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ESUN MS2Unit3 > Pyschiatry II > Flashcards

Pyschiatry II Flashcards

1
Q

Which gene mutations are associated with schizo?

A

COMT/tyrosine hydroxylase/DA D2R/D3R

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2
Q

The ___ number of risk genes—->the high risk of getting schizo

A

Higher

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3
Q

Gene mutations that are responsible for hypofrontal activity of schizo?

A

COMT and DA D3R

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4
Q

Gene mutations that are responsible for hyper ventromedial cortex activity of schizo?

A

DA D2R/tyrosine hydroxylase/MAO

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5
Q

What are the significance of DA and NE in ADHD?

A

DA helps to block out out things/NE helps you to concentrate

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6
Q

Gene mutations that are associated with hypofrontal activity of ADHD?

A

DA D4/5R

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7
Q

What is the precursor of 5HT?

A

Tryptophan

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8
Q

5HT is from __ in the brain?

A

Raphe nuclei

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9
Q

Low 5HT causes hyperactivity in __ of the brain?

A

Amygdala

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10
Q

What gene mutations are associated with 5HT dysfunction?

A

5HT2a/5HTTLPR (reuptake transporter)/tryptophan hydroxylase

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11
Q

Where is NE originated in the brain?

A

Locus coeruleus

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12
Q

High NE gives you?

A

Hyperarousal/panic/worry

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13
Q

Dysfunction of what transmitters give you reduced + affect (loss of interest/happiness and what not)?

A

NE and DA

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14
Q

Dysfunction of what transmitters give you increased - affect (fear/irritability and what not)?

A

NE and 5HT

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15
Q

What is the brain activity of PTSD pt comparing with control?

A

High mid anterior cingulate and amygdala/low frontal activity

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16
Q

In MDD, what gene mutation is responsible for the increase NE and anxiety in limbic areas?

A

COMT Met alleles—>low degradation—>high NE (COMT Val alleles does the opposite)

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17
Q

What parts of the brain light up when you are empathizing?

A

Medial prefrontal cortex (hypoactive means you lack empathy)

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18
Q

Memorizing enhance or disrupt empathetic response?

A

Disrupt (maybe why doctors are not unempathetic when treating pts)

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19
Q

COMT is responsible for what transmitters?

A

DA and NE

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20
Q

What are the 3 methods under whole medical systems of CAM?

A

Ancient healing system/homeopathy (use small dose to stimulate self healing/naturopathy (like massage/exercise/acupuncture and what not)

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21
Q

What are some examples of mind-body medicine of CAM?

A

meditation and relaxation

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22
Q

What are some examples of biologically based practices of CAM?

A

Dietary supplements (vitamins) and herbal remedies

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23
Q

What are some examples of manipulative and body based practices of CAM?

A

chiropractic and osteopathic manipulation

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24
Q

What are some examples of energy medicine of CAM?

