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MQW U3 > Behavioral Week 2 > Flashcards

Behavioral Week 2 Flashcards

1
Q

5 Types of CAM treatments:

A
  1. Whole medical systems
  2. Mind-body medicine
  3. Biologically based
  4. Manipulative and body-based
  5. Energy medicine
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2
Q

St. John’s Wort use:

A

-Antidepressant

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3
Q

Fatty Acid use:

A

-Antiinflammatory

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4
Q

Vitamin D use:

A
  • Depression

- rule out cause of depression

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5
Q

Light Therapy use:

A

-Seasonal depression

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6
Q

Depression treatment w/ regard to 1 Carbon Cycle:

A
  • Use: Folate, L-methylfolate, S-adenosyl methionine (SAMe)

- Increases neurotransmitters

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7
Q

2 most and least hereditary psych disorders

A

Most: Schizophrenia, ADHD
Least: Depression, Anxiety

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8
Q

Functions of 4 Dopamine Pathways:

A
  1. Nigrostriatal: movement
  2. Mesolimbic: reward and perception
  3. Mesocortical: executive function
  4. Tuberoinfundibular: pituitary prolactin
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9
Q

Hyperactivity of 4 Dopamine Pathways:

A

Nigrostriatal –> dyskinetic movement
Mesolimbic –> addiction, hallucinations
Mesocortical –> hypervigilance, insomnia
Tuberoinfundibular –> hypOprolactinemia

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10
Q

Hypoactivity of 4 Dopamine Pathways:

A

Nigrostriatal –> dyskinetic movement, parkinsonism
Mesolimbic –> amotivation, apathy
Mesocortical –> inattention
Tuberoinfundibular –> hypERprolactinemia

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11
Q

4 Genes associated with Schizophrenia

A

COMT, Tyrosine Hydroxylase, D2R, D3R

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12
Q

2 Genes associated with ADHD

A

DRD4 and DRD5

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13
Q

3 Genes associated with MDD

A

DAT, DRD4, COMT

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14
Q

MDD: Resting activity is low in ____ and high in ___

A

Low: DLPFC - dorsolateral prefrontal cortex

High: Amygdala/VMPFC - ventralmedial prefrontal cortex

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15
Q

NE hypERfunctioning in limbic pathways cause ___, ___ and ___.

A

Panic, worry, hyperarousal

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16
Q

NE hypOfunctioning in frontocortico pathways cause ___ and ___

A

ADHD and Depression

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17
Q

___ activity opposes ___ activity in limbic pathway

A

NE opposes Serotonin 5HT

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18
Q

What does poor serotonin activity do to your affect?

A

Cause negative affect states (Depression, anxiety, Eating Disorder, Bipolar)

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19
Q

What does COMT Met and Val alleles lead to?

A

Met alleles –> low degradation –> high NE in limbic area –> anxiety in limbic areas

Val alleles –> high degradation –> low NE in cortex –> inattention

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20
Q

How does X inactivation affect neurotransmitters?

A

No X-inactivation –> high COMT –> low NE and DA in cortex –> depression

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21
Q

Lack of empathy (antisocial, narcissistic) is associated with what neurological function changes?

A

Overactive Cingulates

Hypoactive MPFC

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22
Q

2 Genes associated with hypofrontality

A

COMT, DAR

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23
Q

What are the Cluster A personality disorders?

A

Psychotic-like:

  • Paranoid
  • Schizoid
  • Schizotypal
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24
Q

What are the Cluster B personality disorders?

A

Dreaded, behavioral :

