Patho Exam 2 Flashcards
(310 cards)
1
Q
Opening at the center of the iris
A
pupil
2
Q
In order to see the pupil constricts and dilates to allow the appropriate amount of light into the
_____
A
retina
3
Q
Forms the optic nerve, composed primarily of neurons
A
retina
4
Q
Converts images the brain can understand as vision
A
retina
5
Q
Innermost layer of the eye. Sensory portion of the eye that changes light waves into neuro- impulses that travel to the brain for interpretation
A
retina
6
Q
normally yellow circular clearly defined borders
A
optic disk
7
Q
responsible for central vision
A
macula
8
Q
central region of the macula responsible for sharp vision
A
fovea
9
Q
can optic nerve regenerate?
A
no, you will lose vision
10
Q
Adaptation of the eye for near vision
A
accommodation
11
Q
A reflex direction of the eye toward an object attracting a person’s attention
A
fixation
12
Q
condition where pupil accommodates but does not react to light.
A
Argyll Robertson Pupil
13
Q
Visual field loss secondary to optic nerve damage
A
glaucoma
14
Q
Leading cause of preventable blindness in the United States
A
glaucoma
15
Q
Dilates the pupil with _____
A
myDratics
16
Q
2 types of glaucomas
A
Primary open-angle glaucoma (POAG)
Acute angle-closure glaucoma
17
Q
Significant structural changes occur in glaucoma involve
A
ciliary muscle, trabecular meshwork, and canal of schlemn.
18
Q
Contraction of ciliary muscle allows drainage of _____ fluid through the canal of schlemn
A
aqueous
19
Q
Relaxation of ciliary muscle causes obstruction of the ____
A
canal
20
Q
________ attached to the trabecular meshwork, allows free flow of aqueous humor between the anterior and posterior chambers of eye
A
The ciliary muscle
21
Q
Produced in ciliary body
A
Aqueous Humor
22
Q
regulates IOP
A
canal of Schlemn
23
Q
Ciliary muscles controlled by the ___
A
ANS
24
Q
________ stimulation causes the ciliary muscle to relax (enlarge) which can block the
drainage
A
Sympathetic
25
________ stimulation causes ciliary muscle to contract which allows drainage
parasympathetic
26
If outflow from the anterior chamber is impeded, back pressure will develop and
increase ____ ____ ____
Inter ocular pressure (IOP)
27
Most common form of glaucoma in the United States
primary open-angle glaucoma
28
Devoid of symptoms until significant and irreversible optic nerve injury has occurred
typically has gradual loss of peripheral vision
primary open-angle glaucoma
29
Progressive optic nerve damage, with eventual impairment of vision IOP increases as there is a
slow exit through the trabecular meshwork
primary open-angle glaucoma
30
Primary Open-Angle Glaucoma risk factors
Elevation of intraocular pressure (IOP)
Family history of POAG
Advancing age
African and South American ancestry
31
treatment of primary open-angle glaucoma
Directed at reducing elevated IOP (the only
modifiable risk factor)
Principal method: Chronic therapy with drugs
32
Drugs lower IOP by Facilitating ____ ____outflow, and reducing its production
aqueous humor
33
If drugs are ineffective for glaucoma treatment , surgical intervention is needed to promote outflow of _____
aqueous humor
34
Cholinergic agents
Acetylcholine (Miochol)
Echothiophate (phospholine iodide)
35
Beta-adrenergic blocking agents
Timolol (Timoptic)
36
Mimic parasympathetic action of acetylcholine
Cholinergic/MIoTICS
37
Block sympathetic nerve endings in the ciliary epithelium causing a decrease in aqueous humor production
beta blockers
38
pharmacologic form of naturally occurring neurotransmitter
acetylcholine – constricting pupil
direct acting MOA (parasympathomimetics, miotics)
39
onset, peak, duration of direct acting -Acetylcholine
onset and peak- insant
Duration- 10 mins
40
Another direct-acting commonly used MIOTIC is called
_____ – a derivative of acetylcholine
pilocarpine
41
inhibits cholinesterase enzymes which then allows for the pupils to constrict because acetylcholine is not broken down
