Sleep
8 yo w/ persistent delayed sleep onset despite good sleep hygiene, no indication of broader psychopathology, which med has best evidence to tx this problem and restore normal circadian rhythm? (2x)
Melatonin
First step to manage restless leg syndrome: (2x)
Check for iron deficiency
Adolescent with recurrent hypersomnia, hyperphagia, hypersexuality, and irritability—diagnosis? (2x)
Klein-Levin syndrome
School age child w/ ADHD, methylphenidate ineffective. Next step in management (5x)
Dextroamphetamine
Studies show effective intervention for children w/ ADHD is to involve their parents in what part of tx? (4x)
Behavioral management
REM sleep behavior disorder is commonly associated with abnormal inclusions containing what protein? (2x)
Synuclein
Physiologic changes during REM sleep: (2x)
INCREASED HEART RATE, INCREASED EYE MOVEMENTS, DECREASED MUSCLE TONE
Maximum sleepiness in humans occurs when melatonin reaches its highest point and when what reaches its lowest point? (2x)
Body temperature
7 yo is brought in by parents who report he has been hyperactive since 4 yo, talks constantly, interrupts, has trouble sitting still to do homework, will not play quietly outdoors. What else do you need for ADHD dx? (4x)
Teacher report
Child w/ ADHD not responding to methylphenidate IR. What med to try next? (4x)
Mixed amphetamine salts
Medical student asks for something to help w/ attention and alertness. Taking a 2-week board review course and struggles to keep up w/ the pace. Sleeping 4hrs/night. Usually sleeps 8hr/night. Dx? (2x)
Dyssomnia NOS
REM sleep behavior disorder associated w/ what pathology: (2x)
Parkinson's disease
Spouse of 66M ofen awakened by pt’s swearing and kicking, pt appears awake during these episodes but eyes closed. Pt doesn’t remember the events. No substance use. Bilateral tremors in upper extremity and slow shuffling gait on exam. Likely diagnosis? (2x)
REM Sleep behavior disorder
What aspect of ADHD is most likely to improve as children age? (4x)
Hyperactivity
Perinatal factor specifically associated w/ development of ADHD: (3x)
Maternal tobacco use prenatally
Age-related sleep pattern change: (2x)
Greater wakefulness intermixed with sleep
Somnambulism during childhood is associated w/ what stage of sleep measured by EEG? (2x)
Stage IV
Electromyography finding seen in REM sleep indicative of REM sleep behavior disorder (2x)
Excess Muscle Tone
Principle mechanism of action of atomoxetine: (2x)
Selective Norepinephrine Reuptake Inhibitor
Atomoxetine is most likely to be considered as initial tx in ADHD in adolescents with what: (2x)
Substance use disorder
Medication best for decreasing nightmares in PTSD: (2x)
Prazosin
Characteristic of sleep in > 65 yo, as compared to that of young adults: (2x)
Increased fragmentation
Which sleep disorder is associated w/ mild neurocognitive disorder w/ Lewy bodies? (2x)
REM Sleep Behavior Disorder
The multimodal tx study of children w/ ADHD examined the comparative responses over 14 months to children to medication and intense psychosocial interventions. What did the findings of the study reveal w/ respect to ADHD symptom changes? (2x)
Medication management is superior to community care treatment
Component of ADHD that is most likely to remain in adulthood: (2x)
Inattention