Q-based Flashcards
Where is DA made?
- Ventral Tegmental Area
- Substantia Nigra
What things are caused by VTA destruction:
- Hypervigilance
- Depression
- Mania
- ADHD
- Anxiety
- Parkinsonian movements
- Psychosis
Low DA –>
- Depression
- ADHD
- Parkinsonian movements
What things are caused by DA excess:
- Hypervigilance
- Depression
- Mania
- ADHD
- Anxiety
- Parkinsonian movements
- Psychosis
- Hypervigilance
- Mania
- Anxiety
- Psychosis
How and on what does Reserpine work?
- Inhibits VMAT transport
- Sequesters NE
What things caused by low NE:
- Insomnia
- Depression
- ADHD
- Anxiety
- Fatigue
- Agitation
- Mania
- Depression
- ADHD
- Fatigue
What things caused by high NE:
- Insomnia
- Depression
- ADHD
- Anxiety
- Fatigue
- Agitation
- Mania
- Mania
- Agitation
- Anxiety
- Insomnia
What’s the only drug approved to treat Huntington’s Chorea?
Tetrabenazine
What is Baclofen used for?
Treat spasticity associated w/ ALS
What is the only drug that can improve QOL and lifespan of ALS patients?
Riluzole
What class of drug is Buproprion?
NDRI Antidepressant
In a COPD patient w/ Glaucoma, what are 1st line drugs?
What class?
COPD = no Beta Blockers
Latanoprast, Travoprost, Bimatoprost, Unoprostone isopryl
Prostaglandin analogs
Blocking what receptor stops Psychosis?
D2
Mechanism of antipsychotics
What class of drug is Tropicamide?
Parasympathetic antagonist
What eye muscle is affected in Horner’s Sydrome?
Superior palpebral muscle of Muller
What class of drug is Pilocarpine?
Muscarinic agonist
What is the use and mechanism of Beta Blockers in Opthalmology?
What drugs?
For Glaucoma
decrease aqueous humor production at ciliary epithelium
Timolol, Betaxolol
Prostaglandin analog mechanism for treating Glaucoma
Increase uveoscleral outflow
little side effect!
How do you separate 1st, 2nd, or 3rd order Horner’s Syndrome?
Paredine (hydroxyamphetamine) –> NE release
No pupil response –> 3rd order lesion (benign)
Which is left and right?
OD, OS
Left: OS
Right: OD
What is the most common type of primary headache?
Tension-type
Definition of a migraine aura:
Focal neurological deficit for >4min but
What drug combo can cause Serotonin Syndrome?
MAOI + SSRI
Mechanism of action for local anesthetics:
Na+ channel block
Haloperidol is a ___ antipsychotic that is most likely to cause ___ and ___ side effects
Typical
Neuroleptic malignant syndrome (NMS) Tardive Dyskinesia (TD)
What drug interactions can cause a Hypertensive Crisis?
MAOI + Releasers(Tyramine)/TCAs/a1 agonists/Levodopa
What are the 3 structural parts of a local anesthetic:
- Aromatic ring
- Intermediate linkage
- Terminal amine
What are the hallmark side effects of Na+ Channel Blockers?
Dizzy, Drunk, Double vision
Why can’t you give a pregnant woman with epilepsy Valproic Acid?
-Teratogenic 4-8%
Match the neurotransmitters with related genes in terms of ADHD:
- Dopamine, Norepinephrine, Serotonin
- DRD4/DRD5/COMT/5HTPPLR/DAT
- DA—DRD4, DRD5, COMT
- NE—COMT
- Serotonin—5HTPPLR
Autoinduction and heteroinduction is associated with what Anti-epileptic drug?
Carbamazepine
-Na+ channel blocker
How can serotonin abnormality cause Anxiety and Depression?
Low serotonin circuit activity –> hyperfunctioning limbic pathway
Patient is sad, weepy, suicida, worried, and ruminating. What gene is most likely mutated?
A. DAT
B. Tyrosine hydroxylase
C. 5HTPLLR
C. 5HTPLLR
Serotonin associated with high negative affect
What are the Cluster A personality disorders?
Psychotic-like:
- Paranoid
- Schizoid
- Schizotypal
What are the Cluster B personality disorders?
Dreaded, behavioral :
- Antisocial
- Histrionic
- Narcissistic
- Borderline
What are the Cluster C personality disorders?
Anxious:
- Avoidant
- Dependent
- Obsessive-compusltive
Difference between homeopathy and naturopathy
Homeopathy: stimulate body’s self-healing response
Naturopathy: noninvasive treatments
What are 3 CAM treatment that have effectiveness treating depression?
