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Neuropsychiatric Disorders Flashcards

1
Q

Caused by antibodies attacking acetylcholine receptors

A

Myasthenia Gravis

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2
Q

Hallmark symptoms: muscle weakness and fatigability

A

Myasthenia Gravis

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3
Q

Treatment for MG

A

ACE Inhibitors
Intravenous Ig
Plasmapharesis
Thymectomy

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4
Q

Treatment for mild MG

A

ACE inhibitors

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5
Q

Tx for moderate or severe MG

Most commonly used in elderly patients and those with comorbid disease

A

Intravenous Ig

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6
Q

Tx for myasthenic crisis and refractory cases

A

Plasmapharesis

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7
Q

First-line therapy for generalized MG

A

Thymectomy

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8
Q

Rapid developing loss of brain fxn due to disturbances in the blood vessels supplying the brain

A

Strokw

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9
Q

2 Causes of Stroke

A

Ischmia

Hemorrhage

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10
Q

Most common neuropsychiatric disorder after stroke

A

Post stroke depression (PSD)

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11
Q

What NT plays a great role in the onset of depression

A

Serotonin

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12
Q

Rupture of one of the major blood vessels

Blood accumulates innthe subarachnoid space or intra-cerebral space

A

Hemorrhagic stroke

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13
Q

Due to lack of blood suplly in the small perforating arteries of the brain

A

Ischemic/Thromboembolic Stroke

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14
Q

Occurs when oxygen and other nutrients supplied by blood flow is insufficient to meet the metabolic demands of brain tissue

A

Cerebral Ischemia

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15
Q

Final event in cerebral ischemia

A

Death of neurons

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16
Q

2 pathways that occurs after ischemia

A

Necrotic pathway

Apoptotic pathway

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17
Q

Type of cell death that is characterized by energy failure

A

Necrotic cell death

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18
Q

NT that participate in memory, movement, sensation, cognition, synaptic plasticity

Activates N-methyl-D-aspartate (NMDA) and non-NMDA channels

A

Glutamate

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19
Q

Converts xanthine dehydrogenase to xanthine oxidase

A

Calpain 1

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20
Q

Releases arachidonic acid from injured cell membrane, metabolized by cyclooxygenase to produce prostaglandin and superoxide (by-product)

A

Phospholipase A2

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21
Q

NO + Superoxides

A

Peroxynitrite

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22
Q

T or F: ↑ [Ca2+] , ↑ RO

A

True

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23
Q

Key event in triggering apoptosis after cerebral ischemia

A

Release of Cyt C from the mitochondria

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24
Q

Cleavage of cytoskeletal and DNA repair proteins

A

Apoptosis

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25
Q

Tx for Ischemic Stroke

A

Dissolution of thrombus/emboli:

  1. Aspirin
  2. IV injection of tissue plasminogen activator (TPA)
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26
Q

Tx for Hemorrhagic Stroke

A

Repair of ruptured vessels:

  1. Surgical blood vessel repair
  2. Surgical clipping
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27
Q

Tx for Neuropsychiatric

A

Antidepressants – fluoxetine

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28
Q

Also known as Martin-Bell Syndrome, Escalante’s

Syndrome

A

Fragile X Syndrome

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29
Q

Most common form of inherited mental retardation

A

Fragile X Syndrome

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30
Q

Inheritance Pattern for Fragile X Syndrome

A

X-linked recessive

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31
Q

FXS is commonly associated with what neuropsychiatric disorder

A

Autism

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32
Q 
Prominent signs and symptoms:
o elongated face
o large/protruding ears
o large testes (macroorchidism)
o premature menopause
A

Fragile X Syndrome

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33
Q

Expansion of CGG trinucleotide repeats in the 5’ untranslated region

A

Fragile X Syndrome

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34
Q

What is the affected gene in FXS?

A

Fragile X mental retardation 1 (FMR1) gene located on the X chromosome

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35
Q

Occurrence of non-penetrant male carrying the mutated
gene
Presence of pre-mutation alleles

A

Sherman Paradox

non-penetrant male -> non-penetrant daughter->
affected son

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36
Q

o Highest concentration in the brain and testes
o Responsible for selectively binding mRNAs in the
mammalian brain
o Part of neuronal polyribosomes

A

Fragile X mental retardation protein (FMRP)

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37
Q

Tx for Fragile X Syndrome

A
  1. No current treatment or cure
  2. Symptom-based
    o Anti-depressants: SSRIs (Selective Serotonin Reuptake Inhibitors)
    o Anti-psychotics: Risperdal, Seroquel
    o Anti-convulsions
  3. Genetic counseling
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38
Q

Progressive degenerative brain disorder

A

Huntington’s Disease (HD)

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39
Q

Pattern of Inheritance for HD

A

Autosomal Dominant

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40
Q

Due to increase in the number of glutamine (CAG) repeats (>36) coding for the cytoplasmic protein Huntingtin (HTT)

A

Huntington’s Disease (HD)

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41
Q

Where is HTT gene located?