indirect MOA of echothiophate
42
onset, peak, duration of indirect acting- Echothiophate
onset: 10-30 mins
peak: 24 hours
duration: 7-28 days
43
for cholinergic drugs, If sufficient amounts enter the bloodstream, _____ effect may occur (most likely with indirect-acting)
systemic
44
adverse effects of cholinergic drugs:
Hypotension
Bradycardia
Headache
Nausea/vomiting
Diarrhea/ abdominal cramps
Asthma attacks
45
1. increase aqueous outflow
2. reduces aqueous humor formation thereby
decreases risk of damage to optic nerve
Timolol Maleate (timoptic) MOA
46
onset, peak, duration of Timolol Maleate (timoptic)
onset: 15-30 mins
peak: 1-2 hours
duration: 24 hours
47
side effects of Timolol Maleate (timoptic)
arrhythmia, bradycardia, heart block,
bronchospasm in asthmatic patient
48
Beta-Adrenergic Blocking Agents local adverse effects are usually _____
minimal
49
Beta-Adrenergic Blocking Agents systemic adverse effects:
Heart and lungs if absorbed in sufficient amounts (bradycardia, bronchospasm)
50
timolol Has drug-drug interaction especially with other _____ drugs
cardiac
51
timolol: Apply light pressure on lacrimal sac for how long after instilling drug to
minimize systemic absorption
1 minute
52
When applying eye drops, have the patient look up to the ceiling, and place the drop in the _______ ___
conjunctival sac
53
also known as narrow-angle glaucoma
angle-closure glaucoma
54
-Develops suddenly and is extremely painful
-No treatment--- irreversible loss of vision in 1
to 2 days
angle-closure glaucoma
55
uses of mydriatics
Adjunct to measurement of refraction
Intraocular examination
Intraocular surgery
56
adverse effects of mydriatics
Blurred vision and photophobia
Precipitation of angle-closure glaucoma
Systemic effects
57
A patient is admitted to the hospital for treatment of symptomatic bradycardia and atrioventricular (AV) heart block. What topical medication for the eye should the nurse withhold and discuss with the healthcare provider before administration?
timolol (will slow heart down even more)
58
middle ear Auditory Ossicles:
malleus, incus, stapes
59
Bridge for sound to the inner ear.
middle ear
60
Conducts sound vibrations from outer ear to central hearing apparatus in the _____ ___
middle ear
61
Protects the inner ear by reducing amplitude of loud sounds.
middle ear
62
______ __ allows equalization of pressure on either side of TM so it doesn’t rupture.
Eustachian tube
63
directs sound waves from the auricle to the tymphanic membrane; coated in cerumen (hydrophobic) repels water protects against Fungus/bacteria
external ear
64
bounded by tympanic membrane
middle ear
65
parts of middle ear that transmits sound
Malleus, incus, stapes
66
parts of external ear
Auricle or pinna
67
inner ear that provides balance houses the apparatus for hearing
Semicircular canals, cochlea
68
this connects the middle ear with the nasopharynx and allows passage of air
eustachian tube
69
Normally closed opens with yawning and swallowing.
eustachian tube
70
Sound transmission to the inner ear impaired
(altered sound transmission through outer and middle ear due to obstruction or trauma)
conductive hearing loss
71
Results in ability to hear sound but inability to understand speech, can lead to misunderstanding by others, Hearing aids make sounds louder but not clearer
sensorineural hearing loss
72
Perception of noise without an actual source of sound, ringing of ears
Tinnitus
73
Age-related hearing loss
presbycusis
74
More than ___ drugs cause tinnitus, usually caused by ____
200, noise
75
Determine if a patient can hear a whispered sentence or a series of numbers when whispered from a
distance of 1-2 feet (covering tragus)
whisper test
76
A sticky liquid secreted by glands in the skin of the ear canal.
protects your ears by trapping outside materials such as dirt particles, dust and bacteria.
