Neuropsychiatric Disorders Flashcards
(112 cards)
1
Q
Caused by antibodies attacking acetylcholine receptors
A
Myasthenia Gravis
2
Q
Hallmark symptoms: muscle weakness and fatigability
A
Myasthenia Gravis
3
Q
Treatment for MG
A
ACE Inhibitors
Intravenous Ig
Plasmapharesis
Thymectomy
4
Q
Treatment for mild MG
A
ACE inhibitors
5
Q
Tx for moderate or severe MG
Most commonly used in elderly patients and those with comorbid disease
A
Intravenous Ig
6
Q
Tx for myasthenic crisis and refractory cases
A
Plasmapharesis
7
Q
First-line therapy for generalized MG
A
Thymectomy
8
Q
Rapid developing loss of brain fxn due to disturbances in the blood vessels supplying the brain
A
Strokw
9
Q
2 Causes of Stroke
A
Ischmia
Hemorrhage
10
Q
Most common neuropsychiatric disorder after stroke
A
Post stroke depression (PSD)
11
Q
What NT plays a great role in the onset of depression
A
Serotonin
12
Q
Rupture of one of the major blood vessels
Blood accumulates innthe subarachnoid space or intra-cerebral space
A
Hemorrhagic stroke
13
Q
Due to lack of blood suplly in the small perforating arteries of the brain
A
Ischemic/Thromboembolic Stroke
14
Q
Occurs when oxygen and other nutrients supplied by blood flow is insufficient to meet the metabolic demands of brain tissue
A
Cerebral Ischemia
15
Q
Final event in cerebral ischemia
A
Death of neurons
16
Q
2 pathways that occurs after ischemia
A
Necrotic pathway
Apoptotic pathway
17
Q
Type of cell death that is characterized by energy failure
A
Necrotic cell death
18
Q
NT that participate in memory, movement, sensation, cognition, synaptic plasticity
Activates N-methyl-D-aspartate (NMDA) and non-NMDA channels
A
Glutamate
19
Q
Converts xanthine dehydrogenase to xanthine oxidase
A
Calpain 1
20
Q
Releases arachidonic acid from injured cell membrane, metabolized by cyclooxygenase to produce prostaglandin and superoxide (by-product)
A
Phospholipase A2
21
Q
NO + Superoxides
A
Peroxynitrite
22
Q
T or F: ↑ [Ca2+] , ↑ RO
A
True
23
Q
Key event in triggering apoptosis after cerebral ischemia
A
Release of Cyt C from the mitochondria
24
Q
Cleavage of cytoskeletal and DNA repair proteins
A
Apoptosis
25
Tx for Ischemic Stroke
Dissolution of thrombus/emboli:
1. Aspirin
2. IV injection of tissue plasminogen activator (TPA)
26
Tx for Hemorrhagic Stroke
Repair of ruptured vessels:
1. Surgical blood vessel repair
2. Surgical clipping
27
Tx for Neuropsychiatric
Antidepressants – fluoxetine
28
Also known as Martin-Bell Syndrome, Escalante's
| Syndrome
Fragile X Syndrome
29
Most common form of inherited mental retardation
Fragile X Syndrome
30
Inheritance Pattern for Fragile X Syndrome
X-linked recessive
31
FXS is commonly associated with what neuropsychiatric disorder
Autism
32
```
Prominent signs and symptoms:
o elongated face
o large/protruding ears
o large testes (macroorchidism)
o premature menopause
```
Fragile X Syndrome
33
Expansion of CGG trinucleotide repeats in the 5' untranslated region
Fragile X Syndrome
34
What is the affected gene in FXS?
Fragile X mental retardation 1 (FMR1) gene located on the X chromosome
35
Occurrence of non-penetrant male carrying the mutated
gene
Presence of pre-mutation alleles
Sherman Paradox
non-penetrant male -> non-penetrant daughter->
affected son
36
o Highest concentration in the brain and testes
o Responsible for selectively binding mRNAs in the
mammalian brain
o Part of neuronal polyribosomes
Fragile X mental retardation protein (FMRP)
37
Tx for Fragile X Syndrome
1. No current treatment or cure
2. Symptom-based
o Anti-depressants: SSRIs (Selective Serotonin Reuptake Inhibitors)
o Anti-psychotics: Risperdal, Seroquel
o Anti-convulsions
3. Genetic counseling
38
Progressive degenerative brain disorder
Huntington’s Disease (HD)
39
Pattern of Inheritance for HD
Autosomal Dominant
40
Due to increase in the number of glutamine (CAG) repeats (>36) coding for the cytoplasmic protein Huntingtin (HTT)
Huntington’s Disease (HD)
41
Where is HTT gene located?
