question

MOA Acamprosate?

answer

Modulate glutamate neurotransmission at metabotropic-5 recs.

question

Second line against stable alcoholics who fail psychological intervention?

answer

Acamprosate

question

First line pharm. intervention in alcoholics?

answer

Acamprosate and Naltrexone

question

MOA of Naltrexone against alcohol consumption?

answer

Block him mu-opiod rec., decreasing alcohol reinforcing effects

question

Peak age of incidence for schizophrenia in males and females?

answer

Mails from 18 to 25 and females 25 to 35.

question

What is needed for the diagnosis of schizophrenia?

answer

Two or more positive or negative symptoms times six months or more with social or occupational dysfunction.

question

Etiology of schizophrenia?

answer

Increased dopamine concentration in the brain

question

Define schizoid personality disorder?

answer

Isolated and attached from others with no interest and interpersonal relationships.

question

How does schizotypal differ from schizoid personality disorder?

answer

The addition of odd thinking is seen.

question

title schizophrenia symptoms for less than one month? between one and six months? Greater than six months?

answer

Brief psychotic disorder. Schizophreniform disorder. Schizophrenia.

question

Mnemonic for criteria of major depressive disorder?

answer

Two weeks: disturbances in SIGE CAPS sleep interest guilt energy concentration appetite psychomotor agitation's suicidal ideation

question

Triad of serotonin syndrome?

answer

Mental status change, autonomic hyperactivity, and neuromuscular abnormalities.

question

Serotonin syndrome occurs most commonly between what two drug categories?

answer

Serotonergic agents and monoamine oxidase inhibitor's.

question

Describe childhood disintegrative disorder.

answer

Normal development into early childhood and then loss of previously acquired skills between the ages of 2 and 10. More common in boys.

question

Define encopresis.

answer

Loss of bowel control after the age of four. Not caused by a general medical condition except constipation.

question

Characterize Rett's disorder.

answer

Normal development till 5-48 months, then disintegration of previously acquired milestones. Only seen in girls.

question

Drug to simultaneously treat major depressive disorder or, diabetic peripheral neuropathy, fibromyalgia, generalized anxiety disorder, chronic musculoskeletal pain's?

answer

Duloxetine

question

Single drug to simultaneously treat major depressive disorder or, obsessive-compulsive disorder, panic disorder, social anxiety disorder, posttraumatic stress disorder, generalized anxiety disorder or and premenstrual dysphoric disorder?

answer

Paroxetine

question

How long should one wait after discontinuing a MAOI before starting a SSRI? Why?

answer

Five weeks. To prevent serotonin syndrome.

question

Drug class to treat SSRI resistant disorders?

answer

MAOI

question

Why is Quetipine not indicated for treatment in acute cases?

answer

Could take several weeks to become effective.

question

Episodic, violent outbursts from psychiatric disorders are best treated by what two meds? Why?

answer

Olanzapine and Haloperidol. Rapid onset of action.

question

Second line for violent, psychotic behavior when Olanzapine and haloperidol fail? MOA?

answer

Ketamine. Noncompetitive NMDA receptor producing catatonic state

question

Areas of the brain implicated in anxiety, fear, emotion?

answer

Amygdala, anterior cingulate cortex, insula.

question

Function of the basal nuclei (basal ganglia)?

answer

Control of posture involuntary movements.

question

Major site from which output leaves the basal nuclei?

answer

Globus pallidus.

question

What type of neurons to grade in the basal ganglia during Parkinson's disease?

answer

Dopaminergic neurons

question

Conduct disorder in children is termed what in adults?

answer

Antisocial personality disorder.

question

Signs of narcolepsy?

answer

Tetrad of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis.

question

Signs and symptoms of anticholinergic toxicity?

answer

Red as a beat - cutaneous vasodilation dry as a bone - anhydrosis hot as a hair - anhydrotic hyperthermia blind as a bat - non-reactive mydriasis Mad as a Hatter - delirium and hallucinations full is a flask - urinary retention

question

Characterize sleep terror disorder.

answer

Occurs during stage III or stage for sleep: not REM. Either not recalled at all or only distantly remembered. Typical and children, boys. Genetic component. Comorbid with sleepwalking disorder patient will remain unresponsive to external stimuli making it difficult to awaken.

question

Common comorbidity of sleep terror disorder? Treatment?

answer

Sleepwalking disorder. Small doses of diazepam at bedtime.

question

Characterize conversion disorder.

answer

Somatoform disorder characterized by the presence of physical signs or symptoms without underlying medical cause.

question

Characterize nightmare disorder.

answer

Frightening dreams during REM sleep. Patient easily aroused and may wake on their own which differentiates it from sleep terror disorder. Patient remember the dream in the morning which also sets it apart from sleep terror disorder.

question

Characterize REM sleep behavior disorder.

answer

Occurs during REM sleep, patients act out dreams. This includes walking kicking punching etc. and can lead to injuries of the patient or any bed partner.

question

Nephrogenic diabetes insipidus, hyperreflexia, tremor, nystagmus, and seizure are characteristic of overdose on what substance?

answer

Lithium

question

Tinnitus, nausea, vomiting, metabolic acidosis, respiratory alkalosis, seizure, coma, and death characterize overdosed on what substance?

