Neurological and Psychiatric Disorders: Symptoms, Causes, and Treatments, Exams of Nursing

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What is abulia? Lack of will, drive, or initiative for action, speech and thought What is anterior cerebral artery stroke syndrome?

• Contralateral leg paresis
• Abulia, disinhibition, executive dysfunction *In some cases, akinetic mutism, if bilateral caudate head infarction What is middle cerebral artery stroke syndrome?
• Contralateral hemiparesis/sensory loss
• Homonymous hemianopia
• Dysarthria, aphasia, Alexia, agraphia, acalculia, apraxia *If non-dominant side (right hemisphere) affected, patient may neglect the left side of environment What is posterior cerebral artery syndrome?
• Occipital lobe: contralateral homonymous hemianopia, cortical blindness
• Medial temporal lobe: long term and short term memory loss, behavioral alteration (paranoia, agitation, anger)
• Thalamic infarct (decreased level of consciousness, memory impairment, executive function, aphasia, contralateral sensory loss) What is the presentation of midbrain stroke?
• Ipsilateral 3rd nerve palsy
• Contralateral hemiparesis of the arm and leg, sometimes with hemiplegia of the face
• Contralateral hemiataxia What is the presentation of pontine stroke?
• Horner's syndrome on ipsilateral side
• 6th and 7th nerve palsy (diplopia, weak face) on ipsilateral side
• Loss of pain and temperature sense on ipsilateral side
• Nystagmus, nausea
• Loss of sensation/weakness in leg/arm on contralateral side

What is the presentation of medullary stroke?

• Tongue weakness
• Sensory loss in face
• Horner's syndrome
• Palate weakness (dysphagia) What is lacunar stroke syndromes?
• Pure motor stroke: posterior limb of the internal capsule (stuttering over hours to days)
• Pure sensory stroke: thalamic infarction
• Sensorimotor stroke: junction between thalamus and internal capsule
• Ataxic hemiparesis: infarction in the corona radiate (ataxia is unilateral)
• Clumsy hand-dysarthria: pons (sometimes corona radiate and internal capsule) infarction What is the most common comorbidity in a patient with an anxiety disorder? Another anxiety disorder What are the most common causes of copper deficiency? Gastric bypass surgery and zinc toxicity What is the presentation of copper deficiency? Hematological consequences: myelodysplasia, anemia, low white blood cell count Neurological consequences: sensory ataxia, spasticity, muscle weakness, damage to peripheral nerves, myelopathy and rarely optic neuropathy How does vitamin B6 (pyridoxine) present?
• Caused by pyridoxine-inactivating drugs such as isoniazid, protein-energy undernutrition, malabsorption, alcoholism, or excessive loss
• Deficiency can cause peripheral neuropathy, seborrheic dermatitis, glossitis, and cheilosis. In adults, depression, confusion and seizures are typical What statistic variable measures the magnitude of difference between two intervention groups? Effect size What is ornithine transcarbamylase deficiency? Inherited disorder that causes ammonia to accumulate in the blood
• Ammonia, which is formed when proteins are broken down in the body, is toxic if the levels become too high What is MECP2? What disorder does it cause?
• It is a methylated DNA binding protein. It binds to methylated to DNA and removes acytlase.
• In females it causes Rett syndrome.
• Cause an extremely variably expressed syndrome featuring cognitive impairment and other CNS

A mother's capacity to understand her infant's internal states, which is communicated by mirroring What is identity diffusion? Identity diffusion is one step in the process of finding a sense of self. It refers to a period when an individual does not have an established identity nor is actively searching for one. What is projective identification? In the object relations theory of Melanie Klein, projective identification is a defense mechanism in which a person fantasizes that part of his ego is split off and projected into the object in order to harm or to protect the disavowed part What are some differences between subcortical and cortical dementias? Subcortical dementias (Parkinson's) tend to have less severe intellectual and cognitive dysfunction, but more motor dysfunction than cortical dementias (Alzheimer's) What is drive theory? Drive theory is based on the principle that organisms are born with certain psychological needs and that a negative state of tension is created when these needs are not satisfied Which therapeutic approach has demonstrated efficacy in the treatment of trichotillomania? Habital reversal theory What is dialectical behavior therapy? Specialized therapy that focuses on providing psychoeducation, validating the patient's emotional vulnerability and encouraging change Where do the dopaminergic neurons originate in the mesocorticolimbic system? Ventral tegmental area Which antipsychotic is absorbed primarily through the oral mucosa? Asenapine What is the rate-limiting enzyme in the synthesis of norepinephrine? Tyrosine hydroxylase What is salience network? Composed of anterior insula (AI) and dorsal anterior cingulate cortex