cerumen
77
Carbamide Peroxide Otic Solution/Debrox
Ear wax emulsifier, For use in ear only, class: peroxide, soften, loosens and removes cerumen
78
Contraindications for debrox
-ear drainage
-Tympanic membrane rupture (new/unhealed)
-Significant pain or irritation
79
t/f: •Hearing loss caused by noise is not reversible
true
80
Avoidance of continued exposure to noise levels greater than __ dB is essential
70
81
Salicylates, loop diuretics, cancer chemotherapy drugs, antibiotics
ototoxic substances- drugs
82
Toluene, carbon disulfide, mercury
ototoxic substances- industrial chemicals
83
ABX =
antibiotics
84
DM =
diabetes mellitus
85
Tx =
treatment
86
BM =
bone marrow
87
_____ _____ must be functioning properly to defend against pathogens/foreign substances
immune system
88
immune response functions:
defense, homeostasis, surveillance
89
substance that elicits immune response
antigen (on pathogen)
90
bodys ability to resist disease
immunity
91
type of immunity that is present at birth, nonspecific response, and first line defense against pathogens
innate
92
type of immunity that is cell mediated and humoral
acquired/adaptive
93
immunity that does not produce antibodies, cell destruction through T lymphocytes, destroys pathogens inside cell
cell mediated immunity
94
immunity that produces antigen-specific antibodies, destroys cells through B cells, destroys pathogens outside cell
humoral immunity
95
_____ activates the immune system but doesn't always indicate infection
inflammation
96
when defense system fails and pathogen takes over
infections
97
t/f: inflammation is always present with infection; infection is not always present with inflammation
true
98
_______ response is a sequential reaction to cell injury and removes necrotic material; neutralizes and dilates inflammatory agent
inflammatory
99
t/f: inflammation mechanism is the same no matter what the cause
true
100
3 phases of inflammation:
vascular response
cellular response
formation of exudate
101
response that occurs after injury causing arterioles to vasoconstrict, releasing chemicals and histamine to dilate vessels
vascular response
102
during vascular response, _____ mediators cause increased capillary permeability
chemical
103
symptoms of vascular response
redness, heat, swelling
104
plasma protein
fibrinogen
105
accumulation of WBC's, movement of neutrophis and monocytes move to site of injury during what response
cellular
106
local symptoms of inflammation
redness, heat, pain, swelling, fn loss
107
systemic symptoms of inflammation
leukocytosis, malaise, nausea/anorexia, fever, increased HR and RR
108
body reacts to fever by increase of what?
heat production and conservation
109
bodys method of increasing temp to new set point
shivering
110
body reaches new set point =
chills decrease
111
Released cytokines & fever they triggered =
activation of defense mechanisms
112
fevers are beneficial because they kill _________, increase phagocytosis of ________, and proliferation of __ _______
microorganisms, neutrophils, T cells
113
healing process 2-3 weeks, no residual damages, predominately neutrophils
acute inflammation
114
same as acute process but lasts longer (weeks to months)
subacute inflammation
115
lasts weeks, months, or years, agent repeatedly injures tissues, lymphocytes and macrophages
chronic inflammation
116
hormones secreted by adrenal cortex, available as exogenous drugs
corticosteroids
117
inhibition of inflammatory and immune responses; increases BG level and breakdown of proteins to amino acids, stimulate
bone demineralization & stabilize mast cells
corticosteroids MOA
118
Prednisone is a _______
glucocorticosteroid
119
glucocorticosteroid; anti-inflammatory or immunosuppressant, avoided in presence of serious infection, can be secreted in breast milk
prednisone
120
contraindications of prednisone
allergy, serious infections, DM
121
When give steroids --> causes the endogenous production of hormones
to stop, starts stimulating normal production of endogenous hormones
taper dosing
122
drug that influences every body system
prednisone
123
prednisone adverse effects:
moon face, hyperglycemia, psychosis, adrenal suppression, insomnia, nervousness, impaired wound healing
124
Prednisone: monitor/ caution patient with
DM, gastritis, reflux disease, ulcer disease, cardiac/renal/liver disease
125
one celled organisms, normal flora; cocci, bacillia or spirochetes
bacteria
126
gram positive stain ______
purple
127
gram negative stain ____
red
128
microorganism that causes disease
pathogen
129
pathogen invades body, multiplies and produces disease, triggers inflammation and immune responses
infection
130
assists body to combat infection, most effective if combined with functional defense mechanisms
antibiotics
131
bacteria are present but not with over signs/symptoms, presence of bacteria on body surface without causing disease
colonization
132
does colonization require ABX?
