Week 3 Flashcards
Anxiety is linked to what limbic structure?
amygdala
What are the key features of PTSD?
- exposure to a traumatic event
- re-experiencing that event
- avoidance of related stimuli
- emotional numbness
- persistent arousal
- lasting more than one month
What are the features of panic disorder?
recurrent, non-triggered panic attacks with a rapid onset of anxiety and ANS arousal
What are the features of GAD?
- excessive worry about multiple events
- subjective difficulty redirecting worry
- more than six months
- restless, fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance
What sort of condition might lead to anxiety due to a general medical condition?
hyperthyroidism
Anxiety disorders commonly have an onset of what age?
15-21
What NT systems are overactive in those with anxiety disorders?
- NE
- glutamate
- corticosteroid
What NT systems are underactive in those with anxiety disorders?
- serotonergic
- GABA
What is first line medical therapy for those with anxiety disorders?
SSRIs
What are anxiolytics?
drugs that upregulate GABA systems
How do antipsychotics help treat anxiety disorder?
they selectively block D2 receptors
What does cognitive therapy involve for those with anxiety disorders?
attempting to challenge their automatic response and the assumptions that underlie their anxiety
What are the diagnostic criteria for ADHD?
- inattention or hyperactivity-impulsivity lasting more than 6 months
- some impairment before age 12
- impairment in two or more settings
Children with ADHD frequently suffer from what comorbid disorders?
substance abuse and conduct disorder
Adults with ADHD are likely to have what comorbid disorders?
- depression
- substance abuse
- GAD
- OCD
- antisocial personality disorder
What two NT systems have been implicated in ADHD?
NE and DA
What kinds of executive dysfunction have been associated with ADHD?
- response inhibition
- vigilance
- working memory
- planning
How does methylphenidate help those with ADHD?
it blocks DAT, inhibiting DA reuptake
What anatomical finding has been strongly associated with ADHD?
reduced cortical thickness in the right superior gyrus of the frontal lobe
When do fontanels close?
between two months and two years of age
When do cranial sutures ossify?
between six and eighteen years of age
Acromegaly is the result of what hormone?
growth hormone
Describe the facial appearance of someone with Down’s syndrome.
- flattened nose
- up slanting eyes
- protruding tongue
What is torticollis?
stiff neck
What HEENT findings might indicate hyperthyroidism?
- prominent eyes
- fine hair
- lid retraction
- startled expression
What is conductive hearing loss?
hearing loss due to damage to the outer or middle ear
The Weber test relies on what kind of hearing?
sensorimotor
Describe the possible findings on the Weber test.
- if it localizes to affected ear, it indicates conductive hearing loss
- if it localizes to the unaffected ear, it indicates sensorimotor hearing loss
What is the Rinne test for?
to determine if hearing loss is sensorimotor or conductive.
What are the two general features of delirium?
disturbance of consciousness and a change in cognition or perceptual disturbances
What kinds of drugs can cause delirium?
- anticholinergics
- anticonvulsants
- antihypertensives
- opiates
- sedatives
- steroids
Describe the pathogenesis of delirium?
- anoxia causes failure of ATPase pumps
- Ca influx accelerates DA production and release
- ATPase failure prevents reuptake
- hypoxic conditions shift DA metabolism to more toxic pathways
Delirium can cause permanent brain damage by causing DA to be metabolized into what?
cytotoxic quinones
How is delirium treated?
- treat the cause
- restore oxygen levels
- give DA agonists
What is haloperidol?
an antipsychotic with D2 selectivity
What is the best medical treatment of delirium to prevent lasting damage?
haloperidol
What nine things are assessed during a mental status exam?
- speech
- mood/affect
- appearance
- reality
- thought process/content
- perception
- insight/judgement
- sensorium
- suicidal/homocidal ideation
Affect can be described along what three axes?
- quality
- motility
- appropriateness
What is loosening of associations?
a disorder of thought process in which no logical connections are apparent between one idea and the next
What is “flight of ideas”?
a thought process disorder in which there is a fast stream of thought and speech
What is neologism?
a thought process disorder in which one makes up words
Assessment of a patient’s sensorium involves testing what faculties?
- consciousness
- orientation
- attention
- reading/writing
- memory
- fund of knowledge
- calculation
Reality testing includes what two features?
sense of reality (hallucinations) and judgment of reality (delusions)
