Phychiatry

Question 1

Mechanism of Actions of psychoactive stimulants?

Answer 1

Amphetamines: INCREASE synaptic NE and Dopamine
Cocaine: Block NE and DA reuptake.
Nicotine: Agonizes CNS/PNS nicotinic cholinergic receptors.
Caffeine (MUST KNOW): Enhance DA effect by blocking ADO receptors.

Question 2

Caffeine withdrawal signs? (YOU GET THEM EVERYDAY)

Answer 2

Headache, inability to concentrate, flu-like symptoms.

Question 3

What is given to someone to help them with getting over this habit/abstinence?

1. Nicotine
2. Opioids
3. Alcohol

Answer 3

Nicotine—-> Bu-pro pion!
(Bu pro–> pro in smelling bad)

Opioids—> Buprenorphine, Naltrexone
(Bupre dey Nal)

Alcohol—> Disulfiram ( Inhibits aldehyde dehydrogenase)
Acamprosate—> GABA agonist, NMDA antagonist
(BABA is supportive of uncles while camping, but against aunties)

Question 4

Name NMDA-Antagonists?

Answer 4

Ketamine
PCP
Acamprosate given for Alcohol withdrawal.

Question 5

How does Alcohol causes:

1. Hepatitis
2. Testicular Atrophy
3. Pancreatitis

Answer 5

1. Hepatitis–>
2. Testicular Atrophy–> Low testosterone
3. Pancreatitis—> increases the viscosity of pancreatic secretions, causes pancreatic small ducts damaged.

Question 6

Pathophysiology of Alchoholic liver disease?

Answer 6

Alcohol liver disease, ischemia and Cytochrpme p450 affect the zone 3 of hepatocytes.

With increased aldehyde dehydrogenase/acetyldehyde dehydrogenase—> There’s INCREASED NADH–> This is shunted to INCREASE LIPID SYNTHESES, DECREASED LIPID EXCRETION FROM LIVER—> macrovesicles move nuclei of the cells to periphery—> This is steatosis.

Question 7

Histology of Alcoholic liver?

Answer 7

Macrovesicles of fat pushing the nucleus of hepatocyte into periphery–> Fatty inclusions
Mallory Bodies—> Cytoplasmic inclusions of cytoskeleton due to increased lipid peroxidation.
Inflammation
Oxidative damage–> due to increased toxic metabolites and reduced thiamine causing reduced glutathione.

Question 8

What is a can be complications of wernicke-korsakoff syndrome?

Answer 8

—> Atrophy of mamillary bodies (asked so many times, and also tested upon.)

—> Periventricular hemorrhage or necrosis. (can happen when seizures occur in an alcoholic)

Question 9

High-yield thing about Bu-propion?

Answer 9

Causes seizures in Bulimics!!
Can be given with SSRI–> because this drug has a favourable sexual profile, and doesn’t affect serotinin uptake (only NE and Dopa)