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Advanced Pathophysiology > Psychotic/ Musculoskeletal Disorders > Flashcards

Psychotic/ Musculoskeletal Disorders Flashcards

1
Q

Risk Factors for _______:

  • Urban living
  • Immigration
  • Obstetrical complications
  • Viral exposure in utero (flu)
  • AMA
  • Birth during famines
A

Schizophrenia

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2
Q

large extra cellular matric glycoprotein involved in neuronal migration during prenatal development of brain & in synaptic function duing adulthood - low levels of this in prefrontal cortex and hippocampus in schizophrenia

A

reelin

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3
Q

schizophrenia chromosomes are ___, ____, and ____.

A

18,22, 23

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4
Q

neurotransmitter alterations schizophrenia theory that states transmission pathways are altered causing increase in dopamine

A

dopamine hypothesis

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5
Q

neurotransmitter alterations schizophrenia theory that states under-activated glutamate receptors (N-methyl-D-aspartate (NMDA) receptor subtype) causes lower levels of glutamate

A

glutamate hypothesis

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6
Q

type of schizo symptoms that frequently occur during a psychotic episode (loses touch with reality and experiences something that should be absent

A

positive symptoms

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7
Q

positive symptoms of schizo

A

hallucinations
delusions
disorganized speech/behavior

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8
Q

symptoms of schizo that are disruptions in normal emotional states and expressions including social withdrawal, blunted affect, no response to simple questions

A

negative symptoms

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9
Q

negative symptoms of schizo

A

affective flattening
anhedonia
alogia
avolition

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10
Q

low levels of ______ in schizo is related to chromosome 22

A

reelin

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11
Q

if this brain component, which is central in social brain processing, is abnormal, the person has difficulties making appropriate social judgements, ie. facial identity, affect recognition, emotional processing

A

amygdala

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12
Q

symptoms of schizo that are problems with thought processes that severely impair the ability to
perform routine daily tasks that involve attention, planning, and social skills

A

cognitive symptoms

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13
Q

etiology of ________ and _______ is related to deficits of reelin expression on chromosomes 18 and 22

A

depression and bipolar

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14
Q

chromosome 22 is related to _____ behavior

A

psychotic

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15
Q

dysfunction of this has a role in individuals ability to cope with stress

A

hypothalmic-pituitary system

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16
Q

chronic stress-induced actication of this sytem leads to increased glucocorticoid secretion associated with 30-70% of those with major depression

A

hypothalmic-pituitary system

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17
Q

in depression/bipolar, this system increases HPA hormone secretions

A

hypothalmic-pituitary system

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18
Q

this causes depression/bipolar when inflammation increases C-reactive protein -> increased risk for psych distress and depression
-increased cytokine levels may be associated with depression

A

Altered immune and Inflammation from Cortisol

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19
Q

there is an association of _______ function and mental illness but the mechanism is unknown

A

thyroid

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20
Q

patients with _______, have anxiety, dysphoria, irritability, cognitice impairments

A

hyperthyroidism

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21
Q

patients with _____, have depression, apathy, psychomotor slowing, dementia

A

hypothyroidism

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22
Q

in depression/bipolar, a large group of serotonin-synthesizing neurons, in the _________, that project extensively to all regions of the cortex

A

central gray matter

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23
Q

in depression/bipolar, widespread decrease in _______, 5-HT1A receptor subtype in the frontal, temporal, and limbic cortex

A

serotonin

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24
Q

in depression/bipolar, _______ transporter binding in cerebral cortex and hippocampus

A

serotonin

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25
Q

some people with depression/bipolar have dysfunction of ________, which modulates homeostasis, emotionality, and tolerance to aversive experiences.

