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MQW U3 > Behavioral Week 2 > Flashcards

Behavioral Week 2 Flashcards

1
Q

5 Types of CAM treatments:

A
  1. Whole medical systems
  2. Mind-body medicine
  3. Biologically based
  4. Manipulative and body-based
  5. Energy medicine
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2
Q

St. John’s Wort use:

A

-Antidepressant

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3
Q

Fatty Acid use:

A

-Antiinflammatory

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4
Q

Vitamin D use:

A
  • Depression

- rule out cause of depression

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5
Q

Light Therapy use:

A

-Seasonal depression

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6
Q

Depression treatment w/ regard to 1 Carbon Cycle:

A
  • Use: Folate, L-methylfolate, S-adenosyl methionine (SAMe)

- Increases neurotransmitters

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7
Q

2 most and least hereditary psych disorders

A

Most: Schizophrenia, ADHD
Least: Depression, Anxiety

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8
Q

Functions of 4 Dopamine Pathways:

A
  1. Nigrostriatal: movement
  2. Mesolimbic: reward and perception
  3. Mesocortical: executive function
  4. Tuberoinfundibular: pituitary prolactin
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9
Q

Hyperactivity of 4 Dopamine Pathways:

A

Nigrostriatal –> dyskinetic movement
Mesolimbic –> addiction, hallucinations
Mesocortical –> hypervigilance, insomnia
Tuberoinfundibular –> hypOprolactinemia

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10
Q

Hypoactivity of 4 Dopamine Pathways:

A

Nigrostriatal –> dyskinetic movement, parkinsonism
Mesolimbic –> amotivation, apathy
Mesocortical –> inattention
Tuberoinfundibular –> hypERprolactinemia

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11
Q

4 Genes associated with Schizophrenia

A

COMT, Tyrosine Hydroxylase, D2R, D3R

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12
Q

2 Genes associated with ADHD

A

DRD4 and DRD5

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13
Q

3 Genes associated with MDD

A

DAT, DRD4, COMT

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14
Q

MDD: Resting activity is low in ____ and high in ___

A

Low: DLPFC - dorsolateral prefrontal cortex

High: Amygdala/VMPFC - ventralmedial prefrontal cortex

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15
Q

NE hypERfunctioning in limbic pathways cause ___, ___ and ___.

A

Panic, worry, hyperarousal

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16
Q

NE hypOfunctioning in frontocortico pathways cause ___ and ___

A

ADHD and Depression

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17
Q

___ activity opposes ___ activity in limbic pathway

A

NE opposes Serotonin 5HT

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18
Q

What does poor serotonin activity do to your affect?

A

Cause negative affect states (Depression, anxiety, Eating Disorder, Bipolar)

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19
Q

What does COMT Met and Val alleles lead to?

A

Met alleles –> low degradation –> high NE in limbic area –> anxiety in limbic areas

Val alleles –> high degradation –> low NE in cortex –> inattention

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20
Q

How does X inactivation affect neurotransmitters?

A

No X-inactivation –> high COMT –> low NE and DA in cortex –> depression

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21
Q

Lack of empathy (antisocial, narcissistic) is associated with what neurological function changes?

A

Overactive Cingulates

Hypoactive MPFC

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22
Q

2 Genes associated with hypofrontality

A

COMT, DAR

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23
Q

What are the Cluster A personality disorders?

A

Psychotic-like:

  • Paranoid
  • Schizoid
  • Schizotypal
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24
Q

What are the Cluster B personality disorders?

A

Dreaded, behavioral :

  • Antisocial
  • Histrionic
  • Narcissistic
  • Borderline
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25
Q

What are the Cluster C personality disorders?

A

Anxious:

  • Avoidant
  • Dependent
  • Obsessive-compusltive
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26
Q

Difference between homeopathy and naturopathy

A

Homeopathy: stimulate body’s self-healing response

Naturopathy: noninvasive treatments

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27
Q

What are 3 CAM treatment that have effectiveness treating depression?

A

L-methylfolate
S-adenosyl methionine (SAMe)
St. John’s Wort

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28
Q

What’s the difference between Schizoid and Schizotypal PD?

A

Schizoid: trouble relating, have no interest in interactions

Schizotypal: oddities in behavior and thoughts

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29
Q

What is an age related requirement for Antisocial PD?

A

Evidence of a Conduct Disorder with onset before age 15

That leads to pervasive pattern of disregard for or violation of rights of others after age 15

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30
Q

What characterizes Borderline PD?

A

Pervasive Instability: of relationships, self-image, behaviors, and affects

5+/9 Symptoms needed

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31
Q

Which PD are more prevalent in women?

In men?