L-methylfolate
S-adenosyl methionine (SAMe)
St. John’s Wort
What is the rate of placebo effect in EVERYTHING done in psychiatry?
40%
What CAM treatment has very good evidence in treating seasonal depression?`
Light therapy
What’s the difference between Schizoid and Schizotypal PD?
Schizoid: trouble relating, have no interest in interactions
Schizotypal: oddities in behavior and thoughts
What is an age related requirement for Antisocial PD?
Evidence of a Conduct Disorder with onset before age 15
That leads to pervasive pattern of disregard for or violation of rights of others after age 15
What characterizes Borderline PD?
Pervasive Instability: of relationships, self-image, behaviors, and affects
5+/9 Symptoms needed
Which PD are more prevalent in women?
In men?
Women: paranoid, avoidant, dependent
Men: antisocial
Psychopharmacolgy can treat what PDs?
Cluster B: Antisocial, narcissistic, histrionic, borderline
Avoidant (Cluster C)
Psychotherapy works for which one Cluster B PD?
Borderline PD only
-3 psychodynamic and 2 cognitive behavioral models
What is Psychomotor retardation?
Depression causes patient to feel and act slowed down
Criteria for Mania vs Hypomania
Mania: 3+/7 symptoms for 7+ days of expansive mood
Hypomania: 3+/7 symptoms for 4+ days
What is the difference between Bipolar 1 and Bipolar 2?
Bipolar 1: Mania + MDE
Bipolar 2: Hypomania + MDE
What is a requirement/not a requirement for Bipolar 1 and 2?
Must have: Mania or hypomania
Does not need: Depression
What is the criteria for Cyclothymia?
Minor depression + 2+ years of hypomania
What is Kindling Hypothesis?
Related to Bipolar
- Too much neuronal limbic firing
- Once you get mania, you get more
Gender differences in Bipolar
Bipolar 1: men = women
Bipolar 2: women > men
How do Atypical Antipsychotics treat Bipolar?
- D2 receptor block–treats Mania
- 5HT2a receptor block–terats depression
Drugs for treating Bipolar 1:
Lithium, Divalproex, Carbamazepine, Lamotrigine, atypical antipsychotics
Developmental milestones:
Finality of death by \_\_\_ Gender identify by \_\_\_ Social smile at \_\_\_ Morality by \_\_\_ Body image by \_\_\_ Stranger anxiety at \_\_\_ Universality of death by \_\_\_ Separation anxiety by \_\_\_
Finality of death: 6 year Gender identify: 3 year Social smile: 12 week Morality: 12 years Body image: 15 years Stranger anxiety: 9 months Universality of death: 9 years Separation anxiety: by 1 year
Autism Spectrum disorder is seen before age ___
3 years
2 Most common genetic factors causing Mental retardation:
Down Syndrome and Fragile X Syndrome
Age of onset for:
Tourette’s Disorder:
Separation Anxiety:
Selctive Mutism:
Tourette’s Disorder: before 18
Separation Anxiety: 7 years
Selctive Mutism: 6 years
5 Stages of dying are:
Denial Anger Bargaining Depression Acceptance
What is the hallmark symptom of Schizophrenia and what can it present as?
Psychosis: impairment in reality testing
- Hallucinations
- Delusions
- Disorganized or catotonic behavior
- Negative symptoms
- Disorganized speech
Symptom and Duration Criteria for Schizophrenia:
2+ symptoms during 1+ month periods that persists for 6 months
What class of drugs and mechanism that causes NMS and TD?
Antipsychotics
Excessive D2 receptor blockade
Neurotransmitter abnormalities in Schizophrenia:
All high: DA, Glutamate, Serotonin, NE
DSM 5 Criteria for ADHD:
- 6+ symptoms for 6+ months
- Start before age 12
- Multiple settings
ADHD neurologic change/fMRI finding:
hypOactive Anterior Cingulate
SIG E CAPS
Sleep disturbance Interest/pleasure reduction Guilt, worthlessness Energy loss, fatigue Concentration/attention impairment Appetite changes Psychomotor symptoms Suicide Ideation
What 3 Genes are associated with early onset AD
- APP
- Presenilin 1
- Presenilin 2
All autosomal dominant
3 Types of Frontotemporal Lobar Degeneration (FTLD):
- Tau
- TDP
- FUS
Knife-edge gross examination of brain suggests:
Tau form of Frontotemporal Lobar Degeneration (FTLD)
Tau associated diseases:
- Alzheimer’s
- FTLD
- Parkinson’s
- PSP
- CBD
Histological findings in PSP:
- Globose tangle
- Tufted astrocyte
What are Lewy Bodies made of?
Alpha-synuclein
