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Flashcards in Neuropsych Deck (177)
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93

Describe partial seizures.

They are focal seizures start in a localized area in one side of the brain and affect one side of the body (may spread and bc generalized). 2 types.

Most often due to abnormal electrical activity in one of the lobes, ESP temporal.

Simple partial seizures.no loss of cs
Uncontrollable movements, sensory sx, and/or auditory hallucinations.

Complex partial..may start w an aura, some alteration in consciousness, often include automatisms (involuntary complex movements..lip smack, chew, walk in circles)

Partial seizures most often in Temporal lobe seizures...automatisms, auditory hallucinations, sensory phenomenon, déjà vu, depersonalization, autonomic sx

94

Describe generalized seizures.

Bilaterally symmetric and not focal onset.

Tonic clonic or grand mal
Alteration of cs
Tonic stage...muscles stiffen face and limbs
Clonic..jerky rhythmic in arms and legs
When consciousness returns may be depressed, irritable, confused or have amnesia for events that occurred during the seizure.

Absence seizures...brief loss if cs and vacant stare but few or no other sx (petite mal)

95

Describe migraine headaches.

Throbbing pain on one side of head.
May have nausea, vomiting, dizziness, sensitivity to light, sound..

Classic migraine starts with an aura
Common migraine no aura

Triggered by factors like stress, weather, alcohol, foods and additives

Sx may increase by activity

May relate to low level serotonin that constricts bld vessels in brain.

Tx...no steroidal anti-inflammatory drugs, ergotamine, sumatriptan, ssri , and other drugs act in serotonin receptors; beta blockers; combo thermal biofeedback and auto genic training .

96

Describe tension headaches.

Dull and diffuse mild to moderate pain feels like a tight band around the head.

May be due to sustained contractions if muscles in forehead,scalp, neck. Others unknown cause.
Some evidence serotonin or other NT involved.
Tx..pain relievers, EMG biofeedback
Chronic ones..antidepressants

97

Describe the difference between cluster and sinus headaches.

Cluster..severe nonthrobbing pain that lasts 15 to 90 mins; occurs more than once ea day over several weeks or months.
Unilateral pain.
Usually located behind one eye and may spread.
Tx...oxygen tx, sumatriptan or other triptan, lidocaine or other local anesthetic

Sinus headaches...inflammation that produces a dull throbbing pain can be worsened by sudden movement and cold weather.
Tx..antihistamines, decongestants,antibiotics, corticosteroids

98

Nt most associated with voluntary muscle movement is:
A. Norepinephrine
B. serotonin
C. Acetylcholine
D. Dopamine

C

99

The ascending reticular activating system produces its effects on motivation by:
A. Channeling sensory input to proper region of cortex
B. providing diffuse facilitation to entire cortex
C. Inhibiting irrelevant input from receptors
D. Providing generalized facilitation to all muscles

B

RAS involved in behavioral arousal. Screens input to the brain and provides diffuse stimulation to entire cortex when important info must be processed.

100

Three classes of antidepressants. Tricyclics include:

A. Fluoxetine, setraline, paroxetine
B. Prozac, Zoloft, Paxil
C. Nardil and parnate
D. Imipramine, clomipramine, amitryptyline

D

A is SSRIs
B brand names for those in b
C. MAOI

101

The most widely prescribed anti anxiety drugs are:
A. SSRIs
B. tricyclics
C. Benzodiazepines
D. Barbiturates

C

Most widely prescribed anxiolytics include diazepam (Valium), alprazolam (Xanax), clonazepam (klonapin), lorazepam (Ativan ), and triazolam (halcion).

Barbiturates have been replaced for anxiety by the benzodiazepines.

102

What is the difference between agnosia, apraxia, and aphasia?

Agnosia is inability to recognize objects.

Aphasia is impairment in speech functions.

Apraxia is related to movement.

103

Damage to the broca's area of the left hemisphere produces:

A. Apraxia
B. agnosia
C. Aphasia
D. Ageaphia

C

104

Trauma to the temporal lobe is associated with:
A. Loss of coordination
B. visual blurring
C. Apraxia
D. Memory loss

D

105

In tx of schizophrenia, haloperidol is
A. Most effective for treating positive symptoms
B. most effective for treating negative symptoms
C. Equally effective for both
D. Not effective for any

A. This conventional antipsychotic is most useful for positive sx, such as hallucinations, disorganized speech, and delusions.

106

What is one of the effects of estrogen replacement tx?
A. Increased mood swings
B. reduced libido
C. Increase vaginal dryness
D. Increase risk osteoporosis

B

ERT may decrease libido , reduce mood swings, reduce dryness and reduce osteoporosis.

107

Damage to the suprahiasmatic nucleus can often lead to:
A. Disruptive on if normal breathing
B. reduction of appetite
C. Disruption of circadian rhythms
D. Disruption of memory fx

C. Located in the hypothalamus

108

What drug is used to treat enuresis? Tell its generic name.

