ADHD

Question 1

Working memory describes

Answer 1

what is actively being considered at any moment

Question 2

Working memory is associated with

Answer 2

the prefrontal cortex and the parietal lobes

Question 3

Working memory is modulated by the catecholamines:

Answer 3

dopamine (DA) and norepinephrine (NE).

Question 4

Why are adolescents so impulsive and prone to taking risks?

Answer 4

One possible explanation is that the frontal cortex has not yet matured

Question 5

Problems with selective attention are believed to be linked to inefficient information processing in the

Answer 5

dorsal anterior cingulate cortex (dACC)

Question 6

problems with sustained attention are linked to inefficient information processing in the

Answer 6

dorsolateral prefrontal cortex (DLPFC).

Question 7

Hyperactivity may be modulated by the

Answer 7

prefrontal motor cortex

Question 8

impulsivity may be modulated by the

Answer 8

orbitofrontal cortex (OFC).

Question 9

. Sustained attention is hypothetically modulated by

Answer 9

a cortico-striato-thalamo-cortical (CSTC) loop

Question 10

Sustained attention is involves

Answer 10

involves the dorsolateral prefrontal cortex (DLPFC) projecting to the striatal complex

Question 11

Inefficient activation of this can lead to difficulty following through or finishing tasks, disorganization, and trouble sustaining mental effort?

Answer 11

DLPFC (Dorsolateral prefrontal cortex)

Question 12

Inefficient activation of this can result in symptoms such as paying little attention to detail, making careless mistakes, not listening, losing things, being distracted, and forgetting things

Answer 12

dACC dorsal anterior cingulate cortex

Question 13

Impulsivity is associated with?

Answer 13

a cortico-striato-thalamo-cortical (CSTC) loop that involves the orbitofrontal cortex (OFC), the striatal complex, and the thalamus.

Question 14

These are examples of what ADHD symptom? talking excessively, blurting things out, not waiting one’s turn, and interrupting.

Answer 14

Impulsivity

Question 15

Motor activity, such as hyperactivity and psychomotor agitation or retardation, can be modulated by

Answer 15

a cortico-striato-thalamo-cortical (CSTC) loop from the prefrontal motor cortex to the putamen (lateral striatum) to the thalamus and back to the prefrontal motor cortex

Question 16

If stimulation at alpha-2A and D1 receptors is too low, all incoming signals are the same, making

Answer 16

it difficult for a person to focus on one single task (unguided attention).

Question 17

If stimulation is too high (right side) at alpha-2a and D1, incoming signals get jumbled as additional receptors are recruited, resulting

Answer 17

in the misdirection of attention.

Question 18

ADHD is an out-of-tune

Answer 18

prefrontal cortex

Question 19

Alterations within the orbitofrontal cortex (OFC) are hypothesized to lead to

Answer 19

problems with impulsivity or hyperactivity.

Question 20

Inadequate tuning of the DLPFC or the dACC can respectively lead to

Answer 20

sustained or selective attentive symptoms

Question 21

aberrations in the dorsolateral cognitive network have been observed in children with problems of

Answer 21

sustained attention.

Question 22

Salience-provoked phasic firing will lead to bursts of DA release, and when this happens in a controlled manner it can

Answer 22

reinforce learning and reward conditioning, which can provide the motivation to pursue naturally rewarding experiences

Question 23

When the salience-provoked phasic firing that leads to bursts of DA release is hijacked

Answer 23

reward circuitry can be hijacked, and impulses are followed by the development of uncontrolled compulsions to seek drugs.

Question 24

What are the two types of agents that will be hypothetically beneficial in patients with ADHD by bringing prefrontal activity back to optimal level.

Answer 24

Agents that can lead to (1) increased release of these two neurotransmitters, or (2) increased tonic firing of these neurons

Question 25

How does pruning relate to the potential development of ADHD

Answer 25

Incorrect pruning that occurs around 6 or 7 may reduce the development of executive function. This is the age many kids are diagnosed with ADHD.

Question 26

Parietal lesions can cause a neglect syndrome in which patients

Answer 26

ignore objects, people, and even parts of their body to one side of the center of gaze.

Question 27

Inconsistencies in performance, responding too fast or too slow, and procrastination are behaviors that may be impaired due to

Answer 27

temporal processing deficits

Question 28

What tends to have a smaller volume in those with ADHD?

Answer 28

Cerebellum volume

Question 29

Most stimulants act by enhancing

Answer 29

neuronal excitation

Question 30

At usual doses Amphetamines

Answer 30

increase wakefulness and alertness, reduce fatigue, elevate mood, and augment self-confidence and initiative. Euphoria, talkativeness, and increased motor activity are likely. Task performance that had been reduced by fatigue or boredom improves.

Question 31

How do amphetamines affect appetite, respirations, and pain?

Answer 31

decrease appetite, stimulate respirations, suppress pain response

Question 32

By a mechanism that is not understood, amphetamines can enhance the

Answer 32

analgesic effects of morphine and other opioids

Question 33

Norepinephrine acts in the heart to

Answer 33

increase heart rate, atrioventricular conduction, and force of contraction.

Question 34

. Excessive cardiac stimulation

Answer 34

can cause dysrhythmias. In blood vessels, NE promotes constriction. Excessive vasoconstriction can cause hypertension

Question 35

Adverse effects of stimulants

Answer 35

weight loss, insomnia restlessness, and cardiovascular effects

Question 36

Excessive amphetamine use can result in

Answer 36

paranoid psychosis, characterized by hallucinations and paranoid delusions. Amphetamine-induced psychosis looks very much like schizophrenia

Question 37

If withdrawal of amphetamines does not immediately remove psychosis what should be suspected

Answer 37

latent schizophrenia

Question 38

Acute Toxicity in amphetamines

Answer 38

Overdose produces dizziness, confusion, hallucinations, paranoid delusions, palpitations, dysrhythmias, and hypertension. Death is rare.

Question 39

Fatal overdose is associated with

Answer 39

convulsions, coma, and cerebral hemorrhage.

Question 40

In addicts abusing methamphetamines they are finding higher incidences of

Answer 40

Parkinson’s disease

Question 41

ADHD improvement with stimulants are generally

Answer 41

short term

Question 42

Amphetamines work by

Answer 42

reuptaken into the DA terminal andpackaged into vesicles, displacing DA

Question 43

Methylphenidate basically freezes

Answer 43

the transporter in time, preventing DA reuptake and thus leading to increased synaptic availability of DA.

Question 44

Unlike amphetamine, methylphenidate is

Answer 44

not itself taken up into the DA terminal via the transporter.

Question 45

Treatment with a selective alpha-2A agonist would lead to

Answer 45

increased signal via direct stimulation of postsynaptic receptors, resulting in increased ability to sit still and focus.

Question 46

Atomoxetine

Answer 46

Therapeutic effects without abuse potential

NE reuptake blocker in nucleus accumbens

Question 47

Guanfacine

Answer 47

Prefrontal cortex, not nucleus accumbens

Highly selective for alpha-2A

Question 48

Clonidine

Answer 48

Prefrontal cortex, not nucleus accumbens
Less alpha-2A selective than guanfacine
More sedation and hypotension
Off label for ADHD