  • Antisocial
  • Histrionic
  • Narcissistic
  • Borderline
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25
What are the Cluster C personality disorders?
Anxious: - Avoidant - Dependent - Obsessive-compusltive
26
Difference between homeopathy and naturopathy
Homeopathy: stimulate body's self-healing response Naturopathy: noninvasive treatments
27
What are 3 CAM treatment that have effectiveness treating depression?
L-methylfolate S-adenosyl methionine (SAMe) St. John's Wort
28
What's the difference between Schizoid and Schizotypal PD?
Schizoid: trouble relating, have no interest in interactions Schizotypal: oddities in behavior and thoughts
29
What is an age related requirement for Antisocial PD?
Evidence of a Conduct Disorder with onset before age 15 That leads to pervasive pattern of disregard for or violation of rights of others after age 15
30
What characterizes Borderline PD?
Pervasive Instability: of relationships, self-image, behaviors, and affects 5+/9 Symptoms needed
31
Which PD are more prevalent in women? | In men?
Women: paranoid, avoidant, dependent Men: antisocial
32
Psychopharmacolgy can treat what PDs?
Cluster B: Antisocial, narcissistic, histrionic, borderline Avoidant (Cluster C)
33
Psychotherapy works for which one Cluster B PD?
Borderline PD only | -3 psychodynamic and 2 cognitive behavioral models
34
What are 3 risk factors for Personality Disorders?
1. Not married 2. Impoverished 3. Poorly educated
35
Prevalence of different clusters of PD
A and C more common in general | B least common, but more common in the hospital
36
Benzodiazepines can exacerbate conditions in what cluster of PD?
Cluster B
37
What psychotherapy models work for treating Cluster C PDs?
CBT and Psychodynamic
38
Criteria for Mania vs Hypomania
Mania: 3+/7 symptoms for 7+ days of expansive mood Hypomania: 3+/7 symptoms for 4+ days
39
DTRHIGH
- Distractible - Talkative - Racing thoughts - Hyperactive - Impulsive - Grandiose - Hyposomnic
40
What is the difference between Bipolar 1 and Bipolar 2?
Bipolar 1: Mania + MDE Bipolar 2: Hypomania + MDE
41
What is the criteria for Cyclothymia?
2+ years of hyponamia + minor depressions (relative decrease seems large)
42
What is Kindling Hypothesis?
Related to Bipolar - Too much neuronal limbic firing - Once you get mania, you get more episodes
43
Gender differences in Bipolar
Bipolar 1: men = women | Bipolar 2: women > men
44
How do Atypical Antipsychotics treat Bipolar?
- D2 receptor block--treats Mania | - 5HT2a receptor block--treats depression
45
What are the anti-manic agents?
- Lithium - Divaproex - Carbamezepine - Atypical antipsychotics (Risperidone, Aripiprazole, Lurasidone)
46
Neurotransmitter changes associated with Anxiety Disorders:
- Low 5HT - Low GABA - High NE - High Glutamate
47
GAD DSM-5 Diagnostic criteria
- Anxiety/worry more days than not for 6+ months, about 1+ event/activity - 3+ symptoms
48
Gender difference for anxiety disorders:
Women > men except in OCD
49
When are Beta Blockers used in anxiety?
Symptomatic relief of performance anxiety
50
Busipirone mechanism of action:
5HT1a receptor agonist | -Only approved for GAD
51
Psychotherapy models used for GAD:
CBT or Psychodynamic | CBT has most evidence
52
Frontline GAD medications: | 2nd line?
SSRIs, sometimes SNRI | -2nd line = Benzos
53
Panic Attack DSM-5 Criteria
- Initially abrupt, unexpected, untriggered, peaks within minutes - 4+ of symptoms
54
Agoraphobia criteria:
Fear/Anxiety about 2+ situations for 6+ months
55
Emergency treatment for panic disorder:
Fast-acting Benzodiazepines (alprazolam)
56
What is Systematic Desensitization and Flooding?
Systematic Desensitization: Step by step increase in facing fears; type of CBT Flooding: Immediately facing fears
57
Obsession vs Compulsion
Obsession: recurrent/persistent, intrusive and unwanted thoughts or urges that the patient WANTS TO NEUTRALIZE Compulsion: repetitive behavior or activity that patient performs in RESPONSE to obsession
58
First drug approved for OCD
Clomipramine (a TCA)
59
OCD vs. OCPD
OCD patients have insight into their behavior OCPD patient's don't. The're rigid, moralistic. Have no compulsions
