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Brain and Behavior > Week 6 (Test 2) > Flashcards

Week 6 (Test 2) Flashcards

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1
Q

What causes prion formation?

A

•Misfolded protein (PrPSc)

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2
Q

How do you diagnose prion diseases?

A

pathology

Later in the lecture he says:
•Initial diagnosis made on clinical grounds
•Western blot for PrPSc in a tonsil biopsy
•Definitive diagnosis by brain biopsy

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3
Q

What about this slide confirms a prion disease?

A

The white holes which represent the spongiform changes

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4
Q

What are some of the clinical manifestations of
Creutzfeldt-Jakob disease (CJD)?

A

•Abnormal gait and vision
•Headache, dizziness, paresthesias
•Loss of memory, speech abnormalities, anxiety, and depression
•Hyperreflexia and spasticity
•
•Vegetative state within 1 year

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5
Q

•Viral encephalitis characterized by hydrophobia

A

rabies

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6
Q

Describe the composition of the rabies virus.

A

bullet shaped virion; singe strand negative sense RNA

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7
Q

Describe the clinical manifestations of rabies.

A

•Furious versus paralytic
–Agitation, hyperactivity, fluctuating consciousness, and bizarre behavior
–Sore throat, hypersalivation, and hydrophobia
–Flaccid paralysis

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8
Q

A brain biopsy with this pathology would indicate what disease?

A

rabies

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9
Q

How do you make a diagnosis of rabies?

A

used to only be able to diagnose with a brain biopsy but now you can use a direct fluorescent antibody (DFA) stain on tissue from the nape of the neck; this looks for the presence of rabies viral antigen <!--EndFragment-->

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10
Q

How do we treat rabies?

A
  • Rabies immunoglobulin
  • Post-exposure vaccination
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11
Q

Describe clostridium bacteria.

A
  • Large Gram positive bacilli
  • Heat-resistant spores
  • Strictly Anaerobic
  • Toxins cause disease
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12
Q

causes gas gangrene and food poisoning

A

Clostridium perfringens

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13
Q

causes Antibiotic-associated pseudomembranous colitis

A

*clostridium difficile *

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14
Q

trismus =

A

lock jaw (tetanus)

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15
Q

risus sardonicus =

A

patient looks like they are grinning (tetanus)

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16
Q

What actually causes the symptoms of tetanus?

A

the release of the toxin tetanospasmin from clostridium tetani spores

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17
Q

What’s the mechanism of action of tetanospasmin?

A

it is a Plasmid-encoded neurotoxin (A-B toxin) which Binds to motor neurons and then undergoes Retrograde vesicular transmission;
It Blocks inhibitory neurotransmitter (GABA) release
which leads to Unregulated excitatory synaptic activity and Spastic paralysis

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18
Q

When do you need a tetanus vaccine booster?

A

Tetanus booster every 10 yrs or 5 yrs with puncture wound

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19
Q

Which type of botulism is most prevalent?

A

infant botulism by far;
•Colonization of intestinal tract in 5-20 wk old
•Older children & adults are resistant

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20
Q

What should you do with all botulism and tetanus cases?

A

report them to the CDC

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21
Q

How many serotypes of clostridium botulinum are there?

A

7; types A, B, and E are the most common

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22
Q

How would a patient with botulism present?

A
  • Dizziness, nausea
  • Cranial nerve issues - double or blurred vision
  • *-Progressive flaccid paralysis**
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23
Q

How does botulin toxin cause flaccid paralysis?

A

it prevents the release of ACh from the neuromuscular junction

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24
Q

How do you diagnose botulism?

A

symptoms and history, electromyographic studies, and
isolation of C. botulinum or toxin from stool or food

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25
Q

How do you treat botulism?

A

-Heptavalent (A-G) equine antitoxin (HBAT) [need to test them for sensitivity to horse serum first]
-Supportive therapy
(Mortality is 10%)

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26
Q

What’s the main way kiddos get infant botulism?

A

<12 month old given honey

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27
Q

How do you treat infant botulism?

A

-BabyBIG (BIG-IV) [human serum]
- Supportive therapy (ventilation)
[Mortality is 1-2%]

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28
Q

Virus families that include arboviruses:

A

<!--StartFragment-->

•Togaviruses (Alphaviruses) - Equine encephalitis viruses (but not rubella virus)
•Flaviviruses - 1West Nile virus, 2Japanese encephalitis virus, Yellow fever virus, 3Dengue virus
•Bunyaviruses - California encephalitis virus (but not hantavirus)
•Reoviruses - Colorado tick fever virus (but not rotavirus)
<!--EndFragment-->[mnemonic: Transmitted From Bites]

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29
Q

What are the common arbovirus characteristics?

A
  • All have an RNA genome [ Trigger interferon!]
  • Enveloped viruses (Colorado tick fever virus, a reovirus, is an exception) –> makes them Labile!
  • All replicate in the cytoplasm of infected host cells.
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30
Q

Describe the Togavirus family.

A
  • Enveloped viruses
  • Icosahedral capsid
  • Linear, plus-sense, single-strand RNA genome
  • Replicate in the cytoplasm of host cell
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31
Q

What’s a unique feature of the Togavirus family?

