Eppp: Learning Theory And Neuropsychology

Front 1

What is delay conditioning (standard pairing)?

Back 1

The CS (conditioned stimulus) precedes the US (unconditioned stimulus) by a short interval, and overlaps with the presentation of the US.

Front 2

What is trace conditioning?

Back 2

The CS (conditioned stimulus) precedes the US (unconditioned stimulus) and stops just before the US is presented.

Front 3

What is temporal conditioning?

Back 3

The US (unconditioned stimulus) is presented repeatedly at a consistent time interval, so that time itself becomes the CS (conditioned stimulus).

Front 4

What is simultaneous conditioning?

Back 4

The neutral stimulus (NS) and US (unconditioned stimulus) completely overlap, and so no learning or conditioning takes place. This is because the US is not contingent on the NS-- one does not seem to "lead" to the other, even though both are contiguous.

Front 5

What is backward conditioning?

Back 5

The US (unconditioned stimulus) is presented before the NS (neutral stimulus), and so no learning or conditioning occurs, because the US is not contingent on the NS-- one does not seem to "lead" to the other, even though both are contiguous.

Front 6

What is mediated generalization, in the context of learning?

Back 6

It is the same as stimulus generalization; the subject automatically generalizes from a CS (conditioned stimulus) to similar neutral stimuli.

Front 7

Who performed the "little Albert" experiment, and what happened?

Back 7

John Watson. This nine-month-old orphan was classically conditioned to be afraid of a white rat when it was paired with a loud noise (US). He then generalized this fear to many other furry white objects.

Front 8

What is higher order conditioning?

Back 8

A CS (conditioned stimulus) is paired with an NS (neutral stimulus) until the new NS produces the same CR (conditioned response) as the original CS. It is impossible to condition beyond the third level (three CS's.)

Front 9

What is experimental neurosis?

Back 9

In classical conditioning trials; when a subject is presented with a situation in which it must learn stimulus discrimination (one NS is presented with a US, while a similar NS is presented without the US), but the two NS's are too similar to distinguish. In dogs, this may lead to agitated barking and howling, and the dog will become unable to successfully discriminate even if it is returned to an NS it could previously distinguish.

Front 10

What is pseudoconditioning?

Back 10

When an NS which was not deliberately paired with either the US or the CS accidentally comes to elicit the CR.

Front 11

What is habituation?

Back 11

When a subject becomes used to the US (unconditioned stimulus), and does not respond to it. This is different from extinction, when the subject ceases to produce a CR (conditioned response) to the CS (conditioned stimulus) because it is presented many times without being paired to the US.

Front 12

What are two other names for operant conditioning?

Back 12

Skinnerian conditioning and instrumental conditioning.

They all posit that we learn as a result of reward and punishment.

Front 13

What is Thorndike's Law of Effect?

Back 13

Behaviors are initially emitted in random, trial and error fashion; those followed by pleasurable consequences (rewards) become stronger and more frequent, while those followed by unpleasant consequences (punishers) may become weaker and less frequent (this latter half was later removed).

Front 14

What is the difference between reinforcement and punishment?

Back 14

Reinforcement always increases the target behavior; punishment alwas decreases it.

Front 15

What is positive reinforcement?

Back 15

Reward; the subject gets something good for doing a behavior.

Front 16

What is negative reinforcement?

Back 16

Relief; the subject stops being subjected to something unpleasant.

Front 17

What is positive punishment?

Back 17

Pain; something aversive is added.

Front 18

What is negative punishment?

Back 18

Loss; something valuable is removed.

Front 19

What is the acquisition phase?

Back 19

In operant conditioning, the period in which new learning occurs.

Front 20

What is operant strength?

Back 20

In operant conditioning, the rate of responding to stimuli during both acquisition and extinction trials.

Front 21

In operant conditioning, what is satiation?

Back 21

The phenomenon of a reinforcer losing its value through overuse.

Front 22

What is continuous reinforcement?

Back 22

In operant conditioning, when every occurrence of the behavior is reinforced. (Less effective than intermittent reinforcement.)

Front 23

In operant conditioning, what is thinning?

Back 23

Changing a schedule of reinforcement from continuous to intermittent.

Front 24

What are the four schedules of intermittent reinforcement?

Back 24

Fixed Interval (FI): Behavior is reinforced the first time a target behavior is emitted after the fixed time interval has elapsed.
Variable interval (VI): Behavior is reinforced the first time a target behavior is emitted after a variable amount of time has elapsed.
Fixed ratio: (FR) Behavior is reinfoced after an unchanging number of responses are emitted.
Variable ratio (VR): Behavior is reinfoced after an unpredictable number of responses are emitted.

Front 25

What are the results of different schedules of intermittent reinforcement?

Back 25

Fixed Interval: Response rate is low during most of the interval and increased toward the end of it. (Slowest rates during learning, most vulnerable to extinction.)
Variable Interval: Behavior is performed at a moderate rate, without pause.
Fixed Ratio: Response rate is moderate-to-high, subject may pause after reinforcement is provided.
Variable ratio: Subject performs at high rates and without pause. Most resistant to extinction.

Front 26

What is the best schedule of reinforcement for new learning?

Back 26

Continuous reinforcement.

Front 27

What is a response burst?

Back 27

An increase in a behavior resulting from the experimenter's withholding reinforcement.

Front 28

In operant conditioning, what is "superstitious behavior"?

Back 28

Behavior resulting from accidental reinforcement or non-contingent reinforcement.

Front 29

What is discrimination learning?

Back 29

(aka stimulus control) Subject learns to discriminate between situations (stimuli) in which reinforcement will occur and those in which it will not.

Front 30

What is stimulus control?

Back 30

(aka discrimination learning) Subject learns to discriminate between situations (stimuli) in which reinforcement will occur and those in which it will not.

Front 31

What is a discriminative stimulus?

Back 31

SD-- in discrimination learning, the stimulus that signals reinforcement will take place.

Front 32

What is S delta?

Back 32

In discrimination learning, the stimulus that signals reinforcement will not take place

Front 33

What are two kinds of generalization in operant conditioning?

Back 33

stimulus generalization: subject emits target behavior in the presence of stimuli similar to the discriminative stimulus
response generalization: subject performs a behavior similar to the one that has previously been reinforced.

Front 34

In operant conditioning, what is prompting?

Back 34

Cueing a subject about what behavior to perform.

Front 35

In operant conditioning, what is fading?

Back 35

A gradual reduction in prompting.

Front 36

In operant conditioning, what is chaining?

Back 36

Conditioning a complex series of behaviors. Each behavior is mildly reinforced, and serves as a discriminative stimulus/cue to perform the next behavior in the chain; major reinforcement is received only after the last one.

Front 37

What is the Premack Principle?

Back 37

A behavior freely performed at a high frequency (i.e., something we like to do) can be a strong reinforcer. Its strength can vary based on context. I.e., Grandma's rule-- "If you eat your spinach (low frequency behavior) you can go out to play (high frequency behavior)."

Front 38

What is behavioral contrast?

Back 38

In operant conditioning, a situation where two behaviors have been equally rewarded, but then only one is reinforced, leading to an increase in the reinforced behavior and a decrease in the other.

Front 39

What is the premise of social learning theory?

Back 39

Human learning and behavior cannot be completely explained by operant or classical conditioning-- they are also due to observation and modeling (imitation) of others' behavior. It also suggests that we act because we anticipate reinforcement in the future, not just remember it in the past-- our cognitions matter.

Front 40

What is the Bobo doll study?

Back 40

Bandura, Ross and Ross (1963) found that children exposed to violent behavior will also behave violently (especially if the models are high-status, nurturant, and of the same sex).

Front 41

What is reciprocal determinism?

Back 41

A social learning theory; a person's behavior is regulated by the person's cognitions, the person's behavior, and the environment.

Front 42

What are the four steps Bandura posits as necessary for observational learning?

Back 42

1. Attention (to the model)
2. Retention (remembering what is seen/heard)
3. Production (reproducing the memory during imitation)
4. Motivation (reinforcement for accurate performance)

Front 43

In classical conditioning, what is blocking?

Back 43

A pre-existing learned response prevents you from learning a new one.

Front 44

What are six therapeutic uses of classical conditioning?

Back 44

1. Systematic desensitization (phobias)
2. Reciprocal inhibition (phobias)
3. Aversive counter-conditioning (paraphilias) :(
4. Implosive therapy (PTSD)
5. Imaginal flooding (PTSD)
6. Deliberate exposure with response prevention (esp. for OCD)

Front 45

What is systematic desensitization?

Back 45

Combining progressive relaxation with exposure to a hierarchical scale of fears (SUDs)-- replaces anxiety response with relaxation response

Front 46

What is reciprocal inhibition?

Back 46

Replace one response with a new learned response which inhibits the first.

Front 47

What is implosive therapy?

Back 47

Flooding in which the client imagines scenes, of an increasing (and sometimes exaggerated) level of anxiety based on hypothesized sources of anxiety which are often psychodynamic (specifically, classically Freudian) in nature.

Front 48

What is imaginal flooding?

Back 48

There is some difference between this and implosive therapy (possibly the lack of psychodynamically-derived images?) but all my earnest Googling cannot figure it out. Assume that it's:

Flooding in which the client imagines scenes of an increasing (and sometimes exaggerated) level of anxiety in order to reduce the anxiety response.

Front 49

In operant conditioning, what is the difference between primary and secondary reinforcers?

Back 49

Primary are innate: food, contact, etc.
Secondary are learned and linked to other things: money, gold star, etc.

Front 50

What is Vygotsky's theory?

Back 50

Scaffolding; learning by receiving guidance as one performs an action, with the amount of guidance gradually reducing as one becomes more competent.

Front 51

What is Meichenbaum's theory?

Back 51

Self-talk and self-instruction; using verbal messages to modify faulty cognitions which lead to stress.

Three steps:
1) education
2) learning and rehearsing new skills
3) practice

Front 52

What is Neal Miller known for?

Back 52

Biofeedback-- training people to decrease tension and to consciously change body processes (e.g., increasing blood flow to hands and feet in sufferers with Renaud's disease)

Front 53

What is the Yerkes-Dodson law?

Back 53

Relationship between arousal and performance; there is an ideal level of anxiety for a task (enough to keep one focused, not enough to be distracting) mediated by the task's complexity (more complex task=more interference from anxiety)

Front 54

What are the three components of the learned helplessness model of depression?

Back 54

Three core attributions: negative events are
1) Internal (bad things happen because of me)
2) Stable (bad things will always happen)
3) Global (everything is bad)

Front 55

What is Seligman best known for?

Back 55

The learned helplessness theory of depression (though his work in positive psychology is also significant).

Front 56

What is the fundamental attribution error?

Back 56

Events are due to a person's character rather than the situation/environment.

Front 57

What is the central nervous system (CNS)?

Back 57

Brain and spinal cord

Front 58

What is the peripheral nervous system (PNS)?

Back 58

Nerves (cranial nerves, spinal nerves, peripheral ganglia)

Front 59

What is the somatic nervous system?

Back 59

Controls sensory messages that control voluntary motor movement of the skeletal (striated) muscles.

Front 60

What is the autonomic nervous system (ANS)?

Back 60

Controls involuntary functions of the smooth muscles and glands (digestion, heart rate, breathing). Goal is to maintain homeostasis.

Front 61

What are the sympathetic and parasympathetic nervous system parts of?

Back 61

The autonomic nervous system controls them.

Front 62

What are the two types of neurons, and what do they do?

Back 62

Afferent: Carry information back to the CNS
Efferent/Motor: Carry information to muscles and glands.
(Mnemonic: you are *affected* by what the afferent neurons tell you about; you can be *effective* by using your motor neurons to do things.)

Front 63

What are the four regions of the spinal cord?

Back 63

From the top:
1) Cervical (C1-C7)
2) Thoracic (T1-T12)
3) Lumbar (L1-L5)
4) Sacral (S1)

Front 64

What type of spinal cord injury results in quadripalegia?

Back 64

Severing the cord anywhere between the top five cervical vertebrae results in paralysis in all four limbs.

Front 65

What type of spinal cord injury results in paraplegia?

Back 65

Severing the cord between the bottom two cervical vertebrae (which also results in partial paralysis of the arms), or anywhere from the thoracic vertebrae or lower, results in paralysis in the legs.

Front 66

What type of spinal cord injury results in paresis?

Back 66

Incomplete severing of the spinal cord results in muscle weakness.

Front 67

What are the layers of the cerebrum and their functions?

Back 67

The outer layer of the cerebrum is the cerebral cortex, and is responsible for all thought, processing of sensory information, and much of emotion. The inner layer of the cerebrum are the subcortical areas, responsible for coordination and information-relaying between parts of the brain, managing glands and hormones, and maintaining homeostasis.

Front 68

What is the cerebellum and its function?

Back 68

Located behind the brain stem, the cerebellum controls balance, smooth movement, and co-ordinating motor activity.

Front 69

What are the three parts of the brain stem and their functions?

Back 69

The pons (top of the brain stem) and medulla (bottom of the brain stem) are involved in facial expressions, sleep, breathing, movement, and cardiovascular activity-- the things that keep us alive. The Reticular Activating System (RAS), a diffuse set of cells in the brain stem, thalamus and hypothalamus, filter incoming sensory information, and can activate the cortex into a state of alert wakefulness.

Front 70

What are the eight subcortical brain areas important for psychologists to know?

Back 70

1) Corpus Callosum,
2) Thalamus
3) Hypothalamus
4) Pituitary gland
the limbic system includes the following:
5) Amygdyla
6) Septum lucidum
7) Hippocampus
8) Cingulate gyrus

Front 71

What are the six divisions of the cerebral cortex?

Back 71

1) Left hemisphere
2) Right hemisphere
3) Frontal lobes
4) Parietal lobes
5) Occipital lobes
6) Temporal lobes

Front 72

What does the left hemisphere of the brain control ?

Back 72

Language, rational thought, analysis, logic, abstraction. (Dominant in 97% of people.)

Front 73

What six things does the right hemisphere of the brain control?

Back 73

Perception, visuospatial, art, music, intuition, emotion.

Front 74

What do the frontal lobes of the brain control?

Back 74

Personality, emotion, inhibition, planning, initiative, abstract thinking, judgment, higher mental functions. Motor control is toward the back of it. Also speech production (Broca's area).

Front 75

What is Broca's area, and where is it?

Back 75

Behind the left frontal lobe; it controls the muscles that produce speech.

Front 76

What do the parietal lobes of the brain control, and where are they?

Back 76

They are behind the frontal lobes-- at the top. They process sensorimotor information, including proprioreception (body-sense), touch, pain, and heat.

Front 77

What is Gerstmann's syndrome?

Back 77

Lesions of the dominant parietal lobe resulting in agraphia (loss of the ability to write by hand), acalculia (inability to perform simple mathematical tasks), right-left disorientation and finger agnosia (inability to distinguish fingers on the hand).

Front 78

What is agraphia?

Back 78

loss of the ability to write by hand-- associated with Gerstmann's syndrome (lesions to the parietal lobe)

Front 79

What is acalculia?

Back 79

inability to perform simple mathematical tasks-- associated with Gerstmann's syndrome (lesions to the parietal lobe)

Front 80

What is finger agnosia?

