Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro Quiz 4 > Bipolar Pathophysiology > Flashcards

Bipolar Pathophysiology Flashcards

1
Q

Bipolar Disorder is associated with

A

Depressive symptoms and abnormally elevated mood (mania)

“Manic-depression”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Manic phase is characterized by:

A 
Overly happy, excited
Extremely irritable
Racing thoughts/behaviors
Easily distracted
Restless w/o tired
Little sleep
Impulsive
Unrealistic beliefs
Aggressive/provactive
Substance abuse
Denial of symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define Bipolar I

A

More severe disorder where the manic phase is disruptive to normal daily function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define Bipolar II

A

Manic phase is less severe and referred to as “hypomanic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Uncontrolled Bipolar

A

“progressive disorder”

Untreated leads to euthmyic periods becoming shorter over time and highs may become higher with lower lows

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Rapid cycler BD

A

More than 4 mood swings in a year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mixed BD

A

Pts show both depressive and manic symptoms at the same time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cyclothymic BD

A

Both the manic and depressive phase are less severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lifetime prevalence of BD and suicide risk

A

1.5%
Late adolescence to early adult (younger than MDD)
10-20% suicide and higher in BDII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Men vs Women presentation

A

Men: first mania
Women: first depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of BD

A

Environmental (physical, nutrition, social stressors)

Genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pregnancy + Influenza

A

Increased risk of BD by 4-folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

First degree relatives + BD

A

5-10 fold increase risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Monozygotic twin + BD

A

~70% increased risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dizygotic twins + BD

A

~20% increased risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Heritability for BD

A

0.75 (MDD was 0.35)

17
Q

BD has a shared genetic etiology with

A

Schizo and MDD

18
Q

Possible risk factors for BD

A

BNDF
Bcl-2
XBP-1
IMPase

19
Q

BNDF + BD

A

Neurotrophic factor important for neuronal survival and neuroplasticity

20
Q

Bcl-2

A

Mitochonddrial anti-apoptotic protein that stimulates dendritic sprouting and regrowth
Regulates intracellular Ca homeostasis

21
Q

XBP-1

A

Enzyme regulates the ER stress response that results form accumulation of damaged proteins

22
Q

Structural abnormalities in BD

A

Reduced hippocampal volume
Reduced PFC volume
Reduced neuronal cell counts
Decreased glutamate

23
Q

Most consistent finding with BD

A

Excessive activation of amygdala (in response to some emotional triggers) –> due to decreased inhibition from prefrontal regions that regulate limbic activity leading to dysregulation which causes emotional extremes (mania/depression)
- wiring is disrupted between emotional networks and brain regions disrupted too

24
Q

Abnormalities showing face:

A

Before first episode meaning that the development of the networks is abnormal

25
Q

Define kindling

A

Progressive nature of the disorder which is reinforced by abnormal activity through the normal mechanisms of synaptic strengthening

26
Q

Alter Ca Homeostasis in BD

A

Elevated cytoplasmic levels of Ca
Second messenger involved in synaptic plasticity
Changes gene expression
Too much ca __> activates apoptotic pathways

27
Q

Mitochondrial/ER dysfunction + BD

A

Altered Ca leads to mitochondrial dysfunction due to gene expression changes in oxidative phosphorylation and antioxidant defenses
All this leads to oxidative stress and activation of apoptotic pathways

28
Q

Neuronal atrophy/death + BD

A

Altered BDNF and Ca disrupts trophic pathways that support the survival and elaboration of neurons
Too little BDNF = cell atrophy
Too much Ca = activated apoptotic pathways - death

29
Q

Abnormal synaptic plasticity + BD

A

Normally BDNF enhances anabolic pathways that increase and strengthen synpases and inhibit GSK-3 which promotes pruning
Ca stimulates synaptic growth

30
Q

Mood stabilizers =

A

Lithium and anticonvulsants (valproate, carbamazepine, lamotrigine)

31
Q

Use of anti-depressants in BD

A

Means it is similar to MDD

32
Q

Use of anti-psychotics in BD

A

Means mania involves dopaminergic hyperactivity involving accumbens and prefrontal cortex

33
Q

valproate, carbamazepine, lamotrigine target

A

“mood stabilizers”

Target voltage gated Na channels which shows that toning down activity in limbic circuits would reduce mood swings

34
Q

Lamotrigine also tragets

A

Ca channels and could mitigate altered Ca homeostasis

35
Q

Valproate also does what

A

Histone deacetylase activity that could normalize gene expression

36
Q

Lithium in BD

A

Citrate or carbonate salt
Inhibition of IMPase which decreases PI lipids and Ca bc IP3
Na/K ATPase inhibition
Inhibit GSK3
Potentiate AMPA currents
Upregulates BDNF (promotes dendritic growth)
Stimulates hippocampal neurogenesis

Neuro Quiz 4 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions