 308

should take <250 mg /day

Answer 309

can lead to serotonin syndrome, used as OTC hypnotic.

Answer 310

False positive drug tests: Fales positive Cannabinoids- ?NSAIDS False positive Opiates: Poppy seeds, verapimil, quetiapine, and diphenhydramine False positive for amphetamines: Selegiline

Answer 311

Duration in drug testing: PCP in urine for up to 8 days Cannabis: up to 4 weeks Cocaine: up to 8 hrs Heroin: up to 72 hr

Answer 312

Arsenic poisoning:

Answer 313

AKT1 (more consistent data), also COMT (Val/Val and Val/Met/ Val158Met) in homozygous and heterozygous genetic set ups

Answer 314

MDMA (ecstasy)

Answer 315

Nitrous oxide inhalation

Answer 316

B12 deficiency, inactivates cobalamin by oxidation

Answer 317

maladaptive behavior such as assaultiveness, impaired judgment, and neurological signs such as dizziness, slurred speech, ataxia, tremor, blurred vision, stupor, and coma. Can see depressed reflexes when intoxicated.

Answer 318

relative of PCP. Intoxication presents as belligerence, impulsivity, psychomotor agitation, and impaired judgment. Physical signs include nystagmus, hypertension, ataxia, dysarthria, or muscle rigidity. Psychosis may be present and can persist for up to 2 weeks after intoxication.

Answer 319

30% with chronic ETOH have family member with chronic ETOH

Answer 320

Sleep wake disorder: insomnia type- dif falling./staying asleep and nighttime awakening. Restless sleep. Increased nrem sleep, decreased rem sleep. Can increase apneic episodes in OSA

Answer 321

GGT and CDT

Answer 322

poor dentition skin picking and formication

Answer 323

euphoria, anxiety, anger, hypervigilance, and impaired judgment and functioning Can have psychosis—paranoia Visual hallucinations, hyperactivity, confusion and incoherence Muscle cramps, hypoMg, and hypokalemia

Answer 324

GHB withdrawal: Early signs: Later signs; More common in chronic users using every 3-4 hrs

Answer 325

causes monoamines to be released from storage vesicles into the cytoplasm. It also leads to dopamine, norepinephrine and serotonin to release into the synaptic cleft. (inc NE, DA, and 5HT)

Answer 326

Disorientation then rush, euphoria, tachycardia, hypertension, hyperthermia, increased risk for seizures. Decreased appetite. Dilated pupils.

Answer 327

Stage 1: Transition phase (5%)- light sleep, alpha and theta waves EEG Stage 2: Sleep spindles and K complexed on EEG (50%),dec temp RR, and BP Stage 3: Slow-Wave sleep (10-20%)- occurs more frequently in the first half of the night. Slow wave/delta waves on EEG REM (20-50%)- Dreams during this phase, increases in length and frequency as approaching morning. Atonic skeletal muscle, EEG looks like awake. inc RR, HR,BP.

Answer 328

Decreased slow wave sleep (phase 3). Increased sleep latency, decreased total sleep time. REM latency is shorter, and decreased eye movement when in REM.

Answer 329

Newborns sleep longer but shorter intervals, at rem sleep at sleep onset, and increased REM sleep time. As they mature they shift to adult sleep patterns. 3 months start To develop Circadian pattern And start sleep in NREM

Answer 330

Decreased REM latency in schizophrenia exacerbation, decreased sleep time total and decreased slow wave sleep

Answer 331

depression; waking too early and can’t fall back to sleep

Answer 332

Refractory epilepsy (12+) Treatment resistant depression in adults Treatment resistant depression in kids 12-17 Placed around L vagus nerve in carotid sheath (less cardiac innervation than R) maybe by stimulation of locus coeruleus and median raphe nucleus to stimulate 5ht and NE release maybe

Answer 333

Maudsley Model: Anorexia, family based therapy for pts up to 19. Family plays an active role in tx, goal of weight restoration, then the eventual return of control of eating habits.

