Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Interviewing Techniques > Quiz 3 > Flashcards

Quiz 3 Flashcards

1
Q

What are some functions of serotonergic pathways in the brain?

A

Found in CNS (raphe nuclei of the brainstem)

Influence mood, appetite, sleep, cognition, memory, thermoregulation, nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What cells make 90% of the serotonin in the body?

A

Enterochromaffin cells of the GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  1. What is the effect of serotonin on the GI?
A

a. Stimulate myenteric neurons → ↑GI motility
b. Release of 5-HT → acts on vagal afferents → nausea
c. Gut immune response(?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  1. What is the function of serotonin stored in platelets?
A

a. Released from PLT → vasoconstriction, PLT aggregation, clot formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  1. What conditions are treated with therapies that increase serotonin?
A

a. Depression, anxiety, insomnia, OCD, migraines, aggression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  1. What are the symptoms of serotonin syndrome?
A

a. Cognitive: HA, agitation, hypomania, mental confusion, hallucinations
b. Autonomic: HTN, hyperthermia, shivering, sweating, N, D
c. Somatic: tremor, hyperreflexia, myoclonus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  1. What is carcinoid syndrome?
A

a. Disorder caused by tumors of the enterochromaffin cells secreting excess serotonin
b. SXS: D, flushing, dyspnea, abd. pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  1. What is the rate-limiting step in serotonin synthesis? What is this most dependent upon?
A

a. Tryptophan → 5-HTP

b. Dependent on tryptophan concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  1. Why might giving someone tryptophan result in a decrease in catecholamines?
A

a. The enzyme used to convert 5-HTP into serotonin (dopa decarboxylase) is the same enzyme used in catecholamine synthesis. Increasing the pool of tryptophan reduces the amount of dopa decarboxylase available for catecholamine synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  1. How is 5-HT neurotransmission terminated?
A

a. 5-HT is removed from synaptic cleft via reuptake system, similar to catecholamines.
b. SSRIs inhibit this reuptake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  1. Why should MAO inhibitors not be given at the same time as selective serotonin uptake inhibitors (SSRIs)?
A

a. 5-HT is degraded by MAO → MAO inhibitors → ↑5-HT → ↑Serotonin
b. Combining an MAO inhibitor with an SSRI can cause serotonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
  1. What are some conditions that are treated with 5-HT receptor agonists?
A

a. Migraines (triptans), anxiety (Buspar)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. What are some conditions that are treated with 5-HT receptor antagonists?
A

a. Schizophrenia (Risperidone), N/V (Zofran, Metoclopramide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  1. What is the main inhibitory neurotransmitter in the CNS?
A

a. GABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  1. What are effects of GABA?
A

a. Sedative/hypnotic, anti-anxiety, and anti-convulsive effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  1. How are substances that increase GABA activity used?
A

a. Seizure d/o, anxiety d/o, insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  1. How are substances that decrease GABA activity used?
A

a. Antidote for OD of GABA agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
  1. What amino acid is the precursor for GABA?
A

a. Glutamate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q
  1. In addition to the binding site for GABA, what other binding sites exist on the GABAA receptor?
A

a. Binding sites for benzodiazepines, barbiturates, ethanol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
  1. Where do many of the nervine herbs bind on the GABAA receptor?
A

a. Benzodiazepine receptor site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
  1. What is the main excitatory neurotransmitter in the CNS?
A

a. Glutamate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q
  1. What is the excitotoxicity theory?
A

a. Prolonged or repeated depolarization of a neuron d/t glutamate stimulation → cell damage and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q
  1. What is the immediate precursor for glutamate in the brain?
A

a. Glutamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q
  1. How is glutamate neurotransmission terminated?
A

a. Rapidly taken back up into neurons and astrocytes after release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q
  1. What are some endogenous opioids?
A

a. Endorphins, Enkephalins, Dynorphins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q
  1. What are endogenous opioids involved in?
A

a. Pain suppression, reward, mood, motor coordination, feeding, body temperature, immune response, stress response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q
  1. What are effects of opioid overdose?
A

a. CV/Respiratory depression, N/V, constipation, pupillary constriction

28
Q
  1. What is the relationship between β-endorphin and ACTH? How is this important in the stress response?
A

a. β-endorphin and ACTH both come from the same propeptide (pro-opiomelanocortin POMC)
b. In the stress response, when CRF stimulates ACTH production, β-endorphin is also produced.