A

Women: paranoid, avoidant, dependent

Men: antisocial

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32
Q

Psychopharmacolgy can treat what PDs?

A

Cluster B: Antisocial, narcissistic, histrionic, borderline

Avoidant (Cluster C)

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33
Q

Psychotherapy works for which one Cluster B PD?

A

Borderline PD only

-3 psychodynamic and 2 cognitive behavioral models

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34
Q

What are 3 risk factors for Personality Disorders?

A
  1. Not married
  2. Impoverished
  3. Poorly educated
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35
Q

Prevalence of different clusters of PD

A

A and C more common in general

B least common, but more common in the hospital

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36
Q

Benzodiazepines can exacerbate conditions in what cluster of PD?

A

Cluster B

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37
Q

What psychotherapy models work for treating Cluster C PDs?

A

CBT and Psychodynamic

38
Q

Criteria for Mania vs Hypomania

A

Mania: 3+/7 symptoms for 7+ days of expansive mood

Hypomania: 3+/7 symptoms for 4+ days

39
Q

DTRHIGH

A
  • Distractible
  • Talkative
  • Racing thoughts
  • Hyperactive
  • Impulsive
  • Grandiose
  • Hyposomnic
40
Q

What is the difference between Bipolar 1 and Bipolar 2?

A

Bipolar 1: Mania + MDE

Bipolar 2: Hypomania + MDE

41
Q

What is the criteria for Cyclothymia?

A

2+ years of hyponamia + minor depressions (relative decrease seems large)

42
Q

What is Kindling Hypothesis?

A

Related to Bipolar

  • Too much neuronal limbic firing
  • Once you get mania, you get more episodes
43
Q

Gender differences in Bipolar

A

Bipolar 1: men = women

Bipolar 2: women > men

44
Q

How do Atypical Antipsychotics treat Bipolar?

A
  • D2 receptor block–treats Mania

- 5HT2a receptor block–treats depression

45
Q

What are the anti-manic agents?

A
  • Lithium
  • Divaproex
  • Carbamezepine
  • Atypical antipsychotics (Risperidone, Aripiprazole, Lurasidone)
46
Q

Neurotransmitter changes associated with Anxiety Disorders:

A
  • Low 5HT
  • Low GABA
  • High NE
  • High Glutamate
47
Q

GAD DSM-5 Diagnostic criteria

A
  • Anxiety/worry more days than not for 6+ months, about 1+ event/activity
  • 3+ symptoms
48
Q

Gender difference for anxiety disorders:

A

Women > men except in OCD

49
Q

When are Beta Blockers used in anxiety?

A

Symptomatic relief of performance anxiety

50
Q

Busipirone mechanism of action:

A

5HT1a receptor agonist

-Only approved for GAD

51
Q

Psychotherapy models used for GAD:

A

CBT or Psychodynamic

CBT has most evidence

52
Q

Frontline GAD medications:

2nd line?

A

SSRIs, sometimes SNRI

-2nd line = Benzos

53
Q

Panic Attack DSM-5 Criteria

A
  • Initially abrupt, unexpected, untriggered, peaks within minutes
  • 4+ of symptoms
54
Q

Agoraphobia criteria:

A

Fear/Anxiety about 2+ situations for 6+ months

55
Q

Emergency treatment for panic disorder:

A

Fast-acting Benzodiazepines (alprazolam)

56
Q

What is Systematic Desensitization and Flooding?

A

Systematic Desensitization: Step by step increase in facing fears; type of CBT

Flooding: Immediately facing fears

57
Q

Obsession vs Compulsion

A

Obsession: recurrent/persistent, intrusive and unwanted thoughts or urges that the patient WANTS TO NEUTRALIZE

Compulsion: repetitive behavior or activity that patient performs in RESPONSE to obsession

58
Q

First drug approved for OCD

A

Clomipramine (a TCA)

59
Q

OCD vs. OCPD

A

OCD patients have insight into their behavior

OCPD patient’s don’t. The’re rigid, moralistic. Have no compulsions

60
Q

Most common cause of PTSD:

A

Death of a loved one

61
Q

Most likely thing to cause a PTSD:

A

Assault

62
Q

PTSD Criterions A-E

A 
A. Exposure
B. Re-living of events
C. Avoidance of associated stimuli
D. Negative cognition and mood changes
E. Alterations in arousal/reactivity
63
Q

Acute Stress Disorder criteria:

A

PTSD criteria but, >3 days and

64
Q

What drug can stop nightmares in PTSD?

A

Prazosin (a1 inhibitor)

65
Q

Risk factors for TBI:

A
  • Male
  • Age 0-4, 15-24, 65+
  • Lower SES, metropolitan area
  • Recurrent TBI
66
Q

Which are primary causes of TBI?