Answer 334

Complicated bereavement (grief after loss of loved one) Role dispute (conflict in significant relationship) Role transition (difficulties adapting to change in relationships/life circumstances) Interpersonal deficits (difficulties stemming form social isolation and lack of life events.)

Answer 335

Dorsolateral prefrontal cortex

Answer 336

Failed one SSRI at appropriate dose with ongoing sx

Answer 337

De Clerambault syndrome:

Answer 338

Cotard syndrome:

Answer 339

Adults: wt <75% EBW, BP <80/60 mmhg, HR <50bpm, T <97F K <3 mEq/L, Glucose <60, Electrolyte derangements Dehydration Liver, Kidney, or cardiac complications Poorly controlled diabetes Children: Wt <85% EBW, BP <80/50 mmhg, orthostatic hypotn, HR around 40 bpm HypoK (<4)Treatment of board, Hypophos, HypoMg (<2)

Answer 340

abt 9% of kids in most cultures. 2:1 male to female ratio in kids, and 1.6:1 in adults.

Answer 341

prob that person with condition will test positive TP/TP+FN

Answer 342

prob that a person without condition will test negative TN/FP+TN

Answer 343

likelihood that individual with a neg result is truest negative for condition TN/all negatives

Answer 344

risk of exposed group-non exposed group

Answer 345

likelihood individual without a positive result has the disease. TP/All positives

Answer 346

multiple variables have similar patters bc all associated with “latent” variable (a variable that is note measured directly). Can do factor analysis to asses things that are not measured directly

Answer 347

Covariance:

Answer 348

Type I error

Answer 349

Type II error Denoted by study power

Answer 350

sa measurement of the direction and strength of the relationship between two variables. The Pearson correlation coefficient is on a scale from −1 to +1. A positive correlation means that one variable moves the other in the same direction. A negative value means that one moves the other in the opposite direction. A correlation close to −1 or +1 shows a strong relationship. A correlation close to 0 shows a weak relationship.

Answer 351

χ2 Test

Answer 352

The T   test

Answer 353

Correlation

Answer 354

Regression analysis

Answer 355

a diagnosis is based on a general consensus among experienced clinicians and researchers.

Answer 356

diagnosis is based on characteristic features that distinguish it from other disorders.

Answer 357

a diagnosis will allow clinicians to accurately predict treatment response and clinical course.

Answer 358

means that a diagnosis is based on an understanding of the underlying pathophysiology.

Answer 359

Treatment for Adolescents With Depression Study (TADS) 60% of youth respond to tx with meds (fluoxetine - FDA for depression 8-17). 71% in combination group improved. 43% CBT alone improved.

Answer 360

ETOH substance use Naltrexone and therapy together or separate better than acamprosate

Answer 361

Lower brain serotonin turnover 5-hydroxyindoleacetic acid (5-HIAA)

Answer 362

Amnesia mostly anterograde, usually resolves in 2-4 wks. Retrograde amnesia most persistent memory adverse effect, can persist weeks to months.

Answer 363

Varied by time Also can change frequency of treatment and unilateral from bilateral

Answer 364

: reinforcement after set number of times of behavior (one free meal every 10)

Answer 365

: reinforcement after various amount of performed behavior (gambling, like slots)

Answer 366

reinforcement for bx at constant time (getting reward every 10 mins)

Answer 367

reinforcement for responses at various amounts of time (around a certain average) checking email

Answer 368

reinforcement in varied times, regardless if bx is performed.

Answer 369

Sensorimotor (up to 2) Preoperational (2-7) Concrete operational (7-11) Formal operational (12+)

Answer 370

up to 2 yrs: learning object permanance Know the world through movements and sensations Learn about the world through basic actions such as sucking, grasping, looking, and listening Learn that things continue to exist even when they cannot be seen (object permanence) Realize that they are separate beings from the people and objects around them Realize that their actions can cause things to happen in the world around them Piaget believed that developing object permanence or object constancy, the understanding that objects continue to exist even when they cannot be seen, was an important element at this point of development.