A

Qi gong

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25
What is St John's wort used for?
CAM for depression
26
Which vitamin deficiency is associated with depression?
D (so they say)
27
What cluster A of personality disorder?
Psychotic like---->paranoid/schizoid (detachment from social relationships)/schizotypal (odd)
28
What is cluster B of personality disorder?
Behavioral disorder--->antisocial (like conduct disorder)/histrionic (overly dramatic, attention seeking)/narcissistic (need for admiration/entitlement/risky disorder)/borderline (instability of relationships, moods, self image or thought)
29
What is cluster C of personality disorder?
Anxious---->avoidant (from social circumstances)/depdent/obsessive compulsive
30
Which cluster is more common in PD?
Cluster A and C
31
What happens if a child is deprived of maternal nurturing in the beginning? does parenting behaviors affect the risk of the children developing PD?
The child tends to become impulsive and aggressive/yes
32
What would you see if you follow PD pt over 4 years?
Some of them might not meet the PD criterion anymore (remission) but their impairment in functioning still persist
33
What is the treatment for cluster B?
mood stabilizers/antipsychotics/benzodiazepine might worsen the condition
34
What is DSM 5 definition of mania?
abnormally happy for over 1 week/3 symptoms of DTRHIGH for at least 2 weeks/cause dysfunction
35
What is DTRHIGH for mania?
Distractible/talkative/racing thoughts/hyperactive/impulsive/grandiose/hyposomnic
36
What is hypomania?
Mild mania/change in function and personality for at least 4 days/no psychosocial consequences
37
Can a biopolar pt be manic and depressed at the same time?
Ye, 'tis called mixed episode
38
What is bipolar 1 disorder?
Must have mania/do not need to have depression
39
How frequent is rapid cycling of bipolar?
4 or more episodes per year
40
What is bipolar 2 disorder?
Must have hypomania/spend most of the time depressed
41
What is cyclothymia?
Minor depression/have hypomania for more than 2 years/from hypomania to minor depression--->crash and suicidal
42
What is dysthymia?
Chronic low level depression for 2 years
43
What is kindling hypothesis for mania and seizure disorder?
The more you get, the worse you get
44
You have ___ transmitter and ___ receptor when you are manic?
high/low
45
Which gender is more prone for bipolar 1 and 2?
equal for 1/more women for 2
46
Try not to use ___ when the pt is bipolar? what do we use instead and why?
Antidepressant/SGA/tune down mania and also has some built in antidepressant
47
Does psychotherapy work for mania?
Nein
48
What are some medication for bipolar 1?
Li/divalproex/carbamazepine/lamotrigine/SGA
49
What is the physical and psychological manifestations of anxiety?
physical--->hyperventilation/numbness and tingling in the extremities/sleep disturbance psychological--->restlessness/worry/irritability
50
Is socially triggered panic attack considered as panic disorder?
Nein nein
51
What is the diagnostic criteria of anxiety disorder?
Persistent/interfere normal functioning/cause distress
52
Some causes of anxiety of disorder?
Trauma/personality/learned anxiety/30-40% genetic/more women than men
53
What transmitters are low for anxiety disorder?
5HT is low--->that's why antidepressants works well/low GABA/high NE--->alert and freaking out
54
What is the DSM 5 diagnostic criteria for General Anxiety Disorder?
Persistent worrying about more than 1 event for at least 6 months/have at least 3 symptoms of anxiety
55
What do people who worry a lot sometime turn to?
Alcohol (or turkey but unlikely)
56
What do you treat GAD with?
CBT/antidepressant/buspirone (get rid of autoreceptor of 5HT)/benzodiazepine
57
GAGB allows more ___ channel to open?
Cl-
58
DSM 5 diagnostic of panic disorder?
Abrupt unexpected surge of intense fear within mins/have at least 4 symptoms of panic/recurrent/consequence and maladaptive change in behaviors
59
Diagnostic criteria for agoraphobia (panic disorder)?
anxiety for public space for over 6 months
60
Treatment for panic disorder?
CBT (systemic desensitization or flooding)/benzodiazepines/SSRI and SNRI
61
DSM 5 diagnostic criteria of specific and social phobia?
Specific--->disproportionate fear of something/avoid it/over 6 months Social--->same thing but just afraid of being in social situation (fear of embarrassment and what not)
62
Treatment for phobia?
CBT (systemic desensitization and flooding)/SSRI or SNRI/MAOi
63
DSM 5 diagnostic criteria of OCD?
Obsessions and compulsions/time consuming/distress
64
What is the obsession and compulsion in OCD?
Obsession--->recurrent thoughts/urges that are intrusive and unwanted--->undo or neutralize them with a thought or action Compulsion--->repetitive behavior in response to an obsession/reduce anxiety/insight
65
Which gender is more prone to OCD?
Equally
66
What is the worst anxiety disorder?
OCD
67
What syndrome usually comes with OCD?
Tourette's syndrome
68
Treatment for OCD?
CBT (exposure and response prevention)/acceptance and commitment therapy therapy for obsession (desensitize thoughts)/high dose SSRI/clomipramine/benzo does not work
69
What is OCPD?
Anxiety without insight--->harder to treat
70
What are variables associated with PTSD?
proximity/harm by other ppl/severity/repetition
71
DSM 5 diagnostic criteria for PTSD?
Exposure to traumatic event (don't have to be there)/symptoms over 1 month/distress/flashback/avoid stimuli/- change in cognition/jumpy/poor concentration and insomnia
72
DSM 5 diagnostic criteria for ASD?
Like PTSD but symptoms are from 3 days to 1 month
73
Treatment for PTSH and ASD?
Treat right away, don't wait/relive or seal over events (eye movement desensitization and reprocessing)/SSRI/TCA/MAOi/prazosin for nightmares
74
What is mild Traumatic Brain Injury (TBI)?
disruption of brain function or focal neurological deficits/LOS
75
The most causes of TBI is ?
Fall
76
What is primary TBI?
From force of the impact
77
What is secondary TBI?
Ischemia/hypoxia/over time/magnify primary cause
78
What is diffuse axonal injury?
Focal lesion result from primary cause/shearing of brain tissue--->disruption of pathway in the midline structure
79
What is neurometabolic cascade after trauma?
Disruption of the homeostasis of energy supply and metabolism--->mismatch (low vascular supply and high demand)
80
Are the all the NTs level go up or down after TBI?
Go up
81
What are the 3 things Glasgow Coma Scale look for?
Eye opening/verbal response/best motor response (the hight the # the better)
82
What scale is used to track recovery of TBI?
Ranchos Los Amigos Level
83
What are the stages 1-6 of Ranchos Los Amigos Level?
Coma/vegetative state/minimally conscious/confusional (post traumatic amnesia)/post confusional (no amnesia/start therapy)/social competency (back to community)
84
Can you typically categorize the emotional and behavioral changes according to DMS 5 with TBI pts?
No, they come in small elements
85
What is post traumatic agitation and its treatment?
RLAS IV/agressive/akathisia | Treatment--->pindolo (beta blocker)/antiepileptic/SSRI or TCA/no FDA approved medication
86
What might be some emotional changes with TBI pts?
No awareness of inappropriate behaviors/depression and anxiety
87
PTSD is more common in mild or severe TBI?
Mild (even if you don't remember the event)
88
What is dyssomnia?
Problem in timing/quality/amount of sleep
89
What is parasomnia?
Problems in physiology or behavior associated with sleep (abnormal stuff that happen to you at night)
90
What is the DSM 5 diagnostic criteria for insomnia?
Problem falling or maintaining sleep/wake up too early and can't fall back to sleep/cause distress
91
Prevalence of insomnia increase with __?
Age
92
Causes of insomnia?
High excitatory NTs and low inhibitory NTs at night
93
Insomnia sometimes comes down to ___?
Anxiety--->worry about not be able to sleep---->then you don't sleep
94
Withdraw of ___ drugs can cause insomnia?
Sedating drugs
95
Insomnia pts have a risk of ___ abuse
Alcohol/substance--->whatever helps to go to sleep
96
Insomnia management?
Diagnosis/behavioral counseling/sleep restriction therapy/drugs
97
Pharmacotherapy for insomnia?
Ramelteon and Tasimelteon (non habit forming)/zolpidem/benzo (habit forming)
98
Panic disorder/phobia/GAD/PTSD/OCD are all part of the ___ disorder?
Anxiety

ESUN MS2Unit3 (11 decks)

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