no
133
infection acquired by person who has not been hospitalized or had a recent procedure
community-associated infection
134
AKA nosocomial infection, acquired while getting healthcare tx or in hospital
healthcare associated infection
135
therapy where patient requires immediate ABX
empiric therapy
136
therapy where lab identifies microorganism, narrow spectrum use
definitive therapy
137
ABX to prevent an infection in situations with high contamination, prior to surgery (30 mins)
prophylactic/preventative ABX
138
certain bacteria and fungi that maintain normal fn in organs
normal flora
139
when normal flora is killed,
bacteria/fungi take over
140
inference with bacterial cell wall and protein synthesis and replication of DNA/RNA
ABX MOA
141
do not actually destroy bacteria, inhibits growth of bacteria
bacteriostatic
142
kill a wide variety of gram pos and some neg bacteria
bactericidal
143
bacterial infections no longer response to typical ABX treatment
bacterial resistant infections
144
ABX that contain beta lactam ring in chemical structure, provides mechanism for bacterial resistance
Beta lactam ABX
145
which ABX was first derived from mold on bread/fruit, bactericidal
penicillins
146
bind to protein, inhibit peptidoglycan, interferes with cell wall synthesis
PCN MOA
147
contraindications of penicillin
drug allergy, cephalosporins
148
semisynthetic ABX, related to PCN
cephalosporins
149
cephalosporins adverse effects
GI and skin, PCN
150
inhibit protein synthesis, effective against wide range infections, compete with drugs metabolized in liver
erythromycin
151
irritates GI tract, stimulates smooth muscle and GI motility, beneficial to patients with delayed gastric emptying
erythromycin
152
adverse effects of erythromycin
-nausea, vomiting, stomach irritation
-cardiac and liver issues
-tinnitus/hearing loss
153
inhibits bacterial protein synthesis, binds to magnesium, calcium, metallic ions. forms insoluble complexes
tetracycline (doxycycline)
154
tetracycline adverse effects
teeth discoloration, effects on fetal development, photosensitivity, upset stomach
155
non prescription neosporin
neomycin and polymyxin B
156
hypersensitivity reactions to ABX can occur __ mins or up to days later
30 (delayed responses can occur after 72 hrs)
157
ADL=
activity of daily living
158
TIA=
transient ischemic attack
159
what is the 5th most common death in the US
CVA
160
2 types of CVA's
-Ischemic
-Hemorrhagic
161
Cerebral blood vessels change ________ in response to BP
diameter
162
During ______ CVA, --> autoregulation
may be impaired
ischemic
163
our cerebral blood vessels can make changed based on BF
Cerebral autoregulation
164
non-modifiable risk factors of CVA
gender, age, ethnicity, family history
165
some modifiable risk factors of CVA
htn, heart disease, diabetes, SMOKING (90%), obesity, sleep apnea, diet, substance abuse
166
mini stroke with brief episode of neurologic dysfunction, without infarction
transient ischemic attack
167
how long does a TIA last
<1 hour
168
which stoke involves a microemboli/temporary clot that temporarily blocks BF
TIA
169
__ % of strokes are ischemic
87%
170
Inadequate blood flow to the brain with blockage of a
cerebral artery by a blood clot
ischemic stroke
171
2 types of ischemic strokes
thrombotic, embolic
172
most common ischemic stroke, often preceded by TIA, narrowed vessel becomes occluded
thrombotic
173
thrombotic and embolic strokes result in _____
infarction
174
Embolus lodges & occludes cerebral artery, Most start as plaque, break off & enter circulation, travels to cerebral circulation & lodges in narrow vessel
embolic stroke
175
Common causes of embolic stroke
Atrial fibrillation, MI, infective, endocarditis, rheumatic heart disease
176
less common for embolic stroke:
air and fat emboli (long bone fractures)
177
ischemic stroke that develops suddenly with no warning signs and develops suddenly, conscious with headache
embolic stroke
178
Weakened blood vessels rupture and bleeding into the brain/ brain tissue (intracerebral), cells begin to die
Hemorrhagic stroke
179
