Test 1 Flashcards
(211 cards)
1
Q
s/s of generalized anxiety disorder
A
excessive worry, restlessness, irritability for at least 6 months
2
Q
benzos work by increasing
A
GABA activity
3
Q
typical pharm trx for GAD
A
antidepressant & benzo
4
Q
risks of benzos
A
dependence, rebound insomnia
5
Q
common side effects of antidepressants
A
weight gain and sexual dysfunction
6
Q
complications of antidepressants in elderly
A
hyponatremia, hypercoagulation, osteoporosis, serotonin syndrome
7
Q
buspirone is only approved for treatment of
A
generalized anxiety disorder
8
Q
TCAs are not first line for generalized anxiety disorder because
A
high risk of cardiac dysrhythmias and lethal overdose
9
Q
s/s of anxiety in children
A
diminished interest, social withdrawal
10
Q
s/s of anxiety in adolescents
A
anger & obedience
11
Q
characteristics of panic disorder
A
palpitations, shaking, sweating, SOB that peak in 10 minutes and then go away
12
Q
characterized by excessive fears of scrutiny, embarrassment and humiliation in social or performance situations, leading to significant distress and/or impairment in functioning
A
social phobia
13
Q
treatment for phobias
A
CBT, desensitization
14
Q
A diagnosis of PTSD is made only after
A
a month has passed since traumatic event
15
Q
treatment for OCD
A
CBT & SSRI
16
Q
progressive cognitive decline mostly seen in those > 65
A
alzheimer’s dementia
17
Q
dementia correlated with CVA
A
vascular dementia
18
Q
dementia with fluctuating cognition associated with parkinsonism, hallucinations and delusions, gait difficulties, and falls.
A
Lewy body dementia
19
Q
dementia with language difficulties, personality changes, and behavioral disturbances
A
frontotemporal dementia
20
Q
these is no evidence that these prevent the onset of dementia
A
statins
21
Q
rule these out when diagnosing alzheimer’s dementia
A
thyroid disease, vit B12 deficiency, depression
22
Q
treatment for mild dementia
A
cholinesterase inhibitors
23
Q
cholinesterase inhibitors
A
donepezil (Aricept) and rivastigmine (Exelon)
24
Q
treatment for moderate to severe dementia
A
cholinesterase inhibitors, Namenda, or antipsychotics
25
Acute neurologic complication of illness and/or medication, especially common in older patients, manifested by new confusion and impaired attention.
delirium
26
difference between delirium and dementia
delirium is acute, dementia is chronic and progressive
27
characteristics of autism
ineffective social skills, inability to sustain conversation, repetitive behaviors
28
environmental need for autistic child
structured educational program with a routine.
29
early signs of autism are present by
18 months of age
30
red flags for autism are
don't respond to name being called by 1 year old, no single word by 16 months
31
screen for autism in ALL children at
18-24 months of age
32
stages of grief
denial, anger, bargaining, depression, acceptance
33
low levels of this neurotransmitter is associated with depression
serotonin
34
dosage for escitalopram (Lexapro)
5-20 mg
35
dosage for citalopram (celexa)
10-40 mg
36
dosage for sertraline (zoloft)
50-200 mg
37
dosing for paroxetine (paxil)
20-60 mg
38
dosing for fluoxetine (prozac)
10-80 mg
39
SNRIs
venlaxafine (Effexor) and duloxetine (Cymbalta)
40
dosing for venlaxafine (Effexor)
75-373 mg
41
dosing for duloxetine (Cymbalta)
20-60 mg
42
dosing for buproprion (Wellbutrin)
200-450 mg
43
antidepressants should be continued for
6-9 months
44
lifelong trx of antidepressants are needed if
more than 3 depressive episodes
45
s/s of serotonin syndrome
confusion, hyperreflexia, fever, myoclonus
46
differences between depression and dementia
dementia has a slower decline in function; depression occurs more rapidly with a fluctuating course
47
suicide screening
o Thoughts of suicide
o Plan to commit suicide
o Means to complete the plan
o Intention to follow through with the plan
48
one or more manic or mixed episodes during a patient’s lifetime
bipolar I
49
at least one major depressive episode are met in addition to at least one hypomanic episode
bipolar II
50
the onset of bipolar is at ages ____ with initial episodes of _____
15-30; depression
51
manic episode lasts usually
one week
52
people with bipolar have a high risk of
substance abuse and suicide
53
antidepressants in a bipolar patient can
cause them to switch from a depressed to manic mood
54
mood stabilizers for bipolar
lithium, lamotrigine, valproate
55
baseline lab before starting lithium
TSH and calcium
56
lamotrigine for bipolar has a high risk of developing
skin rash and SJS
57
complications of anorexia
