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47 Cards in this Set

  • Front
  • Back
Name the structures that are part of the 'limbic system'
Anterior thalamus
Limbic cortex (anterior cingulate, ventral prefrontal, orbitofrontal (P Gage), insula, temporal)
What is Kluver-Bucy syndrome? What are the symptoms?
Bilateral lesion of the amygdala

May cause:
problems remembering emotional stimuli,
reduced aggression,
reduced inhibition,
over-friendliness and
Characterise the input and outputs to the amygdala
Massive sensory input

Outputs to:
Hypothalamus (SNA)
CNV (fear look)
medulla (reflexes)
What are the results of stimulation or lesion of the ventral prefrontal cortex (part of limbic cortex)?
The ventral prefrontal cortex causes happiness when stimulated and the opposite when lesioned.
What is the function of the anterior cingulate cortex (part of limbic cortex)?
The anterior cingulate is important for the awareness of self and recognition of pain (may be important in depression)
Which of the following is NOT conflicting with the idea of dualism:
1) Issue of influence
2) Brain damage
3) Plasiticity
4) Evolution of consciousness

The idea of neural plasticity is conflicting with the central dogma of the identity theory (i.e. brain state is responsible for mind state)
Define functionalism (a branch of materialism) in the context of the mind-body problem
That the mind state is the result of inputs, outputs and other mental states
Define eliminative materialism in the context of the mind-body problem
That what we understand (folk pyschology) about the mind state/mind-body problem doesn't currently account for many of the questions posed, but that continuing investigation will produce answers.
Describe the ascending monoamine pathway for noradrenaline
Locus coeruleus

Describe the ascending monoamine pathway for serotonin
Raphe nucleus

Cite two pieces of pharmacological evidence that go against the monoamine theory of depression
1. Cocaine (inhibs reuptake of 5HT and NAd) has no therapeutic effect on depressive patients
2. Amphetamine (stims release of 5HT and NAd and inhibs reuptake of 5HT and NAd) has no therapeutic effect on depressive patients
3. Plasma response to pharmacotherapy is near instant but therapeutic effect takes up to 8 weeks
4. Some therapeutics have no effect on monoamines
How do MAOI's work?
Inhibit the metabolism of 5HT and NAd thereby increasing plasma concentration
T/F Monoamines and their metabolites may be found in reduced levels in urine, CSF and brainstem of depressed patients
True (not a good diagnostic though)

This is a strong piece of biochemical evidence for the monoamine hypothesis of depression
Neuronal loss in which areas may be associated with chronic depression?
Prefrontal cortex
What is the mechanism of action of tricyclic antidepressants in depression? Give two examples
TCAs inhibit the reuptake of serotonin (via 5HT transporter) and noradrenaline (via uptake 1 transporter).

e.g. imipramine, amitriptyline, doxepin
Name three unwanted side effects of tricyclic antidepressants
Autonomic (constipation, dry mouth, blurred vision, tachycardia)
Postural hypotension
Sexual dysfunction
Cardiac arrhythmias (K+ cycling)
What is the mechanism of action of MAOIs in depression? Give one example
They prevent the conversion 5HT/Nad/Da to inactive metabolites in the presynaptic site

e.g. phenelzine, moclebemide
Name two unwanted effects that may occur with MAOI use
Postural hypotension
Weight gain
The 'Cheese Reaction': reaction to cheese, beer, game, wine,
What is the mechanism of SSRIs in depression? Give two examples
They selectively inhibit the reuptake of serotonin via the 5HT transporter.

e.g. citalopram, sertraline, fluoexitine
What is the reason for the current preference for SSRIs over TCAs?
The side effects of the two are similar, although SSRIs seem to cause less acute toxicity and have a lower overdose risk.

However, there is concern over the use of SSRIs in children and adolescents because of some studies showing an increase in early suicide following therapy
Name two drugs that may be used in the treatment of depression that do not directly act on monoamines
Lithium (mostly for bipolar)

Sodium valproate

What is required by the DSMIV for diagnosis of bipolar disorder?
At least one episode of mania/hypomania
T/F The incidence of bipolar disorder is equal in males and females
Which of the following are commonly comorbid with bipolar disease:
vascular disease
substance abuse
T/F Most bipolar sufferers are asymptomatic in between episodes
What defines the difference between bipolar 1 and bipolar 2 disorders?
Bipolar 1: at least one episode of mania

Bipolar 2: recurrent depression with at least one episode of hypomania WITHOUT an episode of mania
What are the atypical features of bipolar depression?
Weight gain
What are the common drugs used for treatment of mania and depression in bipolar disorder?
Mania: LITHIUM, valproate/carbamazepine, atypical antipsychotics

Depression: lithium, lamotrigine, antidepressants (some refractoriness)

Best: lithium + valproate (+atypical antipsychotic?)
Which feature of bipolar disorder is most commonly the index case
How is chronic stress theorised to be involved in the etiology of depression?
Chronic cortisol
->increased NMDA activity
->Ca influx, enzyme hyperactivity, free radicals, DNA damage, downreg CREB-BDNF

Downreg BDNF: hippocampal and frontal atrophy
How do antidepressants stimulate neurogenesis?
-> GPCR -> cascade
CREB-BDNF upregulation
T/F Atrophic changes in seen in depression may be reversed by antidepressants
Name one gene that may be involved in the genesis of depression (along with environmental factors)
COMT: catabolises dopamine. Involvement in schizophrenia also - sensitises to adolescent cannabis use.

Serotonin transporter gene:
Which areas are most likely to be atrophied in the depressed brain?
Hippocampus, possibly frontal lobe and hypothalamus as well
What is the main refractive element of the eye?
T/F The epithelium of the cornea is simple squamous
False - stratified squamous
From where does the cornea derive its nutrient supply and innervation?
Nutrients: Cornea is avascular (unless irritated/inflamed). Therefore aqueous hum and limbic vessels

Innervation: V1
What test might be used to diagnose a penetrating vs non-penetrating corneal injury?
Seidel's test
A corneal injury as deep as what layer would be expected to leave a thin white scar?
What does the conjunctiva cover/lie on?
Inner eyelid + sclera (NOT cornea)
What is the name of the ligament that support the tarsal plates?
medial palpebral lig
Name the three layers of a tear film (from deep to superficial)
Superficial oily film
Aqueous layer
Superficial lipid film
Describe the shape of the globe in a myopic eye. Should the sufferer use + or - lenses?
Globe is too long, causing light to bend and focus in front of the retina.

Requires negative lenses
Describe the shape of the globe in a hyperobic eye. Should the suffer use + or - lenses?
Globe is too short, causing light to bend too little and focus behind the retina.

Requires positive lenses
Describe the shape of the globe in an astigmatic eye.

Should the sufferer use + or - lenses?
Like a rugby ball

Astigmatics may require either + or - lenses
What is arcus senilis?
Accumulation of lipid in the stroma
What is the name for typically symmetric, chronically red, dry eyelid margins?