Behavioral Week 3 +4 Flashcards

1
Q

What is the definition of Obesity?

A
  • More than 20% over ideal weight

- BMI >30

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2
Q

2 Genetic mutations associated w/ obesity

A
  • Leptin receptor

- Melanocortin 4 receptor

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3
Q

What drug class can cause weight gain?

A

Antipsychotics (D2 receptor, 5HT2c blockade –> increased prolactin)

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4
Q

Amphetamine mechanism for obesity

A

Decrease appetite

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5
Q

Orlistat mechanism:

A

Lipase inhibitor

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6
Q

Topiramate/Phentermine combo mechanism:

A

Improves carb metabolism, less gluconeogenesis, appetite suppressant

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7
Q

Naltrexone/Bupropion combo mechanism:

A

Dampens reward of eating, appetite suppressant

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8
Q

Lorcaserin mechanism:

A

5HT2c receptor stimulator –> increase metabolism, lessen tendency to store fat, improve leptin sensitivity?

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9
Q

Anorexia Nervosa DSM-5 Criteria

A
  • Refusal to maintain 85% of typical weight
  • Restricting energy intake
  • Fear of gaining
  • Body dysmorphism
  • Restricting vs Binge/Purge type
  • Severity based on BMI
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10
Q

Age and Gender pattern in Anorexia:

A
  • Start mid-teen to 20s

- Female > male (20:1)

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11
Q

What is lanugo hair?

A
  • Fine, white hair

- Seen with anorexia

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12
Q

Bulimia Nervosa DSM-5 Criteria

A
  • Recurrent binge eating = eating a lot in discrete period of time disproportionate to typical eating
  • Purging vs. non-purging type
  • 1x/week for 3+ months
  • Compensatory behaviors necessary for diagnosis
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13
Q

Age and Gender pattern in Bulimia:

A
  • Later onset than anorexia

- Female > male (10:1)

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14
Q

Bulimia characteristics compared to Anorexia:

A
  • Greater prevalence
  • More personality disorder
  • More substance abuse
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15
Q

What are physical symptoms of Bulimia?

A
  • Poor dentition, enamel loss, cavities
  • Abraided knuckles = Russell’s sign
  • Salivary enlargement
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16
Q

Name for milder versions of Anorexia and Bulimia

A

Mild anorexia = Avoidant/Restrictive Food Intake Disorder

Mild bulimia: Binge Eating Disorder

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17
Q
Pharmacotherapy can be used for what eating disorder?
What drug class is most commonly used?
A
  • Bulimia Nervosa

- SSRIs

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18
Q

What is Capgras Delusion?

A

Thinks someone has been replaced by an imposter

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19
Q

What is Fregoli Delusion?

A

Thinks different people are a single person who changes apperance or is in disguise

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20
Q

What is Vampirism?

A

Thinks that oneself is a vampire

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21
Q

What is Lycanthropy?

A

Thinks that oneself is a werewolf

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22
Q

Psychopathic Cannibalism is associated with what disorders?

A
  • Antisocial personality
  • Psychopathy
  • Sociopathy
  • with delusions…
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23
Q

What is Shared Delusion Disorder?

Most common version?

A

-1st person has a psychotic symptom and passes it on to others who develop the symptoms (not necessarily psychotic)

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24
Q

What is conversion disorder?

A

-Neurologic disorder induced by stress

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25
Q

What is Cotard’s Delusion

A

Thinks that oneself is dead, does not exist, or is missing organs

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26
Q

What is Morgellons/Delusional Parasitosis?

A

Believes they are infested, and can see or feel parasites in or on them

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27
Q

What is Erotomanic Delusions?

A

Thinks another person, usually a stranger, is in love with him/her

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28
Q

What is the neurobiologic basis of Delusions?

