Wernicke encephalopathy
on imaging,symptoms, managementincieased MRI T2 FLAIR signal involving the ☆mammillary bodies, →Confusion
dorsomedial thalami, →Amnesia
tectal plate,
periaqueductal area,
(around the third ventricle)
+Ataxia,Nystagmus,Ophthalmoplegia
(CAAN Of beer)
intravenous thamine should be administered before infusion of glucose-containing fluids in at-risk patient because ☆glucose can deplete the last remaining stores of thiamine neurologypsychiatryUWorld HirotoShishido
diagnosis of obsessive-compulsive disordertime consuming(>1hr/day), or cause significant distress or impairment
eating/ grooming rituals are driven by a symmetry obsession and the need to prevemt a feared event ⇔ body dysmorphic disorder(preoccupation with defects in physical appearance)
difference between delusional disorder (jealous) and paranoid personality disorderdelusional disorder→ does not markedly impair the person’s functioning in daily activities, and the ramifications are limited to the delusional content
(schizoid→aloof, schizotypal→ awkwardness ≒ odd belief, magical thinking)
paranoid personality disorder→ have pervasive, long-standing distrust of ☆many people,
☆but do not have fixed, specific delusions psychiatryUWorld HirotoShishido
opioid detoxification and relapse preventionmethadone→ full agonist, ☆☆longer half time
(codeine, fentanyl, hydromorphone, meperidine are also full agonist)
buprenorphine→ partial agonists, ☆can
precipitate withdrawal in patients on long term opioid therapy
naloxone→ ☆short acting opioid antagonist (frequent redosing is necessary)
naltrexone→ long acting opioid antagonist, ☆first line pharmacotherapy for moderate to severe alcohol use disorder(second line→disulfiram) psychiatrypharmacologyUWorld HirotoShishido
globus sensationGlobus sensation (also called globus hystericus and globus pharyngeus) is a common abnormal sensation of a foreign body, tightness, or fullness in the throat.
It is often worse when swallowing saliva and may be alleviated with food or liquid. Globus is a ☆functional disorder of the esophagus and by definition is not due to a structural abnormality or motility disorder. psychiatryUWorld SIM1 HirotoShishido
Huntington disease
pathogenesis, symptoms, mechanism of silencingexpansion of CAG repeatIN(more than 36 repeat)
Caudate loses Ach and Gaba(GABA)
especially, INdirect way is affected
(↓GPi activity)
chorea, athetosis, psychiatric symptoms→ highly prevalent and may occur prior to the onset of chorea, including ☆phychosis, depression, anxiety, apathy
dementia can be seen later in the disease course and characterized by a prominent execuive dysfunction
mechanism of the treatment for attention-deficit-hyperactivity disorder(ADHD)
adverse effectsmethylphenidate
stimulates the release of norepinephrine (NE) and ☆dopamine from presynaptic nerve terminals leading to increased action potential transmission
(inhibit reuptake of serotonin)