Answer 371

2-7: symbolic play think symbolically and learn to use words and pictures to represent objects Egocentric and struggle to see things from the perspective of others Getting better with language and thinking, but still concrete terms Children become much more skilled at pretend play during this stage of development, yet they continue to think very concretely about the world around them. 

Answer 372

7-11: conservation Begin to think logically about concrete events Begin to understand the concept of conservation Thinking becomes more logical and organized, but still very concrete Thinking is still rigid. Struggle with abstract and hypothetical concepts. Less egocentric and begin to think about how other people might think and feel. Begin to understand that their thoughts are unique to them and that not everyone else necessarily shares their thoughts, feelings, and opinions (theory of mind).

Answer 373

12+: Begins to think abstractly and reason about hypothetical problems Begins to think more about moral, philosophical, ethical, social, and political issues that require theoretical and abstract reasoning Begins to use deductive logic, or reasoning from a general principle to specific information

Answer 374

Parallel: usually around 2years old, play with similar things near each other. Associative: 3 y.o. share same toys but play separately. Play begins to overlap Cooperative: around 4 y.o. Play with toys and interact together

Answer 375

Psychoanalytic observation of children b/w 6 mo and 3 yrs. Autistic phase - first 3 weeks, separation and self absorption. Mostly sleeping Symbiotic phase: until 5 months recognizes caregiver, but lacks sense of individuality. Separation-individiation (3 stages) 1. Hatching: increased interest in outside world 2. Practicing (9-16 months: physical ability to separate from caregiver 3. Rapprochement (15-24 months): infant explores outside world but requires mother to be present for emotional support of completing the task. 4. Object constancy: (24+ months) the development of an internalized mental model of the mother, which unconsciously accompanies and supports the child even when they are physically separated. In addition, a sense of individuality begins to develop. The degree of ambivalence in the internalized model implicates the formation of a healthy self concept and self-confidence.

Answer 376

1. Hatching/Differentiaton (5-9 mo): increased interest in outside world 2. Practicing (9-16 months: physical ability to separate from caregiver 3. Rapprochement (15-24 months): infant explores outside world but requires mother to be present for emotional support of completing the task. 4. Object constancy: (24+ months) the development of an internalized mental model of the mother, which unconsciously accompanies and supports the child even when they are physically separated. In addition, a sense of individuality begins to develop. The degree of ambivalence in the internalized model implicates the formation of a healthy self concept and self-confidence.

Answer 377

Disruption in rapprochement: borderline disruption in symbiotic: narcissistic PD

Answer 378

Homocystinuria

Answer 379

: Latin American cultures. In response to stressful event (Eg sudden loss of loved one). Similar to panic attacks, but also crying, shouting, anger, possible suicidal or violent bx. Seizure like features and fainting can happen.

Answer 380

ongoing illness related to stressful circumstances. Associated it’s depression, anxiety, and somatoform sx.

Answer 381

Described in Mexico, Central America, South America. Believes soul has left the body in response to fearful event.

Answer 382

condition in Japan culture. Fear or appearance may be offensive to others. Fear of offending others lead to social avoidance.

Answer 383

Malaysian. Sudden rampage including homicide and/or suicide, which ends in exhaustion and amnesia.

Answer 384

Asian delusion that the penis will disappear into the abdomen and cause death. genitalia retract into abdomen

Answer 385

female Eskimos of northern Greenland. It involves anxiety, depression, confusion, depersonalization, and derealization, ending in stuporous sleep and amnesia.

Answer 386

Native American Indians . Fear of being turned into a cannibal through possession by a supernatural monster, the Wihtigo.

Answer 387

Mediterranean descent . Vomiting, fever, and restless sleep. It is thought to be caused by the evil eye.

Answer 388

: loss of semen

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