W8_02 Anxiety

Question 1

describe the low road fear pathway

Answer 1

visual/auditory sensation;
thalamus;
amygdala;
hypothalamus

Question 2

describe the high road fear pathway

Answer 2

visual/auditory sensation;
thalamus;
visual/auditory cortex;
frontal cortex;
amygdala;
hypothalamus

Question 3

which receptor is responsible for long term potentiation/depression?

Answer 3

NMDA receptor causes up/downregulation of the AMPA receptor

Question 4

what is the role of catecholamines in the brain?

Answer 4

carry meta information. can modify the response to other neurotransmitters.

Question 5

where does serotonin come from in the brain?

Answer 5

raphe nuclei

Question 6

where does dopamine come from in the brain?

Answer 6

ventral tegmental area

Question 7

activity in the amygdala is experienced as what emotion?

Answer 7

fear/anxiety

Question 8

where are fear-context associations stored in the brain?

Answer 8

amygdala in conjunction with the hippocampus

Question 9

conscious vs unconscious fear?

Answer 9

amygdala gives a general vague sense of fear because it’s subcortical

Question 10

what are three general types of pathological anxiety?

Answer 10

panic attacks;
generalized anxiety disorder;
phobias;
OCD;
PTSD;
acute stress disorder

Question 11

name symptoms of panic

Answer 11

tachycardia;
sweating;
trembling;
shortness of breath;
choking;
chest pain;
nausea;
dizziness;
fear of going crazy;
fear of dying;
parasthesia;
flushes;
derealization;
depersonalization

Question 12

what are three neurotransmitters involved in anxiety?

Answer 12

norepinephrine, serotonin, GABA

Question 13

where are the structural abnormalities in anxiety?

Answer 13

amygdala, hippocampus, cortex, and their connections

Question 14

dopamine uses which type of receptor?

Answer 14

GPCR

Question 15

what’s the timeline of SSRI treatments?

Answer 15

initially exacerbate anxiety by increasing serotonin;
panic attacks reduced over 2-4 weeks;
we believe receptors are downregulated

Question 16

where in the brain does norepinephrine come from?

Answer 16

locus ceruleus

Question 17

yohimbine and caffeine act on what? what clinical effect do they have?

Answer 17

act on locus ceruleus to produce increased anxiety

Question 18

which structure does benzodiazepines and imipramine affect?

Answer 18

the locus ceruleus

Question 19

citalopram, fluoxetine, paroxetine, sertraline, fluvoxamine are examples of which class of drugs?

Answer 19

SSRIs

Question 20

-ipramines and nortryptiline are examples of which class of drugs?

Answer 20

tricyclic antidepressants

Question 21

venlafaxine, desvenlafaxine, duloxetine, are examples of which class of drugs?

Answer 21

serotonin norepinephrine reuptake inhibitors

Question 22

mechanism of action for benzodiazepines?

Answer 22

binding to GABA_A receptors increases their conduction to chloride;
hyperpolarization and less excitability

Question 23

effects of benzodiazepines?

Answer 23

sedation, relaxation, disinhibition, amnesia, anticonvulsant

Question 24

fact: benzodiazepines are lipophilic due to multiple rings, so can cross BBB easily

Answer 24

good

Question 25

mechanism of action for tricyclic antidepressants?

Answer 25

increase NE by binding to NE and 5-HT reuptakers, but cause down regulation of NE receptors

Question 26

describe the cycle of avoidance

Answer 26

situation provokes anxiety; escape provides relief like reward system; thoughts of being in the situation again creates more anxiety; generalization occurs when thoughts of related situations also cause panic

Question 27

how does conditioned fear work in humans?

Answer 27

any stimuli at time of attack will become conditioned fear stimuli; stimuli generalize; may worsen to agoraphobia

Question 28

fact: exposure therapy reduces anxiety

Answer 28

good

Question 29

how does gradual exposure work?

Answer 29

patient ranks top 10 anxiety-causing things. exposure therapy for each and slowly increase in severity until they get over them

Question 30

fact: extinction does not erase fears. it teaches the cortex to inhibit them.

Answer 30

good

Question 31

what does CCK do in the brain?

Answer 31

CCK receptor agonists provoke panic attacks. activate amygdala and cingulate gyrus

Question 32

fact: recall the mouse grooming example of epigenetic modification

Answer 32

attentive moms produce pups that are less fearful and have less HPA axis activation