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Sem 4 - Nervous System > Anxiety, OCD > Flashcards

Anxiety, OCD Flashcards

1
Q

What is the stress response made up of?

A

Limbic system

Limbic-hypothalamo-pituitary-adrenal axis

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2
Q

What is the limbic system made up of?

A

Hippocampal formation

Amygdala

Prefrontal cortex

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3
Q

What is the hippocampus?

A

Curved piece of cortex

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4
Q

Where is the hippocampus located?

A

Medial surface of temporal lobe

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5
Q

How does the hippocampus relate to the ventricular system?

A

Floor to temporal horn of lateral ventricle

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6
Q

What are the parts of the hippocampus?

A

Subiculum

Hippocampus proper

Dentate gyrus

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7
Q

What is the amygdala?

A

Collection of nuclei

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8
Q

Where is the amygdala located?

A

Roof of lateral ventricle

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9
Q

What are the inputs to the amygdala?

A

Sensory information

Brainstem

Thalamus

Cortex

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10
Q

What are the outputs of the amygdala?

A

Brainstem

Hypothalamus

Cortex

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11
Q

What are the functions of the amygdala?

A

Drive related behaviours, processing of associated emotions

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12
Q

What are the functions of the prefrontal cortex?

A

Modulators effect on processes associated with the hypothalamus

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13
Q

What does a prolonged stress response cause?

A

Continued cortisol secretion

  • muscle wastage
  • suppression of immune system
  • hyperglycaemia
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14
Q

What is anxiety?

A

Feeling of nervousness or unease about something with an uncertain outcome

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15
Q

What are the signs and symptoms of anxiety?

A

Palpitations

Sweating

Trembling

Dry mouth

Nausea

Dizziness, light-headedness

Difficulty breathing

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16
Q

What are the types of anxiety disorders?

A

Generalised anxiety disorder

Panic disorder

Phobias

Obsessive compulsive disorder

Post-traumatic stress disorder

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17
Q

What is the pathophysiology of anxiety?

A

GABA levels decreased in cortex in patients with panic disorder

18
Q

How is anxiety treated?

A

Selective serotonin reuptake inhibitors

Pregabalin

Cognitive behavioural therapy

19
Q

How do selective serotonin reuptake inhibitors treat anxiety?

A

Increased levels of serotonin
Increased stimulation of serotonin receptors in hippocampus
Leads to neuroprotection

20
Q

What is neuroprotection?

A

Refers to a preservation of neuronal structure and function

21
Q

How does cognitive behavioural therapy treat anxiety?

A

Look at trigger, thoughts, emotions, behavioural and physical reaction of patient’s anxiety together with the patient

22
Q

How does pregabalin treat anxiety?

A

Pregabalin is a GABA analogue
Increased stimulation of GABA receptors in the cortex
Increased inhibition of neurones

23
Q

Why are benzodiazepines not used to treat anxiety?

A

Addictive, dangerous in overdose

24
Q

What are the functions of the hippocampus?

A

Memory

Expressions of emotion

25
Q

What is an obsession?

A

Thought that persists and dominates an individual’s thinking
Even though they are aware that the thought is entirely without purpose, or is beyond the point of relevance and usefulness

26
Q

What is a compulsion?

A

Obsessional motor acts

Obsessional mental acts

27
Q

What causes a compulsion?

A

Obsessional impulses that lead directly to the action

Obsessional mental image that leads to the action

28
Q

How is OCD diagnosed?

A

Obsessions or compulsions or both present on most days, for at least 2 weeks

Obsessions and compulsions

  • originate in mind of patient
  • repetitive
  • acknowledged as unreasonable
  • unpleasant
  • patient tries to resist, but unsuccessful

Interfere with patient’s individual or social functioning

29
Q

What age group is OCD most common in?

A

Younger people, before age 30

30
Q

What sex is OCD more common in?

A

In adults, equally common in men and women

In children, more common in boys

32
Q

What is the pathophysiology of OCD?

A

Re-entry circuits in basal ganglia

Reduced serotonin

Paediatric autoimmune neuropsychiatric disorder associated with streptococcal infection PANDAS

33
Q

How does PANDAS present?

A

Sudden onset of OCD symptoms as well as other psychiatric symptoms after infection with Group A beta-haemolytic strep

34
Q

What is the pathophysiology of PANDAS?

A

Antibodies cross-react with neurons in basal ganglia

35
Q

How is OCD treated?

A

Cognitive behavioural therapy

Selective serotonin reuptake inhibitors, high dose and longer treatment course

Antipsychotics

Deep brain stimulation

36
Q

How does cognitive behavioural therapy treat OCD?

A

Exposure response prevention, meaning the patient learns to resist the compulsion after their obsessional thoughts

37
Q

What antipsychotic drug is used to treat OCD?

A

Clomipramine

38
Q

What is post-traumatic stress disorder?

A

After a severely traumatic event
Repetitive recollection of the event in memories, daydreaming, dreaming
Avoiding stimuli that might arouse recollection of the event

39
Q

What is the timing of PTSD?

A

Within 6 months of the severely traumatic event

40
Q

When is deep brain stimulation used to treat OCD?

A

OCD that has been resistant to other methods of treatment

41
Q

How is PTSD treated?

A

Selective serotonin reuptake inhibitors

Pregabalin

Cognitive behavioural therapy

Eye movement desensitisation reprocessing

42
Q

What is eye movement desensitisation reprocessing?

A

Patient follows visual stimulus while recollecting event

To distract brain

43
Q

What is the pathophysiology of PTSD?

A

Hyperactivity of amygdala, causing exaggerated stress response to perceived threat

However low levels of cortisol, more recollection of event

Sem 4 - Nervous System (25 decks)

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