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63 Cards in this Set

  • Front
  • Back
general definition of cognitive disorder
typically represent a decline from a previously higher level of function
Impairment in memory in the absence of clouded consciousness or other note-worthy cognitive dysfunction
amnestic disorder
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
dementia
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
five major axes of psychiatric diagnosis
I: clinical disorder
II: personality disorder, mental retardation
III: physical conditions and disorder
IV: psychosocial and environmental problems
V: global assessment of functioning
one of the greatest differences between human brains and the brains of other animals
development of much of the cortex into association areas
three major association areas in the human brain
Prefrontal

Parieto-temporal occipital

Limbic
two major functions of the prefrontal association cortex
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))
function of much of the PTO association cortex
related to high-level interpretation of sensory inputs, leading to:

analysis of spatial coordinates
language comprehension
initial processing of visual language
naming of objects
functions of the PTO association cortex on the non-dominant side
understanding/interpreting music
non-verbal visual experiences
body language
function of the limbic association area
involved in the interpretation of emotional context
**specialization of some of the pyramidal cells of the association cortex
some give off recurrent collaterals, that synapse onto:

the cell that activated it
neighboring cells

this creates complex feedback networks
anatomical substrate for navigation
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
definition of anhedonia
can't experience or even imagine any pleasant emotion
definition of clang associations
illogical connections by rhythm or puns
definition of echolalia
repeating in answer many of the same words as in the question
definition of echopraxia
imitations of movements or gestures
definition of perseveration
responding to all questions in the same way
definition of poverty of speech
sparse and slow speech
definition of pressured speech
abundant and accelerated speech
definition of verbigeration
senseless repetition of same words or phrases
definition of illusion
a false perception; the mistaking of something for what it is not
schizophrenia subtypes
paranoid
catatonic
disorganized
residual
undifferentiated
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
schizophrenia characterized by:
motor immobility
extreme negativity
peculiarities of voluntary movement
echolalia or echopraxia
catatonic schizophrenia
schizophrenia characterized by disorganized speech and behavior, and flat or inappropriate affect

criteria for catatonic type are not met
disorganized schizophrenia
positive symptoms associated w/ schizophrenia
hallucinations
delusions
thinking disturbances
disorganized speech
negative symptoms associated w/ schizophrenia
apathy/social withdrawal
blunted affect
anhedonia
poverty of speech
inattention
avolition
general features of the brain that are fairly consistent among those suffering from schizophrenia
decreased cortical volume
increased size of lateral ventricles
decreased volume or neuronal number in subcortical structures (caudate, putamen and amygdala)
**szhizophrenia is generally thought to be linked to....
overactivity of the dopaminergic system
**3 most important proteins implicated in the genetic basis for schizophrenia
Dysbindin ("best supported")
DISC-1
COMT
**function of dysbindin
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
type of COMT that is associated w/ schizophrenia
valium containing (at codon 108/158)
4 areas of the brain affected by antipsychotics to provide clinical benefit as well as adverse effects
mesolimbic (tx of hallucinations/delusions - positive sympotms)
mesocortical (Tx of psychoses & SE: worsening of negative symptoms)
nigrostriatal (SE: movement disorders)
tuberinfundibular(SE: prolactin release)
two classes of antipsychotics
typical ("-azine" and Haloperidol) and atypical ("-apine" or "-idone")
what distinguishes typical drugs from atypical drugs in the treatment of schizophrenia
atypical agents don't have the same capacity to cause movement disorders and are subsequently used more often
primary mechanism for all of the typical agents (1st generation) in the treatment of schizophrenia
D2 blockade
2 general categories of typical agents used in the treatment of schizophrenia
high potency (more movement disorders
low potency (sedation, hypotension, and seizure-threshold reduction)
primary mechanism of action for atypical agents in the treatment of schizophrenia
great propensity to block serotonin receptors (in addition to D2 blockade to a lesser degree)
atypical schizophrenia drug used to treat recurrent suicidal behavior
clozapine
treatment for extrapyramidal movement disorder brought on by treatment with a typical schizophrenia drug
use anticholinergic agent:
Benztropine
Diphenhydramine (benadryl)
Trihexyphenidyl
major side effect associated w/ clozapine
agranulocytosis

**MONITOR WBC COUNT** not first line because of this
the two most superior drugs in the treatment of schizophrenia
clozapine and alonzapine

not necessarily used more than the others due to other difficulties associated w/ administration
treatment for fatal, severe Parkinson's like movement disorder brought on by schizophrenia drugs
dantrolene
important side effects of the atypical drugs used to treat schizophrenia
metabolic effects (hyperglycemia and hyperlipidemia)
black box warning associated w/ all atypicals
increased incidence of death in elderly demented patients
MAKE SURE TO CHECK OUT THAT CHART POSTED TO BLACKBOARD ON THE SIDE EFFECTS OF THE VARIOUS DRUGS
CONCENTRATE ON THE HIGHS AND THE LOWS
how to administer medications for patients who are dangerously non-compliant
injectable agents (every 2-4 weeks)

Haloperidol decanoate
Fluphenazine decanoate
Risperidone mirospheres
How does the age at which we learn a second language affect the pathway activated in the brain?
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
topics strung together
flight of ideas
jump from one topic to another
loose associations
Subtypes of delusional disorders (4)?
Erotamaniac - delusions that another person is in love w/ them

Grandiose - delusions of inflated worth, power, knowledge...

Jealous

persecutory - somebody is after them
Role of DISC-1 in development of schizophrenia
It is involved in development of the brain and in schizophrenia the abnormal DISC-1 leads to decreased brain size.
Why don't sympotms of schizophrenia develop earlier in life and why isn't the genetic link stronger?
It requires multiple hits:
Hit1: gentic - increases the stresses on neurons

Hit 2: birth trauma and or viral infections...fruther stressing the neurons
Antipsychotic that has the lowest ADR's overall?
ARIPIRAZOLE
Antiphsychotics that are the most likley to produce ECG changes?
Thioridazine and Ziprazidone

(note: all typcials can cause this ADR and paliperidone as well)
Antiphysychoitcs most likley to cause sedation
Chlorpromazine

Mesoridazine

Clozapine
Antiphyschotic most likley to cause Muscarinic affects (i.e. anticholinergic; dry mouth, constipation...)
Clozapine
Antiphyscotic most likley to cause hypotension
Thioridazine

Clozapine
Antipsychotics most likley to cause EPS?
Fluphenazine

Haloperidol
Antipsychotics most likley to cause weight gain or metabolic effects
Clozapine

Olanzapine
Antipsychoitcs most likley to cause stroke?
Olanzapine

Paliperidone

Risperidone
Antipsychotics most likley to cause prolactin release
Haloperidol

Risperidone