Questions and Answers
What is the diagnosis for a patient whose dad died of severe dementia at 55?
Huntington's disease
Which of the following are typical of idiopathic Parkinson's disease? (Select all that apply)
What is the first-line treatment for restless leg syndrome?
Pramipexole
What does multifocal myoclonus in a comatose patient indicate?
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What is the most effective treatment for 'writer's cramp'?
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What is Atomoxetine's principal mechanism of action?
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When is Atomoxetine most likely considered as initial treatment in adolescents?
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What did the multimodal treatment study reveal about ADHD symptom changes?
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Which component of ADHD is most likely to remain in adulthood?
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What is a diagnostic feature of a panic attack?
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Which respiratory illness is most clearly a risk factor for developing an anxiety disorder?
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What is a differential diagnosis for a patient presenting at the ED with panic disorder?
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What is the best initial treatment for a 28-year-old patient with agoraphobia?
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Which factor has the most evidence supporting its protective effect in bereavement following the loss of a spouse?
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Which condition is most likely to increase the risk of impairment after bereavement in an 80-year-old?
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What predicts bipolarity in adolescents with depression?
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What medication strategy is most effective and rapid in treating severe bipolar illness during the manic phase?
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What is the diagnosis for a 40-year-old woman with insomnia, poor appetite, dizziness/nausea, and fluctuating moods?
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What negative effect does cannabis have on the brain?
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What acute symptoms are expected during caffeine withdrawal?
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What intervention is NOT likely to be effective for a physician with a substance abuse problem?
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Which drug is associated with feelings of euphoria, social withdrawal, and nystagmus?
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What does the pentobarbital challenge test do?
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Adult neurogenesis occurs in which area of the brain?
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Previously pleasant mom becomes profane and irresponsible over 6 months. Most likely a pathology in?
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An MRI scan of the head reveals an infarct in the distribution of the left anterior cerebral artery. The patient most likely exhibits?
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Which cell type secretes innate pro-inflammatory cytokines TNF-alpha and IL-1B in patients with inflammatory conditions affecting the brain?
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What is the role of glycine at the NMDA receptor?
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Which neurotransmitter system is the last to mature in the CNS of children and adolescents?
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A compound that increases muscle mass by increasing episodic secretion of GH is?
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What is the diagnosis for a 9-year-old female with a 3 month history of seemingly unprovoked bouts of laughter, worse when not sleeping well?
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What is the diagnosis for a 5-year-old with a 4 month history of morning headaches, vomiting, and recent problems with gait?
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70-year-old develops flaccid paralysis following severe water intoxication. Likely diagnosis?
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The goal of treatment for a young adult who gained 70 lbs in the last year with severe headaches and papilledema is to?
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Superior homonymous quadrantic defects in the visual fields result from lesions to which structures?
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A tremor with a frequency of around 3 Hz and irregular amplitude is most evident towards the end of reaching movements. Likely cause?
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Patient with fever, severe headaches, confusion, and foul smells on MRI shows hyperintensity in the left temporal lobe. Diagnosis?
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Acute onset of fever, sore throat, diplopia, & dysarthria could indicate what diagnosis?
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What is the most reliable finding from CSF analysis for a patient with multiple sclerosis in the chronic progressive phase?
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What is a benign intracranial hypertension etiology?
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What condition is characterized by gait abnormality, slow movement, and asymmetrical rigidity, improving slightly with levodopa?
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What is the diagnosis for an 8-year-old with persistent pain and weakness in the left arm and shoulder following a car accident?
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Which finding is most common in psychiatric presentation following a stroke?
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What is the most effective treatment for blepharospasm?
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Which drug for the treatment of parkinsonism has been associated with sudden sleep attacks?
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What is the diagnosis for a patient presenting with insomnia and frequent nighttime awakenings?
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Characteristic of alcohol-induced blackouts?
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What characterizes the memory loss in patients with dissociative amnesia?
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An example of declarative memory is?
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Study Notes
Neurogenesis and Brain Areas
- Adult neurogenesis primarily occurs in the hippocampus, critical for learning and memory.
Behavioral Changes and Brain Pathologies
- A previously pleasant mother exhibiting profane and irresponsible behavior may indicate pathology in the frontal lobe.
Cerebrovascular Findings
- MRI may reveal an infarct in the left anterior cerebral artery territory, often leading to weakness in the contralateral foot and leg.
Inflammatory Conditions in the CNS
- Microglia are key cell types that secrete pro-inflammatory cytokines like TNF-alpha and IL-1 beta during brain inflammation.
Neurotransmitter Functions
- Glycine acts as an obligate coagonist at NMDA receptors, influencing synaptic transmission.
Maturation of Neurotransmitter Systems
- The cholinergic neurotransmitter system matures last in children and adolescents.
Substance Effects on Muscle Mass
- Gamma hydroxybutyrate can increase muscle mass by promoting episodic secretion of growth hormone.
Pediatric Neurological Diagnoses
- In a 9-year-old girl with episodes of unprovoked laughter and menstrual onset, consider hypothalamic hamartoma as a diagnosis.
Brain Tumor Symptoms in Children
- A 5-year-old child with morning headaches, vomiting, gait issues, and diplopia is likely suffering from medulloblastoma.
Complications of Water Intoxication
- Following severe water intoxication, flaccid paralysis and dysarthria may suggest central pontine myelinolysis as a likely diagnosis.
Visual Field Defects
- Superior homonymous quadrantic defects in visual fields are linked to lesions in the temporal optic radiations.
Tremors and Neurological Conditions
- A tremor with irregular amplitude, worsened during reaching, may indicate a cerebellar tumor.
