"Premorbid personality" of schizophrenia
Schizotypal
Shifting unacceptable impulses into outside persons, institutions
Projection
This racial/ethnic group has the highest rate of suicide in the United States.
What is Native American?
This antipsychotic is a dopamine stabilizer/modulator - lowering dopamine in areas of brain where it is too high and increasing levels where it is too low.
Abilify
This neurotransmitter has a major role in the acute reinforcing effects of drugs of abuse.
Dopamine
Provocative behavior, influence easily, emotional shallowness, exaggerated emotions
Histrionic
Return to earlier modes of acting or feeling
Regression
A student presents after barely escaping an assailant who attacked and tried to rob him one month ago. The student reports nervousness, being easily startled, having disturbingly vivid dreams of the event, and "not wanting to see anybody." Such symptoms are expected to last no longer than this time period.
BONUS
Dx?
What is 4 weeks?
Clinically significant increase in lamotrigine concentration may occur if co-administered with what medication:
Depakote
This neurotransmitter system most directly regulates impulsive or affective aggression.
Serotonergic
Interpersonally sensitive, afraid of being criticized, constantly concerned about saying or doing something foolish
Avoidant
People or situations seen as all good or all bad
Splitting
Myoclonus, hyperreflexia, diaphoresis, shivering, tremor, and confusion are compatible with this psychiatric diagnosis.
BONUS
First line tx?
What is serotonin syndrome?
Caffeine primarily acts as an antagonist to this neurotransmitter in the brain, which regulates sleep and wakefulness.
Adenosine
This cell type is implicated in both neural circuit formation in the developing brain and scavenging for damaged neurons, plaques, and infectious agents.
Microglia
Associated with low levels of CSF 5-HIAA
Antisocial
(CSF 5-HIAA which has been shown to be associated with violent or impulsive behavior)
Transforming an unacceptable impulse into its opposite
Reaction formation
A 65 year old bipolar patient comes to the ER following a lithium overdose. He is hypotensive, stuporous, agitated, and having severe diarrhea. His plasma lithium level is 4.5, creatinine is 3.0. Following gastric lavage and bowel irrigation with polyethylene glycol, this would be considered the most appropriate next step.
What is emergent hemodialysis?
First and still only FDA-approved medication for schizoaffective d/o
Paliperidone (Invega)
Developmental delay, cardiac abnormalities, palate defects, immune deficiency, and an increased risk of schizophrenia characterize this genetic syndrome.
DiGeorge Syndrome
Of the nine DSM-5 diagnostic criteria for BPD, this one is found at the highest frequency (95%)
BONUS
What is 2nd and 3rd?
Affective instability
(2nd= inappropriate anger is 87%; 3rd= impulsivity is 81%)
Impulses are directed to socially useful projects
Sublimation
A 65 year old man with a history of urinary incontinence is brought to the ED after having 2 days of unusual behavior. He has accused family members of stealing his belongings and is seeing animals and children that are not present. He had been taking oxybutynin and increasing amounts of diphenhydramine for sleep. During exam, he is restless and trying to get off of the hospital stretcher. Physical examination shows dry skin and mucous membranes, mydriasis, tachycardia, and a temperature of 101F. CBC, BMP, U/A, and EKG are unremarkable. Serum toxicology is positive for diphenhydramine only. This is the treatment of choice for his condition.
What is physostigmine?
Cataracts developed in studies with beagle dogs, no human cases. Manufacturer of this medication still recommend a slit-lamp exam every 6 months on label
Quetiapine (Seroquel)
A lesion in the red lines below leads to this type of aphasia

Conduction aphasia
(Fluent speech w preserved comprehension, inability to repeat statements is consistent with
what type of aphasia)