Back 80

inability to distinguish fingers on the hand-- associated with Gerstmann's syndrome (lesions to the parietal lobe)

Front 81

What does the parietal lobe control?

Back 81

Contains sensory areas that process somatosensory information-- light touch, pain, heat, and proprioreception (being able to locate body parts with one's eyes shut).

Front 82

Where are the occipital lobes, and what do they control?

Back 82

The back of the brain.
The primary visual cortex.

Front 83

Where are the temporal lobes, and what four things do they control?

Back 83

Above the temples, on the outside of the sides of the head.
They contain the primary auditory cortex, and Wernicke's area (responsible for thinking about and interpreting language) and are involved in emotional behavior and memory.

Front 84

What three brain structures are involved in emotional behavior and memory?

Back 84

Parts of the temporal lobes, the amygdyla and hippocampus.

Front 85

Where is Wernicke's area, and what does it do?

Back 85

Left temporal lobe.
Thinking about and interpreting language.

Front 86

Where is the corpus callosum, and what does it do?

Back 86

A subcortical brain area; a bundle of fibers which bridge between the two cerebral hemispheres.
It allows communication between the right and left halves of the brain.

Front 87

What are "split-brain patients"?

Back 87

People who have had their corpus callosum surgically cut (to treat epilepsy) and so no longer have communication between their two brain hemispheres. (e.g., can only read words seen in the right visual field and so processed by the left hemisphere, etc)

Front 88

Where is the thalamus, and what does it control?

Back 88

A subcortical brain area, below the corpus callosum.
The brain's major sensory relay center; receives input from all senses except smell, integrates and processes them, projects them into the appropriate cortical areas. Necessary to perceive pain. Abnormalities have been linked to schizophrenia.

Front 89

Where is the hypothalamus, and what does it control?

Back 89

A subcortical brain area, below the thalamus.
Regulates the endocrine system to maintain homeostasis.
Mnemonic-- "five F's"-- fever (temperature regulation), feeding, fucking (controls the gonads-- sex hormones, reproduction, and development of secondary sexual charactaristics), fighting, and falling asleep.
Also controls the pituitary gland.

Front 90

Where is the pituitary, and what does it control?

Back 90

At the bottom of the brain, in front of the pons.
"the master endocrine gland"
Involved in normal and abnormal growth.
Influences the other endocrine glands (thyroid, parathyroid, ovaries and testes, pancreas, adrenal cortex, adrenal medulla).

Front 91

What ten major structures are part of the limbic system?

Back 91

Hypothalamus, hippocampus, amygdyla, septum, parts of the thalamus, parts of the frontal and temporal lobes, cingulate gyrus, parahippocampal gyrus, fornix, and others.

Front 92

What does the limbic system do, and how does it affect aggression?

Back 92

Regulate emotional behavior, especially aggression.(The amygdyla increases aggression; the septum moderates it.)

Front 93

What is the cause of Kluver-Bucy syndrome, and what are five results of it?

Back 93

Results from the removal of the amygdyla; placidity, apathy, hyperphagia (abnormally increased appetite), hypersexuality, agnosias (inability to recognize objects, persons, sounds, shapes, or smells).

Front 94

What does the hippocampus do?

Back 94

Associated with memory, and the consolidation of memory (converting short-term to long-term).

Front 95

What is septal rage?

Back 95

Increased aggression resulting from damage to the septum.

Front 96

Where is the cerebellum located, and what is its function?

Back 96

At the base of the brain, behind the brain stem.
Maintains smooth movement, coordination of motor activity, and balance.

Front 97

What are dendrites?

Back 97

(Part of a neuron) Structures which receive information from other neurons.

Front 98

What is the axon?

Back 98

(Part of a neuron) A tubelike structure which transmits information.

Front 99

What are boutons?

Back 99

(Part of a neuron) Terminal buttons which release neurotransmitters.

Front 100

What is the relation of a neuron's absolute and relative refractory period?

Back 100

Immediately after firing, in the absolute refractory period, the neuron cannot fire at all. After that, there is a relative refractory period in which only intense stimulation will cause firing.

Front 101

What is the space between neurons called?

Back 101

The synaptic cleft

Front 102

What is reuptake?

Back 102

Neurotransmitters bond to the releasing neuron's terminal buttons, and so does not reach the adjacent neuron's dendrites; communication does not occur.

Front 103

What are the two types of neurotransmitters?

Back 103

Classical (basic--chemicals)
and Peptide (short, protein-like chains of amino acids)

Front 104

What is the difference between an agonist and an antagonist?

Back 104

An agonist is a substance which enhances the effect of a neurotransmitter; an antagonist inhibits the neurotransmitter's effect.

Front 105

What is the difference between an excitatory and an inhibitory neurotransmitter (and some examples)?

Back 105

Excitatory: increases likelihood of action potential (acetylcholine, norepinephrine).
Inhibitory: decreases likelihood of action potential (GABA, endorphin)

Front 106

What are the four types of classical neurotransmitters?

Back 106

1) Acetylcholine,
2) the Catecholamines (dopamine and norepinephrine)
3) Serotonin
4) The amino acids (GABA and glutamate)

Front 107

What is acetylcholine, and what does it do?

Back 107

A classical neurotransmitter.
It is involved in voluntary movement, memory, and cognition.
Interference with it (as by the venom of the black widow spider) can cause paralysis.
Prevalent in the hippocampus.
A deficiency is involved in Alzheimer's disease.

Front 108

What neurotransmitter deficiency is involved in Alzheimer's disease?

Back 108

Acetylcholine, which is involved in memory, cognition and voluntary motion.

Front 109

What are the two catecholamines?

Back 109

The classical neurotransmitters dopamine and norepinephrine.

Front 110

What neurotransmitter excess is involved in schizophrenia?

Back 110

Dopamine-- most antipsychotics (except the most recent ones) are dopamine antagonists which act by blocking dopamine receptors.

Front 111

What neurotransmitter deficiency is involved in Parkinson's Disease?

Back 111

Dopamine.

Front 112

What is dopamine, and what (10 things) is it involved in doing?
What is the primary thing it is known for?

Back 112

A classical neurotransmitter-- a catecholamine.
It is involved in a very wide range of functions, including behavior, cognition, voluntary movement, motivation and reward, memory, inhibition of prolactin production (involved in lactation), sleep, mood, attention, and learning.
It is best known for its involvement with the pleasure system of the brain.

Front 113

What is norepinephrine, and what does it do?

Back 113

AKA "noradrenaline."
A classical neurotransmitter-- a catecholamine.
Significantly involved in mood. Also pain perception and sleep.

Front 114

What is noradrenaline?

Back 114

AKA "norepinephrine."
A classical neurotransmitter-- a catecholamine.
Significantly involved in mood. Also pain perception and sleep.

Front 115

What is the catecholamine hypothesis of affective disorders?

Back 115

Depression is associated with a deficiency of catecholamines (especially norepinephrine); mania is associated with a relative catelochalamine excess.
Both feature low levels of serotonin.

Front 116

What is serotonin (5-HT), and what does it do?

Back 116

A classical neurotransmitter.
Low levels of it are significantly involved with mood disorders and possibly schizophrenia.
Plays a role in aggression, sexuality, sleep onset and pain perception. Associated with suicidality and impulsivity.

Front 117

What are the three amino acids which serve as classical neurotransmitters?

Back 117

1) GABA (Gamma-aminobutyric acid)
2) Glycine
3) Glutamate

Front 118

What is GABA and what does it do?

Back 118

Gamma-aminobutyric acid; a classical neurotransmitter-- an amino acid.
One of the two major inhibitory neurotransmitters, and has a calming effect.
Both anxiety and epileptic seizures are associated with insufficient GABA.

Front 119

What neurotransmitter do benzodiazepenes interact with, and how?

Back 119

They are GABA agonists, and so reduce overarousal.

Front 120

What is glycine and what does it do?

Back 120

A classical neurotransmitter-- an amino acid.
One of the two major inhibitory neurotransmitters, and has a calming effect.

Front 121

What is glutamate and what does it do?

Back 121

A classical neurotransmitter-- an amino acid.
A major mediator of fast excitatory synaptic transmission.
Abnormalities in it are suspected in schizophrenia. It is involved in learning and memory.

Front 122

Of the more than 25 peptide neurotransmitters, which two are most important for psychologists?

Back 122

Enkephalins and endorphins, the endogenous opioids.

Front 123

What are the endogenous opioids?

Back 123

Types of peptide neurotransmitters:
Enkephalins and endorphins.
"the body's natural painkillers,"
Involved in the regulation of stress and pain.

Front 124

What are two disorders of the pituitary gland, and their results?

Back 124

Hypopituitarism: insufficient pituitary hormones. Leads to dwarfism and pubertal delay in children, and to gonadal failure and other disorders (hyperthyroidism, diabetes, adrenocortical insufficiency) in adults.
Hyperpituitarism: excess of pituitary hormones; skeletal overgrowth and gigantism.

Front 125

What are two disorders of the thyroid gland, and their results?

Back 125

Hyperthyroidism: (excess secretion of thyroxin) weight loss, increased appetite, heat sensitivity, sweating, diarrhea, tremor, palpitations, fatigue, agitated depression, insomnia, impaired memory and judgment, hallucinations, delusions.

Hypothyroidism (undersecretion of thyroxin) results in unexpected weight gain, sluggishness, fatigue, imapired memory and intellectual functioning, sensitivity to cold.

Front 126

What hormone does the thyroid gland secrete, and what does it do?

Back 126

Thyroxin.
It controls metabolism. (Energy level, body temperature, appetite, heat/cold sensitivity, etc.)

Front 127

What is Grave's disease, and what are five possible symptoms?

Back 127

The most common form of hyperthyroidism, in which the thyroid itself enlarges. Causes increased heartbeat, muscle weakness, disturbed sleep, and irritability. It can also affect the eyes, causing bulging eyes (exophthalmos). It affects other systems of the body, including the skin, heart, circulation and nervous system.

Front 128

What are 4 myxedematous symptoms, and what causes them?

Back 128

Dry skin, puffiness, sparse hair, decreased cardiac output. Caused by hypothyroidism.

Front 129

What is myxedema madness?

Back 129

Can lead to personality changes, paranoid delusions, delirium, mania and hallucinations. Caused by hypothyroidism.

Front 130

What does the parathyroid gland secrete?

Back 130

Calcitonin, which plays a role in calcium retention.

Front 131

What are two disorders of the parathyroid gland?

Back 131

Hyperparathyroidism (excessive calcitonin, leading to excessive calcium)-- delirium, depression, apathy, personality changes, psychosis, stupor, coma.

Hypoparathyroidism (insufficient calcium retention): neuromuscular symptoms, from parasthesias (tingling) to tetany (cramps and convulsions), as well as personality changes and delirium.

Front 132

What does the pancreas secrete, and what does it affect?

Back 132

Insulin.
Undersecretion leads to diabetes.

Front 133

What are the three different kinds of diabetes?

Back 133

Type I: Juvenile onset, aka Insulin Dependent Diabetes Mellitus-- more serious.
Type II: Adult onset, aka Non-Insulin Dependent Diabetes Mellitus
Diabetes Insipidus: rare, usually medication-induced (e.g., from lithium toxicity)

Front 134

How fucking long is this test?

Back 134

Very, very long! Give yourself a reward for studying!

Front 135

What does the adrenal cortex secrete, and what three things does it affect?

Back 135

Corticosteroids.
They're involved in energy use, inhibition of antibody formation, and inflammation.

Front 136

What are two results of disorders in the adrenal cortex?

Back 136

Addison's disease: undersecretion of corticosteroids: apathy, weakness, irritability, depression, and gastrointestinal disturbance.

Cushing's disease: oversecretion of corticosteroids: agitated depression, irritability, emotional lability, difficulties with memory and concentration, sometimes suicide, and adiposity (swelling and fattening) of the face, neck and trunk.

Front 137

What is hypoglycemia, and what are nine of its symptoms?

Back 137

A condition of abnormally low blood sugar (glucose).
Nervousness,
trembling,
cold sweats,
rapid heart rate,
irritability,
fatigue,
hunger
headache,
and confusion.

Front 138

What is hyperglycemia, and what are seven of its symptoms?

Back 138

High blood sugar (glucose), often associated with diabetes.
Increased thirst and urination, dehydration, fatigue and weakness, abdominal pain, nausea, loss of appetite.

Front 139

What are six general, organic (i.e., not specific diseases) causes of cognitive dysfunction?

Back 139

The effects of:
1) Stroke
2) trauma
3) brain tumors
4) dementia
5) delirium
6) amnestic disorders

Front 140

What are eight types of results of stroke, trauma and brain tumors?

Back 140

1) Aphasia
2) One-sided neglect
3) Apraxia
4) Agraphia
5) Alexia
6) Prosopagnosia
7) Anosagnosia
8) Hydrocephalus

Front 141

What is aphasia?

Back 141

A language disorder, resulting from damage to the left hemisphere of the brain.

Front 142

What are four common types of aphasia?

Back 142

1) Broca's aphasia
2) Wernicke's aphasia
3) conduction aphasia
4) Global aphasia

Front 143

What is Broca's aphasia?

Back 143

Resulting from lesions to Broca's area (left frontal lobe, motor strip area). Severe problems with articulation make speech slow and effortful; speak in short phrases and lengthy pauses. Some comprehension problems, but comprehension is basically intact. Have trouble naming objects and repeating verbal phrases.
Mnemonic: "Broken (Broca) speech." Expressive/motor aphasia.

Front 144

What is Wernicke's aphasia?

Back 144

Resulting from lesions to Wernicke's area (left temporal lobe). No language comprehension; cannot understand others and speak gibberish (but do not realize others will not understand). Receptive/sensory aphasia.

Front 145

What is conduction aphasia?

Back 145

Lesions to the connections between expressive (Broca's) and receptive (Wernicke's) speech areas. Can understand language and produce words, but cannot repeat verbal phrases and speak gibberish. Unlike Wernicke's aphasia, they can execute verbal commands.

Front 146

What is global aphasia?

Back 146

Results from damage to much of the cortex. Impaired language fluency, comprehension, repetition, naming, reading and writing.

Front 147

What is one-sided neglect?

Back 147

Damage to one side of the brain --> impairment on the other side of the body, including paralysis or paresis (full or partial loss of motor function), loss of sensory abilities, or inability to attend to one side of the body (forgetting to dress one side, walking into furniture, eating food from only one side of the plate).

Front 148

What is apraxia?

Back 148

Inability to carry out purposeful motor movements despite the absence of motor or sensory deficits. Caused by a left-brain lesion. Can move normally, but misses some step (positions limbs wrong, etc) when trying to carry out a specific motor command.

Front 149

What is agraphia?

Back 149

Inability to write (acquired after person has learned to write). Results from left-hemisphere damage in a variety of areas (frontal, temporal or parietal regions, basal ganglia). May include problems in spelling, word selection, grammar or spatial arrangement.

Front 150

What is alexia?

Back 150

Acquired partial/complete inability to read. Usually caused by stroke to dominant (left) hemisphere.
Pure alexia (w/out agraphia) <-- lesions that disconnect the visual association cortex from the temporoparietal cortices.

