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Advanced Pathophysiology > Psychotic/ Musculoskeletal Disorders > Flashcards

Psychotic/ Musculoskeletal Disorders Flashcards

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1
Q

Risk Factors for _______:

  • Urban living
  • Immigration
  • Obstetrical complications
  • Viral exposure in utero (flu)
  • AMA
  • Birth during famines
A

Schizophrenia

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2
Q

large extra cellular matric glycoprotein involved in neuronal migration during prenatal development of brain & in synaptic function duing adulthood - low levels of this in prefrontal cortex and hippocampus in schizophrenia

A

reelin

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3
Q

schizophrenia chromosomes are ___, ____, and ____.

A

18,22, 23

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4
Q

neurotransmitter alterations schizophrenia theory that states transmission pathways are altered causing increase in dopamine

A

dopamine hypothesis

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5
Q

neurotransmitter alterations schizophrenia theory that states under-activated glutamate receptors (N-methyl-D-aspartate (NMDA) receptor subtype) causes lower levels of glutamate

A

glutamate hypothesis

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6
Q

type of schizo symptoms that frequently occur during a psychotic episode (loses touch with reality and experiences something that should be absent

A

positive symptoms

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7
Q

positive symptoms of schizo

A

hallucinations
delusions
disorganized speech/behavior

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8
Q

symptoms of schizo that are disruptions in normal emotional states and expressions including social withdrawal, blunted affect, no response to simple questions

A

negative symptoms

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9
Q

negative symptoms of schizo

A

affective flattening
anhedonia
alogia
avolition

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10
Q

low levels of ______ in schizo is related to chromosome 22

A

reelin

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11
Q

if this brain component, which is central in social brain processing, is abnormal, the person has difficulties making appropriate social judgements, ie. facial identity, affect recognition, emotional processing

A

amygdala

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12
Q

symptoms of schizo that are problems with thought processes that severely impair the ability to
perform routine daily tasks that involve attention, planning, and social skills

A

cognitive symptoms

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13
Q

etiology of ________ and _______ is related to deficits of reelin expression on chromosomes 18 and 22

A

depression and bipolar

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14
Q

chromosome 22 is related to _____ behavior

A

psychotic

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15
Q

dysfunction of this has a role in individuals ability to cope with stress

A

hypothalmic-pituitary system

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16
Q

chronic stress-induced actication of this sytem leads to increased glucocorticoid secretion associated with 30-70% of those with major depression

A

hypothalmic-pituitary system

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17
Q

in depression/bipolar, this system increases HPA hormone secretions

A

hypothalmic-pituitary system

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18
Q

this causes depression/bipolar when inflammation increases C-reactive protein -> increased risk for psych distress and depression
-increased cytokine levels may be associated with depression

A

Altered immune and Inflammation from Cortisol

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19
Q

there is an association of _______ function and mental illness but the mechanism is unknown

A

thyroid

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20
Q

patients with _______, have anxiety, dysphoria, irritability, cognitice impairments

A

hyperthyroidism

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21
Q

patients with _____, have depression, apathy, psychomotor slowing, dementia

A

hypothyroidism

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22
Q

in depression/bipolar, a large group of serotonin-synthesizing neurons, in the _________, that project extensively to all regions of the cortex

A

central gray matter

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23
Q

in depression/bipolar, widespread decrease in _______, 5-HT1A receptor subtype in the frontal, temporal, and limbic cortex

A

serotonin

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24
Q

in depression/bipolar, _______ transporter binding in cerebral cortex and hippocampus

