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63 Cards in this Set
- Front
- Back
general definition of cognitive disorder
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typically represent a decline from a previously higher level of function
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Impairment in memory in the absence of clouded consciousness or other note-worthy cognitive dysfunction
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amnestic disorder
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a series of disorders characterized by the development of multiple cognitive deficits (including memory impairment) that are due to the direct physiological effects of a general medical condition, the persisting effects of a substance, or multiple causes
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dementia
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behavioral response to
widespread disturbances in cerebral metabolism (acute confusional state, toxic metabolic encephalopathy) Principal disturbance is in the level of consciousness and associated impairments affecting orientation, memory, judgment, and attention |
delirium
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five major axes of psychiatric diagnosis
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I: clinical disorder
II: personality disorder, mental retardation III: physical conditions and disorder IV: psychosocial and environmental problems V: global assessment of functioning |
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one of the greatest differences between human brains and the brains of other animals
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development of much of the cortex into association areas
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three major association areas in the human brain
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Prefrontal
Parieto-temporal occipital Limbic |
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two major functions of the prefrontal association cortex
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planning of complex motor actions (associates w/ PTO association area and all levels of cortex)
carrying out of "thought" processes (associates w/ hippocampus (working memory i.e. memory that we are currently using) and judgment (multiple ares, especially the limbic system)) |
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function of much of the PTO association cortex
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related to high-level interpretation of sensory inputs, leading to:
analysis of spatial coordinates language comprehension initial processing of visual language naming of objects |
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functions of the PTO association cortex on the non-dominant side
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understanding/interpreting music
non-verbal visual experiences body language |
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function of the limbic association area
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involved in the interpretation of emotional context
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**specialization of some of the pyramidal cells of the association cortex
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some give off recurrent collaterals, that synapse onto:
the cell that activated it neighboring cells this creates complex feedback networks |
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anatomical substrate for navigation
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in the standard right-handed individual, it is a right-sided skill (non-dominant), requiring the hippocampus (this is where a spatial map is stored) and the caudate nucleus
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definition of anhedonia
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can't experience or even imagine any pleasant emotion
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definition of clang associations
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illogical connections by rhythm or puns
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definition of echolalia
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repeating in answer many of the same words as in the question
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definition of echopraxia
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imitations of movements or gestures
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definition of perseveration
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responding to all questions in the same way
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definition of poverty of speech
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sparse and slow speech
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definition of pressured speech
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abundant and accelerated speech
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definition of verbigeration
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senseless repetition of same words or phrases
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definition of illusion
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a false perception; the mistaking of something for what it is not
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schizophrenia subtypes
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paranoid
catatonic disorganized residual undifferentiated |
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schizophrenia characterized by preoccupation w/ one or more delusions w/ frequent auditory hallucinations
NONE of the following is prominent-> disorganized speech, disorganized or catatonic behavior, flat or inappropriate affect |
paranoid schizophrenia
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schizophrenia characterized by:
motor immobility extreme negativity peculiarities of voluntary movement echolalia or echopraxia |
catatonic schizophrenia
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schizophrenia characterized by disorganized speech and behavior, and flat or inappropriate affect
criteria for catatonic type are not met |
disorganized schizophrenia
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positive symptoms associated w/ schizophrenia
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hallucinations
delusions thinking disturbances disorganized speech |
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negative symptoms associated w/ schizophrenia
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apathy/social withdrawal
blunted affect anhedonia poverty of speech inattention avolition |
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general features of the brain that are fairly consistent among those suffering from schizophrenia
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decreased cortical volume
increased size of lateral ventricles decreased volume or neuronal number in subcortical structures (caudate, putamen and amygdala) |
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**szhizophrenia is generally thought to be linked to....