Front 151

What is prosopagnosia?

Back 151

Inability to recognize a familiar face (most common of the agnosias). Due to injury to the visual association cortex.

Front 152

What is anosagnosia?

Back 152

Lack of awareness of a disability/illness. E.g.; people w/Wernicke's aphasia do not recognize that they are speaking gibberish.

Front 153

What is hydrocephalus?

Back 153

A pathological accumulation of cerebrospinal fluid in the brain's ventricles --> increased intercranial pressure -->dementia, urinary incontinence, an unsteady gait.
Caused by head injuries, tumors, meningitis or encephalitis--> overproduction or malabsorption of fluid. Can be treated by surgery.

Front 154

What is the DSM diagnosis of dementia?

Back 154

A DSM-IV diagnosis, including:
A. Impairment of memory and
B. At least one of the following four:
1) aphasia
2) apraxia
3) agnosia
4) disturbance in executive functioning

Front 155

What is agnosia?

Back 155

Disturbance in object recognition

Front 156

What are seven types of dementia (i.e., named diseases and other causes)?

Back 156

1) Alzheimer's disease
2) Pick's disease
3) Parkinson's disease
4) Huntington's disease/chorea
5) Vascular dementia
6) AIDS dementia
7) Dementia due to head trauma

Front 157

What are seven causes of dementia?

Back 157

1. Alzheimer's disease
2. Vascular dementia
3. Parkinson's disease
4. Huntington's disease/chorea
5. Pick's disease
6. AIDS dementia
7. Dementia due to head trauma

Front 158

What is the most common cause of dementia?

Back 158

Alzheimer's disease

Front 159

What are the characteristics of the three stages of Alzheimer's disease?

Back 159

Early: impairment in recent memory (forgetting names, household items, what one was about to do; difficulty problem-solving), periods of frustration, irritability and anger.
Middle: further impairment in memory; cognitive deficits such as aphasia, apraxia and agnosia; confusion and a tendency to wander around or perform undesirable social behavior.
Late; gait and motor problems, may become mute and bedridden.

Front 160

What type of dementia is Alzheimer's disease?

Back 160

"cortical dementia"; memory, language and praxis are most affected.

Front 161

Is Alzheimer's disease genetic?

Back 161

Probably-- first-degree relatives have a six times greater chance of getting it.

Front 162

What are the physical results in the brain of Alzheimer's disease?

Back 162

Senile plaques (protein globes) and neurofibrillary tangles (pairs of tangled neuronal filaments) are found throughout the cortex and other brain structures, especially the hippocampus and amygdyla. Decrease in acetylcholine (ACh)

Front 163

How is Alzheimer's disease treated?

Back 163

the drug Aricept (donepezil) --> modest improvements in cognitive function. Also, treat what is treatable without aggravating existing symptoms, and support caregivers.

Front 164

What is the prevalence of vascular dementia?

Back 164

Accounts for 10-15% of all cases of dementia in older adults. Twice as common in males as in females.

Front 165

What is the cause of vascular dementia?

Back 165

Numerous small CVAs (cerebrovascular accidents) or strokes.

Caused by general cerebrovascular disease.

Front 166

What is the course of vascular dementia?

Back 166

Abrupt onset, with plateaus before further degeneration. Half of those diagnosed die within 2 or 3 years.

Front 167

How can vascular dementia be treated?

Back 167

Primarily by prevention: lifestyle changes (reduced smoking, exercise, diet) can arrest its progress by preventing further strokes. Aspirin, anticoagulants, and antihypertensives can also prevent future strokes.

Front 168

What are the eight characteristics of Parkinson's disease?

Back 168

Movement disorder; tremor, rigidity, bradykinesia (slowed initiation of movement), and shuffling gait.

Can also cause psychosis, dementia, and depression.

Front 169

What is bradykinesia?

Back 169

slowed initiation of movement

Front 170

What is the prevalence of Parkinson's disease?

Back 170

Over 1/4 million older adults in the U.S., men slightly more often than women.

Front 171

What type of dementia is Parkinson's disease?

Back 171

Sub-cortical; affecting speed of processing and executive functioning (planning, organizing, sequencing, etc.)

Front 172

How can vascular dementia be treated?

Back 172

Primarily by prevention: lifestyle changes (reduced smoking, exercise, diet) can arrest its progress by preventing further strokes. Aspirin, anticoagulants, and antihypertensives can also prevent future strokes.

Front 173

What are eight characteristics of Parkinson's disease?

Back 173

Movement disorder; tremor, rigidity, bradykinesia (slowed initiation of movement), and shuffling gait.

Can also cause psychosis, dementia, and depression.

Front 174

What is bradykinesia?

Back 174

slowed initiation of movement

Front 175

What is the prevalence of Parkinson's disease?

Back 175

Over 1/4 million older adults in the U.S., men slightly more often than women.

Front 176

What type of dementia is Parkinson's disease?

Back 176

Sub-cortical; affecting speed of processing and executive functioning (planning, organizing, sequencing, etc.)

Front 177

What are the physical effects in the brain of Parkinson's disease?

Back 177

Degeneration of neurons of the substantia nigra (a section of the basal ganglia), leading to a decrease in available dopamine

Front 178

What do the basal ganglia do?

Back 178

Regulate voluntary movement.

Front 179

How is Parkinson's disease treated?

Back 179

L-Dopa (Levodopa), related to dopamine, treats the movement component. But it cannot decrease the dementia or alter the progression of the disease. Antidepressants may also be prescriebed for the 50-90% of sufferers who develop depression.

Front 180

What causes Huntington's disease/chorea (give detailed answer)?

Back 180

An autosomaldominant gene, which affects the basal ganglia, as well as the neurotransmitters acetylcholine and GABA.

Front 181

What are the 5 effects of Huntington's disease/chorea?

Back 181

Personality change
Gradually deteriorating dementia
Choreiform movement (jerking)
Athetosis (slow writhing)
Facial grimaces

Front 182

What is athetosis?

Back 182

Slow, writhing movements associated with Huntington's disease/chorea

Front 183

What are choreiform movements?

Back 183

Frequent, discrete, jerking movements of the pelvis, trunk and limbs, associated with Huntington's disease/chorea

Front 184

What is Pick's disease?

Back 184

A rare dementia clinically indistinguishable from Alzheimer's disease.

Front 185

Who is affected by Pick's disease, and when?

Back 185

Women twice as often as men, onset peaks in the 50s and 60s.

Front 186

What are nine effects of Pick's disease?

Back 186

Decreases in initiative, episodes of tactless and inappropriate behavior, facetiousness, euphoria, explosive temper, disinhibition, poor impulse control, problems with memory and langauge.

Front 187

What are the effects of Pick's disease, simply stated?

Back 187

Frontal lobe dysfunction leading to problems with emotional and impulse control; problems with language and memory.

Front 188

What are the physical effects in the brain of Pick's disease?

Back 188

Affected neurons swell and have "Pick bodies" (irregularly shaped inclusions).

Front 189

What are the physical differences between Pick's disease and Alzheimer's disease?

Back 189

In Pick's, deterioration is not wide-spread throughout the brain, and there are no senile plaques or neurofibrillary tangles.

Front 190

What is AIDS Dementia Complex (ADC)?

Back 190

Dementia caused by the HIV.

Front 191

What are the three general categories of symptoms of AIDS Dementia Complex (ADC)?

Back 191

Cognitive, motor and behavioral changes.

Front 192

What are the four cognitive symptoms of AIDS Dementia Complex (ADC)?

Back 192

Memory problems, difficulty with attention and concentration, language difficulties.

Front 193

What are the four motor symptoms of AIDS Dementia Complex (ADC)?

Back 193

Weakness, lack of coordination, unsteady gait, jerky eye movements

Front 194

What are the five behavioral symptoms of AIDS Dementia Complex (ADC)?

Back 194

1. Apathy/withdrawl/lack of motivation
2. Personality changes
3. Inappropriate affect
4. Mood swings
5. Hallucinations

Front 195

What is the prevalence of AIDS Dementia Complex (ADC) within people who develop AIDS?

Back 195

10-15%

Front 196

What is the fastest-growing population of people infected with HIV?

Back 196

IV drug users.

Front 197

What is the most common result of head trauma?

Back 197

Impaired memory

Front 198

What is the leading cause of brain injury in children and young adults?

Back 198

Head trauma

Front 199

What are three major results of head trauma?

Back 199

1. Delirium
2. Amnestic disorder
3. Chronic dementia

Front 200

What is the difference between closed-head and open-head injury in head trauma?

Back 200

Closed-head: The skull is not pierced or cracked.
Open-head: The skull is penetrated

Front 201

What are the two major categories of head trauma?

Back 201

1. Closed-head (the skull is not pierced or cracked)
2. Open-head (the skull is penetrated)

Front 202

What is a closed-head head trauma?

Back 202

The skull is not pierced or cracked (e.g., concussions or contusions).

Generally results in loss of consciousness.

Front 203

What is an open-head head trauma, and its common results?

Back 203

The skull is penetrated (e.g., gunshot wound.)

Generally does not result in loss of consciousness.

Effects are specific to the injured area, and resemble the surgical removal of a small area of the cortex.

Front 204

What are four frequent results of a closed-head trauma (besides loss of consciousness)?

Back 204

1. Concussions
2. Contusions
3. Discrete impairment
4. Diffuse impairment

Front 205

What is the difference between closed-head and open-head injury in head trauma?

Back 205

Closed-head: The skull is not pierced or cracked.
Open-head: The skull is penetrated

Front 206

What are the two major categories of head trauma?

Back 206

1. Closed-head (the skull is not pierced or cracked)
2. Open-head (the skull is penetrated)

Front 207

What is a closed-head head trauma?

Back 207

The skull is not pierced or cracked (e.g., concussions or contusions).

Generally results in loss of consciousness.

Front 208

What is an open-head head trauma, and its common results?

Back 208

The skull is penetrated (e.g., gunshot wound.)

Generally does not result in loss of consciousness.

Effects are specific to the injured area, and resemble the surgical removal of a small area of the cortex.

Front 209

What are four frequent results of a closed-head injury (besides loss of consciousness)?

Back 209

1. Concussions
2. Contusions
3. Discrete impairment
4. Diffuse impairment

Front 210

What is a concussion, and what are 4 possible results?

Back 210

A head injury resulting from a blow to the head. It may cause
1. short-term loss of consciousness
2. anterograde amnesia (inability to remember new information)
3. retrograde amnesia (inability to remember recent events (generally those for the incident leading to the head injury and just before that)
4. postconcussion syndrome (irritability, fatigue, headache, dizziness, insomnia, hyperchondriacal concern, hypersensitivity to noise, photophobia)

Front 211

What is the most common type of head injury?

Back 211

A concussion.

Front 212

What causes a concussion?

Back 212

A blow to the head, hard enough to cause temporary neural dysfunction, but not hard enough to cause a cerebral contusion (bruising).

Front 213

What are eight symptoms of postconcussion syndrome?

Back 213

1. Irritability
2. Fatigue
3. Headache
4. Dizziness
5. Insomnia
6. Hyperchondriacal concern
7. Hypersensitivity to noise
8. Photophobia

Front 214

How long does a concussion take to heal?

Back 214

About as long as other physical injuries

Front 215

What are cerebral contusions?

Back 215

Serious condition resulting from severe blow to the head, in which there are coup-countrecoup injuries (bruising beneath the point of impact as well as on the other side of the brain)

Front 216

What are coup-countrecoup injuries?

Back 216

Bruising beneath the point of impact as well as on the other side of the brain. Associated with cerebral contusions.

Front 217

What is the difference between concussion and cerebral contusions?

Back 217

Contusions are much more severe, resulting in bruising of the brain.

Front 218

What are seven possible results of cerebral contusions?

Back 218

1. Loss of consciousness
2. Drowsiness
3. Confusion
4. Agitation, possibly violence
5. Temporary aphasia
6. Slight hemiparesis
7. Unilateral numbness

Front 219

What is the cause of discrete impairment, in head injuries?

Back 219

Injury at the site of the coup or countrecoup, most frequently the frontal and temporal lobes.

Front 220

What are two possible results of discrete impairment, in head injuries?

Back 220

1. Frontal lobe syndrome (lack of foresight and concern, irresponsibility, loss of insight).

2. Temporal lobe syndrome (irritability, hostility)

Front 221

What are the results of diffuse impairment, in head injuries?

Back 221

General loss of complex cognitive functioning (reduction in mental speed, ability to concentrate, overall cognitive efficiency).

Front 222

What is the difference between discrete and diffuse impairment, in head injuries?

Back 222

Discrete impairments affects specific areas (the temporal or frontal lobes). Diffuse impairment has wider-ranging effects over the whole brain (slower general processing, less cognitive efficiency).

Front 223

How long does it take to recover from head injuries?

Back 223

It often takes two to three years to recover, although most recovery takes place during the first six to nine months.

Front 224

What are some aspects of memory recovery in the aftermath of head injury?

Back 224

It takes longer to recover memory than to recover general intelligence. In cases of retrograde amnesia, more remote events return before more recent ones. People may never recover the memory of the incident which caused the injury.

Front 225

What is pseudodementia?

Back 225

Cognitive impairments due to depression which mimic organic dementia

Front 226

What are eight symptoms of pseudodementia?

Back 226

1. Slow processing speed
2. Difficulties in concentration and attention
3. Psychomotor retardation
4. Social withdrawl
5. Easily giving up difficult items when tested.
6. Acute onset, dated from a loss or intense emotional distress
7. Rapid progression
8. Awareness of one's own problem

Front 227

What are three ways that pseudodementia can be distinguished from organic dementia?

Back 227

Pseudodementia features:
Acute onset, dated from a loss or intense emotional distress, rapid progression, and awareness of one's own problem. With organic dementia, the problem is more likely to be reported by a relative than the person who has it (although some intelligent people do notice their own memory loss etc.)

Front 228

How is pseudodementia treated?

Back 228

By treating the depression.

Front 229

What is delirium, and what are four of its attributes?

Back 229

An acute confusional state, often including
1. disturbance of consciousness
2. reduced ability to focus, sustain or shift attention
3. a change in cognition (memory, disorientation), and/or
4. perceptual disturbance

Front 230

What is the direct cause of delirium?

Back 230

A disturbance in brain function, related to levels of acetylcholine.

Front 231

What are six ways in which delirium differs from dementia?

Back 231

Delirium features:
1. acute onset
2. fluctuating course
3. clouded sensorium
4. more likely to be reversible
5. often includes disturbed sleep patterns
6. often includes neurological signs (dysphasia, tremor, poor coordination, etc)

Front 232

What are six causes of delirium?

Back 232

1. Infections
2. Metabolic disorders
3. Endocrine disorders
4. Postoperative states
5. Substance intoxication
6. Substance withdrawl

Front 233

How is delirium treated?

Back 233

*Identify the cause
*(w/elderly patients, often reduce the dose or discontinue problematic medications)
*Protect patient from unintentional self-harm
*Reorient times three in a well-lit room with a window, clock, and calendar-- familiar objects from their home can also help
*For agitated delirium, Ativan can be useful, as can antipsychotics.

Front 234

What are amnestic disorders?

Back 234

Disorders featuring a disturbance in memory related to the effects of a general medical condition or the persisting effects of a substance.

