Sheet1-表格 1 Flashcards
Are hallucinations common in narcolepsy patients?
Yes. Both Hypnagogic (just before sleep) and Hypnopompic (with awakening).
Define Cataplexy.
Sudden collapse (falls asleep) while awake.
Define Sleep Apnea.
Person stops breathing for at least 10 seconds during sleep.
Distinguish between central and obstructive sleep apnea.
- In central sleep apnea, no respiratory effort.
- In Obstructive sleep apnea, respiratory effort against airway obstruction.”
Does narcolepsy have a genetic component?
Yes
Does REM sleep increase or decrease with age?
Decreases
Extraocular movements during REM sleep are due to what portion of the brain?
- Parapontine Reticular Formation
- Conjugate Gaze Center
How often does REM sleep occur?
Every 90 minutes (duration may increase during the night)
Name 1 neurotransmitter change associated with Alzheimer’s disease.
Decreased Ach
Name 1 neurotransmitter change associated with Parkinson’s disease.
Decreased Dopamine
Name 1 neurotransmitter change associated with Schizophrenia
Increased Dopamine
Name 2 effects of stress on the body.
- Induces production of FFA, 17-OH corticosteroids, lipids, cholesterol, and catecholamines
- Affects water reabsorption, muscular tonicity, gastrocolic reflex, and mucosal circulation.
Name 2 neurotransmitter changes associated with depression.
Decreased NE and Serotonin (5-HT)
Name 2 neurotransmitter changes associated with Huntington’s disease.
Decreased GABA and Ach
Name 3 changes in sleep stages often found in people with depression.
- Reduced slow-wave sleep
- Decreased REM latency
- Early morning awakening (important screening question!)
Name 3 possible findings in non-REM sleep.
“Sleepwalking, night terrors, and bedwetting”
Name 4 physiological actions found in REM sleep.
- Increased/variable pulse
- rapid eye movements
- increased/variable blood pressure
- penile/clitoral tumescence
Name 5 possible findings in REM sleep.
- Dreaming,
- loss of motor tone
- possible memory processing function
- erection
- increased brain O2 use
Name 5 possible waveform patterns seen in the various sleep/wake stages.
- Alpha, Beta (highest frequency, lowest amplitude)
- Theta, Delta (lowest frequency, highest amplitude)
- Sleep spindles with K-complexes
Name 7 functions of the Frontal lobe.
Concentration, Orientation, Language, Abstraction, Judgment, Motor regulation, Mood
Name 1 possible chronic outcome of sleep apnea.
Chronic fatigue
Name 5 findings associated with sleep apnea
Obesity, loud snoring, systemic/pulmonary HTN, arrhythmias, and possibly sudden death.
What 3 things does the differential diagnosis for sexual dysfunction include?
- Drugs (e.g. antiHTN, neuroleptics, SSRIs, and ethanol)
- Diseases (e.g. depression and diabetes)
- Psychological (e.g. performance anxiety)
What is a common treatment for narcolepsy?
Stimulants (e.g. Amphetamines)
What is a helpful mnemonic for the order of the corresponding waveform patterns in each stage of sleep?
At night, BATS Drink Blood.
What is considered the key to initiating sleep?
Serotonergic predominance of the raphe nucleus
What is the most notable change in function in a frontal lobe lesion?
Lack of social judgement
What is the principal neurotransmitter involved in REM sleep?
Ach
What medication shortens stage 4 sleep and Tx enuresis?
Imipramine
What medication shortens stage 4 sleep and Tx of night terrors and sleepwalking?
Benzodiazepines
What neurotransmitter can reduce REM sleep?
NE
What percentage of time is spent in REM sleep?
0.25
What percentage of time is spent in stage 1 sleep?
0.05
What percentage of time is spent in stage 2 sleep?
0.45
What percentage of time is spent in stage 3-4 sleep?
0.25
What phenomenon caused REM sleep to be known as ‘paradoxical’ or ‘desynchronized’ sleep?
The EEG pattern during REM sleep is the same as the EEG of a person that is awake and alert.
