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104 Cards in this Set
- Front
- Back
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What are the 6 nerve indicies?
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S - sleep
A - appetite M - memory C - concentration E - energy L - libido |
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What causes SAMCELs?
What are SAMCELs? What 2 things do they affect? |
nUnconcious ID, Ego, and Super Ego effect these nerve indicies that affect thinking and behaviour.
Sleep, Appetite, Memory, Concentration, Energy, Libido |
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What structural and topographical components are affected by SAMCELs?
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Topographical = unconscious
Structural = Ego, Super Ego, and ID |
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What is the Ego?
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self-awareness
conscious, sub conscious, and unconscious |
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What is the Super Ego?
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thou shalt and shalt not
conscious, sub conscious, and unconscious |
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What are the 7 basic defenses?
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denial
displacement - redirect to substitute identifying projection - attribute to others reaction formation - Jimmy Swagart Repression Sublimation - bad-->acceptable action |
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What is axis 1 of the Mental Health Assessment?
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State - acute presentation of symptoms
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What is axis II of the Mental Health Assessment?
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Trait - Personality matrix (A=PSS, B=BAHN, C=DOPA) and mental retardation
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What are the 11 personality matrices of Axis II of the Mental Health Assessment?
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A=PSS: Paranoid, Schizoid, Schizotypal
B=BAHN: Bipolar, Antisocial, Histrionic, and Narcissistic C=DOPA; Dependent, Obsessive-compuslive, Passive-Aggressive, Avoidant |
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What is axis III of the Mental Health Assessment?
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Medical
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What is axis IV of the Mental Health Assessment?
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psychocosocial stress
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What is axis V of the Mental Health Assessment?
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Global Assessment of Function
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What is psychosis?
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disorganization of thoughts --> strange behaviours
thought disorder |
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What is a delusion?
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fixed false belief
thought disorder |
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What are the 3 types of though hallucinations?
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auditory, visual, and tactile
thought disorder |
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What are the 3 components of thought disorders?
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psychosis
delusion hallucination |
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At what age do delusions usually begin?
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college age
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Identify the differences between the following types of thought disorders:
Delusional Brief Psychotic disorder Schizoaffective Disorder Schizopheniform Schizophrenia |
Delusional: non-bizarre fixed false belief-->normal behaviour
Brief Psychotic disorder: 1-30d Schizoaffective Disorder: schizo+mood disorder...with 2 weeks of delusion OR hallucinations w/o mood alteration Schizopheniform: 30d-6mo Schizophrenia: >6mo |
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What are the primary diagnostic criteria of schizophrenic (not the delusional and brief psychotic disorders) thought disorders?
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Primary= delusions + auditory hallucinations with a running commentary of patient thoughts + >2 voices
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What are "other" diagnostic criteria of schizophrenic thought disorders?
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suffer from 2 of the following:
delusion disorganized behaviour/catatonia disorganized speech hallucination Bleuler's 4 A's (flat, decreased speech, decreased motivation, withdrawl) AND decreased hygiene social disturbance occupational disturbance |
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What is the firing pattern of the HC?
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HC --> via fornix --> mammillary bodies (or contralateral hemisphere) --> via mammilothalamic tract --> anterior thalamus --> cingulate gyrus (anterior part works with amygdala, and prefrontal gyrus for moral reasoning) --> via cingulum --> paraHC --> back to HC or to basolateral amygdala
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What is the effect of alcoholism on the HC?
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decreased thymidine (B1) causes deficit in the mammillary bodies and Korsakoff's syndrome (amnesic-confabulatory syndrome)
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What is the effect of anoxia on the HC?
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Sommer's sector (CA1) is the most sensitive area and results in retrograde amnesia.
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What part of the HC is most readily effected in Alzheimer's?
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reduced cell quantity in the HC and para HC
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What is the function of the amygdala?
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emotion control (fear and anxiety)
moral reasoning (along with anterior cingulate gyrus, medial and dordolateral prefrontal gyrus) enhances memory of stressful event inducing release of stress hormones |
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What is the firing pattern of the amygdala?
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amygdala --> via striaterminalis --> septal cortex --> hypothalamus, n. accumbens, and habenula
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Where does input (afferents) for the corticomedial amygdala come from?
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olfactory, hypothalamus, and medial thalamus
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Where does input (afferents) for the basolateral amygdala come from?
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dorsal thalamus, and cortex
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Other than the striaterminalis, where does the basolateral amygdala send messages?
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hypothalmus, brainstem, reticular formation, and cortex (cingulate, frontal, and temporal)
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What is the primary NT of the amygdala?
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GABA
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What is the primary excitatory and inhibitory NT of the HC?
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glutamate and GABA
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The left hemisphere specializes in what part of memory?
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formal, logical, ordered
in a monosemantic context (requires higher cerebral activity) |
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The right hemisphere specialized in what part of memory?
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images with multiple simultaneous connections
especially associated with emotions |
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Where are short term memories processed?
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angular gyrus of the parietal region
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Where are long term memories processes?
