Risk of Schizophrenia in monozygotic twins is?
46-50%
Family hx risk of schizophrenia
10x risk with 1st degree relative
brain changes in
... [Show More] schizophrenia
increase in ventricular volume (enlarged cerebral ventricles)
Hippocampus volume decrease, 4% smaller
Decreased electrical activity in frontal lobes
Decrease glutamate and GABA release.
Decreased total brain volume
functional neuroimaging findings of schizophrenia
Abnormal function of frontal cortical regions
Including for solo lateral prefrontal and anterior cingulate cortices
Maximum dose of Celexa
40mg/day as higher doses can cause abnormal electrical activity of the heart. Some experts still prescribe higher
What class of medication is bupropion
NDRI boosts norepinephrine, noradrenaline, and dopamine neurotransmitters
What hematologic change is associated with lithium?
Leukocytosis. Lithium raises WBC counts. Monitor CBC
GABA in terms of anxiety disorders
Most abundant inhibitory neurotransmitter. Decreasing GABA would increase anxiety. Benzos are used to bind with GABA to potentiate the anxiolytic effects of GABA
What to avoid while on Disulfiram
Anything containing alcohol (vinegar, mouthwash, aftershave, cough medicine). Avoid for 2 weeks after discontinuing disulfiram.
Lab effected by disulfiram that requires monitoring
Disulfiram can elevate liver function tests
A medication that can induce mania
Corticosteroids
What finding would be associated with an acoustic neuroma?
Unilateral ringing in the ear (tinnitus) may be the first symptom of an acoustic neuroma.
What delay is expected in a 4 year old with Asperger's?
Delay in social skills development.
Unlike autistic disorder, no significant delays in language, cognitive development, or age appropriate self help skills are observed.
Primary clinical features of Asperger's
Qualitative social impairment
Markedly abnormal nonverbal communicative gestures
Failure to develop peer relationships
Lack of social or emotional reciprocity
Impaired ability to express pleasure in other persons' happiness.
Chlorpromazine (Thorazine) and clozapine cause what troublesome side effect due to their alpha 1-adrenergic blockade?
Orthostatic hypotension. Manage by raising dose of chlorpromazine and clozapine slowly.
What medication is strictly prohibited when the patient is on an MAOI such as selegiline due to the risk of hypertensive crisis and death?
Meperidine (Demerol)
Dopamine pathways in relation to clinical symptoms of schizophrenia
Negative symptoms are related to DA deficit in the cerebral cortex; positive symptoms are related to DA excess in the nucleus accumbens and mesolimbic system.
Facial characteristics of child with fetal alcohol syndrome
Small head
Short eyelid opening
Flat midface
Smooth philtrum
Underdeveloped jaw
Thin upper lip
Short nose
(Can also have inner epicanthal folds, short palpebral fissure)
Physical features of prayer willi syndrome
Obesity
Small stature
Small hands and feet
Hypotonia
Hypogonadism
Physical features of von recklinghausen's disease
Café au lait spots
Neurofibromas
In what condition is the use of bupropion contraindicated?
Bulimia. Do not use bupropion in past or present eating disorders due to increased risk of seizures.
Predominant risk factor of antisocial personality disorder?
Genetic predisposition of first-degree family member.
Antisocial personality disorder is 5X more common among first-degree relative of men with the disorder than the general population.
Risk of inhibition of platelet aggregation (risk of bleeding from SSRIs, NSAIDS, ASA) is an example of this
Pharmacodynamics
Rare but serious side effect of trazodone (Desyrel)
Priapism
arcus senilis (gray opaque band in the cornea) prior to age 40 is associated with what disorder?
Hyperlipidemia [Show Less]