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overactivity of the dopaminergic system
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**3 most important proteins implicated in the genetic basis for schizophrenia
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Dysbindin ("best supported")
DISC-1 COMT |
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**function of dysbindin
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found pre and postsynaptically. In the presynaptic terminal, it interacts inversely (destroys) w/ the vesicular transport protein for EAA (VGlutT1)
in schizophrenia, dysbindin is greatly reduced, leading to more EAA release, leading to excitotoxic cell death of the post-synaptic neuron |
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type of COMT that is associated w/ schizophrenia
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valium containing (at codon 108/158)
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4 areas of the brain affected by antipsychotics to provide clinical benefit as well as adverse effects
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mesolimbic (tx of hallucinations/delusions - positive sympotms)
mesocortical (Tx of psychoses & SE: worsening of negative symptoms) nigrostriatal (SE: movement disorders) tuberinfundibular(SE: prolactin release) |
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two classes of antipsychotics
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typical ("-azine" and Haloperidol) and atypical ("-apine" or "-idone")
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what distinguishes typical drugs from atypical drugs in the treatment of schizophrenia
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atypical agents don't have the same capacity to cause movement disorders and are subsequently used more often
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primary mechanism for all of the typical agents (1st generation) in the treatment of schizophrenia
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D2 blockade
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2 general categories of typical agents used in the treatment of schizophrenia
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high potency (more movement disorders
low potency (sedation, hypotension, and seizure-threshold reduction) |
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primary mechanism of action for atypical agents in the treatment of schizophrenia
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great propensity to block serotonin receptors (in addition to D2 blockade to a lesser degree)
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atypical schizophrenia drug used to treat recurrent suicidal behavior
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clozapine
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treatment for extrapyramidal movement disorder brought on by treatment with a typical schizophrenia drug
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use anticholinergic agent:
Benztropine Diphenhydramine (benadryl) Trihexyphenidyl |
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major side effect associated w/ clozapine
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agranulocytosis
**MONITOR WBC COUNT** not first line because of this |
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the two most superior drugs in the treatment of schizophrenia
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clozapine and alonzapine
not necessarily used more than the others due to other difficulties associated w/ administration |
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treatment for fatal, severe Parkinson's like movement disorder brought on by schizophrenia drugs
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dantrolene
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important side effects of the atypical drugs used to treat schizophrenia
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metabolic effects (hyperglycemia and hyperlipidemia)
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black box warning associated w/ all atypicals
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increased incidence of death in elderly demented patients
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MAKE SURE TO CHECK OUT THAT CHART POSTED TO BLACKBOARD ON THE SIDE EFFECTS OF THE VARIOUS DRUGS
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CONCENTRATE ON THE HIGHS AND THE LOWS
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how to administer medications for patients who are dangerously non-compliant
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injectable agents (every 2-4 weeks)
Haloperidol decanoate Fluphenazine decanoate Risperidone mirospheres |
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How does the age at which we learn a second language affect the pathway activated in the brain?
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If learned during the language activation phase the same pathway as used for the frist language will be activated
If the second language is learned later then activation of an adjacent region of braca's areas occurs |
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topics strung together
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flight of ideas
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jump from one topic to another
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loose associations
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Subtypes of delusional disorders (4)?
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Erotamaniac - delusions that another person is in love w/ them
Grandiose - delusions of inflated worth, power, knowledge... Jealous persecutory - somebody is after them |
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Role of DISC-1 in development of schizophrenia
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It is involved in development of the brain and in schizophrenia the abnormal DISC-1 leads to decreased brain size.
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Why don't sympotms of schizophrenia develop earlier in life and why isn't the genetic link stronger?
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It requires multiple hits:
Hit1: gentic - increases the stresses on neurons Hit 2: birth trauma and or viral infections...fruther stressing the neurons |
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Antipsychotic that has the lowest ADR's overall?
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ARIPIRAZOLE
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Antiphsychotics that are the most likley to produce ECG changes?
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Thioridazine and Ziprazidone
(note: all typcials can cause this ADR and paliperidone as well) |
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Antiphysychoitcs most likley to cause sedation
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Chlorpromazine
Mesoridazine Clozapine |
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Antiphyschotic most likley to cause Muscarinic affects (i.e. anticholinergic; dry mouth, constipation...)
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Clozapine
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Antiphyscotic most likley to cause hypotension
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Thioridazine
Clozapine |
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Antipsychotics most likley to cause EPS?
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Fluphenazine
Haloperidol |
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Antipsychotics most likley to cause weight gain or metabolic effects
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Clozapine
Olanzapine |
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Antipsychoitcs most likley to cause stroke?
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Olanzapine
Paliperidone Risperidone |
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Antipsychotics most likley to cause prolactin release
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Haloperidol
Risperidone |