Psyc 961: Exam Four

Front 1

Which type of dementia is caused by problems with normal blood supply of blood to the brain?

Back 1

Vascular Dementia

Front 2

Vascular dementia has a __________ sudden onset and a pattern of __________ variability from day-to-day.

More or Less?

Back 2

More; More

Front 3

What are the 3 defining features of dementia?

Back 3

1. Persistent (doesn't come and go completely)

2. A decline (as opposed to a developmental issue)

3. Involves 2 or more areas of cognitive functioning

Front 4

What is an example of dementia due to nutritional disorders?

Back 4

Korsakoff's Syndrome

Front 5

The majority of dementia (50-70%) is attributable to what?

Back 5

Alzheimer's Disease

Front 6

_______-________ Alzheimer's begins before age 60 and accounts for less than 10% of cases.

Back 6

Early-Onset

Front 7

Women have a slightly ____________ prevalence for Alzheimer's than men.

Prevalence is ____________ if the parent with AD was one's mother instead of one's father.

Back 7

Higher

Higher

Front 8

The onset of which type of Alzheimer's appears to be genetic as opposed to sporadic?

Back 8

Aggressive, Early-Onset

Front 9

Which gene accounts for 80% of the familial form of early onset Alzheimer's? This gene codes for _________.

Back 9

S182; presenilin 1

Front 10

Which gene accounts for some of the familial form of early-onset Alzheimer's and codes for presenilin 2?

Back 10

STM2

Front 11

Put these genes in order of how much they account for the familial form of early-onset Alzheimer's.

A. Gene that codes for APP
B. S182
C. STM2

Back 11

B, C, A

Front 12

_____ is a protein that is coded by a gene that accounts for 2-3% of cases of familial early-onset Alzheimer's.

Back 12

Amyloid Precursor Protein (APP)

Front 13

What is the only gene associated with late-onset Alzheimer's?

What are the 3 varieties? Which is most common?

Back 13

apoE

Epsilon 2-4; Epsilon 3

Front 14

What are the 3 areas where individuals with Alzheimer's have more abundant amounts of plaques and tangles?

Back 14

Hippocampus; Amygdala; Neocortex

H.A.N. =

Front 15

Tangles and plaques are correlated with the extent of dementia in Alzheimer's patients but which has the strongest correlation?

Back 15

Tangles

Front 16

Extracellular masses consisting of a core of amyloid-beta protein surrounded by neuritic debris and an outer margin of astrocytes found in individuals with Alzheimer's.

Back 16

Neuritic Plaques

Front 17

The gene for APP is found on chromosome 21, so neuritic plaques are also found in patients with _____________ ____________.

Back 17

Down's Syndrome

Front 18

What type of amyloid protein is at the core of neuritic plaque?

Back 18

Amyloid-Beta Protein

Front 19

Masses of neurofibers occuring in the cytoplasm of neurons that are composed of paired helical filaments.

Back 19

Neurofibrillary Tangles

Front 20

Neuritic plaques are __________ the cell while neurofibrillary tangles are ___________ the cell.

Inside or outside?

Back 20

Outside; Inside

Front 21

The paired helical filaments that make up neurofibrillary tangles are made up of what?

Back 21

Tau Protein

Front 22

Tau protein is involved in the production and stabilization of ____________, which are involved in maintaining the axon's cytoskeleton.

Back 22

Microtubules

Front 23

The paired helical filaments that make up neurofibrillary tangles are made up of what?

Back 23

Tau Protein

Front 24

This area of the brain, that is a major cholinergic center, degenerates during Alzheimer's Disease.

Back 24

Nucleus Basilis Meynardt

Front 25

Which major cholinergic pathway is associated with Alzheimer's Disease?

Back 25

Septo-hippocampal Pathway

Front 26

The first attempt to treat the symptoms of Alzheimer's Disease involved enhancing Ach levels by increasing the level of choline in the CNS.

What were two of these drugs?

Back 26

Choline Chloride (odor) and Lecithin

Front 27

What was the first drug approved for the treatment of Alzheimer's Disease?

Name another drug that is used to treat Alzheimer's that you still see advertised on TV today.

Back 27

Tacrine

Donepezil

Front 28

It is thought that Alzheimer's Disease progresses because when neurons die, their cell membranes burst. This releases a lot of Ca which overstimulates nearby cells as they take all of it up. What model is this?

Back 28

Excitotoxicity Model

Front 29

In accordance with the excitotoxicity model of Alzheimer's, ____________ was approved to treat moderate and severe Alzheimer's symptoms by blocking Ca influx in some _________ receptors.

Back 29

Memantine; NMDA

Front 30

What are the 3 classic features of the Parkinsonian Syndrome?

Back 30

Rigidity, Kinesia, and Tremor

Front 31

Which classic feature of Parkinsonian Syndrome involved the tight contracting of muscles?

Back 31

Rigidity

Front 32

Which type of rigidity in PD involves a "break" in the movement of limbs rather than a smooth, fluid movement?

