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2020 Question Book
2020 QUESTION BOOK 13TH EDITION WHO WE ARE Welcome to the thirteenth edition of the Ninja’s Guide to PRITE! Loma Linda University Medical Center is located in sunny Southern California. about 60 miles east of Los Angeles. A part of the Adventist Health System, we provide patient care in one of the largest non-profit health systems in the nation. Loma Linda's mission is to excel in medical education, global healthcare, and community outreach, all under a central tenant: "To Make Man Whole." At the Loma Linda Department of Psychiatry, our residents are trained in many diverse patient care settings. As an official World Health Organization Collaboration Center, our department funds resident electives in Global Mental Health at locations around the world. Additionally, our residents can participate in national and international disaster relief on the LLU Behavioral Health Trauma Team. We were proud to welcome our first group of Child and Adolescent Psychiatry fellows in the Summer of 2019 and work collaboratively with 3 other residency programs within the region. Our residency didactic education is constantly evolving based upon resident feedback, and our residents have the opportunity to aid in course development. More than anything, our residency fosters an environment where residents and faculty treat each other like family. Our faculty are dedicated to resident education and professional development. We believe in "taking 'No' off the table", encouraging innovative change, and passionately supporting our residents to achieve anything they set their minds to. For over a decade our residents have volunteered their time to create The Ninja's Guide to PRITE at our Annual Ninja PRITE Workshop. -
Sleep Problems
Sleep Problems About 70 million Americans have some kind of sleep problem, and for many it’s a long-term problem. Even though sleep problems are very common, they are very often undiagnosed and untreated. Here are descriptions of some of the most common sleep problems. Bruxism Bruxism is grinding, gnashing, or clenching your teeth during sleep or in situations that make you feel anxious or tense. It can be mild and happen only once in a while, or it may be violent and happen often. Bruxism most often happens in the early part of the night. You may not be aware that you have bruxism until your teeth or jaws are damaged. People who have bruxism are also more likely to snore and develop sleep apnea. Hypersomnia Hypersomnia is excessive daytime sleepiness or prolonged nighttime sleep. If you have hypersomnia, you feel very drowsy during the day and have an overwhelming urge to fall asleep, even after getting enough sleep at night. You often doze, nap, or fall asleep in situations where you need or want to be awake and alert. Other symptoms may include irritability, mild depression, trouble concentrating, and memory loss. Kleine-Levin Syndrome Kleine-Levin syndrome is a rare disorder that causes you to be extremely drowsy off and on. You may sleep up to 20 hours a day. Other symptoms include eating too much, being irritable, feeling disoriented, lacking energy, and being very sensitive to noise. The disorder usually starts in the late teens and is more common in men than in women. Symptoms may last for days to weeks, then go away, and then come back. -
The ICD-10 Classification of Mental and Behavioural Disorders : Clinical Descriptions and Diagnostic Guidelines
ICD-10 ThelCD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines | World Health Organization I Geneva I 1992 Reprinted 1993, 1994, 1995, 1998, 2000, 2002, 2004 WHO Library Cataloguing in Publication Data The ICD-10 classification of mental and behavioural disorders : clinical descriptions and diagnostic guidelines. 1.Mental disorders — classification 2.Mental disorders — diagnosis ISBN 92 4 154422 8 (NLM Classification: WM 15) © World Health Organization 1992 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: [email protected]). Requests for permission to reproduce or translate WHO publications — whether for sale or for noncommercial distribution — should be addressed to Publications, at the above address (fax: +41 22 791 4806; email: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. -
Sleep Disturbances in Patients with Persistent Delusions: Prevalence, Clinical Associations, and Therapeutic Strategies