29
Q
  1. From what molecule are endogenous cannabinoids derived?
A

a. Anandamide (arachidonic acid derivatives)

30
Q
  1. What are functions of endogenous cannabinoids?
A

a. Involved in analgesia, eating behavior, immune function, mood, sleep, memory
b. Preventing formation of traumatic memories, extinction of learned fear responses

31
Q
  1. Why are endogenous cannabinoids not stored in membrane vesicles?
A

a. Because they are lipid-soluble

32
Q
  1. How is obesity defined?
A

a. Excess body fat, BMI >30 kg/m2

33
Q
  1. What BMI is associated with the lowest point of all-cause mortality?
A

a. 23-24 kg/m2

34
Q
  1. What health condition is responsible for most of the increased mortality with obesity?
A

a. Coronary heart disease

35
Q
  1. What other health conditions are associated with obesity?
A

a. Thromboembolic d/o, stroke, heart failure

36
Q
  1. What waist circumference in men is associated with increased risk of cardiovascular disease? In women?
A

a. M = >40, F = >35

37
Q
  1. What factors determine what a healthy weight is for a particular patient?
A

a. Clinical picture, diet/exercise hx, lab biomarkers, FHx

38
Q
  1. What are some causes of obesity?
A

a. Genetics
b. Microbiome
c. Physical activity
d. Diet (High fat, high sugar)
e. Environmental toxins
f. Stress-induced hypercortisolism
g. Sleep d/o

39
Q
  1. What are some things to consider in the medical interview when discussing weight loss with a patient?
A

a. Why does patient want to lose weight?
b. Hx of eating d/o?
c. ROS sxs related to obesity?
d. Sleep d/o related to obesity?
e. Risk for high cortisol?
f. Gut health?
g. FHx
h. Current diet/exercise?
i. Diet hx?
j. Readiness for change?

40
Q
  1. What are some effects of weight cycling?
A

i. Inc. total body fat, central adiposity
ii. Inc. food efficiency
iii. Dec. energy expenditure
iv. Inc. BP, insulin resistance, blood lipids

41
Q
  1. What are some things to consider when coming up with a treatment plan for obesity?
A

a. Individualized
b. Specific weight loss goal?
c. Tx for obesity-related sxs?
d. Is mood improving?
e. Reducing BP, blood sugar, blood lipids?

42
Q
  1. What is necessary for a diagnosis of AN?
A

i. Persistent restriction of energy intake → significantly low body weight
ii. Intense fear of gaining weight/becoming fat OR persistent behavior that interferes with weight gain
iii. Disturbance in experience of one’s body weight/shape, undue influence of body shape/weight on self-evaluation, OR persistent lack of recognition of the seriousness of the current low body weight

43
Q

42b. What is necessary for a diagnosis of BN?

A

i. Recurrent episodes of binge eating characterized by:
1. Eating excessive amounts rapidly, lack of control
ii. Recurrent compensatory behavior to prevent weight gain:
1. Vomiting, laxatives, diuretics, medications, fasting, excessive exercise
iii. Behavior occur at least once per week x 3 months
iv. Self-evaluation unduly influenced by body shape/weight
v. Disturbance does not occur exclusively during episodes of Anorexia Nervosa

44
Q

42c. What is necessary for a diagnosis of BEd?

A

i. Recurrent episodes of bing eating (at least weekly x 3 months)
ii. Episodes associated w/ 3 or more of the following:
1. Eating more rapidly than normal
2. Eating until feeling uncomfortably full
3. Eating large amounts of food when not feeling physically hungry
4. Eating alone because embarrassed by how much one is eating
5. Feeling disgusted w/ oneself, depressed, or guilty afterward
iii. Marked distress regarding binge eating
iv. Not associated w/ recurrent use of inappropriate compensatory behaviors, does not occur during Bulimia Nervosa or Anorexia Nervosa

45
Q

43a. What are physical effects of AN?

A

i. Abnormal mineral/electrolyte levels
ii. Reduced metabolism (hypothyroidism)
iii. Confused/slow thinking
iv. Hypotension, bradycardia, fainting
v. Anemia, poor immune function
vi. Stunted growth, osteoporosis
vii. HAs
viii. Poor circulation → pins/needles/purple extremities
ix. Dry skin, easy bruising, dry/chapped lips, glossitis, brittle fingernails, lanugo
x. Amenorrhea, low libido, impotence in males
xi. Abdominal pain, constipation
xii. Edema, KD damage

46
Q

43b. What are physical effects of BN

A

i. Chronic sore throat
ii. Heartburn, reflux
iii. Abdominal pain/bloating
iv. Constipation, Diarrhea
v. Erosion of dental enamel from vomiting, tooth decay
vi. Mood swings, self-harm, anxiety, depression
vii. Dehydration
viii. Electrolyte/blood sugar imbalance → cardiac arrhythmia, muscle fatigue/cramps
ix. Heart failure
x. Stomach/intestinal ulcers
xi. Inflammation/rupture of esophagus/stomach
xii. Swollen salivary glands

47
Q

43c. What are physical effects of BED?

