Behavioral Week 3 +4 Flashcards Preview

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Flashcards in Behavioral Week 3 +4 Deck (85):
1

What is the definition of Obesity?

-More than 20% over ideal weight
-BMI >30

2

2 Genetic mutations associated w/ obesity

-Leptin receptor
-Melanocortin 4 receptor

3

What drug class can cause weight gain?

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

4

Amphetamine mechanism for obesity

Decrease appetite

5

Orlistat mechanism:

Lipase inhibitor

6

Topiramate/Phentermine combo mechanism:

Improves carb metabolism, less gluconeogenesis, appetite suppressant

7

Naltrexone/Bupropion combo mechanism:

Dampens reward of eating, appetite suppressant

8

Lorcaserin mechanism:

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

9

Anorexia Nervosa DSM-5 Criteria

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

10

Age and Gender pattern in Anorexia:

-Start mid-teen to 20s
-Female > male (20:1)

11

What is lanugo hair?

-Fine, white hair
-Seen with anorexia

12

Bulimia Nervosa DSM-5 Criteria

-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

13

Age and Gender pattern in Bulimia:

-Later onset than anorexia
-Female > male (10:1)

14

Bulimia characteristics compared to Anorexia:

-Greater prevalence
-More personality disorder
-More substance abuse

15

What are physical symptoms of Bulimia?

-Poor dentition, enamel loss, cavities
-Abraided knuckles = Russell's sign
-Salivary enlargement

16

Name for milder versions of Anorexia and Bulimia

Mild anorexia = Avoidant/Restrictive Food Intake Disorder

Mild bulimia: Binge Eating Disorder

17

Pharmacotherapy can be used for what eating disorder?
What drug class is most commonly used?

-Bulimia Nervosa
-SSRIs

18

What is Capgras Delusion?

Thinks someone has been replaced by an imposter

19

What is Fregoli Delusion?

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

20

What is Vampirism?

Thinks that oneself is a vampire

21

What is Lycanthropy?

Thinks that oneself is a werewolf

22

Psychopathic Cannibalism is associated with what disorders?

-Antisocial personality
-Psychopathy
-Sociopathy
-with delusions...

23

What is Shared Delusion Disorder?

Most common version?

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

24

What is conversion disorder?

-Neurologic disorder induced by stress

25

What is Cotard's Delusion

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

26

What is Morgellons/Delusional Parasitosis?

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

27

What is Erotomanic Delusions?

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

28

What is the neurobiologic basis of Delusions?

Too much DA activity in Mesolimbic area like in Schizophrenia

29

Normal Age-associated cognitive changes

-Difficulty retreiving words and names
-Slower processing speed
-Difficulty sustaining attention
-More effort to learn
-No functional impairment

30

Mild Cognitive Impairment definition

-Memory complain corroborated by an informant
-Objective memory impairment for age and education
-Preserved general cognition

31

What is Amnestic MCI

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

32

Chromosomes and Genes associated w/ Early-Onset AD

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

33

Chromosome and gene associated w/ Late-Onset AD

19--ApoE4 gene

34

Neuropathologic findings of AD:

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

35

Enzymes that cause B-amyloid monomers

Beta-secretase and Gamma-secretase

36

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

Normal = AB40
Non-normal = AB42

37

1st and 2nd Greatest risk factor for AD

1. age
2. APOE e4 allele

38

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

-Congo Red stain
-Apple-green birefringence

39

What happens to hyperphosphorylated tau?

-Dissociates from microtubules
-Assembles to form paired helical filaments (PHFs)
-PHFs bundle together to form NFTs

40

Important aspects of FTLD

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

41

Pick's Disease Clinical Differentiation from AD

-Early social inappropriateness
-Emotional blunting
-Loss of insight
-Later memory loss

42

How do AChE Inhibitors work in AD?

-AD = basal nucleus of Meynert degeneration --> ACh deficiency
-AChE Inhibitors prevent degeneration to slow progression of memory loss

43

Mechanism of Memantine in AD?

-Glutamate NMDA receptor blocker

44

Where do hypertensive disease infarcts most likely to affect?

Basal ganglia and internal capsule

45

What is a Lewy body?

Intracellular fibriller deposits of a-synuclein

46

2 Most common Lewy body syneuclienopathies:

1. Parkinson's
2. Dementia w/ Lewy bodies

47

Location where disease begins in Synucleinopathies:

Parkinson = substantia nigra

Lewy body Dementia = cortex

48

Dementia w/ visual hallucinations is pathognomonic for:

Dementia of Lewy Body

49

What drugs to avoid in Lewy Body Dementia? Why?

-Antipsychotics
-Increased sensitivity

50

Scoring of MMSE:

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

51

What are the 5 ADLs?

Dressing
Eating
Ambulating
Toileting
Hygiene

52

What are 5 Instrumental ADLs?

Shopping
Housekeeping
Accounting
Food preparation
Transportation

53

What is psychic determinisim?

Everything (event/symptom) has meaning

54

What is in the Topographic model of the mind?

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

55

What are the psychosexual stages of development in order?

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

56

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

1. Id - "child"
2. Ego and ego defense systems - "adult", purpose
3. Superego - "parent", conscience

57

When and how does superego start?

-At age 5
-Start with being taught

58

What are Level 1 Ego Defense Mechanisms?

"Psychotic" -
1. Delusional projection
2. Psychotic denial
3. Distortion

59

What are Level 2 Ego Defense Mechanisms?

"Immature"
1. Projection
2. Somatization
3. Acting Out
4. Splitting

60

What are Level 3 Ego Defense Mechanisms?

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

61

What are Level 4 Ego Defense Mechanisms?

"Mature"
1. Altruism
2. Sublimation
3. Anticipation
4. Suppression
5. Humor

62

What is the most common defense mechanism?

Denial

63

Stockholm syndrome is an example of what defense mechanism?

Identification

64

What is the concept of transference?

Transfer relationships (feelings) from past to current relationships

65

What defense mechanism is most commonly seen in Manics?

Distortion

66

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

-Splitting
-Borderline Personality Disorder

67

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?

Displacement

68

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

Dissocation

69

Difference between Isolation of Affect and Rationalization defense mechanisms

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

70

I say I love studying even though I don't
What defense mechanism?

Reaction formation

71

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

Sublimation

72

Definition of Acute vs. Chronic pain

Acute = 6 months

73

Symptoms of Chronic regional Pain Syndrome

Limb is cold, red, muscle wasting, nail changes

74

What neurotransmitter is responsible for neuropathic pain?

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

75

What kind of pain does anti-epileptics treat?

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

76

What mechanism of antidepressants treats neuropathic pain?

NRI mechanism

77

What is the Hawthorne effect?

Improvement as a result of receiving attention

78

Behavioral therapy is based on what theory and what techniques?

-Learning theory
-Classical and operant conditioning

79

What is Stimulus Generalization

Associating similar stimuli to the conditioned stimulus

80

Difference between punishment and negative reinforcement

Punishment = weakens behavior

Negative reinforcement = strengthens behavior

81

Age and gender distribution of Somatoform Disorders

-Higher incidence in women
-Starts early adulthood

82

Somatization Disorder DSM-5 Criteria

-4+ Pain issues
-Onset before 30
-Chronic symptoms, complete remission rare
-Unconscious, no secondary gain

83

Hypochondriasis requires symptoms to persist for ___

6 months

84

What antidepressant to use for smoking cessation? Mechanism?

Bupropion -- Block reuptake of NE and DA

85

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

Varenicline -- partial agonist