bio

Question 1

1. Stress activates two biochemical systems

Answer 1

• 1) “Fast response” by norepinephrine/epinephrine
• released via the sympathetic nervous system (SNS)
o Effects within seconds, but only lasts minutes (fast-acting & short-term)
o Prepares body for sudden burst of activity
2) “Slow response” by cortisol (the main glucocorticoid) released via the hypothalamic-pituitary-adrenal (HPA) axis
o Activated in minutes to hours and may last hours
o Prepares body for longer-lasting adaptations (occurs later & longer-lasting)
• Cortisol - Restores energy that has been expended
• Shuts down systems not immediately needed to deal with stressor
• Inhibits reproductive system
• Inhibits slow-wave sleep

Question 2

2. Chronic overactivity of the HPA-axis leads to the release of high levels of

Answer 2

cortisol. This in turn may (a) inhibit the immune and reproductive systems (libido, reproductive hormones); (b) cause appetite/weight gain and glucose intolerance; and (c) increase the risk for depression, anxiety, and cognitive dysfunction

Question 3

3. Which receptor is hypothesized to be the major central biological flaw in schizophrenia?

Answer 3

The NMDA-glutamate receptor is hypothesized to be the major central biological flaw in schizophrenia

Question 4

4. NMDA-R hypofunction in patients suffering from schizophrenia causes

Answer 4

(a) hypoactivity of the mesocortical pathway, resulting in cognitive, negative and affective symptoms; and (b) hyperactivity of the mesolimbic pathway, resulting in positive symptoms.

Question 5

5. What is the strongest predictor of real-world functioning in patients suffering from schizophrenia?

Answer 5

o Cognitive/executive symptoms/signs are the strongest predictor of real-world functioning in patients suffering form schizophrenia

Question 6

6. Patients suffering from schizophrenia may have difficulty

Answer 6

interpreting social cues and may have distortions in social judgment and reasoning partially because (a) their amygdalae are hyperactive when viewing neutral faces, (b) their amygdalae are hypoactive when viewing scary faces, and (c) they suffer dysconnectivity between emotion and goal-directed behavior.

Question 7

7. Neuroimaging and neuropsychological assessment have the potential (hopefully in the not-to-distant future) to

Answer 7

identify early, subclinical, or pre- symptomatic patients w/ schizophrenia.

Question 8

8. What are the different symptom profiles of major depression that are associated with abnormalities of each of the three main monoamines (5-HT, DA, NE)?

Answer 8

o Low “level” of 5-HT system is associated with increased “negative affect.”
o Dysphoria, rumination, guilt/disgust, worthlessness, loneliness, fear/anxiety, irritability, hostility, suicidality
o Particularly affects prefrontal cortex, amygdala, hypothalamus.
o Low “level” of DA system is associated with decreased “positive affect.”
o Dysphoria, anhedonia, loss of motivation & enthusiasm, apathy, anergia or psychomotor retardation, impaired attention & cognition, decreased self-confidence
o Particularly affects prefrontal cortex, nucleus accumbens, basal ganglia, hypothalamus
o Low “level” of NE system is associated with increased “negative affect” and decreased “positive affect.”

Question 9

9. Symptoms of fatigue, difficulty concentrating, sleep problems or psychomotor retardation/agitation may occur in someone with

Answer 9

an anxiety disorder or a mood disorder.

Question 10

10. A major hypothesis is that the biologic basis of bipolar symptoms may be due to

Answer 10

unstable “out-of-tune” circuits, resulting in inefficient information processing during both manic and depressive episodes.

Question 11

11. Mistakenly diagnosing bipolar depression as

Answer 11

being unipolar depression (i.e., major depressive disorder) is a serious mistake.

Question 12

12. Fear and panic attacks are associated with

Answer 12

dysfunction of circuits that involve the amygdala; and worry and obsession are associated with dysfunction of circuits that involve the cortex, basal ganglia (striatum), and thalamus.

Question 13

13. Numerous medical conditions can cause

Answer 13

depression, mania, or anxiety even when these affect other body systems in addition to the CNS.

Question 14

14. It is currently believed that all drugs of abuse and behavioral addictions cause

Answer 14

intense and phasic DA firing in the mesolimbic pathway shortly after taking the drug or engaging in the behavior and hypofunction of the mesolimbic pathway during withdrawal (DA deficit).