  • Edema
  • Diffuse axonal injury
  • Vascular tear
  • Seizure
  • Ischemia, hypoxia
  • Intracranial, extracerebral hemorrhage
  • Necrosis, apoptosis
  • Inflammation
  • Vasospasm
  • Focal cortical contusions
A
  • Diffuse axonal injury
  • Vascular tear
  • Focal cortical contusions
  • Intracranial, extracerebral hemorrhage
67
Q

Which are secondary causes of TBI?

  • Edema
  • Diffuse Axonal Injury
  • Vascular Tear
  • Seizure
  • Ischemia, hypoxia
  • Intracranial, extracerebral hemorrhage
  • Necrosis, apoptosis
  • Inflammation
  • Vasospasm
  • Focal cortical contusions
A
  • Ischemia, hypoxia
  • Vasospasm
  • Edema
  • Necrosis, apoptosis
  • Inflammation
  • Seizure
68
Q

Glasgow Comas Scale:
Severe = ___
Moderate = ___
Mild = ___

A 
Severe = 3-8
Moderate = 9-12
Mild = 13-15
69
Q

What functions do the Glasgow Coma Scale test?

A
  • Eye opening
  • Verbal response
  • Best motor response
70
Q

Examples of emotional and behavioral changes after TBI

A
  1. Post-traumatic agitation
  2. Personality changes
  3. Psychiatric disorders
  4. Substance misuse disorders
71
Q

What is akasthesia

A

Can’t sit still, restlessness

72
Q

What is the most disruptive behavior post TBI

A

Post-traumatic agitation, behaviors

73
Q

Trauma to lateral orbitofrontal cortex can cause what kind of behavioral changes?

A

Social comportment

74
Q

Trauma to dorsolateral prefrontal cortex can cause what kind of behavioral changes?

A

Executive function

75
Q

Trauma to the anterior cingulate cortex can cause what kind of behavioral changes?

A

Motivated behavior

76
Q

PTSD is more likely to be seen with what degree of TBI?

A

Mild

77
Q

TBI increases risk for what psychiatric disorders?

A

Depression, Anxiety

78
Q

What are classes of medications used to treat post TBI agitation?

A
  • Beta blockers
  • Antiepileptics/anticonvulsants
  • Antidepressants (SSRI, TCA)
  • Antipsychotics
79
Q

In Depression:
What 2 neutotransmitter abnormalities cause:
decreased positive affect?
increased negative affect?

A

Decreased negative: NE, DA

Increased positive: NE, 5HT

80
Q

Dyssomnia vs. Parasomnia:

A

Dyssomnia: timing, quality, amount of sleep

Parasomnia: abnormal physiology or behavior associated with sleep

81
Q

Insomnia DSM-5 Criteria

A
  • 1+ of: initiating, maintaining, or early morning waking w/ inability to return to sleep
  • 3+ nights/week for 3+ months
82
Q

Age and Gender pattern of Insomnia:

A
  • Increases with age

- Women report insomnia 50% more

83
Q

Endogenous causes of Insomnia:

A
  • High NE from locus ceruleus
  • High 5HT from Raphe nucleus
  • High DA from VTA
  • High Histamine from tuberomamillary nucleus
  • Low GABA, melatonin, adenosine tones
84
Q

What is the relation between Insomnia and Anxiety?

A
  • Anxiety can lead to insomnia

- Fight or flight response to getting in bed

85
Q

What are the 4 steps in managing Insomnia?

A

1= Diagnosis, informed consent, education
2= Behavioral counseling (sleep hygiene, stimulus control)
3=Psychotherapy
4=Pharmacotherapy

86
Q

What kind of therapies are used in Insomnia Stage 3 Management?

A
  • Sleep restriction therapy
  • Cognitive therapy
  • Behavioral therapy
87
Q

1st line pharmacotherapy for Insomnia:

A

Melatonin, antihistamines

88
Q

For insomnia, what’s used first between:

Benzodiazepine Receptor Agonists (BZRAs) and Benzodiazepines?

A

BZRAs 3rd line, Benzos 4th line

-Zolpidem, Zaleplon, Ezopiclone

89
Q

Patient’s with restless legs get what kind of pharmacotherapy?

A

D2 agonists

90
Q

Insomnia patients w/ Apnea do NOT get what pharmacotherapy?

A

Sedatives

91
Q

What does 5HT2a blocking do for Insomnia?

A

Creates deeper sleep patterns

92
Q

What can be done to promote a more accurate circadian clock?

A

Antagonize 5HT1d and 7 receptors

MQW U3 (11 decks)

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