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PSYCH > Cognitive Complaints and Impairment > Flashcards

Cognitive Complaints and Impairment Flashcards

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1
Q

cognitive impairment can be

A

primary manifestation of disorder (altzheimer’s disease)

secondary manifestation and source of excess disability (delirium, medications, brain injury, HIV)

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2
Q

major DA tracts

A

nigostriatal (extra pyramidal motor)
mesolimic
mesocortical (cognition, emotion, substance abuse, psychosis)

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3
Q

DA agonists

A

movement

depression

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4
Q

DA antags

A

psychosis

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5
Q

where is NE synthesized

A

locus coreulus

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6
Q

where does LC project to

A

cortex
limbic
RAS
spinal cord

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7
Q

adrenergic agents

A

depression
MAO-I
tricyclics
venlafaxine

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8
Q

adrenergic antagonists are for

A

tremor
anxiety
beta blockers

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9
Q

setonergic agents used for

A

dpression

migraine

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10
Q

5HT synthesized in

A

raphe nucleus

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11
Q

5HT project to

A 
cortex
limbic system
striatum
cerebellum
blood vessels
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12
Q

Ach synthesized in

A

basal forbrain (nucleus of basalis of Meynert)

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13
Q

Ach projets to

A 
olfactory bulb
hippocampus
amygdala
cortical association areas
==>ANS, NMJ
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14
Q

anticholinergic agents

A

movement disorder

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15
Q

cholinesterase inhibitors

A

Alteimers
organophosphates
nerve gases

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16
Q

GABA A binding sites for

A

benzos

barbiturates

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17
Q

GABA B

A

baclofen

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18
Q

three attentional networks

A

alerting
orientating
executive

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19
Q

alerting brain

A

thalamic

R frontal and partietal activation

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20
Q

Orienting brain

A

superior colliculus
frontal eye fields
temporoparietal
parietal activation

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21
Q

executive brain

A

anterior cingluate

DLPFC

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22
Q

episodic memory

A

minutes to years
explicit
declarative
ex) short story, what you had for dinner last name, what you did on your last bday
–medial temporal lobes, anterior thalamic nucleus mammillary body, fornix, PFC

23
Q

semantic memory

A 
minutes to years
explicit
declaritive
ex) knwing who the first president was
inferolateral temporal lobe
24
Q

procedural memory

A 
minutes to years
explicit/implicit
nondeclaritive
ex) driving a car
basal ganglia cerebellum, supplementary motor area
25
Q

working memory

A

seconds to minutes
explicit
declarative
ex) phonological- phone number in your head before dialing-PFC, Broca’s areas, wernicke
ex) spatial- mentally following a route or rotating an object in your mind-PFC, visual-association areas

26
Q

3 NT of arousal

A

cholinergic
catecholaminergic
glutamatergic

27
Q

executive functions

A

volition/initiative
planning
purposeful action
performance

28
Q

dorsolateral PFC

A

executive function

working memory

29
Q

lateral orbitofrontal

A

social intellifence

30
Q

medial/ventral frontal lobe

A

apathy, amotivation

31
Q

anterior cingulate

A

akinetic mutism

abulia

32
Q

FDA approved medication in cognition treatment

A

none with altz and ADD being major expections

33
Q

prominence of altz

A

11% in individuals >65

32-50% in individuals >85

34
Q

Donepezil/Aricept lass

A

acetylcholinesterase inhibitor

35
Q

adverse rxns donepezil

A

nausea/vomiting
sinus brady
1st degree AV block

36
Q

donepezil used for

A

altz

37
Q

donepezil avaiable as

A

single daily dose

38
Q

Memantine not recommended

A

alone

39
Q

Galantamine is available as

A

extended-release capsule

40
Q

rivastigmine is available as

A

patch

41
Q

methylphenidate class

A

CNS stimulant

42
Q

methylphenidate action

A

blocks reuptake of NE and DA

may also enhance release of catecholamines

43
Q

methylphenidate adverse reactions

A

nervousness
insomnia
abuse potential

44
Q

do not use methylphenidate with

A

MAOIs

45
Q

methylphenidate may increase effects of

A

tricyclics

antiparkinsoniam agents

46
Q

what frequently works when methylphenidate wont and what does it benefit in addition?

A

dextroamphetamine

cognition, depression, anergia impaired motivation

47
Q

Atomoxetine class

A

selective NE reuptake inhibitor

48
Q

Atomoxetine action

A

inhibition of NE transporter

49
Q

atmoxetine metbaolism

A

CYP2D6 (interactswith quinidine)

50
Q

atomoxetine adverse reactions

A

liver toxicity

suicidal ideation

51
Q

Amantadine and Memantine

A
  • moderate-affinity uncompetitive NMDA receptor antagonists
  • dopamine agonists
  • increase DA release
  • decrease presyn DA reuptake
  • stimulate DA receptors
  • enhance post-syn dopamine R sensitity
52
Q

neurotransmitter reuptake inhibitors

A

atomoxetine (strattera)-ADD

duloxetine (cymbalta)-antidepressant

53
Q

Modafinil uses

A

excessive daytime somnolence in patients with narcolepsy

-may have a role in treatment of post-TBI fatigue and impairment

54
Q

treatment of impaired cognition has two major forms

A

catecholaminergic agents

pro-cholinergic agents

PSYCH (25 decks)

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