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BEHAVIORAL MEDICINE > FOUNDATION OF PSYCHIATRY > Flashcards

FOUNDATION OF PSYCHIATRY Flashcards

1
Q

Amyloid precursor protein gene is associated with early onset Alzheimers. On what chromosome is this gene located ?

A

21

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2
Q

PSEN1 & PSEN2 are genes located on chromosome 14 and 1 respectively and associated with what ?

A

Early onset Alzheimer

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3
Q

Acute intermittent porphyria associated with gene on what chromosome ?

A

11

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4
Q

PKU associated with gene on what chromosome ?

A

12

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5
Q

What medical condition with psychiaric manifestations is linked to defective genes on chromosome 13?

A

Wilson’s disease

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6
Q

Typical onset Alzheimer’s is associated with APOE4 alleles on what chromosome ?

A

19

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7
Q

Autistic behavior, mental retardation/intellectual disability are behavioral manifestations of what disease associated with a sex chromosome ?

A

Fragile X

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8
Q

Stereotypes hand mvmts, breathing abnormalities and autism spectrum disorder is indicative of ?

A

Rett’s disorder

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9
Q

Lesion to orbitofrontal cortex :

A

Deshinibition
Decision making
Personnality changes
Lack of judgment
Explosive moods and violent outbursts

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10
Q

Lesion to dorsolateral frontal cortex :

A

Affected planning, strategy formation and executive function ; lack of motivation

ADHD

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11
Q

Lobe most likely involved in seizures ?

A

Temporal

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12
Q

What cortex is associated with intellectual processing of info ?

A

Parietal cortex

Damage to left side may impair language and Gerstmann syndrome may occur : agraphia, acalculia, finger agnosia, right & left disorientation.
Damage on the right side may interferes with visuo-spacial processing resulting in construction apraxia (inability to copy drawings) as well as anosognosia, left hemoparesis/hemispacial neglect.

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13
Q

What is monothematic delusion?

A

When a pt denies ownership of a limb or an entire side of the body without any other delusions.
May occur in primary psychotic disorders but most commonly present in conjunction with brain damage.

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14
Q

What syndrome is associated with cortical blindness along with failure to acknowledge the blindness ?

A

Anton syndrome
bilat occlusion of PCA interrupting fibers involved in self-assessment.

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15
Q

What part of the brain is critical for pain perception and when dysfunctions may lead to impaired memory and arousal ?

A

Thalamus

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16
Q

Reticular activating system involved with ?

A

Consciousness (wakefulness ; arousal)

Lesion ; decreased REM sleep and loss of consciousness

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17
Q

The hippocampus is critical for ?

A

Memory and new learning

Damage leads to anterograde amnesia (short term memory disorder)

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18
Q

Assigns emotional significance to sensory experiences ; mediates learned fear responses and direct expression of emotions ?

A

Amygdala

Gateway through which internal and external stimuli are integrated

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19
Q

Damage to the Amygdala resulting from the bilateral lesions of the anterior temporal lobes causes what syndrome that is associated with ‘‘make love not war’’ condition ?

A

Kluver-Bucy syndrome

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20
Q

Syndrome characterized by amnesia resulting from chronic thiamine deficiency which may result in damage to the thalamus ?

A

Korsakoff

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21
Q

Associated with procedural learning, routine behaviors or habits such as bruxism, eye mvmts, cognition and emotion. Also plays a role in integration of emotions with cognitive and motor behavior. Implicated in depression & dementia as well as Huntingtons ?

A

Basal ganglia

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22
Q

Presents as a triad of dyskinesia, dementia and depression ?

A

Huntington’s

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23
Q

What specific part of the basal ganglia is Parkinson’s associated with ?

A

Substantia nigra

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24
Q

What specific part of the basal ganglia is Huntington’s chorea associated with ?

A

Caudate & putamen

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25
Q

What specific part of the basal ganglia is Tourette’s associated with ?

A

Caudate

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26
Q

Define chorea :

A

Mvmt disorder characterized by random and involuntary quick, jerky and pruposeless mvmts.

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27
Q

What is Athetosis ?