hypotension, bradycardia, hypothermia, amenorrhea
58
heart complication d/t anorexia
mitral valve prolapse
59
ECG findings in anorexic patients
usually normal except for bradycardia
60
xerosis is seen in
anorexia (dry, scaly skin)
61
lab results in anorexia
leukopenia, high BUN, high cholesterol, low estrogen
62
med for anorexia
olanzapine
63
first line trx for anorexia
nutritional rehab and psychotherapy
64
complications of anorexia
high LFT, superior mesenteric artery syndrome, acute pancreatitis
65
anorexia has a ____ body weight and bulimia has a ____ body weight
low; normal
66
in anorexia, the HR is ____, in bulimia the HR is _____.
low; high
67
bulimia is characterized as binge-eating and compensatory behaviors at least
once a week for 3 months
68
s/s of bulimia
tachycardia, hypotension, parotid gland swelling, and dental erosion
69
bulimia has a high risk for
diabetes
70
first line therapy for bulimia
fluoxetine
71
this is contraindicated in both anorexia and bulimia as it can cause seizures
buproprion (wellbutrin)
72
mandatory reporting for
elder and child abuse/neglect`
73
Regardless of the gender identity of the patient, physical exams should be based on
the organs present.
74
In transgender patients, it is important to assess and treat for
cardiovascular disorders d/t hormone intake
75
annual screening should be done in men who have sex with men
HIV, syphilis, chlamydia, gonorrhea
76
treatment for those with hypoactive sexual disorder
testosterone patch for buproprion
77
meds that can cause erectile dysfunction
antihypertensives, antidepressants
78
PDE-5 inhibitors for ED are contraindicated in those
taking nitrates
79
PDE5 inhibitors
sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis)
80
teaching for sildenafil (Viagra) and vardenafil (Levitra)
effective for short periods and have to be taken on an empty stomach
81
patients with dysparenuria should have
a pelvic exam and pap
82
characterized by excessive daytime sleepiness and inappropriate manifestations of REM sleep.
narcolepsy
83
undesirable physical events or experiences that occur during entry in sleep.
parasomnias
84
one type of REM sleep parasomnia
REM sleep behavior disorder
85
when patient physically act out vivid, often unpleasant dreams with vocal sounds and sudden, often violent arm and leg movements during REM sleep
REM sleep behavior disorder
86
REM sleep behavior disorder occurs in
men greater than 50
87
inhalants cause
drowsiness, dizziness, slurred speech
88
major hazard of nitrous oxide inhalation is
anoxia
89
cocaine properties
CNS stimulant
90
cocaine dependence can cause
seizures and arrythmias
91
and increase in GABA causes
sedation
92
intoxication is a BAC
greater than 0.10%
93
DTs develop within ____hour of the last drink
24-72
94
benzos facilitate the action of
GABA
95
causes of carotid sinus syncope
tight collars, shaving, head turning
96
causes of situational syncope
micturition, coughing, swallowing
97
meds that can cause syncope
ACEI, beta blockers, sulfa, quinolones
98
positive orthostatics if
more than 20 mmHg change in systolic, 10 mmHg change in diastolic, or more than 20 bpm in HR
99
how to stabilize after syncope
place supine, loosen clothing, turn patient's head to the side
100
peripheral disorders that can cause dizziness
labryinthitis, benign positional vertigo, Meniere's disease, any inner ear disorder
101
central disorders that can cause dizziness
TIA/CVA, multiple sclerosis, tumor
102
hallmarks of a peripheral lesion r/t dizziness
nausea, normal neurologic exam, position related
103
hallmarks of a central lesion r/t dizziness
abnormal neurologic exam
104
clinical test for positional vertigo
HallPike-Dix
105
caution with anticholinergics as it can cause
drowsiness, urinary retention, and confusion in elderly
106
POUND with migraine
```
pulsating or throbbing
one day duration 4-72 hours
unilateral
nausea
disturbance in everyday activities
```
107
alleviating factors in migraine with/without aura
quiet room with eyes closed
108
triggers to migraines
stress, weather, cheese, chocolate, alcohol, hormonal changes
109
prodrome phase of migraines
irritability, fatigue, food cravings
110
______ is common with migrainers
fibromyalgia
111
when further investigation is needed for HA
age greater than 50, decreased DTR, personality change
112
preventative therapy for migraines
anticonvulsant, CCB, beta blocker, antidepressant
113
abortive therapy for migraines
triptans, NSAIDs, corticosteroids
114
meds for abortive therapy for migraines should be limited to
use of 2 days or less as it can cause rebound headache.