Review Sleep Disturbances in Patients with Persistent Delusions: Prevalence, Clinical Associations, and Therapeutic Strategies Alexandre González-Rodríguez 1 , Javier Labad 2 and Mary V. Seeman 3,* 1 Department of Mental Health, Parc Tauli University Hospital, Autonomous University of Barcelona (UAB), I3PT, Sabadell, 08280 Barcelona, Spain; [email protected] 2 Department of Psychiatry, Hospital of Mataró, Consorci Sanitari del Maresme, Institut d’Investigació i Innovació Parc Tauli (I3PT), CIBERSAM, Mataró, 08304 Barcelona, Spain; [email protected] 3 Department of Psychiatry, University of Toronto, #605 260 Heath St. West, Toronto, ON M5T 1R8, Canada * Correspondence: [email protected] Received: 1 September 2020; Accepted: 12 October 2020; Published: 16 October 2020 Abstract: Sleep disturbances accompany almost all mental illnesses, either because sound sleep and mental well-being share similar requisites, or because mental problems lead to sleep problems, or vice versa. The aim of this narrative review was to examine sleep in patients with delusions, particularly in those diagnosed with delusional disorder. We did this in sequence, first for psychiatric illness in general, then for psychotic illnesses where delusions are prevalent symptoms, and then for delusional disorder. The review also looked at the effect on sleep parameters of individual symptoms commonly seen in delusional disorder (paranoia, cognitive distortions, suicidal thoughts) and searched the evidence base for indications of antipsychotic drug effects on sleep. It subsequently evaluated the influence of sleep therapies on psychotic symptoms, particularly delusions. The review’s findings are clinically important. Delusional symptoms and sleep quality influence one another reciprocally. Effective treatment of sleep problems is of potential benefit to patients with persistent delusions, but may be difficult to implement in the absence of an established therapeutic relationship and an appropriate pharmacologic regimen. -
Early-Onset Parkinson's Disease Caused by PLA2G6 Compound
CASE REPORT published: 21 August 2019 doi: 10.3389/fneur.2019.00915 Early-Onset Parkinson’s Disease Caused by PLA2G6 Compound Heterozygous Mutation, a Case Report and Literature Review Ting Shen 1,2,3, Jing Hu 1,2, Yasi Jiang 2,3, Shuai Zhao 1,2, Caixiu Lin 1,2, Xinzhen Yin 1,2, Yaping Yan 1,2, Jiali Pu 1,2, Hsin-Yi Lai 2,3* and Baorong Zhang 1,2* 1 Department of Neurology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China, 2 Department of Neurology of the Second Affiliated Hospital, Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University, Hangzhou, China, 3 Key Laboratory of Biomedical Engineering of Ministry of Education, Qiushi Academy for Edited by: Advanced Studies, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China Ruey-Meei Wu, National Taiwan University, Taiwan Reviewed by: PLA2G6 has been certified as a causative gene in patients with autosomal recessive Yih-Ru Wu, early-onset Parkinson’s disease (EOPD). We reported an EOPD case caused by Chang Gung Memorial Hospital, Taiwan PLA2G6 gene mutation, and performed neurological examination, genetic analysis, Chin-Hsien Lin, and multimodal neuroimaging to describe this phenotype. A compound heterozygous National Taiwan University, Taiwan mutation c.991G>T/c.1472+1G>A was detected in this patient. Heterozygous for the *Correspondence: c.991G>T and c.1472+1G>A were separately detected in his parents. Pathogenicity Hsin-Yi Lai [email protected] of these two mutations were predicted according to the American college of medical Baorong Zhang genetics and genomics (ACMG) guideline. -
Management Recommendations on Sleep Disturbance of Patients with Parkinson’S Disease
Consensus Management Recommendations on Sleep Disturbance of Patients with Parkinson’s Disease Chun‑Feng Liu1,2, Tao Wang3, Shu‑Qin Zhan4, De‑Qin Geng5, Jian Wang6, Jun Liu7, Hui‑Fang Shang8, Li‑Juan Wang9, Piu Chan4, Hai‑Bo Chen10, Sheng‑Di Chen7, Yu‑Ping Wang4, Zhong‑Xin Zhao11, K Ray Chaudhuri12 1Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China 2Institute of Neuroscience, Soochow University, Suzhou, Jiangsu 215004, China 3Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China 4Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China 5Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, China 6Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China 7Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai 200025, China 8Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China 9Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China 10Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China 11Department of Neurology, Changzheng Hospital, Second Military Medical -
WHO Technical Meeting on Sleep and Health