Chromosome 4p
42
Repeated part of the gene
PolyQ region
43
Increases the decay rate of certain types of neurons
mutant Huntingtin (mHTT) protein
44
Most commonly affected region or area in the brain when suffering from HD
Neostriatum of the basal ganglia
45
Symptoms:
Progressive motor, behavioral, and cognitive dysfunction
Dysarthria (unclear speech), gait disturbance, and
oculomotor abnormalities
Psychosis
Huntington’s Disease (HD)
46
Tx for HD
No treatment or cure – management of symptoms only
47
1st drug approved in the US to treat HD
Tetrabenazine
48
Also known as shake/shaking palsy and paralysis agitans
Parkinson’s Disease (PD)
49
Progressive neurodegenerative disorder, idiopathic in
| nature, affecting neurophysiologic functions and movement abilities
Parkinson’s Disease (PD)
50
Primarily affects dopamine-producing neurons in
| the nigrostriatal pathway of the basal ganglia, specifically in the substantia nigra
Parkinson’s Disease (PD)
51
Major neurotransmitter of nigrostriatal pathway
Dopamine
52
T or F:
Dopamine has:
o Excitatory effect on the indirect pathway
o Inhibitory effect on the direct pathway
F
Dopamine has:
o Excitatory effect on the direct pathway
o Inhibitory effect on the indirect pathway
53
2 Types of Parkinson’s Disease (PD)
Hereditary
| Sporadic
54
Associated genes with PD
PARK3, 10, 11, 12
55
Due to problems with mitochondrial dynamics
Sporadic PD/ Parkinson’s Disease (PD) in general
56
Five receptors of Dopamine
D1,D2, D3, D4, D5
57
Which of the 5 receptors of Dopamine are stimulatory?
D1, D5
58
Which of the 5 receptors of Dopamine are inhibitory?
D2, D3, D4
59
G proteins that aggravate PD
Gs 1 alpha
60
G proteins that relieve PD
Gi 1a, Gi 2a, Gi 3a
61
G proteins that have little effect on PD
Go alpha
62
Converts L-tyrosine to L-DOPA
Tyrosine hydroxylase
63
Hallmarks symptoms: tremor of the extremities, jaw, and face (resting), bradykinesia (slowness of movement) or akinesia (absence of planned motor image prior to movement), rigidity or stiffness of the limb and trunk, and postural instability
Parkinson’s Disease (PD)
64
Most commonly used anti-PD drug
L-dopa
65
DOPA analog
Carbidopa
66
characterized by:
o positive symptoms - delusions and hallucinations
o negative symptoms – impaired cognition, volition and
emotion
o substantial functional deterioration - work,
interpersonal relationships, or self-care
Schizophrenia
67
Theories most relevant to the etiology of schizophrenia
DOPAMINE and SEROTONIN theory
68
Responsible for functions that regulate motivation and reward, pleasure, fine-tuning of motor function, compulsion and perseveration
Dopamine
69
Postulates that there is an increase in (stimulatory)
| dopamine transmission to the D2 receptors
Dopamine Theory
70
Tx for Schizoprenia (Dopamine Theory)
Typical antipsychotics eg, chlorpromazine & haloperidol
71
Involved in pathways affecting mood, memory
| processing, sleep and cognition
Serotonin
72
Postulates that stimulation of the 5-HT2A receptors induces hallucinations similar to that of schizophrenia
Serotonin Theory
73
Due to increase in 5-HT transmission
Schizophrenia
74
Tx for Schizoprenia (Serotonin Theory)
Atypical antipsychotics eg, clozapine & risperidone
75
Presence of amyloid plaques or neurofibrillary
| tangles (NFT)
Alzheimer’s Disease (AD)
76
Symptoms: memory loss, dramatic personality changes, disorientation and declining physical coordination
Alzheimer’s Disease (AD)
77
Types of AD
Familial
| Sporadic
78
Inheritance pattern in AD
None
79
Due to mutation in chromosome 19, APOE4 allele
Alzheimer’s Disease (AD) - Sporadic
80
Natural neuroprotective agent, precursor protein of A-β42 amyloid protein
Amyloid Precursor Protein (APP)
81
Clamps together to form insoluble amyloid plaques
A- β42 amyloid protein
82
o located on chromosome 14
| o codes for γ-secretase
