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ESUN MS2Unit3 > Pyschiatry II > Flashcards

Pyschiatry II Flashcards

1
Q

Which gene mutations are associated with schizo?

A

COMT/tyrosine hydroxylase/DA D2R/D3R

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2
Q

The ___ number of risk genes—->the high risk of getting schizo

A

Higher

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3
Q

Gene mutations that are responsible for hypofrontal activity of schizo?

A

COMT and DA D3R

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4
Q

Gene mutations that are responsible for hyper ventromedial cortex activity of schizo?

A

DA D2R/tyrosine hydroxylase/MAO

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5
Q

What are the significance of DA and NE in ADHD?

A

DA helps to block out out things/NE helps you to concentrate

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6
Q

Gene mutations that are associated with hypofrontal activity of ADHD?

A

DA D4/5R

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7
Q

What is the precursor of 5HT?

A

Tryptophan

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8
Q

5HT is from __ in the brain?

A

Raphe nuclei

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9
Q

Low 5HT causes hyperactivity in __ of the brain?

A

Amygdala

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10
Q

What gene mutations are associated with 5HT dysfunction?

A

5HT2a/5HTTLPR (reuptake transporter)/tryptophan hydroxylase

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11
Q

Where is NE originated in the brain?

A

Locus coeruleus

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12
Q

High NE gives you?

A

Hyperarousal/panic/worry

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13
Q

Dysfunction of what transmitters give you reduced + affect (loss of interest/happiness and what not)?

A

NE and DA

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14
Q

Dysfunction of what transmitters give you increased - affect (fear/irritability and what not)?

A

NE and 5HT

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15
Q

What is the brain activity of PTSD pt comparing with control?

A

High mid anterior cingulate and amygdala/low frontal activity

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16
Q

In MDD, what gene mutation is responsible for the increase NE and anxiety in limbic areas?

A

COMT Met alleles—>low degradation—>high NE (COMT Val alleles does the opposite)

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17
Q

What parts of the brain light up when you are empathizing?

A

Medial prefrontal cortex (hypoactive means you lack empathy)

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18
Q

Memorizing enhance or disrupt empathetic response?

A

Disrupt (maybe why doctors are not unempathetic when treating pts)

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19
Q

COMT is responsible for what transmitters?

A

DA and NE

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20
Q

What are the 3 methods under whole medical systems of CAM?

A

Ancient healing system/homeopathy (use small dose to stimulate self healing/naturopathy (like massage/exercise/acupuncture and what not)

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21
Q

What are some examples of mind-body medicine of CAM?

A

meditation and relaxation

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22
Q

What are some examples of biologically based practices of CAM?

A

Dietary supplements (vitamins) and herbal remedies

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23
Q

What are some examples of manipulative and body based practices of CAM?

A

chiropractic and osteopathic manipulation

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24
Q

What are some examples of energy medicine of CAM?

A

Qi gong

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25
Q

What is St John’s wort used for?

A

CAM for depression

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26
Q

Which vitamin deficiency is associated with depression?

A

D (so they say)

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27
Q

What cluster A of personality disorder?

A

Psychotic like—->paranoid/schizoid (detachment from social relationships)/schizotypal (odd)

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28
Q

What is cluster B of personality disorder?

A

Behavioral disorder—>antisocial (like conduct disorder)/histrionic (overly dramatic, attention seeking)/narcissistic (need for admiration/entitlement/risky disorder)/borderline (instability of relationships, moods, self image or thought)

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29
Q

What is cluster C of personality disorder?

A

Anxious—->avoidant (from social circumstances)/depdent/obsessive compulsive

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30
Q

Which cluster is more common in PD?

A

Cluster A and C

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31
Q

What happens if a child is deprived of maternal nurturing in the beginning? does parenting behaviors affect the risk of the children developing PD?

A

The child tends to become impulsive and aggressive/yes

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32
Q

What would you see if you follow PD pt over 4 years?

A

Some of them might not meet the PD criterion anymore (remission) but their impairment in functioning still persist

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33
Q

What is the treatment for cluster B?

A

mood stabilizers/antipsychotics/benzodiazepine might worsen the condition

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34
Q

What is DSM 5 definition of mania?

