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BEHAVIORAL MEDICINE > FOUNDATION OF PSYCHIATRY > Flashcards

FOUNDATION OF PSYCHIATRY Flashcards

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1
Q

Amyloid precursor protein gene is associated with early onset Alzheimers. On what chromosome is this gene located ?

A

21

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2
Q

PSEN1 & PSEN2 are genes located on chromosome 14 and 1 respectively and associated with what ?

A

Early onset Alzheimer

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3
Q

Acute intermittent porphyria associated with gene on what chromosome ?

A

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4
Q

PKU associated with gene on what chromosome ?

A

12

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5
Q

What medical condition with psychiaric manifestations is linked to defective genes on chromosome 13?

A

Wilson’s disease

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6
Q

Typical onset Alzheimer’s is associated with APOE4 alleles on what chromosome ?

A

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7
Q

Autistic behavior, mental retardation/intellectual disability are behavioral manifestations of what disease associated with a sex chromosome ?

A

Fragile X

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8
Q

Stereotypes hand mvmts, breathing abnormalities and autism spectrum disorder is indicative of ?

A

Rett’s disorder

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9
Q

Lesion to orbitofrontal cortex :

A

Deshinibition
Decision making
Personnality changes
Lack of judgment
Explosive moods and violent outbursts

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10
Q

Lesion to dorsolateral frontal cortex :

A

Affected planning, strategy formation and executive function ; lack of motivation

ADHD

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11
Q

Lobe most likely involved in seizures ?

A

Temporal

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12
Q

What cortex is associated with intellectual processing of info ?

A

Parietal cortex

Damage to left side may impair language and Gerstmann syndrome may occur : agraphia, acalculia, finger agnosia, right & left disorientation.
Damage on the right side may interferes with visuo-spacial processing resulting in construction apraxia (inability to copy drawings) as well as anosognosia, left hemoparesis/hemispacial neglect.

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13
Q

What is monothematic delusion?

A

When a pt denies ownership of a limb or an entire side of the body without any other delusions.
May occur in primary psychotic disorders but most commonly present in conjunction with brain damage.

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14
Q

What syndrome is associated with cortical blindness along with failure to acknowledge the blindness ?

A

Anton syndrome
bilat occlusion of PCA interrupting fibers involved in self-assessment.

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15
Q

What part of the brain is critical for pain perception and when dysfunctions may lead to impaired memory and arousal ?

A

Thalamus

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16
Q

Reticular activating system involved with ?

A

Consciousness (wakefulness ; arousal)

Lesion ; decreased REM sleep and loss of consciousness

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17
Q

The hippocampus is critical for ?

A

Memory and new learning

Damage leads to anterograde amnesia (short term memory disorder)

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18
Q

Assigns emotional significance to sensory experiences ; mediates learned fear responses and direct expression of emotions ?

A

Amygdala

Gateway through which internal and external stimuli are integrated

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19
Q

Damage to the Amygdala resulting from the bilateral lesions of the anterior temporal lobes causes what syndrome that is associated with ‘‘make love not war’’ condition ?

A

Kluver-Bucy syndrome

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20
Q

Syndrome characterized by amnesia resulting from chronic thiamine deficiency which may result in damage to the thalamus ?

A

Korsakoff

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21
Q

Associated with procedural learning, routine behaviors or habits such as bruxism, eye mvmts, cognition and emotion. Also plays a role in integration of emotions with cognitive and motor behavior. Implicated in depression & dementia as well as Huntingtons ?

A

Basal ganglia

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22
Q

Presents as a triad of dyskinesia, dementia and depression ?

A

Huntington’s

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23
Q

What specific part of the basal ganglia is Parkinson’s associated with ?

A

Substantia nigra

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24
Q

What specific part of the basal ganglia is Huntington’s chorea associated with ?