A

Too much DA activity in Mesolimbic area like in Schizophrenia

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29
Q

Normal Age-associated cognitive changes

A
  • Difficulty retreiving words and names
  • Slower processing speed
  • Difficulty sustaining attention
  • More effort to learn
  • No functional impairment
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30
Q

Mild Cognitive Impairment definition

A
  • Memory complain corroborated by an informant
  • Objective memory impairment for age and education
  • Preserved general cognition
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31
Q

What is Amnestic MCI

A
  • Memory loss not meeting criteria for dementia
  • But 10-15% progression to AD
  • Earliest phase of AD?
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32
Q

Chromosomes and Genes associated w/ Early-Onset AD

A

1–Presenilin 2
14–Presenilin 1
21–Amyloid Precursor Protein (APP)

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33
Q

Chromosome and gene associated w/ Late-Onset AD

A

19–ApoE4 gene

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34
Q

Neuropathologic findings of AD:

A
  1. gross cerebral atrophy
  2. B amyloid plaques
  3. Amyloid angiopathy
  4. Neurofibrillary tangles and neuropil threads
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35
Q

Enzymes that cause B-amyloid monomers

A

Beta-secretase and Gamma-secretase

36
Q

What is normal and non-normal products of APP cleavage?

A
Normal = AB40
Non-normal = AB42
37
Q

1st and 2nd Greatest risk factor for AD

A
  1. age

2. APOE e4 allele

38
Q

What stain do you use and what do you see in looking for B-amyloid?

A
  • Congo Red stain

- Apple-green birefringence

39
Q

What happens to hyperphosphorylated tau?

A
  • Dissociates from microtubules
  • Assembles to form paired helical filaments (PHFs)
  • PHFs bundle together to form NFTs
40
Q

Important aspects of FTLD

A
  • 2 most common =Tau and TDP
  • Earlier onset than AD
  • Gross observation = knife-edge
  • Pick bodies (tau)
41
Q

Pick’s Disease Clinical Differentiation from AD

A
  • Early social inappropriateness
  • Emotional blunting
  • Loss of insight
  • Later memory loss
42
Q

How do AChE Inhibitors work in AD?

A
  • AD = basal nucleus of Meynert degeneration –> ACh deficiency
  • AChE Inhibitors prevent degeneration to slow progression of memory loss
43
Q

Mechanism of Memantine in AD?

A

-Glutamate NMDA receptor blocker

44
Q

Where do hypertensive disease infarcts most likely to affect?

A

Basal ganglia and internal capsule

45
Q

What is a Lewy body?

A

Intracellular fibriller deposits of a-synuclein

46
Q

2 Most common Lewy body syneuclienopathies:

A
  1. Parkinson’s

2. Dementia w/ Lewy bodies

47
Q

Location where disease begins in Synucleinopathies:

A

Parkinson = substantia nigra

Lewy body Dementia = cortex

48
Q

Dementia w/ visual hallucinations is pathognomonic for:

A

Dementia of Lewy Body

49
Q

What drugs to avoid in Lewy Body Dementia? Why?

A
  • Antipsychotics

- Increased sensitivity

50
Q

Scoring of MMSE:

A

Normal = 30-27
Mild = 20-27
Moderate=10-20
Severe =

51
Q

What are the 5 ADLs?

A
Dressing
Eating
Ambulating
Toileting
Hygiene
52
Q

What are 5 Instrumental ADLs?

A
Shopping
Housekeeping
Accounting
Food preparation
Transportation
53
Q

What is psychic determinisim?

A

Everything (event/symptom) has meaning

54
Q

What is in the Topographic model of the mind?

A

Consciousness = currently aware
Pre-conscious = easily recalled
[Repression barrier]
Unconscious = repressed thoughts and feelings

55
Q

What are the psychosexual stages of development in order?

A
  1. Oral - birth - 1.5
  2. Anal - 1.5-3
  3. Phallic - 3-5
  4. Latency - 6-adolescence
  5. Gential - adolescence-adult
56
Q

What are 3 parts of the structural model of the mind?