Bleeding into the subarachnoid space or ventricles
Hemorrhagic stroke
180
Cause of hemorrhagic stroke where Bulge/ballooning in
blood vessel d/t weakness in the blood vessel wall; can leak and rupture
aneurysm
181
Abnormal tangle of blood vessels, connection of arteries and veins, Disrupt normal blood flow and oxygen, can weaken and rupture and lead to hemorrhage
Arteriovenous Malformation
(AVM)
182
One side of the brain controls the ______ side of the body
opposite
183
Lesion on one side of brain --> affects motor function on opposite side of body =
contralateral
184
unable to comprehend what is being said
receptive aphasia
185
inability to produce language
expressive aphasia
186
inability to communicate
global aphasia
187
loss of half of your vision
hemianopia
188
Right half or left half of your vision is missing from each eye, Monitor for diplopia, ptosis, loss of corneal reflex
Homonymous Hemianopsia
189
during ischemic stroke, In 1 second=
_______ brain cells die
32,000
190
during ischemic stroke, In 59 seconds=____ million brain cells die
1.9 million
191
door to needle time=
< or equal to 60 mins
192
stroke treatment is a multi- ? approach, or supportive therapy
drug
193
acute care of ischemic stroke
stroke center, treat htn, glycemic control
SBP > 220
DBP > 120
194
golden hour -->
CT upon arrival, blood glucose, NIHSS, fibrinolytic therapy, surgical intervention, 12 lead EKG and labs
195
breaks up clots causing stroke
fibrinolytic therapy
196
acute care of hemorrhagic stroke
antihypertensives, NO anticoagulants or platelet inhibitors, drug therapy, seizure precautions
197
Any process that stops bleeding
hemostasis
198
compression at bleeding site
mechanical hemostasis
199
clamping or cauterization
surgical hemostasis
200
When hemostasis occurs d/t to physiologic clotting of
blood =
coagulation
201
Process of Hemostasis
initial injury, vasospasm, platelet plug formation, coagulation
202
platelet plug formation in order:
adhesion, activation, aggregation, formation
203
tear in blood vessel, endothelium exposed
hemostasis injury
204
blood clot
thrombus
205
thrombus that moves
embolus
206
Hemostasis involves complex interaction of substances that promote ____ ______
clot formation
207
each activated clotting factor is a catalyst that amplifies next reaction
coagulation CASCADE
208
Result of cascade =
large clot forming substance FIBRIN
209
when platelet plug is not enough, use
coagulation cascade
210
Blood vessels are damaged by penetration from the outside, thromboplastin released
extrinsic pathway
211
examples of extrinsic pathway
knife, bullet wound
212
Clotting response to trauma/internal damage inside the blood vessels of body
intrinsic pathway
213
Components are present in the blood in inactive forms
intrinsic pathway
214
Activated when clotting factors come in contact with collage on inside of damaged blood vessels
intrinsic pathway
215
most powerful enzyme in coagulation process
thrombin
216
Factor Xa: Prothrombin -> thrombin ->
fibrinogen -> firbin. final product of coagulation:
meshwork (stable clot)
217
regardless of how clot began, ______ follows the same final common pathway
coagulation
218
the end of coagulation: converts fibrinogen to ____
fibrin
219
potent stimulator of platelet adhesion
collagen
220
antagonizes thrombin
antithrombin
221
thrombin activates conversion of plasminogen
to _____
plasmin
222
without thrombin, no ____
clot
223
reverse of clotting process
fibrinolysis
224
Breakdown of clots & balances clotting
process
fibrinolytic system
225
fibrinolytic system starts with activation of ________, then fibrin binds to it
plasminogen
226
enzymatic protein that breaks down thrombus
plasmin
227
Drugs that affect coagulation, dangerous and preventative, Used to reverse or maintain hemostasis
anticoagulants
228
do anticoagulants work on existing clots?
no
229
Anticoagulants: Contraindications
drug allergy, high risk for bleeding/ active bleeding
230
drug that Turns off 3 major clotting factors
heparin
231
Turns off coagulation pathway, Prevents clots from forming, CANNOT lyse clot
heparin
232
where do we get heparin from?