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via limbic, especially right hemisphere
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Chlorpromazine use:
Binds to: |
Thorazine is a typical antipsychotic. The oldest. Used for positive schizophrenic symptoms, to decrease emisis (in cancer), and bipolar
Binds to 5-HT2a and DA2 |
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Haloperidol use:
Binds to: |
Haldol is a typical antipsychotic.
Bind to DA2 and a little to 5-HT(2a) therefore a lot of EPS |
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Clozapine use:
Binds to: side effects: |
Clozaril is an atypical antipsychotic.
It bind 5-HT(2a) strongly and also DA2 few EPS, moderate diabetes risk, risk of agranulocytosis, cause anxiety (due to 5-HT binding) |
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Aripiprazole use:
Binds to: |
Abilify is an atypical antipsychotic.
It is a DA system stabilizer because it has agonist/antagonist binding to DA2 and still antagonizes 5-HT(2a) |
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Lithium use
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for euphoric mania in BPD
MOA unknown |
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Valproate use:
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valproate is used for dysphoric mania in BPD
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Which antipsychotics carry a risk for diabetes?
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atypicals (Clozapine/Clozaril and Aripiprazole/Abilify)
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Which antipsychotics carry a risk for extrapyramidal symptoms (EPS)?
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typicals (Haloperidol/Haldol and Chlorpromazine/Thorazine)
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What are some early extrapyramidal symptoms (EPS) caused by typical antipsychotics?
With what are they treated? |
Early dystonia, parkinsonism, and akathisia (squirming)
Treat with anticholinergics, benzodiazapine, or Beta Blockers |
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What are late EPS caused by typical antipsychotics?
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tardive dyskinesia
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Other than early and late movement disorders, what are some EPS of typical antipsychotics?
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torsades de pointes (prolongation of QT intervals)
alpha receptor antagonism muscarinic receptor antagonism (brain and parasympathetic) Neuroleptic Malignant Syndrome |
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What is the function of the orbital frontal cortex (OFC)?
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used for drive and motivation, especially in addiction.
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What is the key pathway of addiction?
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median forebrain bundle from the Ventral Tegmental Area to the Nucleus Accumbens
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What is addiction?
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compulsive drug use with overwhelming focus on obtaining and using drug
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What causes the 3 types of tolerance to addictive substances?
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1) D1 stimulation in the VTA (ventral tegmental area)
2) increased glutamate activity in the VTA. 3) Decreased GABA negative feedback. Above 3 result in LTP which causes a state where individual no longer responds to drug |
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What are the 3 types of tolerance to addictive substances?
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pharmacokinetic (dispositional)
pharmacodynamic (decreased response) behavioural (learned) |
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What causes sensitization to addictive substances?
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increased glutamate responsiveness and DA stimulation in the NAc promotes transcription --> increased dendritic spines --> increases conditioned-incentive learning
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What is dependence to addictive substances?
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individual only functions when in the presence of given drug
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What changes cause compulsion during/in addiction?
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1) altered OFC (orbitalfrontal cortex)
2) altered PFC (prefrontal cortex) 3) altered cingulate gyrus (moral reasoning) |
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How does focusing, or filtering out white-noise, occur?
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NE projections from locus coeruleus -->inhibit firing in parietal cortex, superior colliculus, and pulvinar nucleus --> enhances signal-to-noise ratio by quieting noise
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What 3 biological changes occur to cause ADHD?
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1) decreased NE from locus coerulus to PFC and anterior cingulate gyrus (a good functioning system would enhance task-oriented signaling)
2) decreased NE from the locus coeruleus to the posterior attention system/sensory areas (parietal, superior colliculus, and pulvinar nuclei) 3) decreased DA-D1 action in the PFC (normal function gates information from the posterior attention system) |
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What will be the result from disrupting the mesolimbic pathway?
What will be the result from overstimulating the mesolimbic pathway? |
mood flattening
fear or anxiousness leading to addiction |
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What is the consequence of disrupting the nigrostriatal pathway as antipsychotics often do?
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parkinsonism
dystonia (spasms) akathisia (squirming) tardive dyskinesia |
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What is Phentermine?
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Amphetamine (NE/DA reuptake inhibitor) for obesity. Activates lateral hypothalamus to release NE. Potential for abuse.
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What is Sibutramine (Meridia)?
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SNRI for weight loss
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Aside from daytime sleepiness, what are the symptoms of narcolepsy?
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Abnormal REM Sleep.
Cataplexy: Brief (Often < 1 minute) loss of muscle tone/Paralysis. Hypnagogic Hallucinations: Dream-Like Expereince which occurs during transition from Wakefulness to Sleep. |
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What is the treatment for narcolepsy?
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amphetamines or alpha 1 agonists such as Modafinil (provigil)
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What is Modafinil?
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Provigil is an alpha 1 agonist to treat narcolepsy
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What is Bupropion?
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Welbutrin is a DA reuptake inhibitor to treat smoking, depression, and ADHD
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What is Atomoxitine?
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Strattera is a NE reuptake inhibitor to treat ADHD.
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What drug is a Dopamine System Stabilizer (DSS)?