Front 235

What are the two most common causes of amnestic disorders?

Back 235

1. Head trauma
2. Alcohol abuse

Front 236

What is the difference between dementia and amnestic disorders?

Back 236

Amnestic disorders *only* feature disturbance of memory, no other symptoms.

Front 237

What are two common types of amnestic disorders?

Back 237

1. Korsakoff's syndrome
2. Effects of ECT

Front 238

What is Korsakoff's syndrome?

Back 238

An amnestic syndrome thought to be caused by the chronic thiamin (Vitamin B1) deficiency associated with alcoholism. Involves retrograde amnesia, anterograde amnesia, lack of insight, limited spontaneous conversation, and a tendency to confabulate (make up plausible stories about past events).

Front 239

What three types of memory difficulties are associated with Korsakoff's syndrome?

Back 239

1. Anterograde amnesia (difficulty forming new memories), especially learning paired-associates lists.
2. Retrograde amnesia, with extensive impairments in remote memory for most of their adult lives
3. Confabulation (making up plausible stories about past events which did not happen)

Front 240

What are the five symptoms of Korsakoff's syndrome?

Back 240

1. Anterograde amnesia
2. Retrograde amnesia
3. Confabulation
4. Lack of insight
5. Limited spontaneous conversation

Front 241

What is one attribute of Korsakoff's syndrome patients which differentiates them from people with many other types of biological difficulties?

Back 241

They have normal IQs, and are alert, attentive, and generally motivated.

Front 242

What is one side-effect of electro-convulsive therapy (ECT)?

Back 242

Memory loss.

Front 243

What are the differences in side-effects of unilateral and bilateral ECT?

Back 243

Some studies suggest unilateral has less negative effect on memory than bilateral; it is possible that left-side unilateral ECT disturbs verbal memory, while right-side unilateral ECT disturbs nonverbal memory.

Front 244

How do memory effects of ECT change over time?

Back 244

They are cumulative, and positively correlated with number of treatments.

However, most memory problems are reversible, with return to pretreatment functioning in about six months.

Front 245

How long does it take to recover from memory loss due to ECT?

Back 245

Most memory problems are reversible, with return to pretreatment functioning in about six months.

Front 246

What types of memory problems are caused by ECT?

Back 246

Retrograde amnesia is considered to be the most significant problem, though anterograde amnesia can also be significant.

Front 247

What is the gate-control theory?

Back 247

Sensations of pain are not directly related to the activation of pain receptors, but rather are mediated by neural gates in the spinal cord which allow these signals to continue on to the brain. The gate may be closed by pressure stimulation (so rubbing a hurt area can relieve pain), and psychological factors such as moods and attitudes may open the gate and increase experienced pain.

Front 248

Who came up with the gate-control theory of pain, and when?

Back 248

Melzak and Wall, 1965

Front 249

According to the gate-control theory of pain, what can close the gates?

Back 249

Pressure stimulation (so rubbing a hurt area can relieve pain)

Front 250

According to the gate-control theory of pain, what can open the gates?

Back 250

Attitudes/cognitions, and moods (e.g., depression, fear).

Front 251

What is the best schedule for pain management?

Back 251

Time-contingent (i.e., fixed-interval), not pain-contingent (i.e. PRN, as-needed). According to PsychPrep, anyway.

Front 252

What are the major phases of sleep?

Back 252

non-REM (stages 1 through 4) and REM (rapid-eye movement)

Front 253

When are beta waves predominant in the brain?

Back 253

When a person is alert and attentive.

Front 254

When are alpha waves predominant in the brain?

Back 254

When a person is relaxed or closes his/her eyes.

Front 255

What is the magnitude of alpha waves in the brain?

Back 255

8 to 12 Hz

Front 256

When are theta waves predominant in the brain?

Back 256

Entering Stage 1 sleep.

Front 257

What is the magnitude of theta waves in the brain?

Back 257

4-8 Hz

Front 258

What happens during Stage 1 of sleep?

Back 258

Transition from wakefulness to sleep; there is little alpha, but a predominance of theta waves.

Front 259

What are "spindles" in the sleep cycle?

Back 259

Rhythmic responses of 12 to 16 Hz. Occur during Stage 2 of sleep.

Front 260

What happens during Stage 2 of sleep?

Back 260

Spindles (rhytmical responses of 12 to 16 Hz). Takes the most time during sleep.

Front 261

Which stage occupies the greatest percentage of time asleep?

Back 261

Stage 2.

Front 262

What happens during stages 3 and 4 of sleep?

Back 262

Slow delta waves (1 to 2 Hz). The sleeper is hard to awaken.

Front 263

What is the frequency of delta waves in sleep?

Back 263

1 to 2 Hz

Front 264

What is REM sleep?

Back 264

Occurs after Stage 4; recapitulates the drifting through theta waves of stage 1, but features rapid-eye movement.

Front 265

How does the pattern of stages of sleep vary over the lifetime?

Back 265

Newborns spend about 50% of time in REM sleep. By age five it's about 20-25%, and by old age only 18%.

Front 266

How does the pattern of stages of sleep vary over the course of a night?

Back 266

In the second half, the deeper stages become less frequent and REM more prominent.

Front 267

How does the body react to different sleep stages?

Back 267

Non-REM: eye movements absent, heart rate and respiration slow, muscles maintain tone.

REM: respiration and heart rate increase, muscles are very relaxed.

Front 268

What is the difference between REM and non-REM sleep in terms of dreams?

Back 268

REM: usually dreaming, dreams are bizarre and illogical.

NREM: only about 30% of the time, dreams are more "normal."

Front 269

What is the apparent function of REM and non-REM sleep?

Back 269

REM: psychologically restorative

NREM: physically restorative

Front 270

What are the results of sleep deprivation?

Back 270

Drowsiness, desire to sleep, tendency to fall deeply asleep. No real effects on intellectual function after a few nights (they say.)

Front 271

What are the results of dream deprivation?

Back 271

REM-rebound.

Minor effects on memory.

Front 272

What are two types of generalized seizures?

Back 272

1. Tonic clonic seizures (grand mal)-- large scale and alarming

2. Petit mal seizures (absence seizures)-- more subtle, most common in children

Front 273

What is the difference between generalized and partial seizures?

Back 273

Generalized: Involve electrical abnormalities throughout the brain.
Partial: Involve electrical abnormalities in specific part or parts of the brain

Front 274

What is a tonic clonic seizure?

Back 274

e.g. grand-mal seizure:

Involve a tonic stage (continuous tension or contraction) followed by a clonic stage (rapid, involuntary alternating muscular contractions and relaxation).

Front 275

Describe a grand-mal seizure, including four aftereffects.

Back 275

A generalized, tonic-clonic seizure.

Very dramatic, convulsions throughout the body, frequent loss of consciousness, followed by headache, confusion, fatigue, and amnesia of the seizure.

Front 276

What is the tonic stage?

Back 276

In a seizure: continuous tension or contraction.

Front 277

What is the clonic stage?

Back 277

In a seizure: rapid, involuntary, alternating muscular contractions and relaxation.

Front 278

Describe a petit-mal seizure.

Back 278

(i.e., an absence seizure.)

One to thirty seconds; brief change in level of consciousness, followed by blinking or rolling the eyes, a blank stare, and slight mouth movements such as twitching. Posture is maintained, and the person returns to pre-seizure activity without difficulty.

Most common in children, starting before age five.

Front 279

Describe an absence seizure.

Back 279

(i.e., a petit-mal seizure.)

One to thirty seconds; brief change in level of consciousness, followed by blinking or rolling the eyes, a blank stare, and slight mouth movements such as twitching. Posture is maintained, and the person returns to pre-seizure activity without difficulty.

Most common in children, starting before age five.

Front 280

What are three types of partial seizure?

Back 280

1. Simple partial seizures
2. Jacksonian seizures
3. Complex partial seizures

Front 281

Describe simple partial seizures.

Back 281

Electrical abnormalities in one part of the brain only, ranging greatly in size.

The person usually remains conscious, and can describe the seizure in detail.

Front 282

Describe a Jacksonian seizure.

Back 282

Initially localized motor seizure, which spreads to adjacent brain areas. E.g., may start with one foot, and then "march up" the limb as it spreads.

Front 283

Describe what a complex partial seizure looks like from the outside.

Back 283

Frequently preceded by aura, includes purposeless behavior (e.g., aimless wandering), lip smacking, and unintelligible speech, as well as impaired consciousness (losing touch with surroundings, resisting help). Confusion may last for several minutes, but ultimately the person makes a full recovery.

Front 284

What are the five major classes of psychotropic medications?

Back 284

1. Antipsychotics
2. Antidepressants
3. Antianxiety agents
4. Mood stabilizers
5. Stimulants

Front 285

What are the two main types of antipsychotics?

Back 285

1. Typical/traditional antipsychotics (neuroleptics, major tranquilizers)
e.g., Thorazine, Haldol
2. Atypical or novel (e.g., risperidone, clozapine)

Front 286

*What type of medication is thorazine, and what is its brand name?

Back 286

Traditional/typical antipsychotic.

Chlorpromazine.

Front 287

*What type of medication is fluphenazine, and what is its brand name?

Back 287

Traditional/typical antipsychotic.

Prolixin.

Front 288

*What type of medication is haloperidol, and what is its brand name?

Back 288

Traditional/typical antipsychotic.

Haldol

Front 289

*What type of medication is Chlorpromazine, and what is its generic name?

Back 289

Traditional/typical antipsychotic.

Thorazine

Front 290

*What type of medication is Prolixin, and what is its generic name?

Back 290

Traditional/typical antipsychotic.

fluphenazine

Front 291

*What type of medication is Haldol, and what is its generic name?

Back 291

Traditional/typical antipsychotic.

haloperidol

Front 292

What type of medication is Clozaril, and what is its generic name?

Back 292

Atypical/novel antipsychotic

clozapine

Front 293

What type of medication is Risperdal, and what is its generic name?

Back 293

Atypical/novel antipsychotic

risperidone

Front 294

What type of medication is Zyprexa, and what is its generic name?

Back 294

Atypical/novel antipsychotic

olanzapine

Front 295

What type of medication is Seroquel, and what is its generic name?

Back 295

Atypical/novel antipsychotic

quietiapine

Front 296

What type of medication is Geodon, and what is its generic name?

Back 296

Atypical/novel antipsychotic

ziprasidone

Front 297

What type of medication is Abilify, and what is its generic name?

Back 297

Atypical/novel antipsychotic

ariprazole

Front 298

What type of medication is clozapine, and what is its brand name?

Back 298

Atypical/novel antipsychotic

Clozaril

Front 299

What type of medication is risperidone, and what is its brand name?

Back 299

Atypical/novel antipsychotic

Risperdal

Front 300

What type of medication is olanzapine, and what is its brand name?

Back 300

Atypical/novel antipsychotic

Zyprexa

Front 301

What type of medication is quietiapine, and what is its brand name?

Back 301

Atypical/novel antipsychotic

Seroquel

Front 302

What kind of a medication is Geodon, and what is its generic name?

Back 302

Atypical/novel antipsychotic

ziprasidone

Front 303

What kind of a medication is Abilify, and what is its generic name?

Back 303

Atypical/novel antipsychotic

ariprazole

Front 304

What kind of a medication is ziprasidone, and what is its brand name?

Back 304

Atypical/novel antipsychotic

Geodon

Front 305

What kind of a medication is ariprazole, and what is its brand name?

Back 305

Atypical/novel antipsychotic

Abilify

Front 306

What are three types of brain scan?

Back 306

1. PET (positron emission topography)
2. MRI (magnetic resonance imagery)
3. CAT scan (computerized axial tomography)

Front 307

What does a PET scan do?

Back 307

Demonstrate brain activity or functioning; shows capacity of a particular brain region.

Front 308

What does an MRI scan do?

Back 308

Visualize brain structures, using radio waves, not x-rays.

Front 309

What does a CAT scan do?

Back 309

Visualize brain structures, using x-ray like images which are clearer and more accurate than x-rays.

Front 310

What is synesthesia?

Back 310

When one type of sensual stimulation (oooh!) elicits another sense (e.g., see music, smell colors)

Front 311

What is the cause of synesthesia?

Back 311

Probably genetic-- it runs in families.

Front 312

What is the prevalence of synesthesia?

Back 312

Between 1/1000 and 1/25,000

Front 313

What is General Adaptation Syndrome, and what are its stages?

Back 313

A model of response over time to severe stress.
1) Alarm.
2) Resistance
3) Exhaustion

Front 314

Who came up with General Adaptation Syndrome?

Back 314

Hans Selye

Front 315

What is the alarm stage of General Adaptation Syndrome?

Back 315

The body activates the sympathetic nervous system to mobilize resources-- highly alert, but parasympathetic nervous system cuts out, leading to headaches, fatigue, diarrhea, and greater vulnerability to illness.

Front 316

What is the resistance stage of General Adaptation Syndrome?

Back 316

Second stage: Alarm subsides, the body adapts to the stressor-- the person becomes *more* illness-resistant than normally.

Front 317

What is the exhaustion stage of General Adaptation Syndrome?

Back 317

Third stage: After chronic, unremitting stress, the body's resources are exhausted and stress hormones are depleted. It can severely affect health, or lead to death.

Front 318

What is the Rosenstock Health Belief Model?

Back 318

A theory of health behavior and use of health care services. It is multicausal, but at essence, says that people who believe they can control their health are more likely to do healthy habits.

Front 319

What are five variables of the Rosenstock Health Belief Model?

Back 319

1) Psychosocial factors (demographics, peer pressure, etc)
2) Perceived susceptibility to disease
3) Perceived seriousness of disease
4) Perceived benefits of preventative action
5) Perceived barriers to preventative action

Front 320

What are traditional/older antipsychotics effective for?

Back 320

They treat positive symptoms of schizophrenia (hallucinations, delusions, disorganized thinking) more effectively than negative symptoms (affective flattening, lack of motivation, poverty of speech).

Front 321

How does one choose antipsychotic medications?

Back 321

Side-effect profile and individual's response.

Front 322

Define "high-potency antipsychotic."

Back 322

An antipsychotic which requires a lower dose (e.g., 2 mg Haldol (haloperidol) = 100 mg Chlorpromazine (thorazine)). They are less sedating, and have fewer initial side-effects.

Front 323

What are the four most potent antipsychotics?

Back 323

1. Haldol/haloperidol
2. Prolixin/fluphenazine
3. Navane/thiothixine
4. Stelazine/ trifluopenazine

Front 324

What are novel antipsychotics effective for?

Back 324

Both positive and negative symptoms of schizophrenia, as well as some other psychotic disorders.

Front 325

Define "depot neuroleptics."

Back 325

Antipsychotics delivered by injection in doses which last 2-4 weeks.

Front 326

Define "decanoate."

Back 326

Word added to the name of antipsychotics to show they are administered in depot (injected) form.

Front 327

What are two antipsychotic medications delivered in depot (injected) form?

Back 327

1. Prolixin decanoate
2. Haldol decanoate

Front 328

How do traditional antipsychotic medications work?

Back 328

They are dopamine antagonists. They reduce the level of dopamine in the brain by blocking postsynaptic dopamine receptors.