A

serotonin

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25
some people with depression/bipolar have dysfunction of ________, which modulates homeostasis, emotionality, and tolerance to aversive experiences.
raphe-serotonin system
26
in depression/bipolar, functional abnormalities are found in _____ and _____ regions such as the amygdala
frontal and limbic
27
decreased _______ numbers occurs in in people w/uni & bipolar
glial cell
28
in mood disorders and bipolar, cerebral blood flow _______ in dorsolateral and dorsomedial prefrontal cortex
decreases
29
in unipolar depression, cerebral blood flow ________ in ventrolateral, ventromedial, and orbital areas
increases
30
major excitatory neurotransmitter associsated with MDD
glutamate
31
elevated cortical levels of ______ occur in mood disorders
glutamate
32
_______ (glutamate receptor antagonist) was found in animal models to rapidly increase synaptic density and signaling
ketamine
33
psychosocial stress can cause _______ in pro-inflammatory cytokines
increase
34
- Deficit in norepinephrine, dopamine, and/or serotonin may be the cause - Found that drugs, like imipramine elevated norepinephrine levels reduced depression, but drugs that depleted monoamine levels increased depression. - Mania results from ↑ monoamine
Dominant MonoAmine Hypotheseis of Depression
35
the principle of antidepressant medication is increasing ______ neurotransmitter levels within the synapse is the basis for their antidepressant effects
monoamine
36
inability to experience emotion(pain or pleasure, repost a sense of detachment from environment
adhedonia
37
absence of spontaneous speech production to answer questions of express oneself
alogia
38
deficit in spontaneous or goal directed behavior to complete daily tasks
avolition
39
``` Risk Factors for _______: Thin female fam history estrogen/testosterone deficiency heavy caffeine use sedentary ETOH hyperthyroid age glucocorticoids decreased nutrients (Ca, Mg, vit D) ```
osteoporosis
40
most common bone disease that is caused by decreased mast density in porous bone...greater reabsorption of bone than formation of bone
osteoporosis
41
type of osteoporosis caused by menopause
primary
42
type of osteoporosis caused by conditions other than menopause
secondary
43
Clinical Manifestations of _____: Bone deformity increased risk for fx (esp without injury) kyphosis
osteoporosis
44
Diagnosis of ______: | Based on gradations of bone mineral density measured by dexascan
osteoporosis
45
common, degenerative joint disease, age-related disorder of the synovial joints
OA
46
Local areas of damage in joints and loss of articular cartilage w/ new bone formation of joint margins & thickening of joint capsule; Increased ossification around where the cartilage has degenerated, osteophytes
OA Patho
47
nodes on proximal inter-phalangial joint
bouchard
48
nodes on distal inter-phalangial joints
heberden
49
systemic autoimmune destruction of synovial membranes w/ systemic side effects of fever, malaise, rash, leukocytosis, lymph node enlargement
RA (adult)
50
``` Risk Factors of ______: geographic location breastfeeding length or lack of smoking socioeconomic status women HLA death receptor 4 gene is present T cell abnormalities ```
RA (adult)
51
Activation of immune cells, inflammatory cytokines, immune complex deposits that destroy the joint. Inflame mediators and enzymes destroy cartilage & immune cells lead activation of ostoclasts & promote destruction of bone. Pannus occurs
RA Patho
52
Labs for ____: Positive RA or RF- reveal antibodies (IgG, IgM, IgA), serum anti-citrullinated protein antibody ESR
RA
53
``` Clinical Manifestations of ______: Symmetric joint swelling deformity rheumatoid nodules found in organs Fever malaise fatigue Boutounniere deformity Swan-neck deformity of hand ```
RA
54
Score of >6/10 is needed to diagnose _____: - synovitis - widespread symmetrical large and small joints involved - abnormal CRP or ESR - pos RF or ACPA - morning stiffness >1 hr - sx >6 weeks
RA
55
Metabolic inflame joint disorder that disrupts bodys control of uric acid production or excretion and forms crystals that deposit in connective tissues in body
