Behavioral Science Flashcards
use of alendronate sodium?
阿伦膦酸盐, block osteoclasts, 用于治疗骨质疏松
use of teriparatide?
特立帕肽, stimulate osteoblasts, 用于治疗骨质疏松
诊断精神病时measure的代谢产物:
Dopamine?
NE?
5-HT?
Dopamine: HVA (homovanilliac acid, 高香草酸) 记忆法:DA和HVA都以A结尾
NE: VMA(vanillylmandelic acid, 香草扁桃酸)
MHPG (3-methoxy-4 hydroxyphenylglycol; 3-甲氧基4-羟基苯乙二醇)
5-HT:5-HIAA (5-hydroxyindoleacetid acid; 5-羟(基)吲哚乙酸)
DA converted to NE的主要location?
locus ceruleus 蓝斑,脑桥色素核
serotonin/5-HT的前体?作用?localization?
derived from Tryptophan (5-HT: T = tryptamine)
controls mood, sleep, sexuality, impulse
elevated 5-HT: improved mood and sleep, decreased sexual function
过高导致psychotic symptoms
生成5-HT的神经元locate in the dorsal raphe nucleus in the upper pons and lower midbrain
anti-AD drugs? (FDA approved 5)
2 types:
- AchE blockers (to increase [Ach] ): donepezil (Aricept), rivastigmine (Exelon), galantine (Reminyl), tacrine (Cognex)
- NMDA-R antagonist: Memantine (Nemenda)
抗精神病药物引起sedation, increased appetite and weight gain最常见的机制是?
block histamine receptor
Ach异常implicated in which diseases?
Ach decrease: AD
glutamate异常implicated in which diseases?
Glut : AD and schizophrenia
serotonin异常?
5-HT decrease: 1) assaultive, impulsive, aggressive behavior ; 2) depression, 3) bulimia 神经性贪食
(measured by 5-HIAA)
NE异常?
NE decrease: depression (measured by VMA)
DA异常?
DA decrease: PD (measured by HVA)
DA increase: schizophrenia
amygdala responsible for?
- evaluate sensory stimuli to emotion;
i. e.: see photos taken in a difficult time - hateful feelings - in Kluver-Bucy sym (性格变得温顺,好吃,性欲增强)
anxiety中神经递质的变化?
↑ NE, ↓ GABA, ↓ 5-HT,
depression mostly associated with which region of the brain?
left front lobe
decreased impulse control, poor social behavior, lack of characteristic modesty: damage in which brain area?
orbitofrontal cortex
lesion results in disinhibition, inappropriate behavior, poor judgement
decreased executive functioning (motivation, concentration, attention): lesion?
dorsolateral convexity of the frontal lobe
schizophrenia中神经递质的变化?
increased HVA (= increased DA)
Dx: intense abdominal pain + psychiatric symtoms (such as delusion) + purplish red urine?
porphyria
increased porphobilinogen in urine
If using Lithium (mood stabilizer), what should be monitored?
thyroid function + kidney function
- can develop hypothyroidism, occasionally hyperthyroidism
- narrow therapeutic window
Addison disease
hypocortisolism
physical Cx: skin hyper pigmentation, low BP, pain, fainting, hypoglycemia, diarrhea, vomitting
+ psychiatric sym: fatigue, depression, psychosis, confusion
porphyria: Cx?
abdominal cramping, diarrhea, vomiting, seizures, cardiac arrhythmia, flushing, “PURPLE/RED URINE” - caused by elevated porphobilinogen
paranoid delusion, hallucinations, depression, anxiety
计算IQ formule? normal range?
cut-off for retardation?
superior intelligence?
borderline?
IQ = MA/CA * 100 (mental age/chronological age)
normal range: 90-109
mean = 100, SD = 15
IQ < mean - 2 SD = 70: retardation
IQ > mean + 2 SD = 130: superior intelligence
71-84: borderline
Dx delusion vs. hallucination
delusion: false belief
hallucination: false perception
e.g.: pts complains that CIA is listening to her telephone - delusion
child has terrifying dream:
if cannot remember - happens at which sleep stage? Dx?
If can remember: which stage?
if cannot remember: delta wave stage (stage 3/4, 最深的睡眠相. most relaxed) - sleep terrors; 另外associated with episodic body movements, enuresis 尿床,
can remember - REM (most active phase) - can awake and relate the nature of the dreams ; + erection, paralysis of skeletal muscles, increased brain O2 use
neurotransmitter changes in psychiatric disorders:
- anxiety?
- sleeping disorders?
- anxiety: NE ↑, 5-HT ↓, GABA ↓
Dx: anti-anxiety agents
3大类:
- BZ: benzodiazepine 苯(并)二氮卓, chlordiazepoxide
fast acting, but high risk for dependence/addition, likely to be abused - only used for a limited time for acute sym, 比如戒酒病人在刚刚开始戒酒的初期阶段
- buspirone (BuSpar): 丁螺环酮
与苯(并)二氮卓正相反:low abuse potential, but slow action (take 2 weeks to become effective): long term maintain for GAD, but little immediate effect - b-blocker: control ANS sym (tachycardia)
most effective long-term management for PTSD?
for OCD (obsessive - compulsive disorder)?
PTSD: support group!!! (pharmacological treatment is an adjunct)
for OCD: anti-depressents, particularly a selective serotonin reuptake inhibitor (SSRI) such as fluvoxamine (Luvox) or a heterocyclic agent such as clomipramine.
what is “cohort study”?
2组人,然后一组exposed to a risk factor (or treatment), 一组没有。比较结果差异,是prospective的比较。特例就是clinic treatment trial
Absolute, relative, and attributable risks are calculated for cohort studies
what is “case-control study”?
2组人,一组有specific case/disease, 一组没有。然后追述生病前的history
An example of a case-control study would be one in which the smoking histories of women with and without breast cancer are compared
The odds ratio is calculated for case-control studies.
major drawback of MAOI?
potential fatal reaction from interaction of certain food/medication - noradrenergic/hypertensive crisis - lead to stroke or even death)
MAO metablize tyramine 酪胺 in the GI; 用MAOI的抑郁病人如果吃了含tyramine的食物(cheese, beer)或者用拟交感药物,会引起tyramine升高 - 导致高血压危象
代表药物:’tranylcypromine 反苯环丙胺
serotonin syn: cause? Cx? how to prevent?
fatal, caused by 1) MAOI + serotonergic analgesic, or 2) MAOI + SNRIs or HCA
needs WASHOUT periods when giving depressed pt. the combination of these drugs: 2 weeks for HCA, 5 wks for SNRIs
calculate sensitivity?
specificity?
sensitivity = TP / (TP + FN)
specificity = TN (TN + FP); = TN / all people without the disease. should be high to ↓ false positives
Dx: antipsychotic side effect, involuntary movements including chewing and lip-smacking?
tardive dyskinesia 发性运动障碍,
Tardive dyskinesia usually occurs after at least 6 months of starting a high-potency antipsychotic (haloperidol),
and is best treated by changing to a low-potency (thioridazine) or atypical agent (clozapine, risperidone) ; stopping the antipsychotic medication will exacerbate the symptoms.
bipolar: acute manic episode: immediate management? long-term management?
immediate management: high-potency, fast acting antipsythotic agents, such as haloperidol
long-term management: lithium
抑郁症病人不想gain weight, 该用什么antidepressant?
Fluoxetine (SSRI): 抗抑郁同时会减重
最易引起priapism (consistent erection) 和extreme sedation的抗抑郁药?
trazodone 三唑酮
最易引起心脏症状(sinus tachycardia, flat T wave, prolonged QT intervals, depressed ST)的抗抑郁药?
TCAs, e.g.: imipramine 米帕明,丙咪嗪
服用fluoxetine抗抑郁的病人最容易出现的sexual dysfunction是什么?caused by what change in neurotransmitter?
delayed orgasm - caused by ↑ 5-HT
not secondary ED :
fluoxetine and other selective serotonin reuptake inhibitors (SSRIs) are more likely to cause delayed or absent orgasm (orgasmic disorder). That is why the SSRIs are useful in managing premature ejaculation.
effects of neurotransmitters on aggression:
aggression facilitated by? inhibited by?
5-HT, GABA: ↓ aggression
DA, NE: ↑ aggression
effects of heroin, cocaine, amphetamines, and PCP (phencyclidine 苯环利定) on aggression?
heroin: little affect on aggression
cocaine, Amph, PCP all increase aggression
calculate relative risk?
attributable risk?
relative risk (fold increase), 除法 = incidence rate with a factor (i.e., smoking)/ incidence rate without the factor
attributable risk (做减法)= the incidence rate of the illness in exposed individuals - the incidence rate of the illness in those who have not been exposed to a risk factor.
how to calculate NNT (numbers needed treat)?
NNT = numbers of people needed to be treated for 1 person to be benefited
NNT = 1 / (absolute risk in control - absolute risk in treatment)
CSF change in narcolepsy?
↓ Hypocretin-1 (orexin-A)
produced only on the neurons in lateral hypothalamus; it promotes wakefulness and inhibits REM sleep-related phenomena.