• Salience stimuli: things that catch our attention Which cognitive function is measured in continuous performance test? Sustained attention FDA approved use of deep brain stimulation for treatment-resistant obsessive-compulsive disorder involves stimulation of which brain region? Anterior limb of the internal capsule Which region of the frontal lobes is most closely associated with working memory? Dorsolateral prefrontal

Which antipsychotic is used for augmentation in patients with obsessive-compulsive disorder who have inadequate response to a selective serotonin reuptake inhibitor? Aripiprazole What are haplotypes? regions of linked variations in the human genome

• clusters of alleles that are in linkage disequilibrium and inherited as a single unit From which embryonic layer is the neural tube formed from? Ectoderm What is the neurogenic hypothesis of depression? hypothesis that suggests depression is associated with a reduction in the birth of new neurons in the hippocampus, an area of the brain important to stress regulation, cognition, and mood What is modality shift effect? Modality Shift Effect (MSE) refers to a peculiar finding from simple Reaction Time (RT) tasks which require the subject to make the same motor response to each of the stimuli in a random series of lights and tones with variable intervals What is rapid cycling bipolar disorder? Occurrence of 4 or more mood episodes in 1 year (major depressive, hypomanic, or manic).
• Risk factor is female sex What is the optimal time to conduct amniocentesis for chromosomal analysis of genetic disorders? 20 weeks gestation Which psychiatric disorder is most prevalent in patients with cancer? Adjustment disorder Which psychiatric condition is held to a stricter confidentially standard by federal law? Substance use disorders Which form of competency requires the highest legal threshold? Making financial decisions What is alogia? Process of poor thinking inferred from speech and language usage. There may be a general lack of additional, unprompted content seen in normal speech: the replies to questions may be brief and concrete, with a reduction in spontaneous speech. What is anosognosia? Lack of ability to perceive the realities of one's own condition. It's a person's inability to accept that they have a condition that matches up with their symptoms or a formal diagnosis What is one foundational factor that leads to successful abstinence for individuals participating in Alcoholics Anonymous?

Decreased AMPA glutamate receptor signaling Which test is most helpful in delineating between worsening dementia and delirium? EEG Which risk factor is most associated with an increase in the risk of developing Alzheimer's disease in a person with mild cognitive impairment? Elevated blood pressure What is meperidine? Demerol/pethidine

• interactions with MOAi, SSRI Lower birth weight corrected for gestational age must strongly predicts the risk for later development of which mental health illness? Attention-deficit/hyperactivity disorder What is the sublimation defense mechanism? Funneling of an unacceptable impulse into a socially acceptable activity. ex: person who loves cutting and blood, becomes a surgeon instead of a murderer. What is the difference between suppression and repression? Repression is unconsciously, suppression is consciously pushing thoughts out of awareness Which cation blocks the NMDA receptor at resting membrane potential? Magnesium What is a good predictor of later functional and adaptive outcomes in autism spectrum disorder? Verbal ability at age five years What is behavioral activation? It is a therapeutic intervention that is often used to treat depression.
• Stems from a behavioral model of depression that conceptualizes depression as a consequence of a lack of positive reinforcement What is circumduction?
• Combination of flexion, extension, abduction, and adduction
• Occurs with right-sided hemiparesis Which MRI imaging study would demonstrate an abnormality in mild traumatic brain injury? Diffusion tensor imaging By what age does core gender identity typically form? 3 years Severity of cognitive deficits associated with severe head trauma correlates with which factor? Duration of post-traumatic amnesia Which area of the hypothalamus has been reported to play a central role in maternal behavior of mothers towards infants?

preoptic What is Ropinirole used for? Parkinson's treatment as well as Restless leg syndrome

• dopamine agonist Oxytocin suppresses which brain region during emotionally charged situations? Amygdala Energy homeostasis is thought to be regulated by leptin receptors in which brain region? Hypothalamus Which enzyme is the rate limiting step in the synthesis of dopamine? tyrosine hydroxylase In biofeedback, the relaxation state coincides with a measured decrease in which type of factor? skin conductance What is biofeedback? non-drug treatment in which patients learn to control bodily processes that are normally involuntary, such as muscle tension, blood pressure, or heart rate. Damage to which brain structure may account for flapping movements of the limbs seen in carbon monoxide poisoning? Globus pallidus Which medications are used for mono therapy treatment for bipolar depression?