Infectious Encephalitis Diagnosis
- A patient with fever, severe headaches, irritability, and temporal hyperintensity on MRI likely has herpes encephalitis.
Neurological Symptoms of Multiple Sclerosis
- Symptoms like diplopia, dysarthria, and limb spasticity with a protein-rich spinal fluid profile may suggest multiple sclerosis.
CSF Analysis in MS
- The presence of oligoclonal bands is a reliable finding in chronic progressive multiple sclerosis.
Etiology of Benign Intracranial Hypertension
- Hypervitaminosis A can lead to benign intracranial hypertension.
Progressive Supranuclear Palsy Symptoms
- Symptoms include asymmetric rigidity, gaze difficulty, and improvement with levodopa, typical for progressive supranuclear palsy.
Stroke and Mental Health Impact
- Depression is the most common psychiatric presentation after a stroke.
Treatment Strategies for Strokes
- In patients with atrial fibrillation post-stroke, anticoagulation with warfarin significantly reduces recurrent strokes.
Head CT Indicators
- A lens-shaped hyperdensity on head CT suggests an epidural hematoma.
Complications Following Cerebellar Hemorrhage
- A severe complication can be acute hydrocephalus following cerebellar hemorrhage.
Effectiveness of Treatment for Blepharospasm
- Botulinum toxin is the most effective treatment option for blepharospasm.
Diagnostic Criteria for Delirium vs. Dementia
- Fluctuating arousal is a distinguishing feature of delirium compared to dementia.
Neurocognitive Decline in Older Adults
- Information processing speed is the cognitive function most likely to decline with age.
Memory Loss in Dissociative Amnesia
- Patients typically experience episodic memory loss, where specific events are forgotten.
Disorders of Sleep
- Aging is associated with greater wakefulness interspersed with sleep and increased duration of awakenings.
Treatment Options for Sleep Disorders
- Melatonin is effective in treating delayed sleep onset in children with no other psychopathology indicators.
Characteristics of PTSD Nightmares
- Prazosin is recommended for decreasing nightmares associated with PTSD.
Motor Symptoms in Parkinsonism
- Idiopathic Parkinson's disease may present with asymmetrical onset and progression of motor symptoms.
ADHD Treatment Considerations
- Atomoxetine, a selective norepinephrine reuptake inhibitor, is often used for ADHD treatment in patients with substance use disorders.
Panic Attack Features
- Derealization is a common feature experienced during a panic attack.
General Neuroanatomy and Symptomatology
- Cerebellar pathology can lead to significant motor symptoms, while conditions such as syringomyelia may arise from prior trauma.
Epileptic Conditions and EEG Findings
- Specific EEG patterns, such as triphasic waves, can indicate hepatic encephalopathy in comatose patients.
Drug Side Effects in Neurological Disorders
- Ropinirole is linked to sudden sleep attacks, which can have profound implications in the management of Parkinson's disease.
Impaired Reflexes and Limb Weakness
- In acute inflammatory polyneuropathy, patients may experience absent reflexes and varying degrees of motor weakness after viral illnesses.
Treatment Modalities in Movement Disorders
- Pramipexole is utilized as a first-line treatment for restless leg syndrome, while botulinum toxin addresses focal dystonia disorders like writer's cramp.
Chronic Conditions with Genetic Component
- Huntington's disease is characterized by both cognitive decline and chorea, often following a familial pattern of early-onset dementia.### Panic Disorder
- Panic disorder is characterized by sudden and recurrent panic attacks, leading to significant distress or functional impairment.
Differential Diagnosis
- Important differential diagnoses for panic disorder in an emergency department setting include:
- Pulmonary embolism
- Other medical conditions that may mimic panic symptoms
Agoraphobia Treatment
- For a 28-year-old with one year of agoraphobia, the best initial treatment, offering long-term prognosis, includes:
- Cognitive Behavioral Therapy (CBT) with exposure
- Selective Serotonin Reuptake Inhibitors (SSRIs) and benzodiazepines
Bereavement Support
- The quality of social support for individuals who are bereaved has substantial evidence supporting its protective effects following the loss of a spouse.
Bereavement Risk Factors
- Significant depressive symptoms shortly after the loss are most likely to increase the risk of impairment in an 80-year-old following bereavement.
Predictors of Bipolarity
- Psychotic symptoms are a key predictor of developing bipolar disorder in adolescents presenting with depression.
Treatment of Severe Bipolar Illness
- The most effective and rapid treatment for severe manic phases of bipolar illness involves:
- Antipsychotic medications combined with Lithium or Valproate
Rapid Cycling Bipolar Disorder
- A diagnosis of bipolar disorder with rapid cycling is indicated by a patient experiencing significant mood fluctuations, including symptoms such as insomnia, poor appetite, and delusions.
Cannabis Effects
- The high concentration of CB1 cannabinoid receptors in the hippocampus is correlated with cannabis's negative impact on short-term memory.
Caffeine Withdrawal
- Common symptoms of acute caffeine withdrawal include:
- Headache
Substance Abuse Intervention
- Observing a physician with a substance abuse problem until they seek treatment is unlikely to be an effective intervention strategy.
Effects of Ketamine
- Ketamine can cause euphoria, feelings of "flying," social withdrawal, and nystagmus.
Pentobarbital Challenge Test
- The pentobarbital challenge test is used to estimate the initial dosage of pentobarbital required for barbiturate detoxification purposes.
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Test your knowledge on adult neurogenesis and brain pathology with these flashcards. Explore important concepts related to brain structure and functions, including the hippocampus and frontal lobe. Perfect for students of psychology and neuroscience.