A

raphe-serotonin system

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26
Q

in depression/bipolar, functional abnormalities are found in _____ and _____ regions such as the amygdala

A

frontal and limbic

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27
Q

decreased _______ numbers occurs in in people w/uni & bipolar

A

glial cell

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28
Q

in mood disorders and bipolar, cerebral blood flow _______ in dorsolateral and dorsomedial prefrontal cortex

A

decreases

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29
Q

in unipolar depression, cerebral blood flow ________ in ventrolateral, ventromedial, and orbital areas

A

increases

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30
Q

major excitatory neurotransmitter associsated with MDD

A

glutamate

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31
Q

elevated cortical levels of ______ occur in mood disorders

A

glutamate

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32
Q

_______ (glutamate receptor antagonist) was found in animal models to rapidly increase synaptic density and signaling

A

ketamine

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33
Q

psychosocial stress can cause _______ in pro-inflammatory cytokines

A

increase

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34
Q
  • Deficit in norepinephrine, dopamine, and/or serotonin may be the cause
  • Found that drugs, like imipramine elevated norepinephrine levels reduced depression, but drugs that depleted monoamine levels increased depression.
  • Mania results from ↑ monoamine
A

Dominant MonoAmine Hypotheseis of Depression

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35
Q

the principle of antidepressant medication is increasing ______ neurotransmitter levels within the synapse is the basis for their antidepressant effects

A

monoamine

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36
Q

inability to experience emotion(pain or pleasure, repost a sense of detachment from environment

A

adhedonia

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37
Q

absence of spontaneous speech production to answer questions of express oneself

38
Q

deficit in spontaneous or goal directed behavior to complete daily tasks

39
Q 
Risk Factors for \_\_\_\_\_\_\_:
Thin
female
fam history
estrogen/testosterone deficiency
heavy caffeine use
sedentary
ETOH
hyperthyroid
age
glucocorticoids
decreased nutrients (Ca, Mg, vit D)
A

osteoporosis

40
Q

most common bone disease that is caused by decreased mast density in porous bone…greater reabsorption of bone than formation of bone

A

osteoporosis

41
Q

type of osteoporosis caused by menopause

42
Q

type of osteoporosis caused by conditions other than menopause

43
Q

Clinical Manifestations of _____:
Bone deformity
increased risk for fx (esp without injury)
kyphosis

A

osteoporosis

44
Q

Diagnosis of ______:

Based on gradations of bone mineral density measured by dexascan

A

osteoporosis

45
Q

common, degenerative joint disease, age-related disorder of the synovial joints

46
Q

Local areas of damage in joints and loss of articular cartilage w/ new bone formation of joint margins & thickening of joint capsule;
Increased ossification around where the cartilage has degenerated, osteophytes

47
Q

nodes on proximal inter-phalangial joint

48
Q

nodes on distal inter-phalangial joints

49
Q

systemic autoimmune destruction of synovial membranes w/ systemic side effects of fever, malaise, rash, leukocytosis, lymph node enlargement

A

RA (adult)

50
Q 
Risk Factors of \_\_\_\_\_\_:
geographic location
breastfeeding length or lack of
smoking
socioeconomic status
women
HLA death receptor 4 gene is present 
T cell abnormalities
A

RA (adult)

51
Q

Activation of immune cells, inflammatory cytokines, immune complex deposits that destroy the joint. Inflame mediators and enzymes destroy cartilage & immune cells lead activation of ostoclasts & promote destruction of bone. Pannus occurs

52
Q

Labs for ____:
Positive RA or RF- reveal antibodies (IgG, IgM, IgA), serum anti-citrullinated protein antibody
ESR

53
Q 
Clinical Manifestations of \_\_\_\_\_\_:
Symmetric joint swelling
deformity
rheumatoid nodules found in organs
Fever
malaise
fatigue
Boutounniere deformity
Swan-neck deformity of hand
54
Q

Score of >6/10 is needed to diagnose _____:

  • synovitis
  • widespread symmetrical large and small joints involved
  • abnormal CRP or ESR
  • pos RF or ACPA
  • morning stiffness >1 hr
  • sx >6 weeks
55
Q

Metabolic inflame joint disorder that disrupts bodys control of uric acid production or excretion and forms crystals that deposit in connective tissues in body

56
Q 
Risk Factors for \_\_\_\_\_\_\_\_:
Trauma
ETOH
drugs
diet of red meat
renal insufficiency
kidney stones
obesity
renal failure
diuretics
57
Q

Accelerated purine synthesis w/ overproduction of uric acids leads to poor uric acid secretion by kidneys

