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ROSH Review > WEEK 3 > Flashcards

WEEK 3 Flashcards

1
Q

what is responsible for extinction of automatic protective or defensive response to non threatening conditioned stimuli associated with threat (or in PTSD)

A

pre frontal cortex

exerts inhibitiory control over amygdala

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2
Q

which developmental age can reactive attachment disorder be diagnosed?

A

at least 9 months

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3
Q

MSE findings for LBD

A

deficits in attention (fluctuating cognition)

bradykinesia, cogwheel rigidity (parkinsonism)

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4
Q

what is usually comorbid with social (pragmatic) communication disorder?

A

ADHD

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5
Q

in narcolepsy, what can be used to decrease frequency of cataplexy?

A

venlafaxine (and other SNRI.antideperessants since they suppress REM)

(modafinil and methylphen increase wakefulness but don’t effect cataplexY)

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6
Q

diagnostic test for neurosyphilis

A

treponema pallidum particle agglutination assay and fluorescent treponemal antibody absorption (FTA-ABS)

RPR and VDRL tests are SCREENING

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7
Q

what to use to help to alleviate symptoms of benzo withdrawal?

A

carbamazepine/valproate

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8
Q

rumination disorder

A

Repeated regurgitation of food for one month or longer

under feeding and eating disorders

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9
Q

vitamin b3 (niacin) deficiency

A

pellagra - dermatitis, diarrhea, dementia

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10
Q

which serotonin receptor antagonist has potential for life threatening hepatic failure

A

nefazodone (withdrawn from some markets)

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11
Q

what test to do if concerned about conversion disorder in someone with lower extremity weakness (hips and toes)

A

Hoover’s sign - hip extensor weakness that returns to strength on contralateral hip flexion

toes - plantar flexion weakness on physical exam yet are able to use tip toes

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12
Q

difference between internal and external validity

A

internal validity - needs good experimental design to study desired population

external validity - needs to be GENERALIZABLE TO GENERAL POPULATION and not just population in study

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13
Q

median age of onset GAD

A

30 yo

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14
Q

which atypical does not effect qtc?

A

lurasidone

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15
Q

medication for chorea from Huntington’s

A

tetrabenazine/deutetrabenazine

antipsychotics can be used sometimes too

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16
Q

huntington gene location

A

chromosome 4p (autosomia ldominant CAG trinucleotide repeat)

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17
Q

what lab to get if suspect pica?

A

iron level (can also do zinc)

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18
Q

degree that individual factors combined toether results in measuring a REAL disorder

A

construct validity

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19
Q

comparing validity to another instrument or measure that has presumed validity

A

criterion validity

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20
Q

degree to which individual items in a measurement are related to the disorder being measured

A

CONTENT validity

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21
Q

therapy for conduct disorder

A

multiysystemic therapy with parent, teach,er legal, etc (i.e. parent management training)

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22
Q

what does brain look like in ASD?

A

larger brain size due to increase in white matter (causes issues with brain connectivity)

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23
Q

EEG in REM?

A

alpha waves and saw tooth pattern

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24
Q

sleep stages?

A

NREM (N1, N2, N3) then REM

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25
Q

theta waves and vertex sharp waves on polysom; stage?

A

n1

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26
Q

theta waves with k complexes and sleep spindles, stage?

A

N2

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27
Q

delta waves and high ampitude slow waves on polysom

A

N3

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28
Q

usual time to get to REM?

A

90 mins; so if you have decreased REM latency this can indicate MDD

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29
Q

REM sleep in depression

A

decreased latency to REM <90 min, increased percentage of sleep is REM

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30
Q

antidepressants to REM sleep?

A

decrase amount of REM sleep = more restful sleep

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31
Q

benzo use disorder does what to sleep?

A
  • reduced REM latency

- disruption to normal sleep, (inc N2, increased sleep spindles, and intrusion of sleep spindles into REM)

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32
Q

Alzheimer’s to sleep?

A
  • less N2 sleep

- more poorly formed sleep spindles and K complexes

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33
Q

what stage to patients with sleep terrors usually awakeN?

A

first third of night during NON REM (pts can’t remember these whcih makes sense since you can sometimes remember REM)

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34
Q

polysom in sleep terror

A

slow waves characteristic of N3, during terror EEG bcomes ambiguous

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35
Q

EPISODIC periods of hypersomnolence (difficult to waken) + cognitive abnormalities (memory disturbances, deralization, apathy, altered eating behaviors, hypersexuality)

A

Kleine Levin syndrome

36
Q

metabolic side effect VPA

A

metabolic acidosis

37
Q

preventive meds for cluster headaches

A

verapamil, lithium, methysergide, steroids

38
Q

what to use in ACUTE attack of cluster headache

A

oxygen rebreather/sumatriptan

39
Q

migraine preventitive meds

A

antihypertensives (BBs)
anticonvulstants (topiramte, VPA)
TCAs (amitriptyline/nortriptyline)

40
Q

1st and 2nd line rx restless legs

A

1st - ropinorole

2nd - gabapentin/pregalb

41
Q

best option to treat ACUTE depression in bipolar II (most evidencec)

A

quetiapine

42
Q

what can decrease anxiety and depressive symptoms in anorexia?