A

sx characterized by slow, involuntary, convoluted mvmts of the fingers, hands, toes and feet and in some cases ,arms, legs, neck and tongue.

Usually occurs as a result of injury to the basal ganglia

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28
Q

What psychiatric condition is associated with dopaminergic hyperfunction in the prefrontal cortex and serotonergic hypofunction is the basal ganglia ?

A

OCD

Treated with SSRI

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29
Q

Rare heriditary disorder that involves calcification of the basal ganglia ?

A

Fahr disease

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30
Q

Which part of the brain stem is important for REM sleep?

A

Pons

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31
Q

Part of the Ponse that serves as principle site for brain synthesis of norepinephrine ?

A

Locus ceoruleus

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32
Q

In what psychiatric disease is acetylcholine low and glutamate high ?

A

Alzheimer’s

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33
Q

Low GABA, Low serotonin and high norepinephrine is associated with what psychiatric condition ?

A

Anxiety

34
Q

Depression is characterized by what change in neurotransmitters ?

A

Low norepinephrine
low serotonin
low dopamine

35
Q

What psych condition is associated with î dopamine and low GABA ?

A

Mania

36
Q

What psych condition is associated with high dopamine, high serotonin and variable levels of glutamate ?

A

Schizophrenia

37
Q

Increase in homovanillic acid is suggestive of ?

A

î dopamine levels
Schizophrenia

38
Q

Diseases associated with low dopamine levels ?

A

Parkinson’s
Depression
Antipsychotic agents

39
Q

î levels of vanillylmandelic acid indication of ?

A

î norepinephrine
(pheochromocytoma

40
Q

Low MHPG link to :

A

Low norepinephrine
(severe depression and attempted suicide)

41
Q

î 5 HIAA indicative of ?

A

High serotonin
(Autism spectrum disorder)

42
Q

Low serotonin levels associated with low levels of 5-HIAA and presents as :

A

Claims of severe depression, attempted suicide, aggressivness, fire setting, Tourette’s, bulimia, alcohol abuse..

Low Serotonin means low impulse control.

43
Q

What is the amino acid precursor of dopamine ?

A

Tyrosine
Converted to L-DOPA by tyrosine hydroxylase which is in turn decarboxylated by DOPA decarboxylase to form dopamine.

44
Q

Major site of action (dopamine receptor) for traditional (1st gen) antipsychotic agent

A

D2 receptors

45
Q

Nigrostriatal, tuberoinfundibular and mesolimbic mesocrotical tracts are :

A

Dopaminergic tracts

46
Q

The nigrostriatal tract is involved in the regulation of muscle tone and mvmt. This tract degenerate in what disease ?

A

Parkinson’s

47
Q

Blocking dopamin receptors by antipsychotic drugs prevent the inhition of release of what hormone?

A

Prolactin

48
Q

Which tract is targeted to block D2 receptors in trx of psychotic disorders ?

A

The mesolimbic-mesocortical tract

Blocking + sx of shizophrenia linked to hyperactive mesolimbic tract

Thought to have a role in expression of emotions because it projects into the limbic system and prefrontal cortex.

49
Q

Dopamine beta-hydroxylase present in dopaminergic neurons converts :

A

Dopamine to norepinephrine

50
Q

Where are most noradrenergic neurons located ?

A

Locus coeruleus in the Pons

51
Q

Serotonin is synthesized from what amino acid ?

A

L-tryptophan

52
Q

Associated with improved mood and sleep but decreased sexual function ?

A

Serotonin

Delayed orgasms w/ SSRI

53
Q

The serotinin system is mostly targeted by typical or atypical antipsychotics in the trx of psychotic disturbances (*in addition to the dopamin system being targeted at the same time) ?

A

Atypical antipsychotics

54
Q

î the presence of both serotonin and borepinephrine in the synaptic cleft ?

A

SNRIs and MAOIs

55
Q

Fluoxetine (Prozac) is an example of ?

A

SSRI

56
Q

Mechanism of action of MAOIs?

A

Prevent degradation of serotonin & norepinephrine by Monoamine oxidase.

