Bipolar III

Question 1

heritability index

Answer 1

estimate the degree of variance in a trait/disorder in the population due to genetic variance, how much of a role do genetics play in the phenotype of the disease/disorder

Question 2

genes contribute ___ of a role in bipolar than mdd

Answer 2

more

Question 3

heritability index usually measured by examining:

Answer 3

twin studies, parents vs offspring (siblings), adoption studies

Question 4

twin studies:

Answer 4

monozygotic twins (genetically identical) vs dizygotic twins (fraternal)

Question 5

agree that disorders are:

Answer 5

polygenic versus monogenic

Question 6

polygenic and monogenic:

Answer 6

polygenic: multiple gene interitance
monogenic: involving one single gene

Question 7

candidate genes:

Answer 7

genes involved in processes that are believed to be aberrant

Question 8

what is the old way of examining genetic marks for disorders?

Answer 8

candiate gene studies

Question 9

what is the new way of examining genetic markers?

Answer 9

genome-wide association study

Question 10

genuine wide association study:

Answer 10

entire genome is investigated by comparing polymorphisms in individuals without disorder/individuals with disorder

Question 11

polymorphisms:

Answer 11

changes in genes

Question 12

why is gwas controversial?

Answer 12

just because you find differences in genes does not mean they are responsible for the disorder, bpd genes overlap with other disorders

Question 13

why is it hard to draw firm conclusions in gwas studies?

Answer 13

due to inconsistencies and gwas studies have only begun recently

Question 14

bipolar brain causes:

Answer 14

decreased cortical thickness, increase in ventricle size, decreases in white matter integrity

Question 15

evidence points more toward:

Answer 15

dysfunction in brain networks

Question 16

brain network=

Answer 16

coordinated brain activity

Question 17

prefrontal-limbic networks:

Answer 17

involved in regulation of the amygdala in complex emotional states

Question 18

reduced or increased activity in prefrontal limbic networks:

Answer 18

reduced activity

Question 19

default mode network in bipolar:

Answer 19

involved in wakeful rest, may be overactive in bpd in absence of stress.

Question 20

Salience network:

Answer 20

detecting/shifting attention, integration of filtering of noticeable/important stimuli

Question 21

executive control network:

Answer 21

involved in working memory, reasoning, problem solving

Question 22

Neurotransmitter theory

Answer 22

bipolar results from an imbalance of neurotransmitter system

Question 23

monoamine hypothesis and how true is it for bipolar:

Answer 23

depletion in serotonin/norepinephrine responsible for mood/emotion imbalances. less true for bipolar

Question 24

Dopamine hypothesis:

Answer 24

hyperdopaminergic state (mania) induces faulty homeostatic mechanisms leading to hypodopaminergic state (depression)

Question 25

Glutamate/ GABA imbalance

Answer 25

altered balance of glutamatergic (excitatory) and GABAergic (inhibitory) markers, increased glutamatergic tone during mania/ decreased GABAergic activity

Question 26

bipolar medication consists of one or a combination of:

Answer 26

mood stabilizers, anticonvulants, antipsychotics, most patients require a combination therapy of all phases of the illness

Question 27

medication may depend on:

Answer 27

predominant state (manic, hypomanic, or depressive)

Question 28

antidepressants can cause a switch to:

Answer 28

hypomania/ mania therefore caution is greatly used when administering in bipolar depressive episode

Question 29

Biggest issue with medication is:

Answer 29

medication nonadherence, up to 60 percent are fully or partially nonadherent in the year after manic episode

Question 30

Lithium is a:

Answer 30

mood stabilizer, equal efficacy in preventing depressive and manic episodes, requires close-monitoring of blood levels

Question 31

why does lithium require close monitoring of blood levels

Answer 31

can be toxic to thyroid/kidney function as it can interfere with antidiuretic functioning

Question 32

lithium mechanism, 5 steps

Answer 32

1. negative effect on glutamate/dopamine system
2. positive effet on GABA system
3. influences intracellular signaling cascades: cAMP, GSK
4. increased neurogenesis
5. influences resetting of circadian rhythm’s

Question 33

what are anticonvulsants used in?

Answer 33

maintenance treatment usually in conjunction with lithium

Question 34

ANTICONVULSANT MEchanism

Answer 34

Na+/Ca2 channel blocker, suppress release of glutamate diminishing excitation and enhancing inhibition

Question 35

first generation antipsychotics are seen as:

Answer 35

typical

Question 36

second generation antipsychotics are seen as:

Answer 36

atypical

Question 37

antipsychotics focus on what kind of symptoms?

Answer 37

positive symptoms such as hallucinations, delusions, grandiose beliefs

Question 38

both atypical and typical antipsychotics have the:

Answer 38

same efficacy

Question 39

what is the difference between atypical and typical antispsychotics

Answer 39

side effects, atypical have fewer extrapyramidal side effects

Question 40

antipsychotic mechanism

Answer 40

blocks the action of dopamine, primarily by clicking D2 receptors

Question 41

what is extrapyramidal side effects?

Answer 41

an inability to sit still, involuntary muscle contraction, tremors, stiff muscles, and involuntary facial movements.

Question 42

tardive dyskinesia

Answer 42

involves involuntary movement of lips and tongue

Question 43

neuroleptic malignant syndrome

Answer 43

characterized by high fever and extreme muscle rigidity that can be fatal if untreated