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lip smacking last 1-2 min
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Left temporal lobe seizure - Complex partial seizure
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narrow based gait with hallucinations
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lewy body dementia
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pts voice beceomes so weak 10 mo after her husband dies that she cannot speak and has to write to communicate, She blames herself for her husbans death
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conversion disorder
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kid has demineralization and a spiral fracture and refuses to bear weights on his joints. mom thinks he might have hurt himself with the baby sitter
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child abuse
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Public speaking is what kind of phobia
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Specific phobia * (not social phobia)
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1) adjustement disorder vs depression 2) adjustment disorder vs anxiety disorder 3) adjustment disorder vs post-traumatic stress disorder and acute stress disorder
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1) Unlike major depression however, the disorder is caused by an outside stressor and generally resolves once the individual is able to adapt to the situation. 2) anxiety disorder, which lacks the presence of a stressor 3) post-traumatic stress disorder and acute stress disorder, which usually are associated with a more intense stressor. - eg. adjustment - pt just broke up with her bf and is crying adn does bad in classand feels terirble. lac of sleep
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What is a predictor suicidal behavior in schizophrenics?
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5HIAA - ( hydroxyindoleacetic acid)
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CT of head of schizophrenic pt
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Symmetric enlarged ventricles
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characterized by improved mood in response to positive events
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atypical depression
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What two things is buproprion used for?
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1) atypical depression 2) smoking cessation
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What are the characteristics of atypical depression
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significant weight gain or an increased appetite, hypersomnia, a heavy sensation in the limbs and interpersonal rejection sensitivity that results in significant social or occupational impairment. + response to + events
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atypical depression vs melancholic depression
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atypical depression - improved mood in response to positive events. In contrast, people with melancholic depression generally do not experience an improved mood in response to normally pleasurable events.
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pt given 3 doeses of diazepam and has respiratory compromise later - next step?
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flumazenil
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pt says that she would rather kill her boyfriend than kill herself
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admit to hospital
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55 yr old woman acting strange for 3 mo and is claming neighbors are blowing fumes under her door that are giving her headaches and are changing her skin color
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Delusional disorder
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Kid has temper tantrums, increased disobedience and active and angry defiance. next step
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begin parent management training
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generic for benadryl
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diphenhydramine
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27 yr old man states that he is being followed by the FBI, has hypereflexia and is agitated with affect lability and rapid speech
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amphetamine toxicity
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What drugs can cause seotonin syndrome - dilated pupils, hyperreflexia, generalized muscle ridcity
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Opiod - tramadol Antidepressants triptans
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serotonin syndrome
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-Cognitive effects: headache, agitation, hypomania, mental confusion, hallucinations, coma -Autonomic effects: shivering, sweating, hyperthermia, hypertension, tachycardia, nausea, diarrhea. -Somatic effects: myoclonus (muscle twitching), hyperreflexia (manifested by clonus), tremor.
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what diseases do you see epicanthal folds in? ( 4)
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1) downsyndrome 2) fetal alcohol syndrome 3) PKU 4) Turners
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key features
for fetal alcohol sydrome (6)
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1) epicanthal folds 2) flat nasal bridge 3) upturned nose 4) smooth philtrum 5) thin upper lip 6) railroad track ears
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When a pt is in a serious MVAm what do you give for pain if he has a hx of cocaine abuse and meperidine dependance??
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still give Morphine
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15 y/o unsteady gait form a party
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alcohol intox
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A person who binge eats and vomits- bulemia has an increase of what activity
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amylase activity
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what are the pervasive developmental disorders
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Pervasive developmental disorder not otherwise specified (PDD-NOS), which includes atypical autism, and is the most common; Autism, the best-known; Asperger syndrome; Rett syndrome; and Childhood disintegrative disorder (CDD).
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hand ringing in a 5 yr old girl. flaps her hand snad uses nonsensical repetitive words
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Rett syndrome
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pt mumbling and softly moaning and has hallucinations. - not oriented to person time and place. What electolyte abnormalities can this be?
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hypercalcemia - has neuro Sx
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Tx for OCD
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SSRI ( fluvoxamine) and BEHAVIORAL ** therapy
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heroin. opiates affect what part of the brain
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Substantia nigra
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in a fit of anger the 22 yr old woman slaps her 2 yr old acorss teh face, there is nohistory of abuse. What is the most likely outcome of this experience for the child?
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No impact on development
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tx fofr public speaking
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propanolol
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tx for public speaking wen the pt
takes albuterol inhaler for asthma
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cant use propanolol bc of bronchoconstriction USe LORAZEPAM **
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When pt has extrapyradmidal sx from haloperidol. next
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D/C haloperidol - switch to atypical antipsychotic - risperidone
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20 yr old wakes up in teh middl eof the night with with vivid dreams that incolve escape from rape
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Nightmare disorder
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82 yr old man has been forgetting for the past 6 weeks. He is concerned about his wifes death that happened 1 yr ago and recently cant stop thinking about her. He left the pot unattended recently and started a small fire. he can do chores and drives short distances ok. he is very sad when he talks about
the death of his wife. Next step?
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Mini Mental State examination
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2.5 yr old kid has a fit when he gets dropped off to day cara nd clings to dad. when his mom come to pick him up he has a fit and clings to daycare people and wants cookies. Dx?
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normal reaction
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what is buspirone used for?
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GAD - worry about many aspects of life lasting greater than 6 mo
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Pt has daytime sleepiness but does not have OSA or restless leg syndrome and sleeps well at night. polysomnography is most likely to show what?
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Decreased REM
LATENCY
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