Back 32

Intermittent or "Cogwheel" Rigidity

Front 33

What type of kinesia in PD is exhibited by a distinct lack of movement, even a decrease in how often the patient blinks?

Back 33

Hypokinesia

Front 34

What type of kinesia in PD is exhibited by a general slowness during voluntary movements such as getting up from a chair or eating?

Back 34

Bradykinesia

Front 35

In advanced PD cases, hypokinesia may become ____________, a complete freezing as the patient attempts to initiate the first movements of a complex motor task.

Back 35

Akinesia

Front 36

A tremor in PD patients that is less pronounced or disappears when the patients makes a purposeful movement is known as a _________ tremor.

Back 36

Resting Tremor

Front 37

A tremor in PD patients that occurs more on one side than the other is a ____________ tremor.

Back 37

Asymmetrical Tremor

Front 38

While not considered a classic features of PD, many patients have problems with balance known as _________.

Back 38

Ataxia

Front 39

What is often the first complaint of a patient early in the onset of PD? It may disappear as the disease continues.

Back 39

Tremor

Front 40

PD is associated with a degeneration of which dopaminergic pathway in the brain?

Back 40

Nigro-Striatal Pathway

Front 41

PD symptoms occur due to the degeneration of the nigro-striatal pathway, which results in a lowering of _______ levels.

Back 41

DA

Front 42

Ach is responsible for muscle contractions. Therefore, when there is too much Ach, we see ___________ and when there is too little, we see ____________.

Back 42

Akinesia; Dyskinesia

Front 43

To much DA results in ___________ while too much Ach results in ____________.

Back 43

Dyskinesia; Akinesia

Front 44

Which part of the brain degenerates in PD?

Back 44

Substantia Nigra

Front 45

In PD, cells that survive the degeneration DA neurons in the nigro-striatal pathway have inclusions called __________ __________.

Back 45

Lewy Bodies

Front 46

________ was used in patients with PD and was the first attempt to use drugs to increase DA levels. It was more effective than using anticholinergic drugs to treat PD symptoms.

Back 46

L-Dopa

Front 47

What were the negative side effects of L-Dopa?

Back 47

Psychosis and Dyskinesia

Front 48

What are two dopamine agonists used to treat PD? These drugs were often administered once patients could no longer receive benefits from L-Dopa.

Back 48

Bromocriptine & Peroglide

"Bros from the crip, get down with the dope!"

Front 49

__________ is a synthetic opiate similar to demerol. It's byproduct, _____________, is converted to ___________ which destroys melanin-containing neurons of the substantia nigra (where DA is produced) and immediately causes irreversible Parkinson's symptoms.

Back 49

MPPP; MPTP; MPP+

Front 50

It is a theory that some kind of environmental toxin may have contributed to the rise of PD cases after the industrial revolution. __________ is a common herbicide that could be related.

Back 50

Cyperquat

Front 51

What type of drugs are thought to have a neuroprotective effect and are often used to treat PD along with L-Dopa to decrease the number of days L-Dopa is needed?

Back 51

Type B MAO Inhibitors

Front 52

What gene has been identified as playing a role in PD, especially early onset (< age 40) cases?

Back 52

Parkin Gene

Front 53

Which gene has been identified as being linked to PD and is the most abundant protein found in Lewy bodies?

Back 53

Alpha-Synuclein

Front 54

Which pathway is degenerated in Huntington's Disease?

Back 54

The Gabanergic Striatal-Nigral Pathway

Front 55

Who defined the original two major forms of "insanity?"

Back 55

Kraepelin

Front 56

What were Kraepelin's two major forms of insanity?

Back 56

Manic-Depressive and Dementia Praecox

Front 57

Before being renamed "schizophrenia" by Bleuler, the condition was labeled _________ __________ by Kraepelin to emphasize it's characteristic onset in late adolescence and young adulthood.

Back 57

Dementia Praecox

Front 58

In Type I Schizophrenia, ____________ symptoms are dominant while in Type II Schizophrenia, ___________ symptoms are dominant.

Back 58

Positive; Negative

Front 59

Which type of Schizophrenia has a more positive prognosis?

Back 59

Type I

Front 60

What are the two types of Type I Schizophrenia?

Back 60

Paranoid and Non-Paranoid/Disorganized

Front 61

Both types of Type I Schizophrenia involve delusions but which subtype involves bizarre delusions that are not integrated?

Back 61

Disorganized/Non-Paranoid

Front 62

What was the 1st antipsychotic ever discovered?

It was organic and from where did it come?

Limits the storage of __________ in synaptic vesicles.

Back 62

Reserpine

Rauwolfia Serpentina (Snake Root)

Catecholamines (DA and NE)

Front 63

The idea that the threshold for developing another episode of a disorder (particularly schizophrenia and depression) is lower following each episode.

Back 63

Kindling

Front 64

Drugs used to treat PD that keep DA from being broken down and thus increase the presence of DA in the CNS.