A

Caudate & putamen

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25
What specific part of the basal ganglia is Tourette's associated with ?
Caudate
26
Define chorea :
Mvmt disorder characterized by random and involuntary quick, jerky and pruposeless mvmts.
27
What is Athetosis ?
sx characterized by slow, involuntary, convoluted mvmts of the fingers, hands, toes and feet and in some cases ,arms, legs, neck and tongue. | Usually occurs as a result of injury to the basal ganglia
28
What psychiatric condition is associated with dopaminergic hyperfunction in the prefrontal cortex and serotonergic hypofunction is the basal ganglia ?
OCD | Treated with SSRI
29
Rare heriditary disorder that involves calcification of the basal ganglia ?
Fahr disease
30
Which part of the brain stem is important for REM sleep?
Pons
31
Part of the Ponse that serves as principle site for brain synthesis of norepinephrine ?
Locus ceoruleus
32
In what psychiatric disease is acetylcholine low and glutamate high ?
Alzheimer's
33
Low GABA, Low serotonin and high norepinephrine is associated with what psychiatric condition ?
Anxiety
34
Depression is characterized by what change in neurotransmitters ?
Low norepinephrine low serotonin low dopamine
35
What psych condition is associated with î dopamine and low GABA ?
Mania
36
What psych condition is associated with high dopamine, high serotonin and variable levels of glutamate ?
Schizophrenia
37
Increase in homovanillic acid is suggestive of ?
î dopamine levels Schizophrenia
38
Diseases associated with low dopamine levels ?
Parkinson's Depression Antipsychotic agents
39
î levels of vanillylmandelic acid indication of ?
î norepinephrine (pheochromocytoma
40
Low MHPG link to :
Low norepinephrine (severe depression and attempted suicide)
41
î 5 HIAA indicative of ?
High serotonin (Autism spectrum disorder)
42
Low serotonin levels associated with low levels of 5-HIAA and presents as :
Claims of severe depression, attempted suicide, aggressivness, fire setting, Tourette's, bulimia, alcohol abuse.. | Low Serotonin means low impulse control.
43
What is the amino acid precursor of dopamine ?
Tyrosine Converted to L-DOPA by tyrosine hydroxylase which is in turn decarboxylated by DOPA decarboxylase to form dopamine.
44
Major site of action (dopamine receptor) for traditional (1st gen) antipsychotic agent
D2 receptors
45
Nigrostriatal, tuberoinfundibular and mesolimbic mesocrotical tracts are :
Dopaminergic tracts
46
The nigrostriatal tract is involved in the regulation of muscle tone and mvmt. This tract degenerate in what disease ?
Parkinson's
47
Blocking dopamin receptors by antipsychotic drugs prevent the inhition of release of what hormone?
Prolactin
48
Which tract is targeted to block D2 receptors in trx of psychotic disorders ?
The mesolimbic-mesocortical tract | Blocking + sx of shizophrenia linked to hyperactive mesolimbic tract ## Footnote Thought to have a role in expression of emotions because it projects into the limbic system and prefrontal cortex.
49
Dopamine beta-hydroxylase present in dopaminergic neurons converts :
Dopamine to norepinephrine
50
Where are most noradrenergic neurons located ?
Locus coeruleus in the Pons
51
Serotonin is synthesized from what amino acid ?
L-tryptophan
52
Associated with improved mood and sleep but decreased sexual function ?
Serotonin | Delayed orgasms w/ SSRI
53
The serotinin system is mostly targeted by typical or atypical antipsychotics in the trx of psychotic disturbances (*in addition to the dopamin system being targeted at the same time) ?
Atypical antipsychotics
54
î the presence of both serotonin and borepinephrine in the synaptic cleft ?
SNRIs and MAOIs
55
Fluoxetine (Prozac) is an example of ?
SSRI
56
Mechanism of action of MAOIs?
Prevent degradation of serotonin & norepinephrine by Monoamine oxidase.
57
Heterocyclic antidepressants (HCAs), including tricyclic antidepressants (TCA) mechanism of action :
Block reuptake of serotonin and norepinephrine at synaptic cleft by hitting a wide range of receptors including some dopamine receptors and **muscarinic** acetylcholine receptors resulting in anticholinergic effects as well as histamine receptors leading to antihistaminergic effects | Way less used, not first line trx due to risk of OD.
58
Tricyclic antidepressant overdose characterized by ? | E.g. Imipramine
Elevated body temp blurred vision dilated pupils sleepiness cofusion seizures rapid HR cardiac arrest ## Footnote replaced by SSRIs which have fewer side effects and safer in terms of OD.
59
What are frequent side effects of Imipramine overdose ?
Anticholinergic effects, orthostatic hypotension, prolonged QT interval, tachycardia and other cardiac abnormalities, hematologic changes including agranulocytosis.
60
Most serotonergic cell bodies in the brain are contained in the :
Dorsal raphe nucleus
61
Major neurocognitive disorders are associated in general with low levels of what neurotransmitter ?
Acetylcholine | In amygdala, hippocampus and temporal cortex
62
Alzheimer's, Down's, mvmt disorder and sleep disorder (decreased REM sleep) all associated with ?
Degradation of cholinergic neurons
63
Cholinergic neurons synthesize Ach from what molecules using acetyltransferase ?
Coenzyme A Choline
64
Where in the brain is Ach synthesized ?
Nucleus basalis of Meynert & medial septal nucleus (parts of basal forebrain) as well as in the brainstem.
65
Donepezil (Aricept) Rivastigmine (Exelon) Galantamine (Reminyl) are :
Acetycholinesterase inhibitors (Delay cognitive decline in Alzheimer's with no reverse histopathological change)
66
Most common drug-related cause of delirium ?
Anticholinergics
67
Anticholinergic effects
Dry mouth Blurry vision Constipation Urinary retention Delirium | Blind as a bat, dry as a bone, red as a beet, mad as a hatter
68
Amino acid neurotransmitters (3) :
Gutamate GABA Glycine
69
Principle excitatory neurotransmitter in the brain ?
Glutamate ## Footnote May be toxic to neurons (excitotoxicity) and thus contribute to the pathophysiology of Alzheimer's and schizophrenia.
70
NMDA receptor is a receptor for :
Glutamate
71
Predominant neurotransmitter in the brain in terms of quantity and chief inhibitory neurotransmitter of the CNS ?
GABA
72
GABA is synthesized from glutamate by glutaminc acid decarboxylase using which cofactor ?
B6
73
What classes of medications î GABA affinity for its receptor causing more Cl ions to enter the neurons causing hyperpolarization and decreased neuronal firing ultimately decreasing anxiety ? | GABA is an anxiolytic agent
Benzodiazepines & Barbiturates Anticonvulsants
74
Proteinogenic amino acid that serves as an inhibitory neurotransmitters working on its own and regulating glutamate activity ?
Glycine
75
Major transmitter for sensory neurons that convey pain sensations from the periphery (esp skin) into the spinal cord.
Substance P (11 aa peptide)
76
Opiates relieve pain in part by blocking release of
Substance P
77
Endogenous opiods that act on opiate receptors to decrease pain and anxiety and play a role in addiction and mood ?
Enkephalins Endorphins Dynorphins Endomorphins
78
Diseases that affect these structures are more likely to manifest as prominent personality change :
Frontal lobes & subcortical structures
79
2 types of explicit/declarative memory ?
Episodic and semantic | knowledge of facts ans retrieved conciously
80
2 types of implicit/non declarative memory ?
Procedural and working memory | Unconsciously recalled information about how to perform an act
81
Different types of memory

BEHAVIORAL MEDICINE (2 decks)

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