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Neurology
Sleep
Psychosomatics
Substance Use
Psychopharmacology
100
A 72-year-old patient reports severe pain, aching and stiffness in the shoulders and upper arms with normal strength. Labwork shows an elevation in the erythrocyte sedimentation rate (ESR). He is treated with 20mg of prednisone to treat this disorder and he reports dramatic improvement after 2 days.
What is polymyalgia rheumatica?
100
This is the type of dementia most common associated with REM sleep behavior disorders.
What is Lewy Body Dementia?
100
A 35 y/o patient with this disease has severe depression and episodes of anxiety so bad he can no longer leave the house. On exam he is noted to have severe weight loss, hyperpigmentation of exposed skin and cold intolerance.
What is Addison’s disease?
100
The evolution of an addiction from an impulsive act to this type of act is characterized by an increasing importance of negative reinforcement.
What is compulsive?
100
In the treatment of psychosis, this is the only atypical antipsychotic that has consistently demonstrated superior efficacy when compared to typical antipsychotics.
What is clozapine?
200
As compared to numerous other drugs used to treat Parkinson’s disease, Pramipexole is classically most-associated with this unusual psychiatric side-effect, even in individuals with no history of these behaviors.
What is reduced impulse control?
200
This change on sleep-study polysomnogram is commonly associated with major depression.
What is short REM latency?
200
A 28-year old patient presents with emotional lability and impulsivity. Laboratory studies are notable for elevated transaminases. A close relative had similar symptoms and died at the age of 30 from fulminant hepatic failure. In combination with gray-green rings seen around the eye on slit-lamp examination, low serum levels of this marker would be diagnostic of the disorder described above.
What is ceruloplasmin?
200
Wernicke’s triad is characterized by ataxia, global confusion/amnesia, and this finding on examination of the cranial nerves.
What is ophthalmoplegia?
200
A 32-year-old woman presents to the emergency department complaining of diarrhea of 2 weeks duration. On exam she is anxious and tremulous and is not oriented to date or time of day. The patient states she is taking this drug for bipolar disorder and goes on to explain she doubled her dose a month ago because she "wasn't getting better fast enough."
What is Lithium?
300
The computer tomography (CT) scan images reveal an acute stroke in the distribution of this artery.
What is the posterior cerebral artery?
300
REM sleep is first evident at this stage of development.
What is in utero?
300
In comparison to other anxiety disorders, large association analyses have shown comorbid respiratory illness is most clearly a significant risk factor for developing this common Axis I anxiety disorder.
What is Generalized Anxiety Disorder?
300
A 17 year old student is receiving counseling for school truancy related issues. The student understands that truancy is not a desired behavior and is discussing strategies to improve school attendance. According to the stages of change model this student is most likely in this named stage.
What is preparation?
300
A 65-year-old patient with a history of asthma notices more difficulty with breathing after starting this drug for treatment of his essential tremor.
What is propranolol?
400
In Myasthenia Gravis, EMG most commonly shows a decrease in this with repetitive motor nerve stimulation.
What is amplitude?
400
Not including melatonin, this medication is demonstrated to be the most effective treatment for REM sleep behavior disorders.
What is Clonazepam?
400
This infectious agent is sometimes recognized to exacerbate or cause the rapid initial manifestation of Tic Disorder or OCD in children.
What is Group A beta-hemolytic streptococcus? i.e. Pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections (PANDAS)
400
Intoxication with this compound is most likely to explain this patient's presentation: A 23-year old patient presents to the emergency department at 4 a.m. following a late-night party. Initial examination shows dehydration, dilated pupils, hypertension and elevated CPK.
What is MDMA?
400
This TCA would be the best choice to minimize the risk of orthostasis in an 84-year-old patient.
What is Nortriptyline?
500
In this disease, a 35-year-old patient is found to have the insidious onset of facial and arm muscle weakness, eyelid ptosis, and difficulty relaxing the hands after tight grip. Slit lamp examination shows cataracts.
What is myotonic dystrophy?
500
A patient presents with irresistible episodic sleepiness that is accompanied by a vivid, dreamlike state at the onset of an episode. This additional symptom is likely to present for one to two minutes upon awakening.
What is sleep paralysis?
500
A patient with this condition presents as described below: An 18-year-old man is brought to the ED with sudden onset of anxiety. He was in a normal state of good health when suddenly he experienced a pounding heartbeat, shortness of breath, chest pain, and palpitations, which have continued for 1 hour. On exam he appears pale, tachypneic and anxious. Pulse is 200 and BP is 90/60 mm Hg. EKG is shown here. The patient is instructed to hold his breath and bear down as if he were having a bowel movement. After doing so, the patient reports feeling greatly improved.
What is Paroxysmal atrial tachycardia?
500
The primary neurobiochemical effect of PCP is antagonism at this receptor.
What is NMDA?
500
ECG abnormality most commonly seen in patients with therapeutic lithium levels
What are flattened T waves?