A

abnormally happy for over 1 week/3 symptoms of DTRHIGH for at least 2 weeks/cause dysfunction

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35
Q

What is DTRHIGH for mania?

A

Distractible/talkative/racing thoughts/hyperactive/impulsive/grandiose/hyposomnic

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36
Q

What is hypomania?

A

Mild mania/change in function and personality for at least 4 days/no psychosocial consequences

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37
Q

Can a biopolar pt be manic and depressed at the same time?

A

Ye, ‘tis called mixed episode

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38
Q

What is bipolar 1 disorder?

A

Must have mania/do not need to have depression

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39
Q

How frequent is rapid cycling of bipolar?

A

4 or more episodes per year

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40
Q

What is bipolar 2 disorder?

A

Must have hypomania/spend most of the time depressed

41
Q

What is cyclothymia?

A

Minor depression/have hypomania for more than 2 years/from hypomania to minor depression—>crash and suicidal

42
Q

What is dysthymia?

A

Chronic low level depression for 2 years

43
Q

What is kindling hypothesis for mania and seizure disorder?

A

The more you get, the worse you get

44
Q

You have ___ transmitter and ___ receptor when you are manic?

A

high/low

45
Q

Which gender is more prone for bipolar 1 and 2?

A

equal for 1/more women for 2

46
Q

Try not to use ___ when the pt is bipolar? what do we use instead and why?

A

Antidepressant/SGA/tune down mania and also has some built in antidepressant

47
Q

Does psychotherapy work for mania?

A

Nein

48
Q

What are some medication for bipolar 1?

A

Li/divalproex/carbamazepine/lamotrigine/SGA

49
Q

What is the physical and psychological manifestations of anxiety?

A

physical—>hyperventilation/numbness and tingling in the extremities/sleep disturbance
psychological—>restlessness/worry/irritability

50
Q

Is socially triggered panic attack considered as panic disorder?

A

Nein nein

51
Q

What is the diagnostic criteria of anxiety disorder?

A

Persistent/interfere normal functioning/cause distress

52
Q

Some causes of anxiety of disorder?

A

Trauma/personality/learned anxiety/30-40% genetic/more women than men

53
Q

What transmitters are low for anxiety disorder?

A

5HT is low—>that’s why antidepressants works well/low GABA/high NE—>alert and freaking out

54
Q

What is the DSM 5 diagnostic criteria for General Anxiety Disorder?

A

Persistent worrying about more than 1 event for at least 6 months/have at least 3 symptoms of anxiety

55
Q

What do people who worry a lot sometime turn to?

A

Alcohol (or turkey but unlikely)

56
Q

What do you treat GAD with?

A

CBT/antidepressant/buspirone (get rid of autoreceptor of 5HT)/benzodiazepine

57
Q

GAGB allows more ___ channel to open?

A

Cl-

58
Q

DSM 5 diagnostic of panic disorder?

A

Abrupt unexpected surge of intense fear within mins/have at least 4 symptoms of panic/recurrent/consequence and maladaptive change in behaviors

59
Q

Diagnostic criteria for agoraphobia (panic disorder)?

A

anxiety for public space for over 6 months

60
Q

Treatment for panic disorder?

A

CBT (systemic desensitization or flooding)/benzodiazepines/SSRI and SNRI

61
Q

DSM 5 diagnostic criteria of specific and social phobia?

A

Specific—>disproportionate fear of something/avoid it/over 6 months
Social—>same thing but just afraid of being in social situation (fear of embarrassment and what not)

62
Q

Treatment for phobia?

A

CBT (systemic desensitization and flooding)/SSRI or SNRI/MAOi

63
Q

DSM 5 diagnostic criteria of OCD?

A

Obsessions and compulsions/time consuming/distress

64
Q

What is the obsession and compulsion in OCD?

A

Obsession—>recurrent thoughts/urges that are intrusive and unwanted—>undo or neutralize them with a thought or action
Compulsion—>repetitive behavior in response to an obsession/reduce anxiety/insight

65
Q

Which gender is more prone to OCD?

A

Equally

66
Q

What is the worst anxiety disorder?

