Week 3

Question 1

Anxiety is linked to what limbic structure?

Answer 1

amygdala

Question 2

What are the key features of PTSD?

Answer 2

• exposure to a traumatic event
• re-experiencing that event
• avoidance of related stimuli
• emotional numbness
• persistent arousal
• lasting more than one month

Question 3

What are the features of panic disorder?

Answer 3

recurrent, non-triggered panic attacks with a rapid onset of anxiety and ANS arousal

Question 4

What are the features of GAD?

Answer 4

• excessive worry about multiple events
• subjective difficulty redirecting worry
• more than six months
• restless, fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance

Question 5

What sort of condition might lead to anxiety due to a general medical condition?

Answer 5

hyperthyroidism

Question 6

Anxiety disorders commonly have an onset of what age?

Answer 6

15-21

Question 7

What NT systems are overactive in those with anxiety disorders?

Answer 7

• NE
• glutamate
• corticosteroid

Question 8

What NT systems are underactive in those with anxiety disorders?

Answer 8

• serotonergic

- GABA

Question 9

What is first line medical therapy for those with anxiety disorders?

Answer 9

SSRIs

Question 10

What are anxiolytics?

Answer 10

drugs that upregulate GABA systems

Question 11

How do antipsychotics help treat anxiety disorder?

Answer 11

they selectively block D2 receptors

Question 12

What does cognitive therapy involve for those with anxiety disorders?

Answer 12

attempting to challenge their automatic response and the assumptions that underlie their anxiety

Question 13

What are the diagnostic criteria for ADHD?

Answer 13

• inattention or hyperactivity-impulsivity lasting more than 6 months
• some impairment before age 12
• impairment in two or more settings

Question 14

Children with ADHD frequently suffer from what comorbid disorders?

Answer 14

substance abuse and conduct disorder

Question 15

Adults with ADHD are likely to have what comorbid disorders?

Answer 15

• depression
• substance abuse
• GAD
• OCD
• antisocial personality disorder

Question 16

What two NT systems have been implicated in ADHD?

Answer 16

NE and DA

Question 17

What kinds of executive dysfunction have been associated with ADHD?

Answer 17

• response inhibition
• vigilance
• working memory
• planning

Question 18

How does methylphenidate help those with ADHD?

Answer 18

it blocks DAT, inhibiting DA reuptake

Question 19

What anatomical finding has been strongly associated with ADHD?

Answer 19

reduced cortical thickness in the right superior gyrus of the frontal lobe

Question 20

When do fontanels close?

Answer 20

between two months and two years of age

Question 21

When do cranial sutures ossify?

Answer 21

between six and eighteen years of age

Question 22

Acromegaly is the result of what hormone?

Answer 22

growth hormone

Question 23

Describe the facial appearance of someone with Down’s syndrome.

Answer 23

• flattened nose
• up slanting eyes
• protruding tongue

Question 24

What is torticollis?

Answer 24

stiff neck

Question 25

What HEENT findings might indicate hyperthyroidism?

Answer 25

- prominent eyes - fine hair - lid retraction - startled expression

Question 26

What is conductive hearing loss?

Answer 26

hearing loss due to damage to the outer or middle ear

Question 27

The Weber test relies on what kind of hearing?

Answer 27

sensorimotor

Question 28

Describe the possible findings on the Weber test.

Answer 28

- if it localizes to affected ear, it indicates conductive hearing loss - if it localizes to the unaffected ear, it indicates sensorimotor hearing loss

Question 29

What is the Rinne test for?

Answer 29

to determine if hearing loss is sensorimotor or conductive.

Question 30

What are the two general features of delirium?

Answer 30

disturbance of consciousness and a change in cognition or perceptual disturbances

Question 31

What kinds of drugs can cause delirium?

Answer 31

- anticholinergics - anticonvulsants - antihypertensives - opiates - sedatives - steroids

Question 32

Describe the pathogenesis of delirium?

Answer 32

- anoxia causes failure of ATPase pumps - Ca influx accelerates DA production and release - ATPase failure prevents reuptake - hypoxic conditions shift DA metabolism to more toxic pathways

Question 33

Delirium can cause permanent brain damage by causing DA to be metabolized into what?

Answer 33

cytotoxic quinones

Question 34

How is delirium treated?

Answer 34

- treat the cause - restore oxygen levels - give DA agonists

Question 35

What is haloperidol?

Answer 35

an antipsychotic with D2 selectivity

Question 36

What is the best medical treatment of delirium to prevent lasting damage?

Answer 36

haloperidol

Question 37

What nine things are assessed during a mental status exam?

Answer 37

- speech - mood/affect - appearance - reality - thought process/content - perception - insight/judgement - sensorium - suicidal/homocidal ideation

Question 38

Affect can be described along what three axes?

Answer 38

- quality - motility - appropriateness

Question 39

What is loosening of associations?

Answer 39

a disorder of thought process in which no logical connections are apparent between one idea and the next

Question 40

What is "flight of ideas"?

Answer 40

a thought process disorder in which there is a fast stream of thought and speech

Question 41

What is neologism?

Answer 41

a thought process disorder in which one makes up words

Question 42

Assessment of a patient's sensorium involves testing what faculties?

Answer 42

- consciousness - orientation - attention - reading/writing - memory - fund of knowledge - calculation

Question 43

Reality testing includes what two features?

Answer 43

sense of reality (hallucinations) and judgment of reality (delusions)