Neuro 1
16 yo brought to psychiatrist’s attention afer having a single grand mal seizure. Pt’s parents have noted on occasion pt has sudden jerks of the entire body, resulting in dropping objects. EEG: rare 4-6 HZ irregular polyspike/wave bursts. Dx? (10x)
Juvenile Myoclonic Epilepsy
Characterisic change on polysomnogram associated w/ MDD (8x)
SHORT REM LATENCY/REDUCED LATENCY TO REM SLEEP
What aspect of ADHD is most likely to improve as children age? (4x)
Hyperactivity
Pt w/ addiction and social anxiety d/o discusses their painful experience of anxiety during their first AA meeting. What reply is consistent with 12-step facilitation therapy? (7x)
“YOU DID THE MOST IMPORTANT THING, YOU WENT TO THE MEETING. IT WILL GET EASIER."
Fever, HA, seizures, confusion, stupor, and coma, evolving over several days. EEG with lateralized high-voltage sharp waves arising in the L temporal region w/ slow wave repeating at 2-3 sec intervals. CT shows low-density lesion in L temporal lobe. Dx? (8x)
Herpes Simplex Encephalitis
Paralysis when awakening, lasts several minutes. Can see/hear but can't move during episodes. Disappears spontaneously or when called by his wife. No hallucinations, nightmares, daytime sleepiness or h/o falls. Neuro exam normal. Dx? (4x)
Sleep Paralysis
Studies show effective intervention for children w/ ADHD is to involve their parents in what part of tx? (4x)
Behavioral management
Eval of which lab test is most specific for chronic heavy etoh consumption? (9x)
% CDT (PERCENT CARBOHYDRATE DEFICIENT TRANSFERRIN)
8 yo has episodes of staring into space and then blinking for a few seconds. EEG would show what? (7x)
3 cycles per second spike and wave activity
5 yo w/ screaming/crying for no reason about 1 hour after falling asleep. Sits up in bed with eyes open, trembling, sweating, mother can‘t gain his attention for 5 min. No new stressors. Boy has no memory of the event. PE normal. Dx? (4x)
Sleep terror
Child w/ ADHD not responding to methylphenidate IR. What med to try next? (4x)
Mixed amphetamine salts
40 yo has episodes of flailing arms and tonic postures described as “fencing.” EEG confirms seizure. Which seizure type? (5x)
Frontal lobe
School age child w/ ADHD, methylphenidate ineffective. Next step in management (5x)
Dextroamphetamine
62 yo requests antidepressant. Spouse died 6 weeks ago. Crying spells, decreased appetite, poor sleep. Continues to see friends, no SI. Fam hx of depression, no prior depressive episodes. Dx? (4x)
Bereavement. Assure patient of no pathology
EEG that reveals posterior alpha and anterior beta activity is most likely to have been obtained from whom? (4x)
A relaxed adult with eyes closed
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
Pt w/ h/o bipolar presents w/ immobility, posturing, echopraxia. First-line tx? (5x)
Lorazepam