A

i. Weight gain → obesity
ii. High BP, high cholesterol
iii. DM
iv. Stroke
v. Gallbladder disease
vi. Heart disease
vii. Osteoarthritis
viii. Irregular menstruation
ix. CA
x. Chronic KD problems/failure
xi. Acne, candida, eczema

48
Q

44a. What is avoidant/restrictive food intake disorder (ARFID)?

A

a. Persistent failure to meet appropriate nutritional and/or energy needs associated w/ one or more of:
i. Significant weight loss
ii. Significant nutritional deficiency
iii. Dependence on enteral feeding or oral nutritional supplements
iv. Marked interference w/ psychosocial functioning

49
Q

44b. What are some examples of ARFID?

A

i. IBD
ii. IC
iii. Autism
iv. Picky eaters
v. Allergies
vi. Anxiety d/o

50
Q
  1. What are some common psychiatric issues associated with eating disorders?
A

a. Depression
b. Anxiety
c. Bipolar
d. Addiction/alcoholism
e. OCD
f. PTSD
g. Borderline personality d/o
h. Intentional self-harm
i. Schizophrenia

51
Q
  1. When should you consider screening for an eating disorder?
A

a. Patients who want a restrictive diet or have restrictive dieting history
b. Patients who have OCD and perfectionist behaviors surrounding food/diets you give them
c. Weight loss/gain in someone w/ other mood d/o or recent trauma
d. Incidental finding of poor oral health and beat up knuckles, frequent pharyngitis (purging)
e. Observation of cutting behaviors/scars
f. Other issues of alcoholism/addiction
g. Patients overly preoccupied w/ their weight
h. Children w/ weight loss or food restrictive behaviors

52
Q
  1. If a patient has an eating disorder as the primary complaint, what other professionals should be involved in his or her care?
A

a. Dietician
b. Therapist
c. Psychiatrist
d. Other eating d/o programs or tx center support groups

53
Q

48a. When is inpatient hospitalization indicated with an eating disorder?

A

i. Unstable/depressed vital signs
ii. Lab findings presenting acute health risk
iii. Complications d/t coexisting medical problems such as diabetes
iv. Rapidly worsening sxs
v. Suicidal and unable to contract for safety

54
Q

48b. What are some other possible levels of care?

A

a. Residential treatment
b. Partial hospitalization
c. Intensive outpatient/outpatient

55
Q
  1. Why is it important to know whether a patient has a history of an eating disorder?
A

a. Might not mention eating d/o
b. May have liked the safety of an eating d/o, be at risk of going back to it
c. Might have condition that may benefit from dietary changes
d. Naturopaths love to recommend restrictive diets

56
Q
  1. In these patients, what are some things you should not consider doing until you know them well?
A

a. Any food sensitivity/intolerance test (IgG/IgA, Carroll, ALCAT)
b. Elimination/Elemental diet
c. Highly restrictive diets w/ long food lists to avoid

57
Q
  1. Why should drugs and herbs be used in small doses in patients with eating disorders?
A

a. D/t low weight, low protein, altered metabolism → cardiotoxicity, seizures

58
Q
  1. What is the standard treatment for AN?
A

a. Nutritional rehabilitation and psychotherapy

59
Q
  1. What are some treatments for bone loss with AN?
A

a. Vitamin D
b. Calcium, Magnesium, HCl support
c. Support restoration of menstrual cycle
d. Low-dose E w/ cyclic P

60
Q
  1. What drugs are useful in BN?
A

a. Fluoxetine (Prozac) – 1st line
b. Other SSRI (citalopram, sertraline, fluvoxamine) – 2nd line
c. Tricyclic or MAOI – 3rd line

61
Q
  1. What antidepressant should not be used with AN or BN?
A

a. Bupropion

62
Q
  1. What is the first line treatment for BED?
A

a. Cognitive behavioral therapy (CBT)

63
Q
  1. Why is it important not to let patients with AN see their weight?
A

a. This can cause suicidal ideation

64
Q
  1. What types of exercise are especially helpful for patients with eating disorders?
A

a. Yoga, Tai chi, Qigong

65
Q
  1. What are some possible digestive issues in patients with eating disorders?
A

a. IBS, dysbiosis, poor digestive flora

66
Q
  1. What are some conditions that might coexist with eating disorders?
A

a. BN Type 1 diabetes
b. AN Celiac disease, T2DM
c. ED/AN Hypermobility syndrome

67
Q
  1. What are some counseling techniques that might be useful with eating disorder patients?
A

a. Emotional freedom technique (EFT)
b. Eye movement densitization and reprocessing (EMDR)
c. Cognitive behavioral therapy (CBT)

Interviewing Techniques (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions