Term
| An iatrogenic illness is caused by ? |
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Definition
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Term
| A nosocomial infection is picked up at ? |
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Definition
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Term
| GABA involved in what psychiatric problem ? |
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Definition
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Term
| What neurotransmitter uses the NMDA receptor and involved in excitatory toxicity ? and learning ? |
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Definition
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Term
| What neurotransmitter is involved in reward pathways, schizophrenia, and Parkinson's ? |
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Definition
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Term
| What neurotransmitters are involved in mood disorders and stress ? |
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Definition
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Term
| What neurotransmitter is involved in mood disorders, impulsive violence, and anxiety ? |
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Definition
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Term
| What neurotransmitter is involved in Alzheimer's and Down's Syndrome ? |
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Definition
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Term
| Limbic System does what ? |
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Definition
Expression and interpretation of affect and emotion
Involved in emotional learning
Maybe in phobias and PTSD |
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Term
| What is the Papez circuit ? |
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Definition
Papez Circuit is the limbic system, it is the circuit of emotions.
Mamillary bodies
Mamillothalamic tract
Ant nuc of thalamus
Cingulate gyrus
Cingulum
Hippocampus
Fornix
Back to Mammillary bodies |
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Term
| How many types of association cortex are in the limbic system ? |
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Definition
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Term
| What is an association cortex and what are the 3 areas they are located in ? |
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Definition
It is the cerebral cortex outside of the four primary sensory areas.
Three areas are:
Cingulate - just above the corpus callosum
Temporal lobe -
Orbital prefrontal - just above eyes in midline |
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Term
| Function of orbital prefrontal area in association cortex ? |
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Definition
Involved in emotion
Inhibits other limbic areas |
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Term
| What do you see in pt. if orbital prefrontal area is damaged ? |
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Definition
| Psychotic behavior and nightmares ? |
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Term
| What brain structure is needed for fear conditioning ? |
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Definition
Amygdala
It projects to medial dorsal nucleus in thalamus and pre-frontal cortex |
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Term
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Definition
One of the layers of the cerebral cortex and the outer layer of the cerebral hemispheres. Is made up of 6 layers.
Is non-emotional
Enables fast, fine discriminations (for like reading Braille)
Reqd for hypothetical thinking (like to play chess) |
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Term
| What are two kinds of association cortex important in psychiatry ? |
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Definition
PTO (Parietal-Temporal-Occipital)
DLP (Dorso-Lateral-Prefrontal) |
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Term
| Function of PTO (Parietal-Temporal-Occipital) association cortex ? |
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Definition
"multi-media" interpretive cortex
Lesion here makes experiences and objects uninterpretable |
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Term
| Function of DLP (Dorso-Laterao-Prefrontal) association cortex ? |
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Definition
| Needed for planning, thinking |
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Term
| Left and right side of PTO association cortex is involved in what functions ? |
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Definition
Left side in language and arithmetic
Right side in spatial, recognizing faces, prosody (parts of speech like tone and pitch) |
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Term
| Right side lesion to PTO association cortex causes what ? |
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Definition
| "Neglect" syndrome - can't recognize things on left side |
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Term
| Using monkeys, delayed spatial matching in the WGTA (Wisconsin General Test Apparatus) showed what ? |
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Definition
| Lesions of DLP association cortex caused monkeys to do badly on this task |
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Term
| Using monkeys, delayed spatial matching in the WGTA (Wisconsin General Test Apparatus) showed what ? |
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Definition
| Lesions of DLP association cortex caused monkeys to do badly on this task |
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Term
| The prefrontal area contains which 2 different types of cortex ? |
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Definition
DLP (Dorsolateral Prefrontal) - involved in thinking
OPF (Orbital Prefrontal) - involved in feeling |
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Term
| Lesion of DLP cortex causes what ? |
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Definition
| Apathy, inactivity, and less ability to perform complex tasks and plan |
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Term
| Lesion of OPF cortex causes what ? |
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Definition
| Release of euphoria, inappropriate social behavior |
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Term
| Lesion in any of the 2 cortexes of the prefrontal area causes what ? |
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Definition
| Impairment in goal-directed behavior due to deficit in the integration of environmental and internal cues |
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Term
| Pre-frontal leucotomies / lobotomies were discontinued due to what ? |
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Definition
| Because of RCT (randomized clinical trial) |
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Term
| Phineas Gage had damage to what brain areas ? |
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Definition
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Term
| GABA is useful in treating what disorder ? |
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Definition
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Term
| GABA is ________ at both cellular and behavioral levels ? |
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Definition
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Term
| How does GABA mediate its inhibitory effects ? |
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Definition
GABA-a receptor complex opens Cl channel hence hyperpolarizing - inhibitory
Also contains receptors for both benzodiazepines and barbiturates |
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Term
| What do the Alpha1 and Alpha2 receptors of GABA do ? |
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Definition
Alpha 1 mediates sedation
Alpha 2 is related to anxiety |
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Term
| What percentage of synapses in CNS are either GABAergic or glutaminergic ? |
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Definition
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Term
| Stress increases the turnover of what neurotransmitters ? |
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Definition
Cortical NE
Meso-Prefrontal Cortical Dopamine |
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Term
| Anti-anxiety drugs block increase in what neurotransmitters ? |
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Definition
NE and DA
also suppress firing in Locus Ceruleus |
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Term
| _______ given to injured US military personnel, child burn victims, and motor vehicle victims decreases development of PTSD ? |
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Definition
Morphine
probably by blocking the NE-mediated consolidation of conditioned, learned fear |
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Term
| NMDA receptor channel is located on what neurotransmitter ? |
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Definition
Glutamate
Regulate Dopamine release |
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Term
| PCP (angel dust) blocks what receptors ? |
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Definition
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Term
| NMDA receptors involved in what neurological processes ? |
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Definition
memory acquisition LTP, LTD
developmental plasticity
epilepsy |
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Term
| What receptors mediate secondary brain damage after anoxia ? |
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Definition
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Term
| Year first antipsychotic medication (Chlorpromazine) was discovered ? |
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Definition
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Term
| Early effectiveness of Chlorpromazine was different in US and UK because ? |
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Definition
| There was a difference of how diagnoses was made in the two countries |
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Term
| What is the duration for brief psychotic disorder, shizophreniform disorder, schizophrenia ? |
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Definition
Brief Psychotic Disorder: 1 day to 1 month
Schizophreniform Disorder: 1 to 6 months
Shizophrenia: more than 6 months |
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Term
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Definition
| A configuration of symptoms that occur together and constitute a recognizable condition, even if the pathophysiology is not known |
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Term
| Schizophrenia prototype is a pt. who has what symptoms ? |
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Definition
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Term
| What was the primary goal in development of DSM-IV ? |
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Definition
Improved reliability
Kappa went up from .4 to .8 |
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Term
| What is contained in the 5 Axes in a DSM manual ? |
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Definition
Axis 1 - Clinical Disorders (most of psychiatry)
Other conditions (not disorders)
Axis 2 - Personality disorders and mental retardation
Axis 3 - General Medical Conditions
Axis 4 - Psychosocial, Environmental Problems
Axis 5 - Global Assessment of Functioning (0 - 100 scale) |
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Term
| How to diagnose schizophrenia ? |
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Definition
Two or more of the following five, each present for at least 1 month:
-Delusions
-Hallucinations
-Disorganized speech
-Grossly disorganized
-Negative symptoms (flat effect, avolition, alogia)
Total duration of disturbance must be at least 6 months and may include prodromal or residual periods |
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Term
| What are some characterological traits that can be put into Axis 2 for schizophrenia ? |
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Definition
-Social isolation, sense of alienation
-Low self-esteem
-Social skills deficits
These are not helped by typical meds |
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Term
| 50% of people with schizophrenia attempt ... |
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Definition
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Term
| What brain structure involved if pt. with schizophrenia says "My thinking is confused" ? |
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Definition
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Term
| What brain structure involved if pt. with schizophrenia says "My thoughts don't seem to connect quite right" ? |
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Definition
| Frontal lobes, cerebellum, hippocampus |
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Term
| What brain structure involved if pt. with schizophrenia says "I have trouble filtering out unimportant information" ? |
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Definition
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Term
| What brain structure involved if pt. with schizophrenia says "I feel bombarded by stimuli" ? |
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Definition
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Term
