12973931
Descrição
Quiz por Melanie Grynsztejn, atualizado more than 1 year ago
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Criado por Melanie Grynsztejn
mais de 6 anos atrás
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Questão 1
Questão
The following are early onset EPS symptoms
Responda
-
Dystonia
-
Akathisia
-
Parkinsonism
-
Tardive dyskensia
Questão 2
Questão
Which EPS symtom can appear within days
Responda
-
Dystonia
-
Akatsia
-
Parkinsonism
-
Tardive dyskinesia
Questão 3
Questão
Which EPS symptom can appear within weeks?
Responda
-
Dystonia
-
Akathisia
-
Parkinsonsism
-
Tardive dyskenia
Questão 4
Questão
Which EPS symptom can appear within months?
Responda
-
Dystonia
-
Akathisia
-
Parkinsonism
-
Tardive dyskinesia
Questão 5
Questão
Which EPS symtoms can take years to appear?
Responda
-
Dystonia
-
Akathisia
-
Parkinsonism
-
Tardive dyskensia
Questão 6
Questão
Types of drug-induced movement disorders:
[blank_start]Acute:[blank_end] Occur within a short duration of treatment onset or dose increase
[blank_start]Chronic:[blank_end] Symptoms persist throughout treatment
[blank_start]Tardive[blank_end]: Delayed onset of symptoms
[blank_start]Withdrawal:[blank_end] Occur in the absence of treatment. May resolve
Responda
-
Acute:
-
Withdrawal:
-
Chronic:
-
Tardive
-
Tardive
-
Withdrawal
-
Withdrawal:
-
Tardive
Questão 7
Questão
Dopamine system pathways include:
Mesolimbic: arousal, memory, behavior
Mesocortical: cognition, socializaiont
Tuberoinfundibular: regulation of prolactin
Nigrostriatal: modulation of EPS
Responda
- True
- False
Questão 8
Responda
-
Dopamine deficiency in the basal ganglia and striatum
-
Overactive cholinergic system
-
Dopaminergic/serotonergic or dopaminergic/cholinergic imbalance in the nucleus accumbens
-
Blockade of the striatal dopamine receptors
Questão 9
Questão
What are risk factors for dystonia
Responda
-
Young age
-
H/O ECT
-
Male gender
-
High potency neuroleptics - Haldol, Prolixin
-
Comorbid medical conditions
Questão 10
Responda
-
Opisthotonos
-
Blepharospasm
-
Torticollis
-
Oculogyric crisis
-
Oro-mandibular
Questão 11
Questão
The MOA for akathisia, from the Greek meaning "inability to sit", is:
Responda
-
Dopamine deficiency in the basal ganglia and striatum
-
Dopaminergic/serotonergic or dopaminergic/cholinergic imbalance in the nucleus accumbens, Overstimulation of locus coeruleus.
-
Blockade of the striatal dopamine receptors
-
Striatal dopaminergic hypersensitivity
Questão 12
Questão
Which of the following agents cause akathisia
Responda
-
SSRI
-
Second generation antipsychotics
-
Antiemetics
-
CCB
-
Anti-anxiolytics
Questão 13
Questão
What are some differentials for akathisia
Responda
-
GAD
-
ADHD
-
Agitation
-
MDD
Questão 14
Questão
What are clinical presentation of akathisia
Responda
-
Restlessness
-
Breaking out into song & dance for no reason
-
Fidgety movements/leg swinging
-
Marching in place
-
Rocking from one foot to another
-
Picking
Questão 15
Questão
The risk factors for akathisia include
Responda
-
Advanced age
-
Affective disorder
-
Cognitive impairment
-
Female impersonator performer
-
Female
-
H/O akathisia
-
Iron deficiency
-
High dose/potency/neuroleptics
Questão 16
Questão
Pathophysiology of pseudoparkinsonism is:
Responda
-
Dopamine deficiency in the basal ganglia and striatum
-
Dopaminergic/serotonergic or dopaminergic/cholinergic imbalance in the nucleus accumbens
-
Blockade of the striatal dopamine receptors and depletion of pre-synaptic celft
-
Striatal dopaminergic hypersensitivity and cholinergic deficiency in the basal ganglia
Questão 17
Questão
Parkinsonism = [blank_start]bradykesia[blank_end]
Pseudoparkinsonism = [blank_start]apraxic slowness[blank_end]
Responda
-
bradykesia
-
apraxic slowness
-
bradykinesia
-
apraxic slowness
Questão 18
Questão
Parkinsonism = [blank_start]resting tremor[blank_end]
Pseudoparkinsonism = [blank_start]essential tremor, myoclonus[blank_end]
Responda
-
resting tremor
-
essential tremor, myoclonus
-
resting tremor
-
essential tremor, myoclonus
Questão 19
Questão
Parkinsonism = [blank_start]lead pipe rigidity[blank_end]
Pseudoparkinsonism = [blank_start]paratonic rigidity[blank_end]
Responda
-
lead pipe rigidity
-
paratonic rigidity
-
lead pipe rigidity
-
paratonic rigidity
Questão 20
Questão
Parkinsonism = [blank_start]postural instability[blank_end]
Pseudoparkinsonism = [blank_start]frontal ataxia[blank_end]
Responda
-
postural instability
-
frontal ataxia
-
postural instability
-
frontal ataxia
Questão 21
Questão
Parkinsonism = [blank_start]Slow, shuffling gait with festination[blank_end]
Pseudoparkinsonism = [blank_start]Slow, shuffling apraxic gait[blank_end]
Responda
-
Slow, shuffling gait with festination
-
Slow, shuffling apraxic gait
-
Slow, shuffling gait with festination
-
Slow, shuffling apraxic gait
Questão 22
Questão
What are risk factors for pseudoparkinsonism?