What waveform pattern is seen in a young adult who is awake (eyes open), alert, and has active mental concentration?
Beta waves
What waveform pattern is seen in a young adult who is awake but has his/her eyes closed?
Alpha waves
What waveform pattern is seen in a young adult who is in deeper (stage 2) sleep?
Sleep spindles and K-complexes
What waveform pattern is seen in a young adult who is in light (stage 1) sleep?
Theta waves
What waveform pattern is seen in a young adult who is in REM sleep?
Beta waves
What waveform pattern is seen in a young adult who is in the deepest, Non-REM (stage 3-4) sleep?
Delta waves
A person who is unable to remember things that occurred after a CNS insult has?
Anterograde Amnesia
Anterograde amnesia caused by thiamine deficiency?
Korsakoff’s amnesia
Are DT’s life threatening?
Yes
Are the illness production and motivation in somatoform disorders consicous drives?
No
Bipolar I describes?
manic
Bipolar II describes?
hypomanic
Define a Manic episode.
“Distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week”
Define a panic disorder.
Discrete period of intense fear and discomfort peaking in 10 minutes with 4/5 characteristics
Define Anosognosia.
being unaware that one is ill
Define Autotopagnosia.
Being unable to locate one’s own body parts
Define Conversion disorder.
“symptoms suggest motor or sensory neurologic or physical disorder, but tests and PE are negative”
Define depersonalization.
body seems unreal or dissociated
Define Personality disorder
“when patterns become inflexible and maladaptive, causing impairment in social or occupational functioning or subjective distress”
Define Personality trait.
“an enduring pattern of perceiving, relating to, and thinking about the environment and oneself that is exhibited in a wide range of important social and personal contexts”
Delusions are?
false beliefs not shared by other memebers of culture/subculture that are firmly maintained in spite of obvious proof to the contrary
Describe a Paranoid Personality
distrustful and suspicious; projection is main defense mech
Describe a Schizoid Personality.
voluntary social withdrawl; no psychosis; limited emotional expression
Describe a Schizotypal Personality.
“interpersonal awkwardness, odd thought patterns and appearance”
Does the person who has the phobia recognize their fear as excessive?
“yes, they are exhibiting insight”
Does the phobic fear interfere with normal routine?
yes
Hallucinations are?.
perceptions in the absence of external stimuli
How are Cluster A personalities described?
as odd or ecentric; cannot develop meaningful social relationships; Weird
How are Cluster B personalities described?
“Dramatic, emotional, or erratic; Wild”
How are Cluster C personalities described?
“Anxious and fearful, ‘Worried’”
How is a major depressive disorder characterized?
Recurrent-requires 2 or more depressive episodes with a symptom free interval of 2 months
How is a major depressive episode characterized?
“5 of the following for 2 weeks, including
(1) depressed mood or (2) anhedonia: Sleep disturbances, Loss of Interest, Guilt, Loss of Energy, Loss of Concentration, Change in Appetite, Psychomotor retardation, Suicidal ideation, Depressed mood”
How is maladaptive pattern of substance abuse defined?
3 or more of the above signs in 1 year
How is Schizophrenia described?
“periods of psychosis and disturbed behavior lasting > 6months, “
How long does the disturbance due to PSSD last?
> 1 month and causes distress or social/
occupational impairment
How many criteria sets exist for bipolar disorder?
“6 separate criteria exist for bipolar disorders with combinations of manic, hypomanic, and depressed episodes”
How many hallucination types are there? Name them.
7: Visual, Auditory, Olfactory, Gustatory, Tactile, Hypnagogic, Hypnopompic”
How many heroin addicts are there in the US?
~500,000
How would you decribe a dependent personality?
“submissive and clinging, excessive need to be taken care of, low self-confidence”
How would you decribe an obsessive-compulsive?
“preoccupation with order, perfectionism and control”
How would you describe a Borderline personality?
“unstable mood and behavior; impulsive, sense of emptiness”
How would you describe a histrionic personality?
“excessive emotionally, somatization, attention seeking, sexually provocative”