Psychiatry, Pharmacology, and Neurology Review

This set of flashcards covers key vocabulary and concepts from a clinical review transcript spanning pharmacology, neurology, psychiatric assessments, and genetics.

Beck's depression scale (BDI)

A self-rated questionnaire containing $21$ statements with four possible responses for each.

General Health Questionnaire (GHQ)

A self-rated screening instrument used for detecting the presence of psychiatric illness.

Diagnostic interview schedule (DIS)

A non-clinician administered, fully structured interview used in Epidemiological catchment area studies.

Health of Nations Outcome Scale (HONOS)

An instrument used for monitoring clinical recovery and measuring clinical outcomes in mental health.

Lithium Pharmacokinetics

Orally well-absorbed, not metabolized by the liver, and excreted $95\%$ unchanged in the urine by the kidneys.

Carbamazepine Metabolism

Metabolized by the hepatic cytochrome $P450\,2D6$ system, which it also robustly induces (autoinduction).

Zero-order elimination kinetics

Kinetics followed by drugs that rapidly saturate enzymes, such as alcohol and phenytoin.

Grapefruit juice effect

Increases drug oral bioavailability by down-regulating intestinal $CYP3A4$ and $1A2$, significantly affecting drugs like carbamazepine and pimozide.

NSAID-Lithium Interaction

NSAIDs inhibit renal prostaglandins, reducing renal blood flow and increasing lithium re-absorption, potentially leading to toxicity.

Festinant gait

A shuffling gait where the individual takes short steps with a tendency to accelerate; characteristic of Parkinson disease.

Scissoring gait

A stiff-legged gait where the knees slide over each other like scissors; associated with upper motor neuron (UMN) damage in cerebral palsy.

Steppage gait

A high-stepping gait resulting from bilateral foot drop, seen in chronic peripheral neuropathies.

Post-injection delirium/sedation syndrome (PDSS)

A phenomenon occurring in $<0.1\%$ of subjects after olanzapine pamoate depot injection, characterized by symptoms of overdose.

Tangentiality

A thought process where replies are irrelevant or oblique; the response refers to the topic but fails to give a complete answer and never reaches the point.

Logoclonia

A speech disturbance where the patient gets stuck on the last syllable of a word and repeats it; often a symptom of Parkinson's disease.

Thought blocking

The abrupt interruption in a train of thinking before an idea is finished, often with no recall of the preceding thought.

Synaesthesia

A sensory disturbance where a stimulus in one modality produces a sensory experience in another (e.g., 'smelling' music).

Hypoacusis

A raised sensory threshold where sensations are reduced; often seen in delirium.

Collective unconscious

A Jungian concept describing the collective symbolic past of mankind, containing various archetypes.

Archetypes

Images and symbols (e.g., Hero, Old Wise Man) that represent human experience common to different cultures.

Anima

The unconscious feminine aspect of a man.

Anosognosia

The inability to identify or remain aware of one's own neurological deficits.

Astereognosis

The inability to identify familiar objects by touch with eyes closed.

Nucleus basalis of Meynert

A major source of cholinergic (acetylcholine) innervation to the cerebral cortex; degenerates in Alzheimer's disease.

Locus coeruleus

A cluster of neurons in the pons that is the major concentration of norepinephrine-producing cell bodies projecting upward.

Forced utilization behaviour

A frontal lobe deficit where a subject automatically picks up and uses objects despite being told not to do so.

Gerstmann syndrome

A condition associated with lesions of the dominant parietal lobe.

Rivastigmine

A cholinesterase inhibitor that inhibits both acetyl- and butyryl-cholinesterase.

Selegiline

A monoamine oxidase inhibitor selective for $MAO\text{-}B$ at normal therapeutic doses.

Ependymal cells

Neuroglial cells with cilia that line the walls of the ventricular systems and help propel cerebrospinal fluid.

Microglia

Scavenger neuroglial cells derived from macrophages that remove cellular debris at sites of CNS injury.

Glutamic Acid Decarboxylase (GAD)

A neuron-specific enzyme not found in glial cells; used to identify GABA-releasing neurons.

Kuru

A human spongiform encephalopathy with a very slow course (incubation up to $40$ years), associated with ritual cannibalism.

Alpha-synuclein

The key constituent of Lewy bodies found in Parkinson's disease and Lewy body dementia.

P50 suppression

An endophenotype in schizophrenia involving the ability to filter sensory information, prominently regulated by the hippocampus.

Hyperparathyroidism 'Psychiatric Overtones'

Psychiatric symptoms including depression, anxiety, and confusion caused by high serum calcium levels.

Alpha waves

EEG waves oscillating at $8\text{-}13\text{ cycles per second}$, maximal over the occipital region, and first discovered by Hans Berger.

Astasia-abasia

A condition described under dissociative motor disorders in ICD-10.

Kleine Levin syndrome

A rare disorder in adolescent males characterized by periodic hypersomnolence, hyperphagia, and sexual disinhibiton.

Ganser syndrome

A dissociative disorder characterized by 'Vorbeireden' or approximate answers to simple questions.

Huntington's disease genetics

An autosomal dominant disorder on chromosome $4p16$ involving an expanded $CAG$ trinucleotide repeat in the huntingtin gene.

Schizoid personality disorder

A disorder characterized by emotional constriction, indifference to social norms, and a preference for solitary activities.

Ribot's Law

The principle that brain injury affects memories in reverse order of their formation (temporally graded retrograde amnesia).

The Rivermead behavioral memory test

A test designed to measure impairment of everyday memory functioning for rehabilitation purposes.

Orexin (Hypocretin)

A neuropeptide processed in the lateral hypothalamus; a deficiency or 'knock out' produces a phenotype resembling narcolepsy.

PSEN-1

The gene most commonly associated with early-onset Alzheimer's disease, accounting for up to $70\%$ of cases.