Responda
-
Female
-
Male
-
Advanced age
-
Central DA receptor binding agents, Metclopramide, phenothiazines
-
AIDS
-
Cancer
Questão 23
Questão
Tardive dyskinesia
Responda
-
If identified early can be reversed
-
is not reversible
-
increased risk with increased use
-
increased use does not cause increases risk
-
early onset
-
late onset
Questão 24
Questão
MOA for tardive dyskinesia
Responda
-
Striatal dopaminergic hypersensitivity
-
Cholinergic deficiency within basal ganglia
-
Oxidative stress and cell injur
-
Genetic susceptibility
-
Glutamate-induced excitotoxicity
-
GABA mediated neuronal dysfunction
-
Blockade of the striatal dopamine receptors
Questão 25
Questão
Which medications most commonly cause tardive dyskinesia?
Responda
-
Meoclopramide
-
Alpha adrenergic agonists
-
SGA
-
FGA
Questão 26
Questão
Clinical presention of tardive dyskinesia
Responda
-
Choreiform - characterized by jerky, involuntary movements, chiefly of the face and extremitiesImage:Chorea (binary/octet-stream)
-
Athetoid - characterized by slow, involuntary, convoluted, writhing movements of the fingers, hands, toes, and feet and in some cases, arms, legs, neck and tongue
-
Stereotypic - petitive, nonfunctional motor behavior (e.g., hand waving or head banging), that markedly interferes with normal activities or results in bodily injury.
Questão 27
Questão
EPS can be caused by antiemetics, antieliptics, psychotropics, cardiovascular agents and Levodopa
Responda
- True
- False
Questão 28
Questão
EPS can be caused by antiemetics, antieliptics, psychotropics, cardiovascular agents and Levodopa
Responda
- True
- False
Questão 29
Questão
The following drugs cause all four movement disorders: dystonia, akathisia, Parkinsonism, tardive dyskinesia
Responda
-
Metoclopramide
-
Prochloraperazine
-
Amoxapine
-
Neuroleptics
-
SSRI
-
Levodopa
Questão 30
Questão
How often should the Abnormal Involuntary Movement Scale (AIMS) be administered?
Responda
-
Baseline then every week x4 then every 3 months
-
Baseline then every week x2 then every 12 months
-
Baseline then every week x2 then every 6 months
Questão 31
Questão
What are overall tips for treatment of EPS?
Responda
-
Stop offending agen (if possible)
-
Reduce the dose
-
Switch to a second generation antipsychotic
-
Treat prophylactically
-
A wing and prayer and refer to anyone else
Questão 32
Questão
Dystonia put in order of line of treatment
First line = [blank_start]anticholinergic agents[blank_end]
Second line = [blank_start]Baclofen[blank_end]
Third line = [blank_start]Benzo[blank_end]
Fourth line - [blank_start]Botox[blank_end]
Responda
-
anticholinergic agents
-
Baclofen
-
Benzo
-
Botox
Questão 33
Responda
- True
- False
Questão 34
Questão
Drug of choice for dystonia is
Responda
-
Beta-blockers, anticholinergics, benzodiazepines, 5-HT2A receptor antagonist, mirtazapine
-
Anticholinergics (benztropine, diphenhydramine, trihexyphenidyl)
-
Clonzaepam, ginkgo biloba
Questão 35
Questão
Drugs of choice for akathisia include
Responda
-
Anticholinergics (benztropine, diphenhydramine, trihexyphenidyl)
-
Beta-blockers, benzodiazepines, 5-HT2A receptor antagonist, mirtazapine
-
Clonazepam, ginkgo biloba
Questão 36
Questão
Mirtazapine (Remeron)
Responda
-
Used in low doses to treat akathisa
-
Used in low doses to treat dystonia
-
Alpha-adrenergic receptor antagonist
-
Alpha-adrenergic receptor agonist
-
Antagonizes 5-HT2 and 3 receptors
Questão 37
Responda
- True
- False
Questão 38
Questão
Which drugs are used to treat pseudoparkinsonism?