Front 329

How do traditional antipsychotic medications interact with neurotransmitters?

Back 329

They are dopamine antagonists. They reduce the level of dopamine in the brain by blocking postsynaptic dopamine receptors.

Front 330

What is the presumed mechanism of action for traditional antipsychotic medications?

Back 330

They are dopamine antagonists. They reduce the level of dopamine in the brain by blocking postsynaptic dopamine receptors.

Front 331

What is the dopamine hypothesis, and how certain are we that it is true?

Back 331

Schizophrenia is caused by an excess of dopamine in the brain.

It has not been fully confirmed.

Front 332

What four types of effects do novel antipsychotics exert which are stronger than their effect as a dopamine antagonist?

Back 332

1. Antiserotonergic (serotonin antagonist)
2. Antiadrenergic (inhibit the signals of epinephrine and norepinephrine)
3. Anticholerinergic (blocks acetylcholine)
4. Antihistaminergic (histamine antagonist)

Front 333

What is an antiserotonergic?

Back 333

A serotonin antagonist.

One effective factor of novel/atypical antipsychotics.

Front 334

What is an antiadrenergic?

Back 334

Inhibits the signals of epinephrine and norepinephrine

One effective factor of novel/atypical antipsychotics.

Front 335

What is an anticholerinergic?

Back 335

Blocks acetylcholine

One effective factor of novel/atypical antipsychotics.

Front 336

What is an antihistaminergic?

Back 336

Histamine antagonist.

One effective factor of novel/atypical antipsychotics.

Front 337

What are nine anticholinergic effects, and what are they the result of?

Back 337

Side effect of lower potency antipsycyhotic medication.
1. Dry mouth
2. Constipation
3. Urinary hesitation or retention
4. Blurred vision
5. Dry eyes
6. Photophobia
7. Nasal congestion
8. Confusion
9. Decreased memory

Front 338

How long do anticholinergic effects last?

Back 338

They diminish but do not completely disappear within the first month of antipsychotic use.

Front 339

What is orthostatic hypotension, and what is it the result of?

Back 339

Dizziness and lightheadedness on standing up.
Side effect of lower potency antipsycyhotic medication.

Front 340

What are three major categories of extrapyrimidal symptoms?

Back 340

1. Dystonia
2. Parkinsonism
3. Akathisia

Front 341

What are extrapyrimidal symptoms, and what are they the result of?

Back 341

Side effect of lower potency antipsycyhotic medications.
Movement-related side effects.

Front 342

How are extrapyrimidal symptoms treated?

Back 342

Through anticholinergic agents (ACAs) like Cogentin (benztropine) and Artane (trihexyphenidyl).

Front 343

What are two anticholinergic agents? What are they useful for?

Back 343

Cogentin (benztropine) and Artane (trihexyphenidyl).

Treating side-effects of antipsychotic medications.

Front 344

Which antipsychotics do not cause extrapyrimidal symptoms?

Back 344

Novel antipsychotics: Clozaril (clozapine), Risperdol (risperidone) and Zyprexa (olanzapine).

Front 345

What is dystonia, and what causes it?

Back 345

It is an extrapyrimidal symptom, caused by antipsychotic medications.
Painful and acute muscle spasms of the neck, back, tongue, eyes and/or larynx.

Front 346

How long does dystonia last?

Back 346

Usually passes within two weeks.

Front 347

What is the DSM-IV diagnosis for dystonia?

Back 347

Neuroleptic-induced acute dystonia

Front 348

What are six symptoms of parkinsonism, and what causes it?

Back 348

It is an extrapyrimidal symptom, caused by antipsychotic medications.
Mask-like face, shuffling gait, drooling, resting tremor, rigidity and akinesia.

Front 349

What is akinesia?

Back 349

The inability to initiate movement due to difficulty selecting and/or activating motor programs in the central nervous system.

Front 350

What is the course of parkinsonism/pseudoparkinsonism?

Back 350

Lasts throughout treatment, affecting 12-45% of all patients.

Front 351

How is pseudoparkinsonism treated?

Back 351

Lowering dose, switching antipsychotics, or using an anticholinergic agent.

Front 352

What is the DSM-IV diagnosis for pseudoparkinsonism?

Back 352

Neuroleptic-induced Parkinsonism

Front 353

What is akathisia, and what causes it?

Back 353

It is an extrapyrimidal symptom, caused by antipsychotic medications.
Dysphoria, and a sense of agitation or “jitters”-- restlessness, fidgeting, feet-tapping, rocking back and forth, shifting weight.

Front 354

Which side effect is the most common reason for patients to stop taking their antipsychotic medication?

Back 354

Akathisia-- dysphoria and agitation/jitters/restlessness

Front 355

What are three ways that akathisia can be treated?

Back 355

1. Propranolol (a beta-blocker)
2. Benzodiazepines
3. Anticholinergic agents

Front 356

What is the DSM-IV diagnosis for akathisia?

Back 356

Neuroleptic-induced Acute Akathisia

Front 357

What are four symptoms of Neuroleptic Malignant Syndrome (NMS), and what causes it?

Back 357

It is a potentially deadly side effect of antipsychotic medications.
1. Severe muscle rigidity
2. Altered consciousness
3. Autonomic instability (e.g., heart rate and blood pressure changes)
4. High fever

Front 358

What is the prevalence and risk of Neuroleptic Malignant Syndrome (NMS)?

Back 358

1% of patients treated with antipsychotics.
1000-4000 deaths/year.

Front 359

How is Neuroleptic Malignant Syndrome (NMS) treated?

Back 359

Stopping all neuroleptics, using an IV for hydration, administering anti-fever medications, and treating any lung complications.

Front 360

What is the DSM-IV diagnosis for Neuroleptic Malignant Syndrome (NMS)?

Back 360

Neuroleptic Malignant Syndrome

Front 361

What is tardive dyskinesia, and what causes it?

Back 361

Abnormal movements of the lips, tongue, jaw, limbs, and trunk.
A side effect of traditional/typical antipsychotics.

Front 362

Describe tardive dyskinesia.

Back 362

Frowning, blinking, rolling eyes, protruding the tongue, rapid purposeless limb movements, limb tremors, knee tapping, rocking, twisting, pelvic gyrations.

Front 363

What is the course of tardive dyskinesia?

Back 363

Onset after at least six months of treatment; plateaus after 3-6 years without further worsening. May appear only after the antipsychotic has been discontinued or the dosage has been lowered, but may be reversible, and sometimes people experience a full remission of symptoms after antipsychotics have been stopped.

Front 364

Cold agglutinins

Back 364

Mycoplasma pneumonia, infectious mononucleosis

Front 365

What antipsychotic does not cause tardive dyskinesia?

Back 365

Clozaril (clozapine).

Front 366

What is the effect of anticholinergic agents on tardive dyskinesia?

Back 366

They exacerbate it.

Front 367

What is agranulocytosis, and what causes it?

Back 367

A potentially lethal side-effect of Clozaril (clozapine), which consists of a sudden drop in the granulocyte (a type of white blood cell) count, resulting in a sore throat and high fever

Front 368

What are things to bear in mind about they antipsychotic Clozaril (clozapine)?

Back 368

Unlike other antipsychotics, it does not cause tardive dyskinesia. However, it can cause the potentially lethal agranulocytosis, so it is usually tried only after other antipsychotics have failed.

Front 369

What is the course of agranulocytosis?

Back 369

It appears within hours to twelve weeks of the initial administration (often of the antipsychotic clozapine), and manifests as a sore throat and high fever.

Front 370

Do antipsychotics cause addiction, dependence, or tolerance?

Back 370

No.

Front 371

When does withdrawl from antipsychotics occur, and what are four results?

Back 371

Only when a high dose is suddenly stopped.
Gastrointestinal distress, headaches, insomnia, and nightmares.

Front 372

What is the result of an overdose of antipsychotics?

Back 372

Not lethal unless a full 30-60 day supply is taken at once. More lethal when combined with another drug, such as a tricyclic antidepressant.

Front 373

What are four categories of antidepressants?

Back 373

1. Tricyclics (TCAs)
2. Selective Serotonin Reuptake Inhibitors (SSRIs)
3. Monoamine-Oxidase Inhibitors (MAOIs)
4. Others

Front 374

What are two categories of tricyclic antidepressants?

Back 374

1. Tertiary Amines (most important ones are here)
2. Secondary Amines

Front 375

Name three tertiary amine tricyclic antidepressants.

Back 375

1. Elavil (amitryptyline)
2. Anafranil (clomipramine)
3. Tofranil (imipramine)

Front 376

Name six SSRIs.

Back 376

1. Prozac (fluoxetene)
2. Zoloft (sertraline)
3. Paxil (paroxetine)
4. Cymbalta (duloxetine)
5. Celexa (citralopram)
6. Lexapro (escitalopam)

Front 377

Name two monoamine-oxidase inhibitors.

Back 377

1. Nardil (phenelzine)
2. Parnate (trancylcypromine)

Front 378

What is the generic name of Elavil, and what kind of medication is it?

Back 378

amitryptyline.

Tertiary amine tricyclic antidepressant

Front 379

What is the generic name of Anafranil, and what kind of medication is it?

Back 379

Clomipramine.

Tertiary amine tricyclic antidepressant

Front 380

What is the generic name of Tofranil, and what kind of medication is it?

Back 380

Imipramine

Tertiary amine tricyclic antidepressant

Front 381

What is the brand name of amitryptyline, and what kind of medication is it?

Back 381

Elavil

Tertiary amine tricyclic antidepressant

Front 382

What is the brand name of clomipramine, and what kind of medication is it?

Back 382

Anafranil

Tertiary amine tricyclic antidepressant

Front 383

What is the brand name of Imipramine, and what kind of medication is it?

Back 383

Tofranil

Tertiary amine tricyclic antidepressant

Front 384

Name three tertiary amine tricyclic antidepressants.

Back 384

1. Elavil (amitryptyline)
2. Anafranil (clomipramine)
3. Tofranil (imipramine)

Front 385

Name six SSRIs.

Back 385

1. Prozac (fluoxetene)
2. Zoloft (sertraline)
3. Paxil (paroxetine)
4. Cymbalta (duloxetine)
5. Celexa (citralopram)
6. Lexapro (escitalopam)

Front 386

Name two monoamine-oxidase inhibitors.

Back 386

1. Nardil (phenelzine)
2. Parnate (trancylcypromine)

Front 387

What is the generic name of Elavil, and what kind of medication is it?

Back 387

amitryptyline.

Tertiary amine tricyclic antidepressant

Front 388

What is the generic name of Anafranil, and what kind of medication is it?

Back 388

Clomipramine.

Tertiary amine tricyclic antidepressant

Front 389

What is the generic name of Tofranil, and what kind of medication is it?

Back 389

Imipramine

Tertiary amine tricyclic antidepressant

Front 390

What is the brand name of amitryptyline, and what kind of medication is it?

Back 390

Elavil

Tertiary amine tricyclic antidepressant

Front 391

What is the brand name of clomipramine, and what kind of medication is it?

Back 391

Anafranil

Tertiary amine tricyclic antidepressant

Front 392

What is the brand name of imipramine, and what kind of medication is it?

Back 392

Tofranil

Tertiary amine tricyclic antidepressant

Front 393

Name six SSRIs.

Back 393

1. Prozac (fluoxetene)
2. Zoloft (sertraline)
3. Paxil (paroxetine)
4. Cymbalta (duloxetine)
5. Celexa (citralopram)
6. Lexapro (escitalopam)

Front 394

What is the generic name of Prozac, and what kind of medication is it?

Back 394

fluoxetene

SSRI

Front 395

What is the generic name of Zoloft, and what kind of medication is it?

Back 395

sertraline

SSRI

Front 396

What is the generic name of Paxil , and what kind of medication is it?

Back 396

paroxetine

SSRI

Front 397

What is the generic name of Cymbalta, and what kind of medication is it?

Back 397

duloxetine

SSRI

Front 398

What is the generic name of Celexa, and what kind of medication is it?

Back 398

citralopram

SSRI

Front 399

What is the generic name of Lexapro, and what kind of medication is it?

Back 399

escitalopam

SSRI

Front 400

Name six SSRI antidepressants.

Back 400

1. Prozac (fluoxetene)
2. Zoloft (sertraline)
3. Paxil (paroxetine)
4. Cymbalta (duloxetine)
5. Celexa (citralopram)
6. Lexapro (escitalopam)

Front 401

What is the brand name of fluoxetene, and what kind of medication is it?

Back 401

Prozac

SSRI

Front 402

What is the brand name of sertraline, and what kind of medication is it?

Back 402

Zoloft

SSRI

Front 403

What is the brand name of paroxetine, and what kind of medication is it?

Back 403

Paxil

SSRI

Front 404

What is the brand name of duloxetine, and what kind of medication is it?

Back 404

Cymbalta

SSRI

Front 405

What is the brand name of citralopram, and what kind of medication is it?

Back 405

Celexa

SSRI

Front 406

What is the brand name of escitalopam, and what kind of medication is it?

Back 406

Lexapro

SSRI

Front 407

What are six "other" antidepressants?

Back 407

1. Welbutrin (bupropion)
2. Serzone (nerfazodone)
3. Ludiomil (maprotiline)
4. Effexor (venlafaxine)
5. Remeron (mirtazipine)
6. Desyrel (trazadone)

Front 408

What category of antidepressant is Welbutrin (bupropion)?

Back 408

"Other."

Front 409

What category of antidepressant is trazadone (brand name: Desyrel)?

Back 409

"Other."

Front 410

How do antidepressants work?

Back 410

By blocking reuptake of serotonin and/or norepinephrine, thus increasing the levels of these neurotransmitters in the brain.

Front 411

What is the presumed mechaninsm of action of antidepressants?

Back 411

Blocking reuptake of serotonin and/or norepinephrine, thus increasing the levels of these neurotransmitters in the brain.

Front 412

How do SSRIs work?

Back 412

They block the reuptake of serotonin.

Front 413

How do MAOIs work?

Back 413

They inhibit the activity of Monoamine Oxidase, a type of enzyme which eliminates serotonin and norepinephrine by reuptake. Thus, eliminating it leads to greater availability of these neurotransmitters.

Front 414

What are six major disorders treated with antidepressants?

Back 414

1. Major depression/bipolar disorder
2. Panic disorder
3. Obsessive-compulsive disorder
4. Chronic pain disorders
5. Bulimia
6. Premature ejaculation

Front 415

What 8 disorders are best treated with a tricyclic antidepressant?

Back 415

1. Psychotic depression
2. Inpatient, melancholic and geriatric depression.
3. Depression with sleep problems (Sinequan (doxepin))
4. Panic disorder
5. Obsessive-compulsive disorder (Anafranil (clomipramine)
6. Chronic pain disorders
7. Bulimia
8. Premature ejaculation

Front 416

What 5 disorders are best treated with SSRIs?

Back 416

1. Atypical depressions (hypersomnia, increased appetite, rejection sensitivity, profound lack of energy)
2. Panic disorder
3. Obsessive-compulsive disorder (especially Prozac (fluoxetene)).
4. Bulimia (especially Prozac (fluoxetene)).
5. Premature ejaculation (especially Paxil (paroxetine)).