1. Olanzapine-fluoxetine
2. Lurasidone
3. Quetiapine Which hormone is a potent allosteric modulator of the GABA-A receptor and has been implicated in depression? Progesterone Why what age do children understand that others have minds different from their own? About 15 months Which area is targeted with the treatment of repetitive transcranial magnetic stimulation (TMS) for unipolar depression? Dorsolateral prefrontal cortex What are the targeted areas for the treatment of OCD using repetitive transcranial magnetic stimulation (TMS)? Orbitofrontal cortex and the supplementary motor area What are the medications used for migraine prophylaxis? P ropranolol ( Inderal ) T imolol (Blocadren) Amitriptyline

holding environment Which neurotransmitter receptor is down regulated in the ventral striatum in response to persistent pain? Dopamine Which peptide is released in the GI tract to convey satiety information to the brain in response to food intake? Cholecystokinin Where is leptin released from and how does it affect food intake?

• Released from fat cells in adipose tissue
• Leptin signals to the hypothalamus
• Leptin does not affect food intake from meal to meal but instead acts to alter food intake and control energy expenditure over the long term Where is ghrelin released from and how does it affect food intake?
• Released from stomach, small intestine, pancreas and brain
• It stimulates appetite, increases food intake and promotes fat storage Where is orexin secreted from and how does it affect food intake?
• Synthesized by neurons located in the lateral hypothalamus
• Increases craving fo food
• Leptin inhibits orexin What are the lab abnormalities associated with refeeding syndrome?
• Hallmark hypophosphatemia
• However, syndrome is complex and may feature abnormal sodium and fluid balance, changes in glucose, protein, and fat metabolism, thiamine deficiency, hypokalemia and hypomagnesemia AMPA receptor is stimulated by the presence of which neurotransmitter? glutamate What is the difference between AMPA and NMDA receptors?
• Sodium and potassium increases in AMPA receptors whereas calcium increases along with sodium and potassium influx in NMDA receptors
• Moreover, AMPA receptors do not have a magnesium ion block while NMDA receptors do have a calcium ion block What is the difference between operant and classical conditioning?
• Classical conditioning involves associating an involuntary response and a stimulus, while operant conditioning is about associating a voluntary behavior and a consequence At which age do children begin developing concern for others and learning to share? Around 4 years old

Which neurotransmitter facilitates sexual arousal? Dopamine In utero exposure to cannabis during neuronal development is associated with which defect in the infant? Cognitive defects In children with cancer, inadequate prophylaxis of pain and stress during difficult procedures such as bone marrow biopsies, is most likely to result in which psychiatric condition? Generalized anxiety disorder What is the difference between risk and odds? Risk refers to the probability of occurrence of an event or out come Odds refers to the probability of occurrence of an event/probability of the event not occurring What is regression analysis? Reliable method of identifying which variables have impact on a topic of interest Which brain cell is implicated in both neural circuit formation of the developing brain and scavenging for damaged neurons, plaques, and infectious agents? Microglia What is the function of Schwann cells? Myelinate axons in the PNS What is the function of astrocytes?

• Blood brain barrier
• Physical and metabolic support for neurons, detoxification, guidance during migration, regulations of energy metabolism, electrical insulation, transport of blood-borne material to the neuron, reaction to injury What is the function of ependymal cells? Line the ventricles, and they're present at the choroid plexus
• Also form secretory epithelium that produces the CSF that fills the ventricles and bathes the entire CNS What is the function of oligodendrocytes? Myelinate the CNS What are cis-regulatory elements? Regions of non-coding DNA which regulate the transcription of neighboring genes Which neurotransmitter most directly regulates impulsive or affective aggression? Serotonin What is a ten year old's understanding of death? Death is permanent and the dead will not return Successful global cognitive performance with aging has most consistently been positively associated with the size of which brain structure? Hippocampus formation

What is Melanie Klein known for?