A

Chromosome 4p

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42
Q

Repeated part of the gene

A

PolyQ region

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43
Q

Increases the decay rate of certain types of neurons

A

mutant Huntingtin (mHTT) protein

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44
Q

Most commonly affected region or area in the brain when suffering from HD

A

Neostriatum of the basal ganglia

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45
Q

Symptoms:
Progressive motor, behavioral, and cognitive dysfunction
Dysarthria (unclear speech), gait disturbance, and
oculomotor abnormalities
Psychosis

A

Huntington’s Disease (HD)

46
Q

Tx for HD

A

No treatment or cure – management of symptoms only

47
Q

1st drug approved in the US to treat HD

A

Tetrabenazine

48
Q

Also known as shake/shaking palsy and paralysis agitans

A

Parkinson’s Disease (PD)

49
Q

Progressive neurodegenerative disorder, idiopathic in

nature, affecting neurophysiologic functions and movement abilities

A

Parkinson’s Disease (PD)

50
Q

Primarily affects dopamine-producing neurons in

the nigrostriatal pathway of the basal ganglia, specifically in the substantia nigra

A

Parkinson’s Disease (PD)

51
Q

Major neurotransmitter of nigrostriatal pathway

52
Q

T or F:
Dopamine has:
o Excitatory effect on the indirect pathway
o Inhibitory effect on the direct pathway

A

F
Dopamine has:
o Excitatory effect on the direct pathway
o Inhibitory effect on the indirect pathway

53
Q

2 Types of Parkinson’s Disease (PD)

A

Hereditary

Sporadic

54
Q

Associated genes with PD

A

PARK3, 10, 11, 12

55
Q

Due to problems with mitochondrial dynamics

A

Sporadic PD/ Parkinson’s Disease (PD) in general

56
Q

Five receptors of Dopamine

A

D1,D2, D3, D4, D5

57
Q

Which of the 5 receptors of Dopamine are stimulatory?

58
Q

Which of the 5 receptors of Dopamine are inhibitory?

A

D2, D3, D4

59
Q

G proteins that aggravate PD

A

Gs 1 alpha

60
Q

G proteins that relieve PD

A

Gi 1a, Gi 2a, Gi 3a

61
Q

G proteins that have little effect on PD

62
Q

Converts L-tyrosine to L-DOPA

A

Tyrosine hydroxylase

63
Q

Hallmarks symptoms: tremor of the extremities, jaw, and face (resting), bradykinesia (slowness of movement) or akinesia (absence of planned motor image prior to movement), rigidity or stiffness of the limb and trunk, and postural instability

A

Parkinson’s Disease (PD)

64
Q

Most commonly used anti-PD drug

65
Q

DOPA analog

66
Q

characterized by:
o positive symptoms - delusions and hallucinations
o negative symptoms – impaired cognition, volition and
emotion
o substantial functional deterioration - work,
interpersonal relationships, or self-care

A

Schizophrenia

67
Q

Theories most relevant to the etiology of schizophrenia

A

DOPAMINE and SEROTONIN theory

68
Q

Responsible for functions that regulate motivation and reward, pleasure, fine-tuning of motor function, compulsion and perseveration

69
Q

Postulates that there is an increase in (stimulatory)

dopamine transmission to the D2 receptors

A

Dopamine Theory

70
Q

Tx for Schizoprenia (Dopamine Theory)

A

Typical antipsychotics eg, chlorpromazine & haloperidol

71
Q

Involved in pathways affecting mood, memory

processing, sleep and cognition

72
Q

Postulates that stimulation of the 5-HT2A receptors induces hallucinations similar to that of schizophrenia

A

Serotonin Theory

73
Q

Due to increase in 5-HT transmission

A

Schizophrenia

74
Q

Tx for Schizoprenia (Serotonin Theory)

A

Atypical antipsychotics eg, clozapine & risperidone

75
Q

Presence of amyloid plaques or neurofibrillary

tangles (NFT)

A

Alzheimer’s Disease (AD)

76
Q

Symptoms: memory loss, dramatic personality changes, disorientation and declining physical coordination

A

Alzheimer’s Disease (AD)

77
Q

Types of AD

A

Familial

Sporadic

78
Q

Inheritance pattern in AD

79
Q

Due to mutation in chromosome 19, APOE4 allele

A

Alzheimer’s Disease (AD) - Sporadic

80
Q

Natural neuroprotective agent, precursor protein of A-β42 amyloid protein

A

Amyloid Precursor Protein (APP)