A
  1. Id - “child”
  2. Ego and ego defense systems - “adult”, purpose
  3. Superego - “parent”, conscience
57
Q

When and how does superego start?

A
  • At age 5

- Start with being taught

58
Q

What are Level 1 Ego Defense Mechanisms?

A

“Psychotic” -

  1. Delusional projection
  2. Psychotic denial
  3. Distortion
59
Q

What are Level 2 Ego Defense Mechanisms?

A

“Immature”

  1. Projection
  2. Somatization
  3. Acting Out
  4. Splitting
60
Q

What are Level 3 Ego Defense Mechanisms?

A

“Neurotic”

  1. Denial
  2. Displacement
  3. Dissociation
  4. Identification
  5. Intellectualization
    - -Isolation of Affect
    - -Rationalization
  6. Reaction formation
    - -Regression
    - -Undoing
61
Q

What are Level 4 Ego Defense Mechanisms?

A

“Mature”

  1. Altruism
  2. Sublimation
  3. Anticipation
  4. Suppression
  5. Humor
62
Q

What is the most common defense mechanism?

A

Denial

63
Q

Stockholm syndrome is an example of what defense mechanism?

A

Identification

64
Q

What is the concept of transference?

A

Transfer relationships (feelings) from past to current relationships

65
Q

What defense mechanism is most commonly seen in Manics?

A

Distortion

66
Q

Woman who sees everything as super awesome one day, and then all bad the next.
What defense mechanism? Associated w/ what personality disorder?

A
  • Splitting

- Borderline Personality Disorder

67
Q

Your boss tells you that you did something wrong even though you didn’t. You have horrible road rage on the drive home.
What defense mechanism?

A

Displacement

68
Q

After a car accident that kills the driver, the surviving passenger is interviewed, but claims she remembers nothing.
What defense mechanism?

A

Dissocation

69
Q

Difference between Isolation of Affect and Rationalization defense mechanisms

A

Isolation of affect is understanding without experiencing feelings, while rationalization is using reasonable accounts to explain away negative feelings

70
Q

I say I love studying even though I don’t

What defense mechanism?

A

Reaction formation

71
Q

Whenever JoeBob has an inclination to rob a bank, he instead plays GTA.
What defense mechanism?

A

Sublimation

72
Q

Definition of Acute vs. Chronic pain

A

Acute = 6 months

73
Q

Symptoms of Chronic regional Pain Syndrome

A

Limb is cold, red, muscle wasting, nail changes

74
Q

What neurotransmitter is responsible for neuropathic pain?

A

Glutamate – long term potentiation remembers inflammatory pain –> neuropathic pain

75
Q

What kind of pain does anti-epileptics treat?

A

Neuropathic pain – Na or Ca channel blocker, some are Glutamate blockers

76
Q

What mechanism of antidepressants treats neuropathic pain?

A

NRI mechanism

77
Q

What is the Hawthorne effect?

A

Improvement as a result of receiving attention

78
Q

Behavioral therapy is based on what theory and what techniques?

A
  • Learning theory

- Classical and operant conditioning

79
Q

What is Stimulus Generalization

A

Associating similar stimuli to the conditioned stimulus

80
Q

Difference between punishment and negative reinforcement

A

Punishment = weakens behavior

Negative reinforcement = strengthens behavior

81
Q

Age and gender distribution of Somatoform Disorders

A
  • Higher incidence in women

- Starts early adulthood

82
Q

Somatization Disorder DSM-5 Criteria

A
  • 4+ Pain issues
  • Onset before 30
  • Chronic symptoms, complete remission rare
  • Unconscious, no secondary gain
83
Q

Hypochondriasis requires symptoms to persist for ___

A

6 months

84
Q

What antidepressant to use for smoking cessation? Mechanism?

A

Bupropion – Block reuptake of NE and DA

85
Q

What nicotine receptor agonist to give for smoking cessation?
Mechanism?

A

Varenicline – partial agonist