Question 15

15. Compulsive drug use is linked to

Answer 15

(a) neuroplastic changes with the DA reward circuit down-regulating (tolerance) and the compulsive (habit) circuit getting stronger, (b) craving caused by classical conditioning to associated stimuli, and (c) associative learning/conditioning.

Question 16

16. Associative learning/conditioning is one of the major reasons why

Answer 16

why the benefits of drug rehab programs often do not last unless there is follow-up treatment designed to offset this effect.
• Associative learning/conditioning — Drug effects & withdrawal become linked w/ cues & mood states
• A major factor in the “failure” of many in-patient drug rehab programs, unless there is sufficient follow-up treatment designed to offset this effect

Question 17

17. Which type of neurocognitive disorder (NCD) is most associated w/ beta-amyloid (neuritic) plaques and neurofibrillary tangles in addition to impairments in declarative memory, language, and other cognitive impairments?

Answer 17

• Alzheimers?

* The “amyloid cascade hypothesis”

Question 18

18. NCD due to

Answer 18

frontotemporal lobar degeneration (“frontotemporal dementia”) is associated w/ primarily executive dysfunction and changes in mood and behavior.

Question 19

19. Patients w/ Alzheimer’s disease (AD) eventually have

Answer 19

severe memory and other cognitive impairments in addition to emotional, behavioral, or perceptual abnormalities.

Question 20

20. The “gold standard” for diagnosing AD in a living pt requires

Answer 20

a medical workup (H&P, labs, neuroimaging) and neuropsychological assessment.

Question 21

Dr. Burke clearly expressed his belief (and supported that belief with many examples)

Answer 21

that psychiatric sx’s that occur during neurological or other medical illnesses/conditions are often due to the pathology of the illnesses/conditions and not just psychological reactions to having such illnesses/conditions. However, there may also be psychological reactions superimposed on the primary sxs.

Question 22

22. Before beginning individual psychotherapy with a client with a mood or anxiety disorder, a therapist should

Answer 22

review past medical records and recommend a current medical evaluation (unless a recent one within the last several months has already been performed).

Question 23

23. What is the best technique/method for predicting real-world functioning after a CNS injury?

Answer 23

• Neuropsychological assessment, including being the best technique/method for predicting real-world functioning after a CNS injury

Question 24

24. Lesions in which region of the prefrontal cortex may cause cognitive inflexibility and perseveration?

Answer 24

• Cognitive inflexibility and perseveration may occur with dysfunction of the dorsolateral prefrontal cortex (DLPFC).

Question 25

25. Lesions in which region of the prefrontal cortex may cause significant behavioral disinhibition (e.g., angry outbursts); inappropriate social interactions with fellow employees; and decreased concern for social rules?

Answer 25

• Oribtal Prefrontal Cortex

Question 26

26. Which period is the most critical for a woman to avoid drugs, stress, or toxins?

Answer 26

• 1st trimester

Question 27

27. The benefits of complex environments for offspring may occur if

Answer 27

the offspring themselves were raised in complex environments or if the mothers were exposed to complex environments during pregnancy; and the benefits include larger, more adaptable brains.

Question 28

28. ADHD patients may suffer from dysfunction of the

Answer 28

dorsal portion of the ACC, prefrontal cortex, and basal ganglia (including loops that connect these structures).

Question 29

29. ADHD has been associated with

Answer 29

genetic factor(s) or maturational delay.

Question 30

30. Abnormal attention and executive functioning are the usual causes of

Answer 30

the academic and interpersonal difficulties experienced by ADHD patients, not primary dysfunction of such structures as the hippocampus.

Question 31

31. The most significant negative outcomes caused by closed-head injury (CHI) are

Answer 31

executive, emotional, personal, social, and vocational difficulties. However, they also may suffer from deficits in attention, information processing speed, and memory. Most of these are due to lesions in the frontal and temporal lobes; but damage to axons and edema may cause disconnection between areas and overall decreased efficiency.

Question 32

32. Due to the potential severity and complexity of impairment, X is more important for patients who have suffered a CHI, compared to patients who have suffered a penetrating head injury or postconcussive syndrome with no previous head injury.

Answer 32

comprehensive neuropsychological assessment