W8_02 Anxiety Flashcards

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1
Q

describe the low road fear pathway

A

visual/auditory sensation;
thalamus;
amygdala;
hypothalamus

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2
Q

describe the high road fear pathway

A
visual/auditory sensation;
thalamus;
visual/auditory cortex;
frontal cortex;
amygdala;
hypothalamus
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3
Q

which receptor is responsible for long term potentiation/depression?

A

NMDA receptor causes up/downregulation of the AMPA receptor

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4
Q

what is the role of catecholamines in the brain?

A

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

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5
Q

where does serotonin come from in the brain?

A

raphe nuclei

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6
Q

where does dopamine come from in the brain?

A

ventral tegmental area

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7
Q

activity in the amygdala is experienced as what emotion?

A

fear/anxiety

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8
Q

where are fear-context associations stored in the brain?

A

amygdala in conjunction with the hippocampus

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9
Q

conscious vs unconscious fear?

A

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

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10
Q

what are three general types of pathological anxiety?

A
panic attacks;
generalized anxiety disorder;
phobias;
OCD;
PTSD;
acute stress disorder
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11
Q

name symptoms of panic

A
tachycardia;
sweating;
trembling;
shortness of breath;
choking;
chest pain;
nausea;
dizziness;
fear of going crazy;
fear of dying;
parasthesia;
flushes;
derealization;
depersonalization
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12
Q

what are three neurotransmitters involved in anxiety?

A

norepinephrine, serotonin, GABA

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13
Q

where are the structural abnormalities in anxiety?

A

amygdala, hippocampus, cortex, and their connections

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14
Q

dopamine uses which type of receptor?

A

GPCR

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15
Q

what’s the timeline of SSRI treatments?

A

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

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16
Q

where in the brain does norepinephrine come from?

A

locus ceruleus

17
Q

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

A

act on locus ceruleus to produce increased anxiety

18
Q

which structure does benzodiazepines and imipramine affect?

A

the locus ceruleus

19
Q

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

A

SSRIs

20
Q

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

A

tricyclic antidepressants

21
Q

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

A

serotonin norepinephrine reuptake inhibitors

22
Q

mechanism of action for benzodiazepines?

A

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

23
Q

effects of benzodiazepines?

A

sedation, relaxation, disinhibition, amnesia, anticonvulsant

24
Q

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

A

good

25
Q

mechanism of action for tricyclic antidepressants?

A

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

26
Q

describe the cycle of avoidance

A

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

27
Q

how does conditioned fear work in humans?

A

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

28
Q

fact: exposure therapy reduces anxiety

A

good

29
Q

how does gradual exposure work?

A

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

30
Q

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

A

good

31
Q

what does CCK do in the brain?

A

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

32
Q

fact: recall the mouse grooming example of epigenetic modification

A

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