WHO technical meeting on sleep and health Bonn Germany, 22-24 January 2004 World Health Organization Regional Office for Europe European Centre for Environment and Health Bonn Office ABSTRACT Twenty-one world experts on sleep medicine and epidemiologists met to review the effects on health of disturbed sleep. Invited experts reviewed the state of the art in sleep parameters, sleep medicine and, long-term effects on health of disturbed sleep in order to define a position on the secondary and long- term effects of noise on sleep for adults, children and other risk groups. This report gives definitions of normal sleep, of indicators of disturbance (arousals, awakenings, sleep deficiency and fragmentation); it describes the main sleep pathologies and disorders and recommends that when evaluating the health impact of chronic long-term sleep disturbance caused by noise exposure, a useful model is the health impact of chronic insomnia. Keywords SLEEP ENVIRONMENTAL HEALTH NOISE Address requests about publications of the WHO Regional Office to: • by e-mail [email protected] (for copies of publications) [email protected] (for permission to reproduce them) [email protected] (for permission to translate them) • by post Publications WHO Regional Office for Europe Scherfigsvej 8 DK-2100 Copenhagen Ø, Denmark © World Health Organization 2004 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. -
Insomnia Characteristics and Clinical Correlates in Operation Enduring Freedom/Operation Iraqi Freedom Veterans with Post-Trauma
University of Nebraska - Lincoln DigitalCommons@University of Nebraska - Lincoln Public Health Resources Public Health Resources 2011 Insomnia characteristics and clinical correlates in Operation Enduring Freedom/Operation Iraqi Freedom veterans with post- traumatic stress disorder and mild traumatic brain injury: An exploratory study D. M. Wallace University of Miami Miller School of Medicine S. Shafazand Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine A.R. Ramos Bruce W. Carter Department of Veterans Affairs Medical Center D.Z. Carvalho Universidade Federal do Rio Grande do Sul School of Medicine H. Gardener University of Miami Miller School of Medicine See next page for additional authors Follow this and additional works at: https://digitalcommons.unl.edu/publichealthresources Part of the Public Health Commons Wallace, D. M.; Shafazand, S.; Ramos, A.R.; Carvalho, D.Z.; Gardener, H.; Lorenzo, D.; and Wohlgemuth, W.K., "Insomnia characteristics and clinical correlates in Operation Enduring Freedom/Operation Iraqi Freedom veterans with post-traumatic stress disorder and mild traumatic brain injury: An exploratory study" (2011). Public Health Resources. 200. https://digitalcommons.unl.edu/publichealthresources/200 This Article is brought to you for free and open access by the Public Health Resources at DigitalCommons@University of Nebraska - Lincoln. It has been accepted for inclusion in Public Health Resources by an authorized administrator of DigitalCommons@University of Nebraska - Lincoln. Authors D. -
What%Is%Idiopathic%Hypersomnia?%
What%is%Idiopathic%Hypersomnia?% Idiopathic*hypersomnia*is*sleeping*too*much*(hypersomnia)*without*an*obvious*cause.*It*is*different* from*narcolepsy,*because*idiopathic*hypersomnia*does*not*involve*suddenly*falling*asleep*or*losing* muscle*control*due*to*strong*emotions*(cataplexy).* Causes* The*usual*approach*is*to*consider*other*potential*causes*of*excessive*daytime*sleepiness.* Other*sleep*disorders*that*may*cause*daytime*sleepiness*include:* •Isolated*sleep*paralysis* •Narcolepsy* •Obstructive*sleep*apnea* •Restless*leg*syndrome* Other*causes*of*excessive*sleepiness*include:* •Atypical*depression* •Certain*medications* •Drug*and*alcohol*use* •Low*thyroid*function*(hypothyroidism)* •Previous*head*injury* Symptoms* Symptoms*often*develop*slowly*during*adolescence*or*young*adulthood.*They*include:* •Daytime*naps*that*do*not*relieve*drowsiness* •Difficulty*waking*from*a*long*sleep*KK*may*feel*confused*or*disoriented* •Increased*need*for*sleep*during*the*day*KK*even*while*at*work,*or*during*a*meal*or*conversation* •Increased*sleep*time*KK*up*to*14*K*18*hours*per*day* Other*symptoms*may*include:* •Anxiety* •Feeling*irritated* •Loss*of*appetite* •Low*energy* •Restlessness* •Slow*thinking*or*speech* •Trouble*remembering* Cataplexy*KK*suddenly*falling*asleep*or*losing*muscle*control*KK*which*is*part*of*narcolepsy,*is*NOT*a* symptom*of*idiopathic*hypersomnia.* Exams*and*Tests* The*health*care*provider*will*take*a*detailed*sleep*history.*Tests*may*include:* •MultipleKsleep*latency*test* •Sleep*study*(polysomnography,*to*identify*other*sleep*disorders)* -
Reading List Final 2020