57
Q

Heterocyclic antidepressants (HCAs), including tricyclic antidepressants (TCA) mechanism of action :

A

Block reuptake of serotonin and norepinephrine at synaptic cleft by hitting a wide range of receptors including some dopamine receptors and muscarinic acetylcholine receptors resulting in anticholinergic effects as well as histamine receptors leading to antihistaminergic effects

Way less used, not first line trx due to risk of OD.

58
Q

Tricyclic antidepressant overdose characterized by ?

E.g. Imipramine

A

Elevated body temp
blurred vision
dilated pupils
sleepiness
cofusion
seizures
rapid HR
cardiac arrest

replaced by SSRIs which have fewer side effects and safer in terms of OD.

59
Q

What are frequent side effects of Imipramine overdose ?

A

Anticholinergic effects, orthostatic hypotension, prolonged QT interval, tachycardia and other cardiac abnormalities, hematologic changes including agranulocytosis.

60
Q

Most serotonergic cell bodies in the brain are contained in the :

A

Dorsal raphe nucleus

61
Q

Major neurocognitive disorders are associated in general with low levels of what neurotransmitter ?

A

Acetylcholine

In amygdala, hippocampus and temporal cortex

62
Q

Alzheimer’s, Down’s, mvmt disorder and sleep disorder (decreased REM sleep) all associated with ?

A

Degradation of cholinergic neurons

63
Q

Cholinergic neurons synthesize Ach from what molecules using acetyltransferase ?

A

Coenzyme A
Choline

64
Q

Where in the brain is Ach synthesized ?

A

Nucleus basalis of Meynert & medial septal nucleus (parts of basal forebrain) as well as in the brainstem.

65
Q

Donepezil (Aricept)
Rivastigmine (Exelon)
Galantamine (Reminyl)
are :

A

Acetycholinesterase inhibitors
(Delay cognitive decline in Alzheimer’s with no reverse histopathological change)

66
Q

Most common drug-related cause of delirium ?

A

Anticholinergics

67
Q

Anticholinergic effects

A

Dry mouth
Blurry vision
Constipation
Urinary retention
Delirium

Blind as a bat, dry as a bone, red as a beet, mad as a hatter

68
Q

Amino acid neurotransmitters (3) :

A

Gutamate
GABA
Glycine

69
Q

Principle excitatory neurotransmitter in the brain ?

A

Glutamate

May be toxic to neurons (excitotoxicity) and thus contribute to the pathophysiology of Alzheimer’s and schizophrenia.

70
Q

NMDA receptor is a receptor for :

A

Glutamate

71
Q

Predominant neurotransmitter in the brain in terms of quantity and chief inhibitory neurotransmitter of the CNS ?

A

GABA

72
Q

GABA is synthesized from glutamate by glutaminc acid decarboxylase using which cofactor ?

A

B6

73
Q

What classes of medications î GABA affinity for its receptor causing more Cl ions to enter the neurons causing hyperpolarization and decreased neuronal firing ultimately decreasing anxiety ?

GABA is an anxiolytic agent

A

Benzodiazepines & Barbiturates
Anticonvulsants

74
Q

Proteinogenic amino acid that serves as an inhibitory neurotransmitters working on its own and regulating glutamate activity ?

A

Glycine

75
Q

Major transmitter for sensory neurons that convey pain sensations from the periphery (esp skin) into the spinal cord.

A

Substance P (11 aa peptide)

76
Q

Opiates relieve pain in part by blocking release of

A

Substance P

77
Q

Endogenous opiods that act on opiate receptors to decrease pain and anxiety and play a role in addiction and mood ?

A

Enkephalins
Endorphins
Dynorphins
Endomorphins

78
Q

Diseases that affect these structures are more likely to manifest as prominent personality change :

A

Frontal lobes & subcortical structures

79
Q

2 types of explicit/declarative memory ?

A

Episodic and semantic

knowledge of facts ans retrieved conciously

80
Q

2 types of implicit/non declarative memory ?

A

Procedural and working memory

Unconsciously recalled information about how to perform an act

81
Q

Different types of memory

A

BEHAVIORAL MEDICINE (2 decks)

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