60
Most common cause of PTSD:
Death of a loved one
61
Most likely thing to cause a PTSD:
Assault
62
PTSD Criterions A-E
``` A. Exposure B. Re-living of events C. Avoidance of associated stimuli D. Negative cognition and mood changes E. Alterations in arousal/reactivity ```
63
Acute Stress Disorder criteria:
PTSD criteria but, >3 days and
64
What drug can stop nightmares in PTSD?
Prazosin (a1 inhibitor)
65
Risk factors for TBI:
- Male - Age 0-4, 15-24, 65+ - Lower SES, metropolitan area - Recurrent TBI
66
Which are primary causes of TBI? - Edema - Diffuse axonal injury - Vascular tear - Seizure - Ischemia, hypoxia - Intracranial, extracerebral hemorrhage - Necrosis, apoptosis - Inflammation - Vasospasm - Focal cortical contusions
- Diffuse axonal injury - Vascular tear - Focal cortical contusions - Intracranial, extracerebral hemorrhage
67
Which are secondary causes of TBI? - Edema - Diffuse Axonal Injury - Vascular Tear - Seizure - Ischemia, hypoxia - Intracranial, extracerebral hemorrhage - Necrosis, apoptosis - Inflammation - Vasospasm - Focal cortical contusions
- Ischemia, hypoxia - Vasospasm - Edema - Necrosis, apoptosis - Inflammation - Seizure
68
Glasgow Comas Scale: Severe = ___ Moderate = ___ Mild = ___
``` Severe = 3-8 Moderate = 9-12 Mild = 13-15 ```
69
What functions do the Glasgow Coma Scale test?
- Eye opening - Verbal response - Best motor response
70
Examples of emotional and behavioral changes after TBI
1. Post-traumatic agitation 2. Personality changes 3. Psychiatric disorders 4. Substance misuse disorders
71
What is akasthesia
Can't sit still, restlessness
72
What is the most disruptive behavior post TBI
Post-traumatic agitation, behaviors
73
Trauma to lateral orbitofrontal cortex can cause what kind of behavioral changes?
Social comportment
74
Trauma to dorsolateral prefrontal cortex can cause what kind of behavioral changes?
Executive function
75
Trauma to the anterior cingulate cortex can cause what kind of behavioral changes?
Motivated behavior
76
PTSD is more likely to be seen with what degree of TBI?
Mild
77
TBI increases risk for what psychiatric disorders?
Depression, Anxiety
78
What are classes of medications used to treat post TBI agitation?
- Beta blockers - Antiepileptics/anticonvulsants - Antidepressants (SSRI, TCA) - Antipsychotics
79
In Depression: What 2 neutotransmitter abnormalities cause: decreased positive affect? increased negative affect?
Decreased negative: NE, DA Increased positive: NE, 5HT
80
Dyssomnia vs. Parasomnia:
Dyssomnia: timing, quality, amount of sleep Parasomnia: abnormal physiology or behavior associated with sleep
81
Insomnia DSM-5 Criteria
- 1+ of: initiating, maintaining, or early morning waking w/ inability to return to sleep - 3+ nights/week for 3+ months
82
Age and Gender pattern of Insomnia:
- Increases with age | - Women report insomnia 50% more
83
Endogenous causes of Insomnia:
- High NE from locus ceruleus - High 5HT from Raphe nucleus - High DA from VTA - High Histamine from tuberomamillary nucleus - Low GABA, melatonin, adenosine tones
84
What is the relation between Insomnia and Anxiety?
- Anxiety can lead to insomnia | - Fight or flight response to getting in bed
85
What are the 4 steps in managing Insomnia?
1= Diagnosis, informed consent, education 2= Behavioral counseling (sleep hygiene, stimulus control) 3=Psychotherapy 4=Pharmacotherapy
86
What kind of therapies are used in Insomnia Stage 3 Management?
- Sleep restriction therapy - Cognitive therapy - Behavioral therapy
87
1st line pharmacotherapy for Insomnia:
Melatonin, antihistamines
88
For insomnia, what's used first between: | Benzodiazepine Receptor Agonists (BZRAs) and Benzodiazepines?
BZRAs 3rd line, Benzos 4th line | -Zolpidem, Zaleplon, Ezopiclone
89
Patient's with restless legs get what kind of pharmacotherapy?
D2 agonists
90
Insomnia patients w/ Apnea do NOT get what pharmacotherapy?
Sedatives
91
What does 5HT2a blocking do for Insomnia?
Creates deeper sleep patterns
92
What can be done to promote a more accurate circadian clock?
Antagonize 5HT1d and 7 receptors

MQW U3 (11 decks)

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