115
tension headache is described as
tight band around the head
116
cluster headache characteristics
reaches intensity in 15 minutes, patient cannot sit still, severe pain
117
those with cluster headaches have a high risk of
suicide
118
other features that can occur with cluster headaches
ipsilateral conjunctival injection, lacrimation, rhinorrhea
119
preventative therapy for cluster headaches
verapamil and lithium
120
abortive therapy for cluster headaches
oxygen at 7L/min, triptans
121
vasculitis of large and medium vessels
temporal arteritis
122
risk factor for temporal arteritis
age greater than 50
123
s/s of temporal arteritis
fever, weight loss, temporal headache, jaw pain, visual changes
124
diagnostics for temporal arteritis
CRP and ESR
125
treatment for temporal arteritis
glucocorticoids, baby ASA
126
benign, chronic tremor of the upper extremities or head. The legs are NOT involved
essential tremor
127
when the tremor is accentuated as the hand approaches a given target
essential tremor
128
in essential tremor, the tremor disappears during
sleep or when drinking alochol
129
trx for essential tremor
propranolol
130
complication of essential tremor
alcoholism
131
most common cause of resting tremor
parkinson's
132
resting tremor disappears when
movement is voluntary
133
intention tremor is caused by
multiple sclerosis and stroke
134
in intention tremor, the tremor increases as
it moves hand closer to target
135
physical exam of tremor includes
when it’s fully supported at rest, when the limb is elevated against gravity, and during goal-directed movements.
136
Wilson's disease is
autosomal recessive
137
Wilson's disease is an impairment of
copper
138
Wilson's disease tremor
asymmetrical tremor
139
partial seizures involve
only a portion of the brain
140
when the patient has deja vu, hallucination, or activity of an arm or leg that doesn't cause a loss of consciousness
simple partial seizure
141
when the patient stares into space and either remains motionless or engages in repetitive behaviors (lip smacking, chewing, etc).
complex partial seizure
142
generalized seizures involve
both hemispheres of the brain
143
nonconvulsive generalized seizure
absence (petit mal)
| atonic (drop attacks)
144
convulsive generalized seizure
myoclonic
| tonic-clonic
145
caution with antiepileptic drugs as they have interactions with
warfarin, antibiotics, and oral contraceptives
146
education with antiepileptics
- don't switch between brand name and generic
| - can increase suicide thougts
147
Most common neuro disorders in children with a systemic viral or bacterial infection.
febrile seizure
148
risk factor for febrile seizure
age, viral infection, recent immunization
149
simple febrile seizure
last less than 15 min once in a 24-hour period
150
complex febrile seizure
last more than 15 min more than once in 24 hours
151
Lumbar puncture in children with febrile seizures
unnecessary if the child returns to baseline
152
Do not treat patients with febrile seizures with
antiepilectic drugs
153
to obtain a driver's license, there is no evidence of clinical seizures in a
3 month period prior to medical review
154
is the doctor held liable for their recommendation on the patient for obtaining driver's license?