answer

Salicylates

question

Domino pain, nausea, vomiting and possible severe liver toxicity characterize overdose on what substance?

answer

Acetaminophen.

question

Lethargy, tremors, and dystonia characterize overdose on what substance?

answer

Antipsychotics

question

Third stage of Piaget's theory of cognitive development? Characterize.

answer

Concrete thinking. Starts at age 7 and lasts till age 11. Child begins to use inductive logic, using a specific experience to apply a general principle: but has difficulty with hypothetical concepts

question

Describe childhood disintegrative disorder.

answer

Late onset of developmental delays in language, social function, and motor skills.

question

Characterize loosening of Association (Derailment or Asyndetic thinking)

answer

Thought disorder which is disorganized that jumps between ideas that seem entirely unrelated.

question

Fourth stage of Piaget's theory of cognitive development? Characterize.

answer

Formal operation. Starts at age 12 and into adulthood. Emphasize the deductive logic and emergence of the ability to use abstract thought for hypothetical situations.

question

Conditions where loosening of Association (Derailment or Asyndetic thinking) is commonly seen?

answer

Schizophrenia and episodes of mania.

question

Characterize autistic thinking (Dereistic). What conditions does it normally associated with?

answer

Thinking not in consensus with reality which is largely narcissistic and egocentric emphasizing subjectivity without regard for reality. Associate with schizophrenia and autistic disorder.

question

Characterize body dysmorphic disorder.

answer

Preoccupation with imagined defect and physical appearance

question

Characterize conversion disorder.

answer

Symptoms involving voluntary motor or sensory function that suggest neurological illness are not intentionally produced by cannot be explained by medical condition substance affect or cultural or behavioral experience.

question

Difference between post traumatic stress disorder and acute stress disorder?

answer

Poster medic stress disorder must last greater than one month, whereas acute stress disorder can last no longer than one month.

question

What is Capgras syndrome? What is it often associated with?

answer

Illusion of doubles: delusion of miss identification the familiar person has been replaced by an imposter. Sudden brain damage.

question

What is Cotards syndrome (nihilistic delusional disorder)? What is it often a precursor of?

answer

Pts c/o losing possessions, status, strength, heart, blood, intestines. Schizophrenic depressive episode.

question

Nonpharmacologic treatment of neuroleptic malignant syndrome?

answer

IV rehydration an active cooling.

question

Pharmacologic treatment of neuroleptic malignant syndrome? MOAs?

answer

Dantrolene - muscle relaxer for muscle rigidity, hyperthermia, hypermetabolism bromocriptine - Central dopamine agonist

question

Antidote for acute benzodiazepine intoxication?

answer

Flumazenil

question

MOA of phencyclidine? Signs of intoxication?

answer

glutamate receptor antagonist Violence, belligerent, psychosis, vertical/horizontal nystagmus and other similar symptoms of intoxication

question

Patients on monoamine oxidase inhibitor's should avoid what foods in order to prevent a hyperadrenergic crisis?

answer

Cured meats, fish, beer, red wine, all cheeses except cottage cheese and cream cheese, Andover right fruits. Also must avoid many over-the-counter pain and flu medications.

question

Pharmacologic intervention of extraparametal side effects?

answer

Benztropine and diphenhydramine

question

Characterize Kleine-Levin syn

answer

Rare sleep disorder with recurrent hypersomnia, hyperphagia, and hypersexuality: predominantly affecting adolescent males of Jewish origin.

question

Define Cullen and Grey-Turners sign. What can it represent?

answer

Bluish coloration of the Peri-umbilical area and flank. Early pregnancy, pancreatic necrosis, retroperitoneal bleeding, severe acute pancreatitis

question

Define Coursoisier sign. What is it often associated with?

answer

Palpable gallbladder. Found and 50% of patients with carcinoma in the head of the pancreas.

question

Chvostek sign. What is indicative of?

answer

Tapping the facial nerve elicits momentary contraction of ipsilateral facial muscles. Hypocalcemia

question

Russell sign? What is it indicative of?

answer

Callus formation on the dorsal surface of the hand. Bulimia nervosa repetitive contact with the teeth during self-induced vomiting.

question

What is the most sensitive side of opioid intoxication?

answer

Respiratory depression.

question

Define displacement.

answer

Neurotic defense mechanism in which unacceptable emotions in one situation are expressed in a different situation where they are more tolerable

question

Define projection.

answer

Attribution of thoughts or feelings to another person who does not in fact have those thoughts or feelings.

question

Define rationalization.

answer

Neurotic defense mechanism whereby the patient unconsciously creates explanations for situation in order to make the outcome more acceptable on their behalf.

question

Which SSRIs are most likely to cause abnormal bleeding problems? Mechanism?

answer

Fluoxetine and paroxetine. Decreased platelet serotonin uptake decreased liver microsomal enzymes

question

Pneumonic for try cyclic antidepressant side effects?

answer

Tri-Cs anticholinergic = convulsions,, coma, cardio toxic

question

Side effects of lithium?

answer

LMNOP= lithium, movement, nephrogenic diabetes insipidus, hypothyroidism, pregnancy problems (Ebstein's anomaly)

question

Criteria for Somatization disorder (Briquets)?

answer

Four pain symptoms, two gastrointestinal symptoms, one sexual symptom, one pseudo-neurological symptoms: beginning before age 30

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