A

Gout Patho

58
Q

lab for gout diagnosis

A

Uric acid level

59
Q 
Clinical Manifestions of \_\_\_\_:
Tophi (crystal nodule)
pain in great toe
recurrent attacks of monoarticular arthritis
renal stones
low grade temp
60
Q

stage of gout: asymptomatic hyperuricemia

61
Q

stage of gout: acute gouty arthritis

62
Q

stage of gout: tophaceous gout

63
Q

Chronic widespread joint and muscle pain, fatigue, tender points over muscles

A

fibromyalgia

64
Q 
Risk Factors for \_\_\_\_:
Flu-like viral illness
chronic fatigue syndrome
medications
physical or emotional trauma
HIV
lyme-disease
women
A

fibromyalgia

65
Q

CNS in a state of dysfunction-amplified pain transmission and interpretation leads to Sensitization to pain and
HPA axis shows abnormal response to pain

A

fibromyalgia patho

66
Q 
Clinical Manifestations of \_\_\_\_\_:
Increased sensitivity to touch
Diffuse chronic pain that comes and goes and doesn’t follow dermatomal pattern
sleep changes
fatigue in morning or mid day
anxiety
depression
short term memory loss
A

fibromyalgia

67
Q 
Diagnosis of \_\_\_\_\_\_\_\_:
11/28 positive tender points
WPI of 7 and SSI of 5 or
WPI of 3-6 and SSI of at least 9 
Widespread pain affecting all 4 quadrants of axial skeleton
Sx>3months
A

fibromyalgia

68
Q

scoliosis that consists of poor posture, unequal leg length, pain (mild spinal curve w/ one pronounced hip or shoulder that disappears with forward flexion of spine)

A

non structural

69
Q

scoliosis that consists of vertebral rotation of skeletal abnormalities (asymmetry of hip and shoulder height, should, scapular and rib prominence.)

A

structural

70
Q 
Risk Factors for \_\_\_\_\_\_\_\_:
Neuromuscular disease
trauma
spinal contractions
bone infection of vertebra
metabolic bone disorders
joint disease
tumors (all are structural)
Girls
high incidence in family
hx of connective tissue disorder
71
Q

scoliosis will not progress Curve

72
Q

scoliosis with curve > ___ degrees results in pulmonary function decrease

73
Q

most common rheumatological disease in children
Same as adults except for mode of onset.
-1st is pauciarticular arthritis- <5 joints involved

  • polyarticular: >5 joints
  • systemic: likely to progress to true adult RA
A

Juvenile Idiopathic Arthritis/RA

74
Q

Labs for ____:
Pos antinuclear antibody test. Rheumatoid factor seldom detected.
+ cyclic citrullinated peptide antibody

75
Q

Unexplained arthritis of one or more joints for at least 6 weeks in pt less than 16 y/o

A

Diagnosis of JIA

76
Q 
difficulty sleeping
difficulty concentrating
irritability
restlessness
muscle tension
easily startled
**more often in females than in males
A

symptoms of GAD

77
Q

neurotransmitters involved with panic disorder

A

norepinephrine and serotonin

78
Q

comorbidities associated w/ OCD

A

anxiety/depreesion

79
Q

general age of onset for OCD

80
Q

persistent depressive disorder

81
Q

____ tends to skip generations

A

shizophrenia

82
Q

neurotransmitter associated with schizophrenia

83
Q

bone remodelers- bone regenerative cells

A

osteoclasts

84
Q

bone formation cells

A

osteoblasts

85
Q

post-menopausal women are at increased risk for osteoporosis due to lack of _______

86
Q

development of a pannus is associated w/ ______

87
Q 
lab tests to diagnose \_\_\_\_
rheumatoid factors (70-75% specifcity)
antibodies (anti CCP- 95% specificity)
CBC
CRP 
ESR
88
Q

______ is thought to be caused by gene products of the major histocompatibility system

89
Q

____ is present in the majority of patients with RA

A

HLA-DRB1 (Human Leukocyte Antigen)

90
Q

uric acid crystalline concentration that makes nodule in joint usually on big toe

91
Q 
Clinical Manifestations of \_\_\_\_\_:
fever 
rash fatige
splenomegaly
lymphandectomy
92
Q

arthritis that is more likely to affect the larger joints

A

juvenile arthritis

Advanced Pathophysiology (10 decks)

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