A

•Temporally regulate expression of non-structural and structural proteins through use of subgenomic RNA.

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32
Q

Describe the Flavivirus family

A
  • Enveloped viruses
  • Icosahedral capsid
  • Linear, plus-sense, single-strand RNA genome
  • Replicate in the cytoplasm of host cell
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33
Q

What’s unique about the Flavivirus family?

A

•Entire genome translated as polyprotein, processed to structural and non-structural proteins

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34
Q

Describe the Bunyavirus family.

A
  • Enveloped viruses
  • **Helical capsid
  • Single-strand, segmented, negative-sense RNA genome**
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35
Q

What’s unique about the Bunyavirus family?

A

•Capable of transovarial transmission
–> arthropods that have this can give it to their offspring

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36
Q

Arboviruses typically have a specific ____.

A

geography;

The presence of the natural host and vector are critical determinants of geography!

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37
Q

Who is most at risk for virus induced encephalitis and why?

A

children and elderly becuase immuno-competence is important for limiting disease

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38
Q

What’s the gold standard for diagnosing viral encephalitis?

A

•RT-PCR for specific viral genome

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39
Q

What should you do as soon as you suspect viral encephalitis?

A

start with acyclovir

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40
Q

when should you consider a diagnosis of Dengue virus?

A

•Consider Dengue in anyone with a fever who has visited the tropics. Other warning signs include: nausea/vomiting, myalgia, rash, low WBC count, and positive tourniquet test.

41
Q

Why is Dengue fever referred to as “break-bone fever”?

A

•Infects dendritic cells and macrophages, elicits vigorous innate immune response, thus the bone-breaking feeling.

42
Q

Who is at the greatest risk of severe dengue virus disease?

A

healthy children (have a competent immune system)

43
Q

Enhanced Dengue virus disease may occur by antibody-dependent enhancement (ADE). What is this?

A

•non-neutralizing, pre-existing antibodies may enhance viral uptake into phagocytic cells; Instead of neutralizing them, they help the virus get into cell types it wants to infect

44
Q

What should be on the differential diagnosis for Dengue?

A

Chikungunya

45
Q

•Destruction results in apraxia, aphasia & neglect

A

supramarginal gyrus (area 40)

46
Q

•Destruction results in contralateral loss of tactile discrimination (astereognosis) & inability to recognize forms and body position

A

superior parietal

47
Q

•inability to see more than one object at a time (usually bilateral damage)

A

Simultanagnosia

48
Q

•deficit in reaching under visual guidance that cannot be explained by motor, somatosensory, visual field deficits (lesion is often unilateral, affects the contralateral hemifield and alters visuo-spatial integration)

A

optic ataxia

49
Q

Visual agnosia is more commonly associated with damage to the _______.

A

inferior temporal lobe and adjacent visual cortex

50
Q

List the Components of Balint’s Syndrome

A
  • Psychic paralysis of gaze (difficulty initiating eye movements) with haphazard scanning.
  • Optic ataxia.
  • Simultanagnosia.
  • Caused by bilateral lesions in parieto-occipital cortex due to stroke, trauma or degenerative disease.
51
Q

Destruction of Brodmann’s area 17 results in what?

A

•Destruction results in visual field defects

52
Q

Destruction of Brodmann’s area 18 & 19 results in what?

A

•Destruction results in visual hallucinations, agnosia, and alexia

53
Q
  • A form of cortical blindness in which the patient denies visual impairment.
  • Confabulation is common.
A

Anton’s syndrome

54
Q

What causes Anton’s syndrome?

A

Typically caused by bilateral damage to the occipital lobe extending from primary visual cortex to association cortex.

55
Q

What are the 4 symptoms of Gerstmann syndrome?

A

Acalculia= calculation deficit for simple math problems

Agraphia= can’t write

Agnosia= inability to process sensory information

left-right confusion

<!--EndFragment-->

56
Q

•a deficit in visual object recognition where elementary visual capacities are intact (acuity, visual fields).

A

visual agnosia

57
Q

•Elementary shape perception is intact so the patient can draw objects but not associate the visual object with its meaning. They can not name objects or show recognition by pointing unless another sensory modality, like sound or smell, is used to access object knowledge.

A

associative visual agnosia

58
Q

what causes associative visual agnosia?

A

localized damage often to inferior temporal lobes and adjacent occipital cortex

59
Q

Left hemisphere destruction of Area 22 results in ____.

A

Wernicke’s aphasia

60
Q

right hemisphere destruction of area 22 results in ____.