Gout
56
``` Risk Factors for ________: Trauma ETOH drugs diet of red meat renal insufficiency kidney stones obesity renal failure diuretics ```
Gout
57
Accelerated purine synthesis w/ overproduction of uric acids leads to poor uric acid secretion by kidneys
Gout Patho
58
lab for gout diagnosis
Uric acid level
59
``` Clinical Manifestions of ____: Tophi (crystal nodule) pain in great toe recurrent attacks of monoarticular arthritis renal stones low grade temp ```
Gout
60
stage of gout: asymptomatic hyperuricemia
1st stage
61
stage of gout: acute gouty arthritis
2nd stage
62
stage of gout: tophaceous gout
3rd stage
63
Chronic widespread joint and muscle pain, fatigue, tender points over muscles
fibromyalgia
64
``` Risk Factors for ____: Flu-like viral illness chronic fatigue syndrome medications physical or emotional trauma HIV lyme-disease women ```
fibromyalgia
65
CNS in a state of dysfunction-amplified pain transmission and interpretation leads to Sensitization to pain and HPA axis shows abnormal response to pain
fibromyalgia patho
66
``` Clinical Manifestations of _____: Increased sensitivity to touch Diffuse chronic pain that comes and goes and doesn’t follow dermatomal pattern sleep changes fatigue in morning or mid day anxiety depression short term memory loss ```
fibromyalgia
67
``` Diagnosis of ________: 11/28 positive tender points WPI of 7 and SSI of 5 or WPI of 3-6 and SSI of at least 9 Widespread pain affecting all 4 quadrants of axial skeleton Sx>3months ```
fibromyalgia
68
scoliosis that consists of poor posture, unequal leg length, pain (mild spinal curve w/ one pronounced hip or shoulder that disappears with forward flexion of spine)
non structural
69
scoliosis that consists of vertebral rotation of skeletal abnormalities (asymmetry of hip and shoulder height, should, scapular and rib prominence.)
structural
70
``` Risk Factors for ________: Neuromuscular disease trauma spinal contractions bone infection of vertebra metabolic bone disorders joint disease tumors (all are structural) Girls high incidence in family hx of connective tissue disorder ```
scoliosis
71
scoliosis will not progress Curve
40
72
scoliosis with curve > ___ degrees results in pulmonary function decrease
80
73
most common rheumatological disease in children Same as adults except for mode of onset. -1st is pauciarticular arthritis- <5 joints involved - polyarticular: >5 joints - systemic: likely to progress to true adult RA
Juvenile Idiopathic Arthritis/RA
74
Labs for ____: Pos antinuclear antibody test. Rheumatoid factor seldom detected. + cyclic citrullinated peptide antibody
JIA
75
Unexplained arthritis of one or more joints for at least 6 weeks in pt less than 16 y/o
Diagnosis of JIA
76
``` difficulty sleeping difficulty concentrating irritability restlessness muscle tension easily startled **more often in females than in males ```
symptoms of GAD
77
neurotransmitters involved with panic disorder
norepinephrine and serotonin
78
comorbidities associated w/ OCD
anxiety/depreesion
79
general age of onset for OCD
age 20-25
80
persistent depressive disorder
dysthmia
81
____ tends to skip generations
shizophrenia
82
neurotransmitter associated with schizophrenia
dopamine
83
bone remodelers- bone regenerative cells
osteoclasts
84
bone formation cells
osteoblasts
85
post-menopausal women are at increased risk for osteoporosis due to lack of _______
estrogen
86
development of a pannus is associated w/ ______
RA
87
``` lab tests to diagnose ____ rheumatoid factors (70-75% specifcity) antibodies (anti CCP- 95% specificity) CBC CRP ESR ```
RA
88
______ is thought to be caused by gene products of the major histocompatibility system
RA
89
____ is present in the majority of patients with RA
HLA-DRB1 (Human Leukocyte Antigen)
90
uric acid crystalline concentration that makes nodule in joint usually on big toe
tophi
91
``` Clinical Manifestations of _____: fever rash fatige splenomegaly lymphandectomy ```
JIA
92
arthritis that is more likely to affect the larger joints
juvenile arthritis

Advanced Pathophysiology (10 decks)

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