• Play therapy and object relations (the theory suggests that the way people relate to others and situations in their adult lives is shaped by family experiences during infancy) What s Harry Stack Sullivan known for?
• Interpersonal theory
• The theory of personality which is based on the belief that people's interactions with other people, especially significant others, determine their sense of security, sense of self, and the dynamisms that motivate their behavior Which action do 4 year old kids engage in in terms of language skills? Story telling using words
• most children by the age of 4 years old, have developed sufficient language skills to be able to engage in story telling using words Which neurochemical abnormality has been associated in patients with depressive disorders? Reduced circulating levels of GABA What is the difference between efficacy and effectiveness? Efficacy can be defined as the performance of an intervention under idea and controlled circumstances, whereas effectiveness refers to its performance under "real-world" conditions (naturalistic investigations) What is efficiency in statistics? Measure of quality of an estimator, of an experimental design. Essentially, a more efficient estimator, experiment, or test needs fewer observations than a less efficient one to achieve a given performance. (the number of times it takes to get to the result)
• whereas efficacy, it is whether or not it works What is accuracy? Closeness of a measured value to a standard or known value (whereas precision is how closely the same values are to each other) What is precision? a measure of how close a series of measurements are to one another (whereas accurate is if the average of data points are close to the real true value) What distinguishes Tourette syndrome from other tic disorders? The presence of multiple motor tics and one or more vocal tics What is the Simpson-Angus Rating Scale?

Measures drug induced Parkinsonism symptoms

• Measures gait (hypokinesia), six items measuring rigidity, and three items measuring glabella tap, tremor and salivation, respectively. What is the glabellar tap? primitive reflex where the eyes shut if an individual is tapped lightly between the eyebrows At which age does a child possess sufficient cognitive ability and meet the Appelbaum criteria for general healthcare decision-making capacity? 12 years old What are the four dimensions of Appelbaum criteria for decision making capacity?

1. Understanding
2. Appreciation
3. Reasoning
4. Expression of a choice Which neurotransmitter is contained in sleep-promoting neurons of the ventrolateral pre-optic nucleus? GABA What is most significantly affected when syringomyelia first presents? Pain perception What are the 3 major epigenetic mechanisms?
5. DNA methylation
6. Histone modification
7. Expression regulation by micro-RNAs The avoidance that occurs with social phobia is regulated between which two brain regions? Amygdala and periaqueductal gray area of the brainstem What is the function of the periaqueductal gray area of the brainstem? Functional interface between the forebrain and the lower brainstem

• Major role in integrated behavioral responses to internal (pain) or external (threat) stressors What are the most common compulsions in adults with obsessive compulsive disorder? Cleaning and checking How do oral contraceptives and lamotrigine interact with each other? Oral contraceptives containing estrogens decrease serum levels of lamotrigine What is the risk of using St John's wort in patients with depression? May induce mania (if patient has bipolar disorder) What happens with NMDA and GABA receptors in acute alcohol intoxication? NMDA receptor antagonism GABA receptor agonism What is a finding found in sleep studies for a patient with periodic limb movement disorder?

Obsessive compulsive The loop involves connections between the cortex, the basal ganglia, the thalamus, and back to the cortex. It is of particular relevance to hyperkinetic and hypokinetic movement disorders, such as Parkinson's disease and Huntington's disease, as well as to mental disorders of control, such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder(OCD), and Tourette syndrome Ainsworth introduced the strange situation experiment to evaluate which relationship? Attachment between a parent and a child

• attachment theory (9 to 18 months) Which paraneoplastic syndrome is associated with anti-yo antibodies? Paraneoplastic cerebellar degeneration In which way does sexual health change in older individuals? Refractory period for men increases Which developmental stage in psychodynamic group therapy is characterized by intimacy? Differentiation and individuation What are the developmental stages in psychodynamic group therapy? Engagement, Differentiation, Individuation, Intimacy, Mutuality and Termination. Which aspect is associated with an increased risk of depression in patients with multiple sclerosis? Lesion of volume What is primary process thinking in psychoanalytical theory? Unconscious thoughts that do not maintain logical connections the unconscious thinking of the id, which uses symbols and metaphor, is focused on immediate gratification of instinctual demands and drives, disregards logic, and manifest itself during dreaming, in patients in psychotic states, and in young children Which infant & toddler temperamental style has been shown to have greatest association w eventual onset of anxiety symptoms in childhood? inhibited What is the principle of the "Goldwater rule" for psychiatrists? It is unethical for psychiatrists to offer professional opinions on public figures without a face-to-face evaluation Why is lithium readily dialyzable? Due to its low molecular weight Which medication was among the first to be approved to treat depression? Iproniazid