81
Q

Clamps together to form insoluble amyloid plaques

A

A- β42 amyloid protein

82
Q

o located on chromosome 14

o codes for γ-secretase

A

PS1 (Pre-Senilin 1) gene

83
Q

Located on chromosome 19

84
Q

Located on chromosome 21

85
Q

Abnormally phosphorylated tau protein

A

Neurofibrillary tangles (NFT)

86
Q

Microtubule associated protein that functions to

assemble and stabilize the microtubules

A

Tau protein

87
Q

T or F

absence of NFT –> neuronal death due to Lewy bodies

88
Q

[Stages of AD]
o Memory loss may go unrecognized or be ascribed to benign forgetfulness
o trouble understanding visual images and spatial relationships

A

Early stage AD

89
Q

[Stages of AD]
o confused on where they are and what day it is
o major personality and behavioral changes
o unable to work

A

Mid-stage AD

90
Q

[Stages of AD]
o major changes in sleep pattern
o tend to wander and become lost
o lose the ability to respond to their environment, carry on conversations, or control movements
o loss of judgment, reason and cognitive abilities

A

Late Stage AD

91
Q

[Stages of AD]
o becomes rigid, mute, incontinent, bedridden
o generalized seizures may occur

A

End-stage AD

92
Q

Tx for AD

A

Cholinesterase inhibitors

Memantine

93
Q

aka manic-depressive illness

A

Bipolar Disorder (BD)

94
Q

Brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks

A

Bipolar Disorder (BD)

95
Q

Types of Bipolar Disorder

A 
Bipolar I
Bipolar II
Bipolar Disorder Not Otherwise Specified (BP-NOS)
Cyclothymia / Cyclothymic Disorder
Rapid-cycling Bipolar Disorder
96
Q

Due to problem with the balance of neurotransmitters involved in both brain and bodily functions

A

Bipolar Disorder (BD)

97
Q

Main NT involved in BD

A

Serotonin and dopamine

98
Q

CATECHOLAMINE HYPOTHESIS

Inc EPI/NE -> ?
Dec EPI/NE -> ?

A

INCREASE in EPI and NOREPI – mania

DECREASE in EPI and NOREPI – depression

99
Q

Monoamine Hypothesis

DEPLETED levels of monoamines -> ?

A

DEPLETED levels of monoamines - depression

100
Q

Noradrenaline Hypothesis
Low plasma concentration of noradrenalin -> ?
Increased levels of noradrenalin -> ?

A

Low plasma concentration of noradrenalin - BD

Increased levels - hypomania

101
Q

Serotonin (5-HT) Hypothesis

↑ serotonin 2A receptors, ↓serotonin 1A receptors -> ?

A

↑ serotonin 2A receptors, ↓serotonin 1A receptors - Depression

102
Q

Dopamine Hypothesis
↑ Dopamine–?
↓Dopamine– ?

A

↑ Dopamine– mania

↓Dopamine– depression

103
Q

Substance P Hypothesis
↑ Substance P – ?
↓ Substance P – ?

A

↑ Substance P – depression

↓ Substance P – mania

104
Q

Tx for BD

A 
Mood stabilizers (Lithium Carbonate)
Anti-convulsants (Valproic acid/Divalproex sodium)
Atypical Antipsychotics
o Olanzapine – mania and psychosis
o Aripiprazole – mania or mixed
Antidepressants (Fluoxetine, Paroxetine)
Psychotherapy
105
Q

Characterized by qualitative abnormalities in social

interactions, markedly aberrant communication skills, and restricted repetitive and stereotyped behaviors

106
Q

Three recognized disorders in the autism spectrum

disorder (ASD)

A
  1. Autism
  2. Asperger Syndrome: lack or delays in cognitive
    development and language
  3. Pervasive Developmental Disorder (PDD-NOS):
    diagnosed when the full set of criteria for Autism or
    Asperger Syndrome are not met
107
Q

What genes directly regulate expression of glutamic acid decarboxylase?

A

DLX5, DLX2 (both located on Chromosome 7)

108
Q

Due to reduced cerebellar Purkinje neuron density

109
Q

Tx for Autism

A

Special education
2nd-gen antipsychotic agents (Risperidone, Aripiprazole,
Ziprasidone)
Methylphenidate

110
Q

Developmental condition of inattention and distractibility, with or without accompanying hyperactivity

A

Attention Deficit Hyperactivity Disorder (ADHD)

111
Q

Main neurotransmitters involved in ADHD

A

Dopamine and Norepinephrine

112
Q

Tx for ADHD

A 
Pharmacological
o Stimulants- Methylphenidate, dextroamphetamine
o Non-stimulants- Atomoxetine
Non-pharmacological
o Behavioral psychotherapy
o Cognitive therapy for adults with ADHD
o Psychosocial interventions

Biochemistry (1 decks)

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