Responda
-
Cogentin (benztropine)
-
Symmetrel (amantadine)
-
Benzodiazepines
-
Mirtazapine (Remeron)
-
Diphenhydramine (Benadryl)
Questão 39
Questão
MOA for amantadine (Symmetrel) is
Responda
-
Dopamine agonist
-
Dopamine antagonist
-
5-HT2 agonist
-
5-HT2 antagonist
Questão 40
Questão
Side effects for benztropine (Cogentin) include
Responda
-
Dry mouth
-
Hypotension
-
Diarrhea
-
Constipation
-
Cognitive impairment
-
Sialorrhea
Questão 41
Questão
Side effects for amantadine (Symmetrel) include:
Responda
-
Hypotension
-
Hypertension
-
Agitation
-
Sedation
-
Worsening s/s of psychosis
Questão 42
Questão
Which drugs are used in the treatment of tardive dyskinesia
Responda
-
Diltiazem
-
Baclofen
-
Galantamine
-
Clonazepam
-
Ginkgo biloba
Questão 43
Questão
What is the first FDA approved medication for Tardive Dyskinesia
Responda
-
Velbeazine (Ingrezza)
-
Benztropine (Cogentin)
-
Trihexphenidyl (Artane)
-
Amantadine (Symmetrel)
Questão 44
Questão
What is the MOA for valbenazine (Ingrezza)?
Responda
-
Blocks alpha-adrenergic receptors and antagonizes 5-HT2 and 3 receptors
-
Reversible inhibition of vesicular monoamine transporter 2 (VMAT2), a transporter that regulates monoamine uptake from the cytoplasm to the synaptic vesicle for storage and release
-
Increase in synthesis and release of dopamine, and inhibition of dopamine uptake.
-
Selective M1 muscarinic acetylcholine receptor antagonist. It is able to discriminate between the M1 (cortical or neuronal) and the peripheral muscarinic subtypes (cardiac and glandular)
Questão 45
Questão
Acute [blank_start]laryngeal[blank_end] dystonia is considered a medical emergency.
Must seek treatment immediately. May require IV diphenhydramine
Responda
-
laryngeal
Questão 46
Questão
Velbenazine is extensively metabolized by hydrolysis to form active metabolite
and by oxidative metabolism to form mono-oxidized valbenazine and other minor metabolites
Responda
- True
- False
Questão 47
Questão
High fat meals may [blank_start]decrease[blank_end] absorption of valbenazine (Ingrezza)
Responda
-
decrease
-
increase
Questão 48
Questão
Common adverse side effects of valbenazine (Ingrezza) include:
Responda
-
Fatigue
-
HA
-
Constipation
-
Diarrhea
-
UTI
-
Somnolence
Questão 49
Questão
Warnings for valbenazine (Ingrezza) include:
Responda
-
Somnolence
-
QTc prolongation
-
Pregnancy/breastfeeding
-
Hypertension
Questão 50
Questão
Valbenazine should not be used in:
Responda
-
Severe renal impairment (< 30 mL/min)
-
CHF
-
Cirrhosis
-
Pancreatitis
Questão 51
Questão
Strong 3A4/2D6 inhibitors: [blank_start]Increase[blank_end] valbenazine concentration
Strong 3A4 inducer: [blank_start]Decrease[blank_end] valbenazine concentration
Responda
-
Increase
-
Decrease
-
Increase
-
Decrease
Questão 52
Questão
Valbenazine (Ingrezza) interacts with MAOIs by [blank_start]increasing[blank_end] the monamine NT in the synapse
Responda
-
increasing
-
decreasing
Questão 53
Questão
Valbenazine (Ingrezza) interacts with digoxin and [blank_start]increase[blank_end]s the digoxin concentration by p-glycoprotein [blank_start]inhibtion[blank_end]
Responda
-
increase
-
decreases
-
inhibtion
-
inducer
Questão 54
Questão
Deutetrabenazine (Austedo) is used for the treatment of chorea and schizophrenia/schizoaffective disorder. It is metabolized by CYP2D6
Responda
- True
- False
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