A

OCD

67
Q

What syndrome usually comes with OCD?

A

Tourette’s syndrome

68
Q

Treatment for OCD?

A

CBT (exposure and response prevention)/acceptance and commitment therapy therapy for obsession (desensitize thoughts)/high dose SSRI/clomipramine/benzo does not work

69
Q

What is OCPD?

A

Anxiety without insight—>harder to treat

70
Q

What are variables associated with PTSD?

A

proximity/harm by other ppl/severity/repetition

71
Q

DSM 5 diagnostic criteria for PTSD?

A

Exposure to traumatic event (don’t have to be there)/symptoms over 1 month/distress/flashback/avoid stimuli/- change in cognition/jumpy/poor concentration and insomnia

72
Q

DSM 5 diagnostic criteria for ASD?

A

Like PTSD but symptoms are from 3 days to 1 month

73
Q

Treatment for PTSH and ASD?

A

Treat right away, don’t wait/relive or seal over events (eye movement desensitization and reprocessing)/SSRI/TCA/MAOi/prazosin for nightmares

74
Q

What is mild Traumatic Brain Injury (TBI)?

A

disruption of brain function or focal neurological deficits/LOS

75
Q

The most causes of TBI is ?

A

Fall

76
Q

What is primary TBI?

A

From force of the impact

77
Q

What is secondary TBI?

A

Ischemia/hypoxia/over time/magnify primary cause

78
Q

What is diffuse axonal injury?

A

Focal lesion result from primary cause/shearing of brain tissue—>disruption of pathway in the midline structure

79
Q

What is neurometabolic cascade after trauma?

A

Disruption of the homeostasis of energy supply and metabolism—>mismatch (low vascular supply and high demand)

80
Q

Are the all the NTs level go up or down after TBI?

A

Go up

81
Q

What are the 3 things Glasgow Coma Scale look for?

A

Eye opening/verbal response/best motor response (the hight the # the better)

82
Q

What scale is used to track recovery of TBI?

A

Ranchos Los Amigos Level

83
Q

What are the stages 1-6 of Ranchos Los Amigos Level?

A

Coma/vegetative state/minimally conscious/confusional (post traumatic amnesia)/post confusional (no amnesia/start therapy)/social competency (back to community)

84
Q

Can you typically categorize the emotional and behavioral changes according to DMS 5 with TBI pts?

A

No, they come in small elements

85
Q

What is post traumatic agitation and its treatment?

A

RLAS IV/agressive/akathisia

Treatment—>pindolo (beta blocker)/antiepileptic/SSRI or TCA/no FDA approved medication

86
Q

What might be some emotional changes with TBI pts?

A

No awareness of inappropriate behaviors/depression and anxiety

87
Q

PTSD is more common in mild or severe TBI?

A

Mild (even if you don’t remember the event)

88
Q

What is dyssomnia?

A

Problem in timing/quality/amount of sleep

89
Q

What is parasomnia?

A

Problems in physiology or behavior associated with sleep (abnormal stuff that happen to you at night)

90
Q

What is the DSM 5 diagnostic criteria for insomnia?

A

Problem falling or maintaining sleep/wake up too early and can’t fall back to sleep/cause distress

91
Q

Prevalence of insomnia increase with __?

A

Age

92
Q

Causes of insomnia?

A

High excitatory NTs and low inhibitory NTs at night

93
Q

Insomnia sometimes comes down to ___?

A

Anxiety—>worry about not be able to sleep—->then you don’t sleep

94
Q

Withdraw of ___ drugs can cause insomnia?

A

Sedating drugs

95
Q

Insomnia pts have a risk of ___ abuse

A

Alcohol/substance—>whatever helps to go to sleep

96
Q

Insomnia management?

A

Diagnosis/behavioral counseling/sleep restriction therapy/drugs

97
Q

Pharmacotherapy for insomnia?

A

Ramelteon and Tasimelteon (non habit forming)/zolpidem/benzo (habit forming)

98
Q

Panic disorder/phobia/GAD/PTSD/OCD are all part of the ___ disorder?

A

Anxiety

ESUN MS2Unit3 (11 decks)

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