Society of Behavioral Sleep Medicine (SBSM) Reading List The purpose of this document is to provide a reference with content-specific reading options for: 1) those who are preparing for the Diplomate of Behavioral Sleep Medicine (DBSM) exam; 2) participants in a BSM training program; or 3) anyone interested in learning more about a certain topic in BSM. Please note that this list is not intended to serve as a comprehensive study guide for exam preparation. For those preparing for the DBSM exam, we do not anticipate that it is feasible to review all of the materials on this list. At the same time, there may be exam content that is not covered by the materials below. This document is prepared and maintained by the SBSM Education Committee. The SBSM is independent from the organization that oversees the exam itself (Board of Behavioral Sleep Medicine; BBSM), and Education Committee members do not have access to the exam. The readings were not designed to serve as preparatory material for the exam, but to provide an overview of various topics to learners. Thus, the SBSM cannot guarantee that the information presented in the readings is up-to-date and comprehensive for exam preparation. We would love your feedback! If you perceive that any articles did not cover the information in a category, or included inaccurate information, please let us know. If you would like to propose additional articles for inclusion in this list, we will consider these as well. Please email [email protected] with your feedback. Instructions: Click on the number to access the publication reference, which can also be found in the alphabetical reference list below. -
Hypersomnia (Hypersomnolence) Symptoms and Diagnosis
Hypersomnia (Hypersomnolence) Symptoms and Diagnosis Hypersomnia (Hypersomnolence) Symptoms and Diagnosis By Yolanda Smith, BPharm Hypersomnia, also known as hypersomnolence, is a condition involving excessive daytime sleepiness or prolonged nighttime sleep on a recurring basis. Adolescents and young adults are most likely to be affected by the condition. It often causes affected individuals to take repeated naps throughout the day, which may disrupt other activities, such as work, study or social activities. These naps typically only provide temporary relief of symptoms and the desire to nap returns shortly afterwards. Common Symptoms It is common for people with hypersomnia to have difficulty waking up, particularly after a long sleep. They may feel disorientated and confused, which can continue for several hours in some patients. Excessive daytime sleepiness is the defining symptom of hypersomnia, despite getting a full night’s sleep. This may inhibit affected individuals from participating in daily routines or events. Additionally, it can be more difficult for them to maintain normal function in family, social and work environments. It can cause affected individuals to perform poorly and may lead to distress about other areas of their life. In particular, patients affected by hypersomnia are more likely to suffer from depression and anxiety than the general population. Although not all patients experience other signs and symptoms, hypersomnia may also be associated with: Anxiety Agitation Clouded thought processes and decision-making Depression Hallucinations Low energy levels Reduced appetite Reduced memory Restlessness Slow speech Diagnostic Techniques The primary diagnostic criterion for primary hypersomnia is excessive daytime sleepiness for at least one month in acute conditions or three months in persistent conditions. -
Sleep and Dreaming
The Journal of Neuroscience, February 1990, fO(2): 371-382 Feature Article Sleep and Dreaming J. Allan Hobson Laboratory of Neurophysiology, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115 With its increasing emphasis upon functional questions, sleep mals to activate their brains periodically in sleep. The only research has entered a new and exciting third phase. Since sleep exceptions are birds, who show brief REM episodes in the first had never been objectively studied in any detail prior to the few days after hatching. They lose this sleep state as they mature, beginning of its first phase in about 1950, it was to be expected thus paralleling the dramatic decline in sleep-and especially that much of the early work in the field would be descriptive. REM-in all young mammals (Roffwarg et al., 1966). Amphibia (For reviews ofthe early work, see Jouvet, 1972; Moruzzi, 1972.) have none of the sleep features of mammals and, unless their Sleep proved a more complex behavior than such distinguished temperature falls, they remain constantly alert even when im- physiologists as Pavlov (1960) and Sherrington (1955) had imag- mobile and relaxed for long periods of time. ined, and, even today, new discoveries continue to be made, I begin this essay by describing the most recent findings re- especially in the clinical realm. In the second phase of sleep garding sleep function, not only because they are exciting in research, beginning about 1960, specific mechanistic theories their novelty, but because they strongly support some of our began to be enunciated and tested. New cellular and molecular commonsense notions about the importance of sleep.