A

weight restoration

43
Q

two highest hierarchy of evidence?

A
  1. meta-analysis (multiple RCTs)

2. systematic review (summarizes all research with rigorous/predefined search method)

44
Q

what is also called longitudinal study (followed over time)

A

cohort study

45
Q

patient with chorea…infection?

A

Group A strep (sydenham chorea)

46
Q

mechanism modafinil

A

NON-amphetamine wakefulness agent

increases dopamine int he brain

47
Q

where is hypocretin-1/orexin-A produced

A

lateral hypothalamus

48
Q

man gets muscle spasms, stiffness, rigidity triggered by stress/being touched/sudden movement/noise; dx and rx

A

stiff person/stiff man syndrome
rx with Diazepam

can also adding bacolfen, or IVIG, ritux

49
Q

DID with comorbid OCD, rx?

A

SSRIs

50
Q

age window to diagnosis DMDD

A

6-18 yo (school age to before adulthood)

51
Q

pharmacologic treatment for REM sleep behavior disorder

A

benzo

52
Q

most common anxiety disorder in children under 12

A

separation anxiety

53
Q

relationships more intimate than they are in reality, overly dramatic, displaying rapidly shifting/shallow emotions

A

histrionic personality d/o

54
Q

1st line treatment binge eating disorder

A

CBT!!!!

then lisdexamfetamine is FDA approved

55
Q

how long without symptoms is considered to be in “full remission” after bipolar disorder

A

2 months without ANY SYMPTOMS
if you are below 2 months without any symptoms or symptoms don’t meet criteria for full episode that is PARTIAL remission

56
Q

more than half of patients with bipolar disorder meet criteria for whcih substance use disorder?

A

alcohol use d/o

57
Q

eye involvement in MG

A

asymmetric; diplopia and ptosis

in all other skeletal groups in MG it is symmetric (weird)

58
Q

What’s good to check after starting clozapine within initial 6-8 weeks? besides ANC

A

troponins and CRP levels

59
Q

threshold ANC for clozapine initiation

A

greater than 1,500 microliter (1.5)

in benign ethnic neutropenia its 1,000

60
Q

stuttering aka

A

childhood-onset fluency d/o

61
Q

viral causes of congenital hearing loss

A

CMV, rubella, lymphocytic choriomengitis virus

62
Q

happy disposition, paroxysymal laughter, ataxia, moderate to severe ID

A

angelman

63
Q

which syndrome is recognized phenotype of fragile X?

A

Prader Willi

64
Q

long narrow face, prominent ears, enlarged testicles adolescent boy

A

fragile X

65
Q

FMR 1 gene mutation

A

fragile x (x-linked)

66
Q

sertraline CYP substrate

A

3A4

67
Q

two examples of strong 3a4 inducers

A

Carbamazepine and Phenobarbital

“carb and barb”

68
Q

example of strong 2d6 inhibitors

A

Buproprion, Fluoxetine, Paroxetine

“Big, Freakin, Problems”

69
Q

interactions between valproate and lamotrigine

A

Val-hal-la

when using VALproate be sure to HALf the dose of LAmotrigine

VPA has some inhibitor effect causing higher levels of lamotrigine (risks SJS)

70
Q

drug drug cigarette, which metbaolizer

A

1A2, always ask for smoking history

71
Q

St john’s wort

A

strong 3a4 inducer

72
Q

which psych drugs are renally metabolized

A

Gabapentin, acamprosate, litihum

GAL

73
Q

adverse effect of alphla-methyldopa

A

depression

74
Q

weird day timefeature of hypersomnolence

A

AUTOMATIC BEHAVIOR

performs routine behavior such as driving a car without recall of activity after a certain time

75
Q

atmoxetine better for inattention or hyperactivity?

A

inattention

76
Q

mechanism PMDD

A
  • higher sensitivity to proge/estrogen levels

- rapid decline in progesterone level during luteal phase

77
Q

What is elevated in luteal phase for patients with DMDD

A

BDNF

78
Q

What antihypertensive commonly used in patients who are pregnant may cause depressive symptoms as an adverse effect?

A

alpha-methyldopa

79
Q

what organism good for prevention of migraines

A

botulinim toxin A

80
Q

what is often co-occuring with Prader Willi

A

OCD

81
Q

brain finding in schizophrenia

A

enlarged ventricles (lateral and 3rd ventricles)

82
Q

SNRI effective in preveenting migraines

A

Venlafaxine

83
Q

what study used in DSM III determined prevalance rates of psych disorders and comorbidity of substance use

A

NCS National Comobidity Survey

84
Q

treatment for BPD that’s psychodynamic + CBT

A

mentalizationb based therapy

85
Q

how long must adult patient demonstrate hypomanic and depressive symptoms (but not meet criteria for episode) to be dx with cyclothymic?

A

2 years

86
Q

most common cause of Bell’s palsy’

pregnancy next

A

herpes SIMPLEX activation

ROSH Review (4 decks)

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