| What are the characteristics of a good prognosis in schizophrenia ? |
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Definition
Older age of onset
Rapid onset
Positive symptoms
Socially ok
Affective symptoms |
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Term
| What are the characteristics of a bad prognosis in schizophrenia ? |
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Definition
Younger age at onset
Slow onset
Negative symptoms
Socially withdrawn |
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Term
| What drugs are not a good model of schizophrenia ? |
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Definition
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Term
| What drugs are a good model for schizophrenia ? |
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Definition
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Term
| What drug use can produce paranoid schizophrenia ? |
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Definition
| Chronic amphetamine abuse |
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Term
| What class of drugs usually make schizophrenia worse ? |
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Definition
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Term
| What drug is a NMDA antagonist and may be used as an antidepressant ? |
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Definition
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Term
| People with schizophrenia have more of what receptors in their limbic system, especially in their nucleus accumbens ? |
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Definition
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Term
| First anti-psychotic drug was discovered in ? |
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Definition
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Term
| Blocking D2 dopamine receptors produces what effects ? |
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Definition
Non-compliance
Weight gain
Impotence
Extra Pyramidal Signs (EPS) |
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Term
| Another name for dopamine ? |
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Definition
| PIF (Prolactin Inhibiting Factor) |
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Term
| Which dopamine pathway is involved in schizophrenia ? |
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Definition
| Meso-cortical, meso-limbic tracts |
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Term
| What are the four dopamine pathways ? |
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Definition
Meso-cortical, meso-limbic tracts
Nigrostriatal tract
Tuberoinfundibular tract
Short fibers in retina, olfactory bulb |
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Term
| Antipsychotics, perphenazine, and haloperidol help treat schizophrenia how ? |
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Definition
| By blocking dopamine receptors and autoreceptors |
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Term
| Dopamine blocking drugs help what disease but can cause what disease ? |
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Definition
Helps Schizophrenia
But can cause Parkinsonian symptoms |
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Term
| L-Dopa helps what disease but can cause what disease ? |
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Definition
| Helps Parkinson's Disease but can make Schizophrenia worse |
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Term
| What side-effect has a 3 to 5 % risk of occurring when someone takes Haloperidol (Haldol) ? |
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Definition
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Term
| What is the first atypical anti-psychotic medicine ? |
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Definition
Clozapine (Clozaril).
Works on D1 to D4 receptors but mostly on D1 |
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Term
| Two older classical anti-psychotic meds ? |
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Definition
| Chlorpromazine and Haldol |
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Term
| How are new anti-psychotic meds different from older, classical anti-psychotic meds ? |
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Definition
| New anti-psychotic meds show no EPS (extra-pyramidal symptoms), show agraulocytosis, reduce negative symptoms, good for resistant cases, and are more expensive |
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Term
| Later 'Atypical' antipsychotic meds like Quetiapine do not require what ? |
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Definition
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Term
| What drug is now recommended as a good choice for treating depression in bipolar pts ? |
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Definition
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Term
| What problem in front lobe is seen in schizophrenia ? |
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Definition
Hypo-frontality
It is associated with Negative symptoms, not due to treatment |
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Term
| Anatomically, what changes occur in brain in pts. with schizophrenia ? |
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Definition
Hypo-frontality
Enlarged ventricles and sulci
Loss of white matter |
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Term
| Kandel thinks what brain problems are due to schizophrenia ? |
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Definition
Functional deficit in ascending dopamine tracts from VTA to pre-frontal cortex
Resulting behavior is hypofrontal and hyperlimbic |
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Term
| Key points to tell pts. who take antipsychotic medications ? |
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Definition
Not addicting
Do not stop taking meds if you feel akathesia (inner feeling of restlessness)
Keep taking meds for 1 year even if you feel better
Avoid amphetamines, cocaine, L-Dopa
Know about the Tardive Dyskinesia risk and sign a consent form |
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Term
| What transporters are the brain's principal "cocaine receptors" ? |
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Definition
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Term
| What is the dopamine "pleasure center" in the brain ? |
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Definition
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Term
| What things trigger dopamine release ? |
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Definition
NAM HAC
Nicotine
Alcohol
Marijuana
Heroin
Amphetamine
Caffeine |
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