Front 417

What 8 disorders are best treated with a tricyclic antidepressant?

Back 417

1. Psychotic depression
2. Inpatient, melancholic and geriatric depression.
3. Depression with sleep problems (Sinequan (doxepin))
4. Panic disorder
5. Obsessive-compulsive disorder (Anafranil (clomipramine)
6. Chronic pain disorders
7. Bulimia
8. Premature ejaculation

Front 418

What disorders are best treated with MAOIs?

Back 418

Atypical depressions (hypersomnia, increased appetite, rejection sensitivity, profound lack of energy)

Front 419

What 5 disorders are best treated with SSRIs?

Back 419

1. Atypical depressions (hypersomnia, increased appetite, rejection sensitivity, profound lack of energy)
2. Panic disorder
3. Obsessive-compulsive disorder (especially Prozac (fluoxetene)).
4. Bulimia (especially Prozac (fluoxetene)).
5. Premature ejaculation (especially Paxil (paroxetine)).

Front 420

What 2 disorders respond particularly well to the tricyclic antidepressant Sinequan (doxepin), and why?

Back 420

1. Depression with sleep problems.
It has a hypnotic effect.
2. Chronic pain disorders

Front 421

What disorders are best treated with MAOIs?

Back 421

Atypical depressions (hypersomnia, increased appetite, rejection sensitivity, profound lack of energy)

Front 422

What 2 disorders respond particularly well to the tricyclic antidepressant Sinequan (doxepin), and why?

Back 422

1. Depression with sleep problems.
It has a hypnotic effect.
2. Chronic pain disorders

Front 423

What disorder responds particularly well to the antidepressant Desyrel (trazadone), and why?

Back 423

Depression with sleep problems.
It has a hypnotic effect.

Front 424

What disorder responds particularly well to the antidepressant Desyrel (trazadone), and why?

Back 424

Depression with sleep problems.
It has a hypnotic effect.

Front 425

What 8 disorders are best treated with a tricyclic antidepressant?

Back 425

1. Psychotic depression
2. Inpatient, melancholic and geriatric depression.
3. Depression with sleep problems (Sinequan (doxepin))
4. Panic disorder
5. Obsessive-compulsive disorder (Anafranil (clomipramine)
6. Chronic pain disorders
7. Bulimia
8. Premature ejaculation

Front 426

What 5 disorders are best treated with SSRIs?

Back 426

1. Atypical depressions (hypersomnia, increased appetite, rejection sensitivity, profound lack of energy)
2. Panic disorder
3. Obsessive-compulsive disorder (especially Prozac (fluoxetene)).
4. Bulimia (especially Prozac (fluoxetene)).
5. Premature ejaculation (especially Paxil (paroxetine)).

Front 427

What disorders are best treated with MAOIs?

Back 427

Atypical depressions (hypersomnia, increased appetite, rejection sensitivity, profound lack of energy)

Front 428

What 2 disorders respond particularly well to the tricyclic antidepressant Sinequan (doxepin), and why?

Back 428

1. Depression with sleep problems.
It has a hypnotic effect.
2. Chronic pain disorders

Front 429

What disorder responds particularly well to the antidepressant Desyrel (trazadone), and why?

Back 429

Depression with sleep problems.
It has a hypnotic effect.

Front 430

What 2 disorders responds particularly well to the tricyclic antidepressant Tofranil (imipramine)?

Back 430

1. Panic disorder
2. Bulimia

Front 431

What 2 disorders respond particularly well to the SSRI Paxil (paroxetine)?

Back 431

1. Panic disorder
2. Premature ejaculation

Front 432

What 3 disorders respond particularly well to the SSRI Prozac (fluoxetine)?

Back 432

1. Panic disorder
2. Obsessive-compulsive disorder
3. Bulimia

Front 433

What 2 disorders respond particularly well to the tricyclic antidepressant Anafranil (clomipramine)?

Back 433

1. Obsessive-compulsive disorder
2. Premature ejaculation

Front 434

What disorder responds particularly well to the tricyclic antidepressant Elavil (amitryptiline)?

Back 434

Chronic pain disorders

Front 435

What is the best way to treat psychotic depression?

Back 435

Tricyclic antidepressants (TCAs) in combination with an antipsychotic.

Front 436

What is the best way to treat inpatient, melancholic and geriatric depression?

Back 436

Tricyclic antidepressants (TCAs)

Front 437

What is the best way to treat atypical depression (i.e., symptoms of hypersomnia, increased appetite, rejection sensitivity, profound lack of energy)

Back 437

MAOIs, though SSRIs may also be effective.

Front 438

What are four symptoms of atypical depression?

Back 438

1. hypersomnia
2. increased appetite
3. rejection sensitivity
4. profound lack of energy

Front 439

What is the best way to treat mild to moderate depression?

Back 439

Psychotherapy

Front 440

What is the best way to treat bipolar disorder, depressed type?

Back 440

Very carefully-- tricyclics induce mania in 10-15% of the population. SSRIs also induce mania, but at a much lower rate.

Front 441

What percentage of people with bipolar disorder can be triggered into mania by tricyclic antidepressants?

Back 441

10-15%

Front 442

What two drugs are the best way to treat depression with sleep problems?

Back 442

Desyrel (trazadone)
Sinequan (doxepin)

Front 443

What five drugs are the best way to treat panic disorder?

Back 443

Two antianxiety drugs:
Xanax (alprazolam)
Klonopin (clonazepam)

in addition to an antidepressant such as

Tofranil (imipramine), a TCA
Paxil (paroxetine) an SSRI
Prozac (fluoxetine) an SSRI

Front 444

What drugs are the best way to treat obsessive-compulsive disorder?

Back 444

Anafranil (clomipramine), a TCA
or any of the SSRIs, especially Prozac (fluoxetine)

Front 445

What drugs are the best way to treat chronic pain disorders?

Back 445

TCAs, especially
Elavil (amitryptiline)
Norpramin (desipramine)
Sinequan (doxepin)

Front 446

What drugs are the best way to treat bulimia?

Back 446

TCAs, especially
Norpramin (desipramine)
Tofranil (imipramine)

or SSRIs, especially
Prozac (fluoxetene)

Front 447

What two drugs are the best way to treat premature ejaculation?

Back 447

Anafranil (clomipramine), a TCA
Paxil (paroxetine), an SSRI

Front 448

What are seven "other," less common uses of antidepressant medications?

Back 448

1. Severe bereavement
2. Anorexia nervosa
3. Premenstrual phase dysphoric syndrome
4. Eneuresis
5. Childhood sleeping or night terrors
6. Dysthymia
7. Borderline personality disorder

Front 449

What are seven side effects of tricyclic antidepressants?

Back 449

1. Manic episodes in people with bipolar disorder
2. Anticholinergic effects (e.g., confusion, memory problems, dry mouth)
3. Sedation
4. Orthostatic hypotension ("head rush," blood pressure falling suddenly when the person stands up)
5. Weight gain
6. Nausea
7. Sexual dysfunction

Front 450

What are eight anticholinergic effects?

Back 450

1. confusion
2. blurred vision
3. constipation
4. dry mouth
5. light-headedness
6. difficulty starting and continuing to urinate
7. loss of bladder control
8. memory loss

Front 451

What is orthostatic hypotension?

Back 451

"head rush," blood pressure falling suddenly when the person stands up

Front 452

What are seven side effects of SSRIs?

Back 452

1. Headaches
2. Nervousness
3. Restlessness
4. Insomnia
5. Sedation
6. Gastrointestinal distress
7. Sexual dysfunction

Front 453

What type of antidepressants have the least severe side-effects?

Back 453

Arguably, SSRIs, which cause less sedation than TCAs, and no anticholinergic effects.

Front 454

What are six side effects of MAOIs?

Back 454

1. Orthostatic hypotension ("head rush," blood pressure falling suddenly when the person stands up)
2. Weight gain
3. Edema (abnormal accumulation of fluid beneath the skin or in one or more cavities of the body)
4. Sexual dysfunction
5. Insomnia
6. Tyramine-induced hypertensive crisis

Front 455

What is edema?

Back 455

Abnormal accumulation of fluid beneath the skin or in one or more cavities of the body. (Can be caused by MAOIs.)

Front 456

What are the six symptoms of tyramine-induced hypertensive crisis, and what causes it?

Back 456

1. Severe headache
2. Stiff neck
3. Palpitations
4. Sweating
5. Nausea
6. Vomiting.

A side-effect of MAOIs, brought on by eating foods rich in tyramine.

Front 457

What are ten tyramine-rich foods which must be avoided by people taking MAOIs to avoid a tyramine-induced hypertensive crisis?

Back 457

1. Alcohol
2. Fava beans
3. Aged cheese
4. Liver
5. Orange pulp
6. Pickled/smoked fish/meat
7. Packaged soups
8. Yeast vitamin supplements
9. Meat extracts
10. Dry sausage

Front 458

What are ten tyramine-rich foods which must be eaten only in moderation by people taking MAOIs to avoid a tyramine-induced hypertensive crisis?

Back 458

1. Soy sauce
2. Sour cream
3. Bananas
4. Avocados
5. Eggplants
6. Plums
7. Raisins
8. Spinach
9. Tomatoes
10. Yogurt

Front 459

Why are MAOIs seldom used?

Back 459

Because of their serious side-effects and the need for strict dietary compliance.

Front 460

Do antidepressants cause dependence, tolerance, or addiction?

Back 460

No.

Front 461

Which two categories of antidepressants are highly lethal if overdosed?

Back 461

TCAs and MAOIs

Front 462

How lethal are SSRIs and antidepressants if overdosed?

Back 462

Not very lethal.

Front 463

What are three contraindications for use of TCAs?

Back 463

1. High blood pressure
2. Heart conditions
3. Seizures

Front 464

How many contraindications are there for use of MAOIs?

Back 464

A wide variety of medical conditions-- can be very dangerous in conjunction with other prescribed medications.

Front 465

What are two types of benzodiazepines?

Back 465

1. Anxiolytics
2. Sedative/Hypnotics

Front 466

What are three types of antianxiety medications?

Back 466

Benzodiazepines:
1. Anxiolytics
2. Sedative/Hypnotics

3. Non-benzodiazepine sedative/hypnotics

Front 467

List four anxiolytic benzodiazepines

Back 467

1. Xanax (alprazolam)
2. Klonopin (clonazepam)
3. Valium (diazepam)
4. Ativan (lorazepam)

Front 468

List two sedative/hypnotic benzodiazepines

Back 468

1. Restoril (temazepam)
2. Halcion (triazolam)

Front 469

List three non-benzodaizepine sedative/hypnotics

Back 469

1. Ambien (zolpidem)
2. Sonata (zaleplon)
3. Lunesta (eszopiclone)

Front 470

What is the generic name of Xanax and what kind of medication is it?

Back 470

alprazolam

anxiolytic benzodiazepine

Front 471

What is the generic name of Klonopin and what kind of medication is it?

Back 471

clonazepam

anxiolytic benzodiazepine

Front 472

What is the generic name of Valium and what kind of medication is it?

Back 472

diazepam

anxiolytic benzodiazepine

Front 473

What is the generic name of Ativan and what kind of medication is it?

Back 473

lorazepam

anxiolytic benzodiazepine

Front 474

What is the generic name of Restoril and what kind of medication is it?

Back 474

temazepam

sedative/hypnotic benzodiazepine

Front 475

What is the generic name of Halcion and what kind of medication is it?

Back 475

triazolam

sedative/hypnotic benzodiazepine

Front 476

What is the generic name of Ambien and what kind of medication is it?

Back 476

zolpidem

non-benzodiazepine sedative/hypnotic

Front 477

What is the brand name of alprazolam and what type of medication is it?

Back 477

Anxiolytic benzodiazepine

Xanax

Front 478

What is the brand name of clonazepam and what type of medication is it?

Back 478

Anxiolytic benzodiazepine

Klonapin

Front 479

What is the brand name of diazepam and what type of medication is it?

Back 479

Anxiolytic benzodiazepine

Valium

Front 480

What is the brand name of lorazepam and what type of medication is it?

Back 480

Anxiolytic benzodiazepine

Ativan

Front 481

What is the brand name of temazepam and what type of medication is it?

Back 481

Sedative/hypnotic benzodiazepine

Restoril

Front 482

What is the brand name of triazolam and what type of medication is it?

Back 482

Sedative/hypnotic benzodiazepine

Halcion

Front 483

What is the brand name of zolpidem and what type of medication is it?

Back 483

Ambien

Sedative/hypnotic non-benzodiazepine

Front 484

What is are the two suffixes of generic names of benzodiazepines?

Back 484

1. -pam
2. -lam

Front 485

What is are the two frequent suffixes of generic names of tricyclics?

Back 485

1. -amine
2. -tyline

Front 486

What is the frequent suffix of generic names of antipsychotics?

Back 486

-azine

Front 487

What is the presumed mechanism of action of benzodiazepines?

Back 487

They facilitate GABA's ability to bind to its receptor site; they are GABA agonists.

Front 488

How do benzodiazepines work?

Back 488

They facilitate GABA's ability to bind to its receptor site; they are GABA agonists.

Front 489

What are four results of increasing GABA in the brain?

Back 489

1. Reduced anxiety
2. Increased sedation
3. Muscle relaxation
4. Reduction in seizures

Front 490

What are the three general categories of disorders treated with anti-anxiety meds?

Back 490

1. Anxiety disorders
2. Sleep disorders
3. 'other"

Front 491

What are four types of anxiety disorders which can be treated with benzodiazepines?

Back 491

1. Adjustment disorder
2. Panic disorder
3. Generalized anxiety disorder
4. "other" (social and specific phobias, OCD, PTSD)

Front 492

What are two important considerations before prescribing benzodiazepines?

Back 492

1. They can be abused and addictive.
2. Consider other possible secondary causes of anxiety such as medical illness, illicit drugs, withdrawl from depressants and medications

Front 493

What five medical illnesses can cause anxiety symptoms?

Back 493

1. Hyperthyroidism
2. Stroke
3. Heart attack
4. Asthma
5. Peptic ulcer disease

Front 494

What three illicit drugs can cause anxiety symptoms?

Back 494

1. Cocaine
2. Amphetamines
3. Pseudoephederine (Sudafed, can be used to make meth)

Front 495

List four CNS depressants the withdrawl from which can cause anxiety symptoms.

Back 495

1. Benzodiazepines
2. Alcohol
3. Opiates
4. Barbituates

Front 496

List three types of medications which can cause anxiety symptoms.

Back 496

1. SSRIs
2. Tricyclics
3. Antipsychotics

Front 497

What is the appropriate period of prescription of benzodiazepines for adjustment disorder?

Back 497

1-2 weeks surrounding the stressful event (e.g., trip, wedding, etc.)

Front 498

What is one disadvantage of Xanax (alprazolam)?

Back 498

It can trigger "mini-withdrawals" between doses and may make people feel worse and more dependent on the drug.

Front 499

What type of medication is best for long-term treatment of panic disorder?

Back 499

Antidepressants. Benzos (such as Xanax or Klonapin) can help, but can also be addictive.

Front 500

How are benzos used in the treatment of generalized anxiety disorder?