lungs or intestinal mucosa of pig
233
t/f: heparin is weight based
true
234
Large molecule only given IV, low molecular heparin just into really small molecules
unfractionated heparin
235
small structure, easier to target specific, more predictable outcome, injectable only
LMWH
236
DVT Prophylaxis -->
subq
237
Inhibits vitamin K synthesis, inhibits production of certain clotting factors
warfarin
238
Foods high in Vitamin K may ↓
______ ability to prevent clots
warfarin’s
239
toxic effect of anticoagulants
hemorrhagic
240
S/S of anticoag toxicity:
hematuria, melena, petechia, ecchymoses,
gum/mucus membrane bleeding
241
warfarin is synthesized in
liver
242
May take liver __ hours to resynthesize clotting
factors to reverse warfarin
36
243
heparin antidote
protamine sulfate
244
main anticoag AE
bleeding!
245
warfarin Antidote
vitamin K
246
Measure blood clotting time, if number is HIGHER, blood clot takes ______, if number is LOWER, ____
longer, quicker
247
Prevent clot formation, Prevent platelet adhesion at the site of blood vessel injury, Occurs before clotting cascade
antiplatelets
248
Collagen is stimulator of
platelet adhesion
249
After adhesion -->
stimulators from activated plts are released
250
stimulators tell platelets to _____, causing platelets to adhere
aggregate
251
Affect cyclooxygenase pathways, Final enzymatic pathway that operates within platelets & on cell
walls
final platelets
252
Inhibits cyclooxygenase in platelet, Inhibits enzyme so can’t regenerate --> prevents formation of thromboxane A2 (TXA2), TXA2 causes blood vessels to constrict & platelets to aggregate
aspirin
253
_____ Result = vessels dilate, prevent platelets from
aggregating and form a clot
aspirin
254
contraindications of aspirin:
thrombocytopenia, active
bleeding & allergy
255
fibrinogen attaches to receptors on platelet, Platelet will be able to aggregate now since it received the signal, inhibits activation of this receptor, Platelet does not
receive signal to clot
Clopidogrel
(Plavix)
256
Reduce risk of thrombotic stroke, TIA
prophylaxis, prevention of thrombosis
clopidrogel
257
KAVA is a sedative and ______
anxiolytic (acute liver failure)
258
St.John's wort (natures prozac)
makes birth control uneffective
259
acute onset, reversible, minutes to hours
-Systemic syndrome characterized by decreased attention span (inattention), doesn't recognize confused thinking
delerium
260
symptoms of delerium
hyperactive, with agitation, combative, hallucination, delusional, OR hypoactive, with inability to focus
or concentrate
261
emotional problems of delerium
fear, depression, euphoria, perplexity
262
Up to ___% of older adults hospitalized for medical conditions have delirium at some point in hospitalization
60%
263
Most common surgical complication among older adults, 15-25% after major elective surgery, 50% after high-risk procedures
delerium
264
Disorder characterized by a decline from previous level of
function in 1 or more cognitive domains:
Attention
Executive function
Language
Learning
Memory
Social cognition
dementia
265
devastating, progressive memory loss, impaired thinking, Neuropsychiatric symptoms, Inability to perform routine tasks of daily living
Alzheimers disease
266
Sixth leading cause of death in the United
States
Alzheimers disease
267
degeneration of neurons, early in hippocampus (memory), later in cerebral cortex (speech, perception, reasoning)
Alzheimers (pathopshysiology)
268
Degeneration of cholinergic neurons & deficiency of acetylcholine, Beta amyloid plaques form outside neurons and in the cerebral cortex, Presence of neurofibrillary tangles with twists inside of the neurons
Alzheimers
269
what gender is a risk factor for alzheimers
female
270
sundowning is common with what disease
Alzheimers
271
although the treatment of AD is to reverse cognitive decline, and there are no to do so, 3 cholinergic inhibitors approved for the treatment of Alzheimer’s dementia are:
Donepezil, galantamine, and rivastigmine
272
what happens if we lose acetocholyine in our brain
lose cognitive function
273
AD patients lose __% of their aceticholyine
90%
274
Acetylcholinesterase Inhibitors, AD drug
-Therapeutic Use: improves memory w/ mild to moderate AD by enhancing effects of acetylcholine in neurons in cerebral cortex not yet damaged – does not reverse disease
donepezil (aricept)
275
cholinergic toxicity (donepezil) symptoms: leads to dumbells
Circulatory collapse, Hypotension,
- SLUDGE – Salivation, Lacrimation, Urination,
Diarrhea, GI distress, Emesis
276
DUMBELLS (cholinergic toxicity) stands for:
diarrhea, urination, miosis, bradychardia, emesis, lacrimation, lethargy, salivation
277
Largest category of psychiatric problems, second only to HTN as chronic clinical condition
depression
278
__% of the U.S. population will experience
some form during their lifetime
30
279
Incidence of depression is twice as high in which gender?