PS1 (Pre-Senilin 1) gene
83
Located on chromosome 19
APOE gene
84
Located on chromosome 21
APP gene
85
Abnormally phosphorylated tau protein
Neurofibrillary tangles (NFT)
86
Microtubule associated protein that functions to
| assemble and stabilize the microtubules
Tau protein
87
T or F
| absence of NFT –> neuronal death due to Lewy bodies
T
88
[Stages of AD]
o Memory loss may go unrecognized or be ascribed to benign forgetfulness
o trouble understanding visual images and spatial relationships
Early stage AD
89
[Stages of AD]
o confused on where they are and what day it is
o major personality and behavioral changes
o unable to work
Mid-stage AD
90
[Stages of AD]
o major changes in sleep pattern
o tend to wander and become lost
o lose the ability to respond to their environment, carry on conversations, or control movements
o loss of judgment, reason and cognitive abilities
Late Stage AD
91
[Stages of AD]
o becomes rigid, mute, incontinent, bedridden
o generalized seizures may occur
End-stage AD
92
Tx for AD
Cholinesterase inhibitors
| Memantine
93
aka manic-depressive illness
Bipolar Disorder (BD)
94
Brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks
Bipolar Disorder (BD)
95
Types of Bipolar Disorder
```
Bipolar I
Bipolar II
Bipolar Disorder Not Otherwise Specified (BP-NOS)
Cyclothymia / Cyclothymic Disorder
Rapid-cycling Bipolar Disorder
```
96
Due to problem with the balance of neurotransmitters involved in both brain and bodily functions
Bipolar Disorder (BD)
97
Main NT involved in BD
Serotonin and dopamine
98
CATECHOLAMINE HYPOTHESIS
Inc EPI/NE -> ?
Dec EPI/NE -> ?
INCREASE in EPI and NOREPI – mania
| DECREASE in EPI and NOREPI – depression
99
Monoamine Hypothesis
| DEPLETED levels of monoamines -> ?
DEPLETED levels of monoamines - depression
100
Noradrenaline Hypothesis
Low plasma concentration of noradrenalin -> ?
Increased levels of noradrenalin -> ?
Low plasma concentration of noradrenalin - BD
| Increased levels - hypomania
101
Serotonin (5-HT) Hypothesis
| ↑ serotonin 2A receptors, ↓serotonin 1A receptors -> ?
↑ serotonin 2A receptors, ↓serotonin 1A receptors - Depression
102
Dopamine Hypothesis
↑ Dopamine–?
↓Dopamine– ?
↑ Dopamine– mania
| ↓Dopamine– depression
103
Substance P Hypothesis
↑ Substance P – ?
↓ Substance P – ?
↑ Substance P – depression
| ↓ Substance P – mania
104
Tx for BD
```
Mood stabilizers (Lithium Carbonate)
Anti-convulsants (Valproic acid/Divalproex sodium)
Atypical Antipsychotics
o Olanzapine – mania and psychosis
o Aripiprazole – mania or mixed
Antidepressants (Fluoxetine, Paroxetine)
Psychotherapy
```
105
Characterized by qualitative abnormalities in social
| interactions, markedly aberrant communication skills, and restricted repetitive and stereotyped behaviors
Autism
106
Three recognized disorders in the autism spectrum
| disorder (ASD)
1. Autism
2. Asperger Syndrome: lack or delays in cognitive
development and language
3. Pervasive Developmental Disorder (PDD-NOS):
diagnosed when the full set of criteria for Autism or
Asperger Syndrome are not met
107
What genes directly regulate expression of glutamic acid decarboxylase?
DLX5, DLX2 (both located on Chromosome 7)
108
Due to reduced cerebellar Purkinje neuron density
Autism
109
Tx for Autism
Special education
2nd-gen antipsychotic agents (Risperidone, Aripiprazole,
Ziprasidone)
Methylphenidate
110
Developmental condition of inattention and distractibility, with or without accompanying hyperactivity
Attention Deficit Hyperactivity Disorder (ADHD)
111
Main neurotransmitters involved in ADHD
Dopamine and Norepinephrine
112
Tx for ADHD
```
Pharmacological
o Stimulants- Methylphenidate, dextroamphetamine
o Non-stimulants- Atomoxetine
Non-pharmacological
o Behavioral psychotherapy
o Cognitive therapy for adults with ADHD
o Psychosocial interventions
```