no
155
seizure free restriction of ____ months is needed to drive in Texas
6 months
156
Chronic progressive inflammatory and neurodegenerative disease affecting the CNS.
multiple sclerosis
157
s/s of multiple sclerosis
paresthesia, limb weakness, increased DTR, unsteady gait, nystagmus
158
diagnostic of multiple sclerosis
MRI
159
trx for multiple sclerosis
disease modifying therapy: interferons
160
prognosis for multiple sclerosis
capable of living a regular life for 15-20 years
161
clinical features of parkinson's
resting tremor, bradykinesia, rigidity, postural instability
162
parkinson's is caused by
low dopamine
163
the goal of trx for parkinson's is to
maximize functional ability. you cannot slow the progression of the disease
164
complications of parkinson's
psychosis, dementia, depression
165
TIAs are
acute ischemic deficits that last less than 24 hours
166
most common causes of meningitis in adults and children
N. meningitides and Strep pneumoniae
167
presentation of meningitis
fever, headache, stiff neck
168
is present if the patient resists passive knee extension when the hip is fully flexed.
kernig sign
169
present if a patient actively flexes the hips when the neck is passively flexed.
Brudzinski sign
170
LP in meningitis shows
very high WBC and protein, high glucose, and positive gram stain
171
encephalitis is caused by
herpes virus, west nile, adenovirus, enterovirus, mumps/measles
172
difference b/t meningitis and encephalitis
normal mental status in meningitis; encephalitis has altered mental status
173
LP in encephalitis
high WBC and protein, normal glucose, neg gram stain
174
this has been effective in lowering in the meningitis rate
Hib vaccine
175
when meningitis vaccine is given
11-12 and college freshman
176
acute inflammation of the facial nerve
bell's palsy
177
goal of bell's palsy trx
protection of the eye
178
higher risk of bell's palsy in
pregnancy
179
bell's palsy affects CN
VII
180
trigeminal neuralgia affects CN
V
181
trigeminal neuralgia characterisitscs
burning, sharp pain to one side of the face
182
trigeminal neuralgia can be exacerbated by
chewing, talking, facial movement, weather
183
trigeminal neuralgia trx
anticonvulsant
184
Characterized by rapid, progressive, and symmetric loss of motor function
GBS
185
causes of GBS
occurs 1-4 weeks after a URI and GI infection.
186
characteristics of GBS
numbness/tingling in lower limbs that works up.
187
complication of GBS
decline in respiratory status
188
initial diagnostics for GBS
peak flow meter and pulse ox.
189
hydrocele in an infant resolves at
1 year of age
190
characteristics of muscle dystrophy
muscle weakness, normal intellect
191
age when toddler should walk independently
12-14 months
192
risk factors for hydrocephaly
prematurity, meningitis, intrauterine infection
193
what child should do at 6-8 months
wave bye, sit up without support
194
newborn jaundice that occurs less than 12 hours old indicates
ABO incompatibility
195
how long should child remain in "time out"
1 min for each year of life
196
should a 2 year old with asthma receive the Flu-mist vaccine?
no
197
a child should not delay immunizations when
they are being treated with atbx
198
anterior fontanel closes at
9-14 months
199
the posterior fontanel closes at
4 months
200
age to use "time out" as a discipline method
18 month-2 years
201
a childhood immunization that is likely to cause a fever
pneumococcal
202
at what age should a child be to ride a tricycle?
3 years old
203
children should not receive tetracycline before
9 years of age
204
when should children be able to tie their shoes?
6-7 years
205
when should children be able to voice that they are hungry, cold, tired, etc
4 years old
206
a newborn loses up to ___% of birth weight in the first week of life
10
207
Fluoroquinolones should be not be given before
18 years of age
208
sulfa drugs should not be prescribed before
2 months of age
209
Wernicke encephalopathy is caused by
thiamine deficiency
210
rotten teeth is associated with
methamphetamines
211
alcohol withdrawal is associated with
clonidine