Back 64

Dopa Decarboxylase Inhibitors

Front 65

What are two Type B MAO Inhibitors that are used to treat PD?

Back 65

SELEgiline & RASAgiline

Front 66

What are the two main families of traditional antipsychotic drugs? They are all _________________antagonists.

Back 66

Phenothiazines (DA and NE) & Butyrophenones (DA)

Catecholamine

Front 67

Why did the catecholamine hypothesis of schizophrenia become the dopamine hypothesis of schizophrenia?

Back 67

The Butyrophenone antipsychotics had antipsychotic effects with only blocking DA.

Front 68

What is an example of a Phenothiazine antipsychotic?

What is an example of a Butyrophenone antipsychotic?

Back 68

Chlorpromazine

Haloperidol

Front 69

What types of drugs were discovered by Laborit who was searching for an antihistamine drug to diminish pre-surgical stress?

Back 69

Synthetic Anti-psychotics

(specifically chlorpromazine which is in the phenothiazine family of the catecholamine antagonists)

Front 70

Why do schizophrenic patients on high doses of Butyrophenones experience Parkinsonian symptoms?

Back 70

Blocking dopamine creates an imbalance with Ach where the higher levels of Ach cause Parkinsonian symptoms.

Front 71

What is the effective blockade of D2 receptors that is required to treat psychotic symptoms?

What happens if you block more than this percentage of DA receptors?

Back 71

60-65% of D2 receptors

Parkinsonian Symptoms

Front 72

Is schizophrenia a pre-synaptic issue (too much DA) or a post-synaptic issue (higher frequency or sensitivity of DA receptors)?

Back 72

Post-Synaptic

Front 73

The fact that homovanillic acid levels (a waste product of a certain NT) in schizophrenic patients are normal was a sign to scientists that these patients were not overproducing ______.

Back 73

DA

Front 74

________ potency DA blocking antipsychotics don't cause EPS as much as ______ potency drugs.

Why?

Back 74

Low; High

Low potency drugs are also anticholinergic (maintains balance) and high potency drugs block more DA in the nigro-striatal pathway (linked to PD).

Front 75

With sustained treatment of antipsychotics (chronic blockade of _______ receptors), the brain automatically starts doing what?

This causes the development of _________ __________.

Back 75

DA, making more DA post-synaptic receptors

Tardive Dyskinesia

Front 76

In schizophrenia, the absence of behavior that should be there are referred to as ___________ symptoms.

Back 76

Negative

Front 77

What are the 4 major negative symptoms of schizophrenia?

Back 77

Anhedonia, Autism, Avolition, and Alogia

The 4 A's!

Front 78

Which negative symptom of schizophrenia involves emotional flatness and absence of pleasure?

Back 78

Anhedonia

Front 79

Which negative symptom of schizophrenia involves social withdrawal or avoidance and sometimes lack of speech?

Back 79

Autism

Front 80

Which negative symptom of schizophrenia involves amotivation, apathy, or lack of initiative, energy, and interest?

Back 80

Avolition

Front 81

Which negative symptom of schizophrenia involves the absence of logical coherence or cognitive connectedness?

Back 81

Alogia

Front 82

What are the 4 major positive symptoms of schizophrenia?

Back 82

Delusions, Hallucinations, Disordered Thoughts/Speech, and Catatonic Behavior

D.H.D.C. = Don't Hate Disobedient Children

Front 83

Work on treatment for treatment-refractory schizophrenic patients lead to the development of ___________ antipsychotic drugs.

What is unique about them?

Back 83

Atypical

Lower affinity for D2 receptors but block more D4 receptors, which we find results in fewer EPS.

Front 84

What was the 1st atypical antipsychotic medication that was successful for treatment-refractory patients but ran the risk of causing agranulocytosis (decrease in parts of white blood cells)?

Back 84

Clozapine

Front 85

What are two atypical antipsychotics that do not have the agranulocytosis problem like Clozapine?

Back 85

Rispiridone and Olanzapine

Front 86

Atypical antipsychotic drugs that block serotonin are not beneficial on their own, but help with depressive schizophrenic symptoms when combined with other tx because of their antagonism of _________ postsynaptic receptors.

Back 86

5HT2

Front 87

Dopa decarboxylase inhibitors helps prevent some side effects of L-Dopa in the PNS when treating PD? Name one.

Back 87

Carbidopa

Front 88

What type of drugs are used to treat PD because they limit Ach and thus create more balance between DA and Ach and decrease symptoms?

Back 88

Muscarinic Antagonists

Front 89

What do MAO-inhibitors, vitamins E/C & cannabinoids, aspirin/ibuprofen, & red wine have in common?

Back 89

They are Neuroprotective agents for Alzheimer's Disease.

Front 90

What other substances can elicit symptoms of disorganized schizophrenia?

Back 90

Glutamate & PCP

Front 91

What other substances can elicit the characteristics of paranoid schizophrenia?

Back 91

L-Dopa & Amphetamine