What alternative stimuli can be used by examiner to overcome the wicrawal response of babinski reflex by patient? downward scraping of the shin When observed in a young adult, bilateral paresis of the medial muscle of the eye on attempted lateral gaze, with a coarse nystagmus in the abducting eye, is characteristic of which disease? Multiple sclerosis Ethical standards issued by the American Medical Association prohibit physician involvement in which aspect of a death penalty case unless s a commutation order is in place? Restoration of competence to be executed What is a hypnagogic hallucination? Visual, auditory, or tactile hallucinations at sleep onset What is a hypnopompic hallucination? Hypnopompic Hallucinations. Vivid dreamlike experiences—called hypnagogic or hypnopompic hallucinations —can seem real and are often frightening. They may be mistaken for nightmares, and they can occur while falling asleep ( hypnagogic ) or waking up ( hypnopompic ). What is a form of learned fear in which a person or an experimental animal learns to respond strongly not only to a harmful stimulus, but also to a subthreshold stimulus? Sensitization What is a comorbid condition in children with autism spectrum? Intellectual disability What are indels? Small insertions and deletions in DNA sequence How many times should CBC be tested for patients taking clozapine? Patients newly started on clozapine must have an FBC taken weekly for the first 18 weeks of treatment then biweekly for the next 34 weeks. After that they receive monthly monitoring for as long as they are taking clozapine Which vitamins have been effective as an adjunct to antidepressant medications for the treatment of depression? D Which assessment is the initial assessment of delirium in the geriatric population? Confusion assessment method Which arterial stroke would result in an inability to read, but with preserved ability to write? Posterior cerebral What is mentalization theory? the ability to understand the mental state, of oneself or others, that underlies overt behaviour. What is self psychology?

neatAnal expulsive: reckless, careless, defiant, disorganized, coprophiliac Phallic (3-6 years) - Genitalia//Oedipus complex (in boys and girls); according to Sigmund Freud. Electra complex (in girls); according to Carl Jung. Promiscuity and low self-esteem in both sexes. Latency (6-puberty) - Dormant sexual feelingsImmaturity and an inability to form fulfilling non-sexual relationships as an adult if fixation occurs in this stage. Genital( Puberty-death) - Sexual interests matureFrigidity, impotence, sexual perversion, great difficulty in forming a healthy sexual relationship with another person Deep brain stimulation targeting which brain region has been most frequently studied for the experimental treatment of depression? Subcallosal cingulate cortex Which neurotransmitter is thought to play a key role in fine-tuning working memory function in the dorsolateral prefrontal cortex? Dopamine What is apraxia? Loss of the ability to execute or carry out learned (familiar) movements, despite having the desire and the physical ability to perform the movements What is atonia? paralysis of body's muscles What is aphasia? loss of ability to understand or express speech, caused by brain damage. What is areflexia? absence of a reflex What is agraphesthesia? Inability to identify a number traced on the skin of the palm of the hand despite normal cutaneous sensation. What are splice variants? different proteins encoded by the same gene According to Erikson, the predominant emotional issue in typically developing, school-age children is? Personal worth and competence An epigenetic cause of fragile X syndrome involves which changes regarding the fragile X mental retardation 1 gene? Methylation of the CpG sites of the promoter region

Which disorder is associated with the loss of fast-conducting peripheral sensory nerves and decreased sex steroid secretion that accompanies aging? Delayed ejaculatin Which area of the frontal cortex is most consistently activated during shifting of cognitive sets in the Wisconsin Card Sorting Test? Dorsolateral (working memory and selective attention) In the Belmont Report, which ethical principle underlies the practice of informed consent? Respect for persons The frequency of typical sexual behaviors (self stimulation, exhibitionism, sexual intrusiveness) exhibited by children of both genders peaks at around which age? 5 years Sleep spindle density most markedly decreases from middle age into old age in which regions of the brain? Frontal and occipital lobes Which occurs in epigenetic histone protein amino acid residue modification? Acetylation is generally rapid and reversible Which psychosocial treatment modality is most relevant and effective for the positive symptoms of schizophrenia? Cognitive behavioral therapy What is positive effect (health promoting effect) of the neuroinflammatory response? Microglial propagation of cytokines with associated decreased physical activity in response to a peripheral infection Which sleep change is often seen in depressive disorders? Decreased REM latency Pervasive and excessive emotionality and attention-seeking behaviors are essential features of which personality disorder? Histrionic What is an alpha-2 adrenergic agonist? Guanfacine What is progressive supra nuclear palsy? Degenerative disease involving the gradual deterioration and death of specific volumes of the brain. The condition leads to symptoms including loss of balance, slowing of movement, difficulty moving the eyes, and dementia. PSP may be mistaken for other neurodegenerative diseases such as Parkinson's and Alzheimer's. The