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Atypical antipsychotic Aripiprazole (Abilify).
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What drug might cause Agranulocytosis?
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Clozapine (clozaril) an atypical antipsychotic.
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Treatment for tourettes?
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Haldol an atypical antipsychotic.
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What is Clonidine (Catapres) used to treat?
What is the MOA? |
Tourettes, ADHD, or hypertension
MOA=alpha 2 agonist |
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What is Intuniv (guanfacine)?
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An alpha 2 agonist (like Clonidine). Used to treat ADHD in kids.
Newly approved. |
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What is the MOA of methylphenidate?
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Ritalin is a NE/DA reuptake inhibitor and increases release.
Gold standard for kids. |
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Slow Deep Tendon Reflexes are a sign of?
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low TSH
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What is Rett's Disorder?
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X-Linked disorder seen almost exclusively in Girls (affected Males die in utero or shortly after Birth).
Progressive disorder characterized by loss of development, mental retardation, loss of verbal abilities, ataxia, and steryotyped hand-wringing |
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What is Childhood Disintigrative Disorder?
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Marked regression in multiple areas of functioning after at least 2 years of apparently normal development. Usually in males.
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What lab values are elevated in alcohol abusers?
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GGT and MCV
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What are the symptoms and time of onset for uncomplicated alcohol withdrawl?
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tremors from 12 hours - 7 days
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What are the symptoms and time of onset for complicated alcohol withdrawl?
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tremors --> seizures and hallucinations from 7 hours - 36 hours
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What is the MOA of antabuse?
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acetyladehyde dehydrogenase inhibitor
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What is Campral (Acamprosate)?
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It balances glutamate and GABA in alcohol withdrawl
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What is ReVia?
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Naltrexone is a mu opiod antagonist used to decrease the positive reinforcement of alcohol. It is used to help with withdrawl.
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What is Vivitrol?
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injectable Naltrexone (mu opiod antagonist used in alcohol witihdrawl)
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What is Lorazepam?
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Ativan is a liver safe benzodiazepine for alcohol withdrawl hallucinations, GAD, and panic disorder.
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What is Serax (oxazepan)?
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It is a liver safe benzodiazepine used for alcohol withdrawl hallucinations
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What is euthymia?
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normal mood
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Adjustment disorder?
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identifiable stressor with in the last 3 months
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Atypical MDD symptoms include?
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increased sleep, increased wt gain and eating, decreased energy
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Dysthymia is?
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decreased mood for greater than 2 years in adults greater than 1 year in kids
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Bipolar I
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at least 1 manic episode
(mania is at least 1 week of consistent/persistent elevation/expansion or irritability with 3 of 7: decreased sleep, grandiosity, talk pressure, racing thoughts increased goal oriented activity, increased pleasure seeking with impairs work/life |
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Bipolar II
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at least 1 hypomania and MDD episode
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Bipolar III
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mixed irritability, excitability, depression and happiness
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Hypomania
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at least 4 days (non-life impairing) of either elevation or irritability and 3 of 7: decreased sleep, grandiosity, pleasure seeking, goal-oriented activity, talk pressure, racing thoughts
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Cyclothymic Disorder
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cycling between hypomania and dysthymia (no mania like BPD I and no MDD like BPD II)
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What is delusional disorder?
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non-bizarre fixed false belief with normal behaviour
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What is the time frame of suffering in:
Brief psychotic disorder Schizophreniform disorder Schizophrenia |
Brief psychotic disorder <30 d
Schizophreniform disorder 30d-6m Schizophrenia >6m |
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Are typcial or atypical antipsychotics approved for BPD?
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atypicals such as Clozapine (clozaril) and aripiprazole (Abilify)
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Are typical or atypical antipscychotics more likely to have anticholinergic effects?
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atypical (typical have more EPS)
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What does this scenario define?
Substance use leads to work/social issues. Withdrawl symptoms. Time spent seeking substance. Attempt to cut down. Annoyed. Guilty. Need an eye opener. Tolerance |
Dependence
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What are the differences between somatoform disorder, factitious disorder, and malingering?
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Somatoform unconscious problem leads to unconscious induction of symptoms
Factious disorder is an unconcious problem leading to conscious creation of symptoms Malingering conscious/conscious |
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What is the time frame difference between BPD I and II?
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BPD I mania > 1 week
BPD II hypomania >4d plus MDD >2w |
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What is agrophobia?
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Fear of market place. Person is afraid they will have a feeling of panic in public and not be able to extricate themselves. Eventually the fear makes them homebound.
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What amount of time per day does someone with OCD spend tending to anxiety?
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>1hour
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What is the time frame for anxiety to be considered GAD?
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>6m
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What part of the brain is responsible for recognition memory? Damage to this area will cause what kind of amnesia?
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mammilary bodies
anterograde (no new memories are made (such as in Wernicke-Korsakoff syndrome) |
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Reserpine is used to treat tardive dyskinesia from antipsychotic use and may cause depression.
What is it's MOA? |
Deplete MAO
Helps get reupdaken NE, 5-HT, and DA into vessicles might cause depression |