Back 500

On an as-needed basis to forestall acute anxiety, or on an on-going basis in conjunction with psychotherapy. However, there are many problems with this approach.

Front 501

What are some of the problems with using benzos in treating generalized anxiety disorder?

Back 501

High rates of failure to respond (25-35%), tolerance and dependence.

Front 502

What is the failure rate of benzos in treating generalized anxiety disorder?

Back 502

25-35%

Front 503

What type of medication is best for long-term treatment of generalized anxiety disorder?

Back 503

Antidepressants or Buspar (buspirone)

Front 504

What are four "other" anxiety disorders (besides adjustment disorder, panic disorder, and GAD) for which benzodiazepines can be useful?

Back 504

1. Social phobia
2. Specific phobia
3. OCD
4. PTSD

Front 505

How can benzodiazepines be used to treat sleep problems?

Back 505

Carefully and for a short-term, such as insomnia lasting less than seven days and precipitated by an acute stressor (e.g., a trip, the night before a test).

Front 506

What are two difficulties with using benzodiazepines to treat sleep problems?

Back 506

1. "rebound insomnia," wherein discontinuing use of the drug causes insomnia
2. benzodiazepines disrupt the normal sleep cycle and repress REM sleep-- upon the discontinuation of its use, REM rebound can cause vivid, disturbing dreams which also interfere with sleep.

Front 507

What are seven uses for benzodiazepines besides treating anxiety and sleep problems?

Back 507

1. Depression
2. Acute Mania (Klonapin)
3. akathisia ("restless leg syndrome")
4. Alcohol Withdrawal
5. anticonvulsants (Klonapin)
6. muscle relaxants
7. adjuncts in anesthesia (e.g, for a surgical procedure)

Front 508

What are six side effects of benzodiazepines?

Back 508

1. Sedation/drowsiness
2. Mild cognitive impairment
3. Amnesia
4. Ataxia (incoordination)--at high doses
5. Depression-- at high doses
6. Dangerous interactions with alcohol

Front 509

What is ataxia?

Back 509

Incoordination-- can be a side-effect of benzodiazepines.

Front 510

What are four possible side-effects of the interaction of benzodiazepines with alcohol?

Back 510

1. Severe drowsiness
2. Paradoxical disinhibition (Increased excitement, irritability, aggression, hostility and impulsivity, sometimes leading to attacks of rage)
3. Respiratory problems
4. Death

Front 511

What is paradoxical inhibition?

Back 511

Increased excitement, irritability, aggression, hostility and impulsivity, sometimes leading to attacks of rage.

Can be a side-effect of benzodiazepines.

Front 512

Can benzodiazepines lead to physiological and psychological dependence?

Back 512

Dear gods, yes.

Front 513

What are the features of the most addictive benzodiazepines?

Back 513

Rapid onset and short half-life, which leads to a mini-withdrawal and so increased use of the drug.

Front 514

What is the relationship of benzodiazepines to alcohol?

Back 514

They are "cross-tolerant," meaning that people who experience a tolerance for benzodiazepines also experience an increased tolerance for alcohol.

Also, benzodiazepines can reduce the symptoms of alcohol withdrawal.

Front 515

Define "cross-tolerant."

Back 515

People who experience a tolerance for one substance (e.g., benzodiazepines) also experience an increased tolerance for the other (e.g., alcohol).

Front 516

What are the three stages of benzodiazepine withdrawal?

Back 516

Stage one: tremors, sweating, agitation and increased autonomic reactions.
Stage Two: hallucinations, panic.
Stage Three: single or multiple grand mal seizures.

Overall: very dangerous, can be fatal, resembles alcohol withdrawal, people should never do it without doctor's advice.

Front 517

Describe four symptoms of stage one of benzodiazepine withdrawal.

Back 517

1. tremors
2. sweating
3. agitation
4. increased autonomic reactions.

Front 518

Describe two symptoms of stage two of benzodiazepine withdrawal

Back 518

hallucinations, panic

Front 519

Describe the symptoms of stage three of benzodiazepine withdrawal

Back 519

single or multiple grand mal seizures.

Front 520

Which are more dangerous, benzodiazepines or old-line barbituates?

Back 520

Old-line barbituates.

Front 521

How dangerous is a benzodiazepine overdose?

Back 521

Rarely fatal when taken alone; can be deadly when taken with alcohol or other CNS depressants.

Front 522

Describe four symptoms of chronic benzodiazepine overdose.

Back 522

1. Drowsiness
2. Ataxia (gross lack of coordination of muscle movements)
3. Slurred speech
4. Vertigo

Front 523

Describe five possible symptoms of acute benzodiazepine overdose.

Back 523

1. Lethargy
2. Confusion
3. Coma
4. Heart attack
5. Death

Front 524

What is ataxia?

Back 524

Gross lack of coordination of muscle movements. Associated with chronic benzodiazepine overdose.

Front 525

What five populations should probably not be prescribed benzodiazepines?

Back 525

1. The elderly
2. Those with liver problems
3. Those with a history of alcohol dependence
4. Those with a history of drug dependence
5. People who do not comply well with prescription directions

Front 526

List six anti-anxiety drugs/types of drugs

Back 526

1. Benzodiazepines
2. Buspar (buspirone)
3. Beta blockers
4. Non-benzodiazepine hypnotics such as
5. Antihistamines
6. Barbiturates

Front 527

What is the generic name of Buspar, and what kind of medication is it?

Back 527

buspirone.

A non-benzodiazepine anxiolytic.

Front 528

What is the brand name of buspirone, and what kind of medication is it?

Back 528

Buspar.

A non-benzodiazepine anxiolytic.

Front 529

What are the advantages and disadvantages of the anti-anxiety medication Buspar (buspirone)?

Back 529

Advantages: It is non-addictive, and does not cause sedation or cognitive impairment.
Disadvantages: It may require two to four weeks for a clinical response.

Front 530

What are three side-effects of the anti-anxiety medication Buspar (buspirone)?

Back 530

1. Headaches
2. Nausea
3. Dizziness

Front 531

For what disorder is the anti-anxiety medication Buspar (buspirone) most useful?

Back 531

Generalized anxiety disorder.

(It is less useful for panic disorder because it cannot be taken PRN.)

Front 532

Name a common beta-blocker

Back 532

Inderal (propranolol)

Front 533

What is the generic name of Inderal, and what kind of medication is it?

Back 533

propranolol

beta-blocker

Front 534

What is the brand name of propranolol, and what kind of medication is it?

Back 534

Inderal

Beta-blocker

Front 535

For what five problems are beta-blockers prescribed?

Back 535

1. Somatic manifestation of anxiety, especially social and performance anxiety
2. Drug-induced akathisia (feeling of inner restlessness and a compelling need to be in constant motion)
3. Lithium-induced tremor
4. Alcohol withdrawal
5. Heart and blood pressure problems

Front 536

What are eleven side effects of beta-blockers?

Back 536

1. Sexual dysfunction (impotence in up to 10% of male patients)
2. Dizziness
3. Drowsiness
4. Shortness of breath
5. Angina (chest pain)
6. Cold hands and feet
7. Difficulty sleeping
8. Nightmares

less commonly:
9. Depression
10. Anxiety
11. Thought-disturbance

Front 537

Are beta-blockers addictive?

Back 537

No, nor do they cause withdrawal.

Front 538

What is the result of a beta-blocker overdose?

Back 538

Problematic (difficulty breathing, shock, heart failure, coma, confusion, etc.)

Front 539

For what two symptoms can antihistamines be used as a treatment?

Back 539

1. Mild insomnia
2. Extra-pyrimidal symptoms

Front 540

What are three side effects of antihistamines?

Back 540

1. Sedation
2. Dizziness
3. Low blood pressure

Front 541

Name three antihistamines.

Back 541

1. Atarax (hydroxyzine chloride)
2. Vistaril (hydroxyzine pamoate)
3. Benadryl (diphenhydramine)

Front 542

Are barbituates commonly used in psychiatry, and why?

Back 542

Not any more-- they have strongly sedating effects, and are much more likely to cause addiction and lethal overdoses than benzodiazepines, with inferior therapeutic effects.

Front 543

What are three major categories of mood stabilizers?

Back 543

1. Lithium
2. "other"
3. Anticonvulsants

Front 544

What are three brand names for lithium carbonate?

Back 544

1. Eskalith
2. Eskalith CR
3. Lithane

Front 545

What are two brand names for lithium citrate?

Back 545

1. Cibalith-S
2. Lithobid

Front 546

What are two types of lithium?

Back 546

1. lithium carbonate (Eskalith, Eskalith CR, Lithane)
2. lithium citrate (Cibalith-S, Lithobid)

Front 547

What is the presumed mechanism of action of lithium?

Back 547

Largely speculative. Probably by stabilizing cell membranes, and so affecting a variety of neurotransmitters.

Front 548

What is the primary disorder for which lithium is used?

Back 548

Bipolar disorder

Front 549

What are six disorders which are treated with lithium?

Back 549

1. Bipolar disorder
2. Treatment-resistant depression
3. Schizophrenia (with antipsychotics)
4. Impulse-control disorders (e.g., intermittent explosive disorder)
5. Cyclothymia
6. Borderline Personality Disorder

Front 550

How long does it take for lithium to take effect?

Back 550

1-3 weeks for mania; 6-8 weeks for depression

Front 551

What combination of medication-types is best for bipolar disorder?

Back 551

For manic episodes: lithium + antipsychotic

For depressive episodes: lithium + antidepressant.

Over the long term, lithium has a prophylactic (preventative) effect, decreasing number and severity of episodes.

Front 552

What medication is useful to treat Schizoaffective Disorder, Bipolar Type?

Back 552

Lithium

Front 553

How often are lithium levels in the blood checked, to be sure that they are in therapeutic range without being toxic?

Back 553

Initially: every week.

Eventually: three to four times per year.

Front 554

What are twelve side effects of lithium?

Back 554

1. Fine hand tremor
2. Gastric distress
3. Weight gain
4. Polyuria (excessive passage of urine)
5. Polydipsia (increased thirst)
6. Fatigue
7. Mild cognitive impairment
8. Negative effects on the kidneys
9. Negative effects on the thyroid
10. Negative effects on the heart
11. Negative effects on the skin
12. Lithium toxicity

Front 555

What are the 9 symptoms of lithium toxicity?

Back 555

1. Vomiting
2. Abdominal pain
3. Severe diarrhea
4. Severe tremor
5. Ataxia (gross lack of coordination of muscle movements)
6. Coma
7. Seizures
8. Confusion
9. Irregular heart beat

Front 556

Does lithium cause tolerance, dependence or withdrawal?

Back 556

No.

Front 557

What are four contraindications for lithium use?

Back 557

1. Pre-existing heart disease
2. Thyroid disease
3. Renal damage
4. Pregnancy

Front 558

What two factors cause non-compliance with lithium use?

Back 558

1. Side-effects
2. The nature of bipolar disorder (tactfully put, PsychPrep!)

Front 559

What are three "other" mood stabilizers?

Back 559

1. Zyprexa (olanzipine), atypical antipsychotic
2. Klonopin (clonazepam), benzodiazepine
3. Risperidal (resperidone), atypical antipsychotic

Front 560

How is Zyprexa (olanzipine) used in treating bipolar disorder?

Back 560

For maintenance treatment

Front 561

How is Klonopin (clonazepam) used in treating bipolar disorder?

Back 561

For acute mania

Front 562

How is Risperidol (resperidone) used in treating bipolar disorder?

Back 562

For acute mania

Front 563

Name seven anticonvulsants used in treating bipolar disorder

Back 563

1. Tegretol (carbamazepine)
2. Neurontin (gabapentin)
3. Depakote (divalproex)
4. Topamax (topiramate)
5. Depakene (valproic acid)
6. Lamictal (lamotrigine)
7. Trileptal (oxcarbarzepine)

Front 564

What is the generic name of Tegretol, and what kind of medication is it?

Back 564

carbamazepine

anticonvulsant

Front 565

What is the generic name of Neurontin, and what kind of medication is it?

Back 565

anticonvulsant

gabapentin

Front 566

What is the generic name of Depakote, and what kind of medication is it?

Back 566

anticonvulsant

divalproex

Front 567

What is the generic name of Topamax, and what kind of medication is it?

Back 567

anticonvulsant

topiramate

Front 568

What is the generic name of Lamictal, and what kind of medication is it?

Back 568

anticonvulsant

lamotrigine

Front 569

What is the generic name of Trileptal, and what kind of medication is it?

Back 569

anticonvulsant

oxcarbazepine

Front 570

When are anticonvulsants used to treat bipolar disorder?

Back 570

When lithium does not work, or is contraindicated.

Front 571

When is Tegretol (carbamazepine) most effective for bipolar disorder than lithium?

Back 571

Rapid cycling or dysphoric manic episodes

Front 572

For what four mental disorders can anticonvulsants be effective?

Back 572

1. Bipolar disorder
2. Impulse control disorders (e.g., intermittent explosive disorder)
3. Depression
4. Some neurological chronic pain disorders, such as trigeminal neuralgia

Front 573

What is trigeminal neuralgia, and what can be effective in treating it?

Back 573

A neurological chronic pain disorder.

Anticonvulsants-- specifically, Tegretol (carbamazepine)

Front 574

Describe the side effects of Tegretol (carbamazepine).

Back 574

Like alcohol intoxication

Front 575

Describe the three side effects of the anticonvulsant Depakene (valproic acid).

Back 575

1. Gastrointestinal distress
2. Sedation
3. Tremor

Front 576

Do anticonvulsants cause withdrawal?

Back 576

No.

Front 577

Name four significant stimulants.

Back 577

1. Ritalin (methylphenidate)
2. Concerta (methylphenidate)
3. Adderall (amphetamine)
4. Provigil (modafinil)

Front 578

What are the seven types of stimulants (generic names)?

Back 578

1. amphetamine
2. destroamphetamines
3. Methylphenidate
4. dexmethylphenidate
5. phendimetrazine
6. pemoline
7. modafinil

Front 579

What is the generic name of Ritalin and what kind of medication is it?

Back 579

methylphenidate

stimulant

Front 580

What is the generic name of Concerta and what kind of medication is it?

Back 580

methylphenidate

stimulant

Front 581

What is the generic name of Adderall and what kind of medication is it?

Back 581

amphetamine

stimulant

Front 582

What is the generic name of Provigil and what kind of medication is it?

Back 582

modafinil

stimulant

Front 583

What disorder is treated with Provigil (modafinil)?

Back 583

Narcolepsy

Front 584

What is the presumed mechanism of action for stimulants?

Back 584

They work various ways to increase the level and effect of the catecholamines (epinephrine (adrenaline), norepinephrine (noradrenaline) and dopamine)

Front 585

What is the primary disorder treated with stimulants?

Back 585

ADHD in children

Front 586

How long does it take medication to be effective for ADHD?

Back 586

Two days.

Front 587

What are six conditions treated with stimulants?

Back 587

1. ADHD in children
2. Adult ADHD
3. Treatment-resistant depression
4. Treatment-resistant obesity
5. Narcolepsy
6. Chronic medically-debilitating conditions (e.g., AIDS, cancer)

Front 588

What are five major side effects of stimulants?