Imipramine aka tofranil

109

What med is used to treat OCD? Give generic and category.

Clomipramine or anafranil is an tricyclics antidepressant.

110

What are the TCA's?

Block re uptake of serotonin and norepinephrine.

Imipramine/tofranil
Clomipramine/ anafranil
Amitryptyline/elavil
Endepdoxepin/adapin
Sinquan

111

What do the tricyclics treat and what are the side effects?

They block reuptake of NE and SE
Supports catecholamine hypothesis that predicts depression is due to lower than normal levels if NT.

Major Depression (hopelessness, no pleasure, ESP vegetative sx, like appetite, sleep, energy sx)
Dysthymia
Enuresis (imipramine)
OCD (amitryptyline)
Panic do
Agoraphobia
Chronic pain

Side effects...often subside weeks or if lower dose
Anticholenergic effects (dry mouth, blurred vision, constipation..)
GI sx
Impaired sexual fx
Drowsie
Weight gain
Confusion and memory probs (ESP old)
Cardiovascular effects
Toxic OD

Cautious when given to heart disease or suicidal ppl given toxicity to OD.

112

What is the difference between agonist and inverse agonist and antagonist?

Agonist...effects similar to NT

Inverse agonist..opposite effects of NT or agonist

Antagonist...no activity on own but reduce or block effects of NT or agonist.

113

How does race and ethnicity impact a person's drug response?

Older people have decreased metabolism which can extend te half life of the drug and increase toxicity risk.

Asians and African Americans metabolize certain isoenzymes more slowly than Caucasians. Greater sensitivity to therapeutic and side effects of meds, such as benzodiazepines, neuroleptic a, Li, and some antidepressants.

So start low dose and titrate up.

114

How are the SSRIs different than the TCA's?

SSRIs have quicker onset of effectiveness
Fewer and less severe side effects
Safer in overdose
Few or no anticholenergic effects.
Less likely cause sedation
Less likely cause cognitive impairment
Fewer cardiovascular effects

115

What are the SSRIs, uses, and side effects?

SSRIs increase SE at synapses.

Fluoxetine / Prozac
Paroxetine/ Paxil
Sertraline/ Zoloft

Major depression, panic, OCD, dysthymia
Social phobia, binging, premature ejaculation

Side effects:
Sexual fx
Loss of Appetite
Dizzy
Nausea
Agitation
Headaches
Insomnia
Combo w other drugs that increase SE cause SE syndrome (altered consciousness, agitation, other mental status changes, autonomic changes..sweating, dilated pupil.., tremor, muscle rigidity, akathisia (restless).

116

How much does mylenization increase the speed of conduction? What is this type of conduction called?

What disorders are linked to a loss of mylenization?

10 to 100 times

Saltatory conduction

Multiple sclerosis..loss of mylein

117

What are the 4 types of neurotransmitters?

Catecholamines include Dopamine,
Epinephrine, and norepinephrine.
Personality,drive and mood states.
Too much of D in schizophrenia. Too little D in Parkinson's .D involved with movement.
Low Levels of NE with some depression.

Acetylcholine is called a
cholenergic system involved in pns voluntary movement of skeletal muscles.
In brain involved in learning and memory. Alzheimer's deterioration of neurons in brain that secrete Ach.
Mediate sexual behavior and REM.

Serotonin Hunger
Mood states, aggression, arousal, pain, obesity, sleep.personality, temperature, pain
Elevated levels related to schizophrenia.

GABA Optimal levels have a calming effect.
Low levels underly anxiety, Low levels in motor regions of brain
involved with huntingtons chorea....dementia, and jerky movements.

118

What is activated by the sympathetic nervous system?

Mobilizes resources. Gets it ready to expend energy
Increase heart rate
Increase blood flow to extremities.

Inhibits digestive system
Dilates pupils
Conversion of energy stores into glucose.
Occur as unit ready for fight or flight.

119

What measures parasympathetic systems?

Deactivates processes. Conservation of energy. Active during rest and digestion.

More specific in responses

EKG...measures contraction of heart muscle

Galvanic skin response. Electrical conductance of skin

120

Primitative core...basic activities like eating and sleeping. Too if spinal cord.

Old brain...limbic system..hunger, thirst and emotion

New brain..cerebral cortex with higher functions

What is a way to view the brain?

121

What does the septum do which is part of the limbic system.

Part of the limbic system in the forebrain. Mediation of emotions.

Amygdala, septum, and hippocampus are the limbic system.

Inhibition of emotional behavior.
One of brains pleasure center.
Rats will stimulate this over and over. Septal rage syndrome...lesions cause hyper emotionality and vicious attack behaviors.

122

What does the pons do?

Part of the brainstem. Above medulla and connects cerebellum.

Role in relaying sensory and motor information.
Regulates arousal
Sleep
Respiration