twice as high in women than men
280
to get diagnosed with depression, symptoms must be present
most of the day, nearly every day, for at least 2 weeks
281
Insufficient amount of brain neurotransmitters such as Norepinephrine, Serotonin or Dopamine
- Decreased Serotonin permits it to occur
- Decreased Norepinephrine causes it
depression
282
Biochemically derived from Tryptophan, Primarily in the GI tract (90%) with remainder in the CNS serotonergic
neurons (parasympathetic cholinergic
receptors)
serotonin
283
Primarily used to relieve symptoms of
depression, Can also help patients with anxiety disorders
antidepressants
284
Most commonly prescribed antidepressants
selective serotonin reuptake inhibitors
285
Most widely prescribed SSRI in the world, primarily for major depressions, Produce selective inhibition of serotonin reuptake, Produce central nervous system (CNS) excitation
fluoxetine (prozac)
286
adverse effects of SSRI
-Withdrawal syndrome
-Neonatal effects when used during pregnancy
-Extrapyramidal side effects
- Bleeding disorders
- Sexual dysfunction
-Weight gain
287
Begins 2 to 72 hours after treatment, Altered mental status, resolves spontaneously after
discontinuing the drug
serotonin syndrome
288
Toxicity – Serotonin Syndrome
SHIVERS:
shivering
hyperreflexia and myoclonus
increased temp
vital sign instability
encephalopathy
restlessness
sweating
289
conditions that affect a
person’s thinking, feeling, mood,
or behavior
mental illness
290
examples of mental illness
Depression, anxiety, bipolar
disorder, schizophrenia, etc
291
More than __%, 1 in ___ will be
diagnosed with a
mental illness/disorder
at some point.
50%, 1 in 5
292
Amino acid neurotransmitter in brain
Gamma-Aminobutyric Acid (GABA)
293
Excitatory neurotransmitter, excessive amount = restlessness, nervous tension, anxiety
Glutamate
294
GABA is ____ while glutamate is ____
inhibitory, excitatory
295
GABA= promotes sense of ___
calm
296
Unpleasant state of mind; sense of dread and fear (anticipated or past experiences)
anxiety
297
drugs with Goal to decrease anxiety by reducing
overactivity in the CNS
anxiolytic drugs
298
Benzodiazepine receptor blocker, reverse effects of benzos, may cause withdrawal symptoms or seizures
flumazenil
299
State in which person lacks conscious awareness
sleep
300
wakes up or almost wakes up; interrupting continuous sleep
fragmented
301
sleeps recommended amount; does not feel refreshed and alert the next day
nonrestorative
302
Brain controls changes between sleep & waking, Forebrain & brainstem interact to regulate this
sleep wake cycle
303
Maintained by network of arousal systems from brainstem & forebrain, promoted by neurotransmitters
wake behavior
304
In hypothalamus --> sleep promoting neurons
sleep behavior
305
sleep is stimulated by neurotransmitters and _______
peptides
306
Hormone made by pineal gland, Release signals the time for sleep, Secretion is linked to the environmental light/dark cycle
melatonin
307
Synchronizes genetic clocks within individualized cells, master clock of body, in hypothalamus, regulates 24h sleep wake cycle
superchiasmatic nucleus (SCN)
308
Biologic rhythm pattern in 24 hours, Synchronized to environmental light & day periods, Through specific light detectors in retina
circadian rhythms
309
Pattern of nighttime sleep, Recorded using brain waves, eye movement, & muscle tone: NREM and REM
sleep architecture
310
difficulty falling and staying asleep, waking too early and feeling unrefreshed, dissatisfaction with sleep quality
insomnia