Back 588

1. Headaches
2. Insomnia
3. Loss of appetite
4. Gastrointestinal distress (nausea and stomachaches)
5. Temporarily suppress growth in children

Front 589

What are eleven possible side effects of stimulants?

Back 589

1. Loss of appetite
2. Gastrointestinal distress (nausea and stomachaches)
3. Liver damage (decreased appetite, fatigue, stomach fullness)
4. Increases in heart rate and blood pressure
5. Temporarily suppress growth in children
6. Movement disorders
7. Headaches
8. Insomnia
9. Irritability
10. Anxiety
11. Dysphoria

Front 590

What are three symptoms of liver damage caused by stimulants?

Back 590

1. decreased appetite
2. fatigue
3. stomach fullness

Front 591

What is a drug holiday?

Back 591

(No, not what you're thinking.)

Children taking stimulants going off the medication during weekends and summer vacations-- lets them compensate for growth suppression.

Front 592

Do stimulants cause psychological dependence?

Back 592

Yes-- they can lead to this and to drug abuse.

Front 593

Which stimulant does not have street value as an upper?

Back 593

Cylert (pemoline)

Front 594

Can stimulants cause physical dependence, tolerance, addiction, and physical withdrawal?

Back 594

Yes.

Front 595

Treating what disorder with stimulants is particularly likely to lead to tolerance of the drug?

Back 595

Narcolepsy

Front 596

What are five possible symptoms of stimulant withdrawal?

Back 596

1. Increased appetite
2. Weight gain
3. Increased sleep
4. Decreased energy
5. (sometimes) paranoid symptoms

Front 597

Is stimulant overdose fatal?

Back 597

Rarely-- the therapeutic dose of the drug is *much* lower than the lethal one.

Front 598

What are seven symptoms of stimulant overdose?

Back 598

1. Agitation
2. Suicidal thoughts
3. Dysphoria
4. Hallucinations
5. Confusion
6. Delusion
7. Chest pain

Front 599

What psychotropic medications are most often used as drugs of abuse?

Back 599

Psychostimulants.

Front 600

What are the two primary divisions of the nervous system?

Back 600

Central nervous system (CNS)-- Brain and spinal cord
Peripheral nervous system (PNS)-- nerves that connect the CNS to the rest of the body. Composed of the autonomic nervous system (ANS) and the somatic nervous system (SNS)

Front 601

What are the two components of the peripheral nervous system?

Back 601

1. autonomic nervous system (ANS)--involuntary activity
2. somatic nervous system (SNS)--voluntary activity

Front 602

What does the somatic nervous system do?

Back 602

Receives information from sensory organs; sends signals to skeletal muscles to move.

Front 603

What does the autonomic nervous system do?

Back 603

Maintains homeostasis-- heartrate, breathing, digestion, etc.

Front 604

What are the two components of the autonomic nervous system?

Back 604

Sympathetic and parasympathetic.

Front 605

How many neurons are there in the human brain?

Back 605

More than 100 billion.

Front 606

What are the three components of the nerve?

Back 606

Dendrites
Axon
Cell body (soma)

Front 607

What is an action potential?

Back 607

An electrical charge which travels through the cell body of a neuron and down the length of the axon, where it triggers the release of neurotransmitters from the terminal buttons.

Front 608

What is the "all or none" law?

Back 608

An action potential occurs-- the nerve fires-- or it doesn't. There is no variation in how strongly the nerve fires (more intense sensations are caused by *more* nerves firing, not any variation in the firing strength of each nerve).

Front 609

What two processes can prevent neurotransmitters from reaching the dendrites of the next neuron?

Back 609

1. Reuptake
2. Enzymatic degradation (enzymes break down neurotransmitters into other substances)

Front 610

How can one increase the amount of neurotransmitter present? (two ways)

Back 610

1. Inhibit reuptake
2. Inhibit enzymatic degradation

Front 611

In which nervous systems can acetylcholine (ACH) be found?

Back 611

Both peripheral (somatic, autonomic--> parasympathetic) and central.

Front 612

What does acetylcholine (ACH) do in the somatic nervous system?

Back 612

Essential for voluntary movement; released by efferent nerves that connect to skeletal muscles.

Front 613

What does acetylcholine (ACH) do in the parasympathetic nervous system?

Back 613

Control of the heartbeat and sweat glands.

Front 614

What does acetylcholine (ACH) do in the central nervous system?

Back 614

Affects parts of the brain that mediate learning and memory.

Front 615

What disease is associated with a deterioration of neurons that secrete acetylcholine (ACH) and ACH receptors in the hippocampus and cortex?

Back 615

Alzheimer's.

Front 616

Is acetylcholine usually excitatory or inhibitive?

Back 616

Can be both.

Front 617

What nervous systems are norepinephrine/noradrenaline found in, and what does it do there?

Back 617

Central nervous system (brain)

Mediates functions such as arousal, sleep & eating.

Sympathetic nervous system. (Peripheral; autonomic)

Internal changes that occur in response to stressors.

Front 618

What disorder is linked to a decrease in norepinephrine?

Back 618

Depression

Front 619

What two disorders are linked to an increase in norepinephrine?

Back 619

Schizophrenia
Mania

Front 620

What is the catecholamine hypothesis?

Back 620

Depression is due to a deficiency in norepinephrine; mania is due to an excess.

Front 621

Where is dopamine found?

Back 621

In the brain; parts which control voluntary movement.

Front 622

What is another word for neuroleptics, and what are they?

Back 622

phenothiazines.

Medications which block dopamine at receptor sites, to treat schizophrenia.

Front 623

What are phenothiazines?

Back 623

Neuroleptics; medications which block dopamine at receptor sites, to treat schizophrenia.

Front 624

Where is serotonin found?

Back 624

Multiple parts of the brain; also the intestinal wall and large constricted blood vessels.

Front 625

What are two disorders linked to high levels of serotonin?

Back 625

1. Schizophrenia
2. Possibly anorexia

Front 626

What type of neurotransmitter is glutamate?

Back 626

Excitatory.

Front 627

Where is glutamate found?

Back 627

In all cells. Especially in the hippocampus, neocortex, and other parts of the brain.

Front 628

With what functions is glutamate associated?

Back 628

Learning and memory.

Front 629

What are five possible results of excessive glutamate?

Back 629

excitotoxicity; excessive stimulation of nerve cells.

Linked to epilepsy, strokes, and post-traumatic damage.

May also play a role in neurodegenerative disorders (e.g., Parkinsons, Huntingtons, & Alzheimer's)

Front 630

What does GABA stand for?

Back 630

Gamma Aminobutyric acid

Front 631

How do barbituates work?

Back 631

Increasing the activity of GABA.

Front 632

What is hemipalegia?

Back 632

Paralysis on one half the body.

Front 633

What is paresis?

Back 633

Slight or partial paralysis

Front 634

What is paresthesia?

Back 634

Abnormal sensations such as tingling, numbness or burning.

Front 635

What are three causes of ataxia (slurred speech, severe tremors, and a loss of balance)?

Back 635

1. Damage to the cerebellum.
2. Alcohol
3. Anti-anxiety medications (barbituates and benzos)

Front 636

What is the extrapyrimidal system? (What six components are connected via it?)

Back 636

The nerve cells, nerve tracts and pathways that connect the cerebral cortex, basal ganglia, thalamus, cerebellum, reticular formation, and spinal neurons. The EPS helps regulate reflex movements such as balance and walking.

Front 637

What six structures are connected by the extrapyrimidal system?

Back 637

1. cerebral cortex
2. basal ganglia (includes substantia nigra, caudate nucleus)
3. thalamus
4. cerebellum
5. reticular formation
6. spinal neurons

Front 638

What is the function of the extrapyrimidal system?

Back 638

Helps regulate reflex movements such as balance and walking.

Front 639

What is the substantia nigra?

Back 639

A brain structure located in the mesencephalon (midbrain) that plays an important role in reward, addiction, and movement. Part of the extrapyrimidal system.

Front 640

What brain structures and neurotransmitters are involved in Parkinson's disease?

Back 640

Basal ganglia (includes substantia nigra)

Lowered dopamine.

Front 641

What are the chemical changes correlated with Huntington's chorea, and what are four of its symptoms?

Back 641

1. Deficiency of GABA; excessive levels of dopamine in the basal ganglia.

2. Rapid involuntary jerking movements; anxiety, depression, and irritability.

Front 642

What brain abnormalities are linked to Tourettes' syndrome?

Back 642

Abnormalities in basal ganglia and frontal lobes.

Front 643

What brain abnormalities are linked to autism?

Back 643

Abnormalities in basal ganglia and frontal lobes.

Front 644

What brain abnormalities are linked to OCD?

Back 644

Abnormalities in basal ganglia and frontal lobes.

Front 645

What brain abnormalities are linked to ADHD?

Back 645

Abnormalities in basal ganglia, cerebellum and frontal lobes.

Front 646

Where is the reticular formation?

Back 646

The core of the brainstem running through the mid-brain, pons and medulla. The ascending reticular activating system connects to areas in the thalamus, hypothalamus, and cortex, while the descending reticular activating system connects to the cerebellum and sensory nerves.

Front 647

With what three things is the reticular formation associated with?

Back 647

1. Sleep/arousal
2. Movement, especially unconscious
3. Sensations of touch, pain and temperature

Front 648

What does the reticular activating system do?

Back 648

Serves as a gateway for sense-information, allowing selective activation of the brain. Produces alterations in arousal.

Front 649

What does the hypothalamus do?

Back 649

Maintains homeostasis.Five Fs (feeding, fucking, fighting, fleeing, fever (temperature)). Controls circadian rhythms.

Front 650

What controls your circadian rhythm?

Back 650

Hypothalamus.

Front 651

What does the thalamus do?

Back 651

Acts as a relay station for sensory information-- all senses except for smell (which just goes directly to the limbic system) go to the thalamus before the cortex. Includes pain and temperature.

Front 652

What are the four parts of the limbic system?

Back 652

1. Amygdyla
2. Septum
3. Hippocampus
4. some portions of the Thalamus

Front 653

What does the amygdyla do?

Back 653

Integrates and directs emotional development; attaches emotional significance to information coming in through the senses. Can trigger an emotional reaction to a stimulus before it can be interpreted by the cortex.

Front 654

What is the cause and four symptoms of Kluver-Bucy Syndrome?

Back 654

Bilateral lesions of the amygdyla and temporal lobes.

1. Emotional blunting
2. Prominent oral exploratory behavior.
3. Altered dietary practices
4. Inappropriate sexual activity

Front 655

What does the septum do?

Back 655

Inhibits emotionality.

Front 656

What does the septum do?

Back 656

Inhibits emotional activity. Also, it is a pleasure center.

Front 657

What does the hippocampus do?

Back 657

Memory processing and memory consolidation. Transfers information from short-term to long-term memory. Explicit memory.

Front 658

What two disorders are linked to degeneration of the hippocampus?

Back 658

1. Alcoholism
2. Alzheimer's disease

Front 659

What does contralateral representation mean?

Back 659

The left side of the brain controls the right side of the body and vice versa.

Also, what is seen by the right eye is processed by the left occipital lobe, etc. (True for all senses except smell.)

Front 660

What is lateralization of functions?

Back 660

= cerebral dominance. One side of the brain is dominant.

Front 661

What is the last part of the brain to develop?

Back 661

The frontal lobe.

Front 662

What does the prefrontal association area do?

Back 662

Executive functioning (planning, goal-setting, organization of ideas.)

Front 663

What is hypofrontality? With what two disorders is it associated?

Back 663

Reduced activity in the prefrontal cortex, linked to schizophrenia and ADHD.

Front 664

What does damage to Broca's area cause?

Back 664

Expressive aphasia

Front 665

What is hypofrontality, and with what two disorders is it associated?

Back 665

Reduced activity in the prefrontal cortex.

1. Schizophrenia
2. ADHD

Front 666

What are six characterstics of "frontal lobe pesonality"?

Back 666

1. Depression
2. Apathy
3. Irritability
4. Inability to plan and focus attention
5. Poor judgment
6. Lack of control over sexual and other impulses

Front 667

What does damage to the right frontal lobe cause?

Back 667

Happy indifference, jocularity

Front 668

What does damage to the temporal lobe cause?

Back 668

Auditory agnosia-- he inability to recognize familia sounds, despite adequate hearing.

Front 669

What does damage to Wernicke's area cause?

Back 669

Receptive aphasia: cannot understand spoken language, name objects. Speaks normally but nonsensically. Unaware of deficit.

Front 670

What is conduction/association aphasia?

Back 670

Damage to the fibers that connect Wernicke's to Broca's area. No effect on comprehension; normal-sounding but senseless speech.

Front 671

Is Wernicke's area associated wth long-term memory?

Back 671

Why, yes, yes it is.

Front 672

What is the result of bilateral lesions of the tempoal lobe, hippocampus and amygdyla?

Back 672

Amnesia.

Front 673

What are five possible results of damage to the parietal lobe?q

Back 673

1. Tactile agnosia (inability to identify objects by touch)
2. Impaired spatial orientation
3. Left/right confusion
4. Prosopagnosia (inability to recognize faces)
5. Apraxia (difficulties with limb and full body movememtn)

Front 674

What is tactile agnosia?

Back 674

inability to identify objects by touch

Front 675

What is prosopagnosia?

Back 675

inability to recognize faces

Front 676

What is apraxia?

Back 676

difficulties with limb and full body movememtn

Front 677

What is the James-Lange Theory of Emotion?

Back 677

We experience bodily feelings (autonomic arousal) and deduce our emotions from these.

Front 678

What is the Cannon-Bard Theory of Emotion?

Back 678

emotions lead to physiological changes

Front 679

When does stage 2 of sleep begin?

Back 679

After a few minutes of stage 1.

Front 680

What is the Two-Factor Theory of Emotion?

Back 680

we deduce feelings from our situation.

Front 681

What is the cognitive/physical state associated with theta waves?

Back 681

Deep relaxation.

Front 682

What is the cognitive/physical state associated with delta waves?

Back 682

Deep sleep.

Front 683

What is another name for REM sleep, and why is it called that?

Back 683

Paradoxical sleep.

Because during it, the activity of the brain's neurons is quite similar to that during waking hours, but the body is paralyzed due to atonia

Front 684

Describe the sleep of a person with depression.

Back 684

Enters REM sleep more quickly, and spend a greater percentage of time asleep in REM, decreased percentage of slow wave sleep.

Front 685

As we age, do we spend shorter intevals in REM sleep, or do we enter REM sleep less often?

Back 685

Both.

Front 686

What is another name for a partial seizure?

Back 686

Focal seizure.

Results in convulsions in only part of the body.

Front 687

What are the two main types of neuroimaging techniques?

Back 687

Structural (anatomical structures: CAT scans, MRIS.

and functional (patterns of cerebral blood or metabolic activity-- PET scans)

Front 688

What type of neuroimaging technique is an MRI?

Back 688

Structural-- looks at anatomical structures o examine head traumas, tumors, strokes, etc.

Front 689

What type of neuroimaging technique is a CAT scan?

Back 689

Structural-- looks at anatomical structures o examine head traumas, tumors, strokes, etc.

Front 690

What type of neuroimaging technique is a PET scan?

Back 690

Functional-- looks at patterns of cerebral blood or metabolic activity