A

sensory dysprosodia
(no pitch or timing control–> can’t control the way the words are coming out of their mouths)

61
Q

▫Refusal to accept reality or fact; acting as if a painful event, thought or feeling did not exist
▫“I like to drink but it isn’t a problem” (in person with cirrhosis, GI bleed)

A

denial (immature)

62
Q

▫A return to an earlier period of development
▫Acting child-like in periods of extreme stress
▫Sleeping with transitional object (teddy bear, blankie)

A

regression (immature)

63
Q

▫Expressing an unconscious wish through action to avoid becoming consciously aware of it
▫Punching walls when you want to kill your partner

A

acting out (immature)

64
Q

▫Attributing your thoughts or feelings to someone else because they are uncomfortable
▫“You’re angry with me, I can tell” (ah, no, I’m thinking about pizza)

A

Projection (immature)

65
Q

▫Lesser form of dissociation, wherein parts of oneself are separated from awareness of other parts and behaving as if one had separate sets of values
▫Honest man cheats on taxes; philanderers

A

compartmentalization (immature)

66
Q

▫Temporary but drastic modification of a person’s character or sense of identity to avoid distress
▫Often seen in people with h/o severe trauma

A

dissociation (immature)

67
Q

▫Converting of unwanted or dangerous thoughts, feelings or impulses into their opposites
▫You want to play with your feces, but instead you wash compulsively (an actual psychodynamic “explanation” of OCD that was obviously wrong)
▫Acting like you hate someone you secretly love (to avoid being hurt)

A

reaction formation (immature)

68
Q

▫Division or polarization of beliefs, actions, objects, or persons into good and bad by focusing selectively on their positive or negative attributes
▫“Those other doctors were mean but I can see you really care” (red flag!)

A

splitting (immature)

69
Q

Splitting is tied to which personality disorder?

A

borderline personality disorder

70
Q

▫Processes whereby the idealized aspects of the self are preserved, and its limitations denied

▫People who talk about their college degree (or have t-shirts, bumper stickers, etc.), jobs, possessions, etc., may be trying to cover up feelings of inadequacy

A

narcissism (immature)

71
Q

▫Internalizing the qualities of another person
▫“Identification with the aggressor” (kids in concentration camps boot stepping like Nazi guards), or abused person believing they deserve abuse and abusers as mates
▫Can be healthy, such as taking on best aspects of your parents

A

introjection (immature)

72
Q

▫Dealing with emotional conflict or internal or external stressors by excessive daydreaming as a substitute for human relationships or more effective action
▫Having a fantasy of being important and loved despite no reality to either

A

schizoid fantasy

73
Q

▫A tendency to experience and communicate psychological distress in the form of physical symptoms and to seek medical help for them
▫Psychological trauma from childhood abuse is too difficult to think about so distress is channeled to more “appropriate” and less difficult to discuss sxs
▫“I’ve got a headache” becomes way of escaping difficult conversations

A

•Somatization/ hypochondriasis

74
Q

▫Redirecting of thoughts feelings and impulses directed at one person or object, but taken out upon another person or object
▫Mad at the boss, a person goes home and kicks the dog
▫Taken out on a person, not a wall

A

displacement (immature)

75
Q

▫Unconscious blocking of unacceptable thoughts, feelings and impulses
▫Unconscious /less mature version of suppression
▫The person may still be aware of the feelings associated with the repressed issue, but will not know where the feelings come from
▫Extreme anxiety when around someone who looks like a person you hate/fear without realizing

A

repression (immature)

76
Q

▫Overemphasis on thinking when confronted with an unacceptable impulse, situation or behavior without employing any emotions
▫Dealing with stress by excessively using abstract thinking and generalizations to avoid or minimize unpleasant feelings

A

intellectualization (immature)

77
Q

▫Offer rational explanations to justify thoughts ideas, feelings and behaviors that may otherwise be unacceptable
▫“I would like to spend more time with my daughter, but I am so busy”
▫“It makes sense I make this much money because I worked hard for it”

A

rationalization (immature)

78
Q

▫Conscious postponing attention to a conscious impulse or conflict
▫“I can’t worry about this now”
▫Repression is similar but unconscious

A

supression (mature)

79
Q

▫Achieving impulse gratification and retention of goals but altering a socially objectionable aim or object to a socially acceptable one
▫Aggressive person with authority figure issues becomes a police officer

A

sublimation (mature)

80
Q

▫Using constructive and instinctually gratifying service to others to undergo a vicarious experience
▫Guilty feelings alleviated by unsolicited generosity towards others
▫Charitable giving?

A

altruism (mature)

81
Q

▫Using comedy to overtly express feelings/thoughts without personal discomfort and without producing an unpleasant effect on others
▫Making light of difficult situations: “If I don’t pass Step I, I can always go flip burgers!”

A

humor (mature)

82
Q

▫Psychologically counterbalancing perceived weaknesses by emphasizing strength in other arenas
▫“I’m not great at NBME exams but I’m better with people than some other students”

A

compensation (mature)

83
Q

Describe a strategy often helpful with people with significant Narcissistic traits.

A

go along with it. play into their narcissism

84
Q

Name the type of psychotherapy most often cited as evidence-based treatment for Borderline Personality Disorder.

A

<!--StartFragment-->

Dialectical Behavioral Therapy (DBT)

<!--EndFragment-->

85
Q

Which personality disorders fall into cluster A?

A

WEIRD –>
Paranoid
Schizoid
Schizotypal

86
Q

Which personality disorders fall into cluster B?

A

WILD –>
Antisocial
Borderline
Histrionic
Narcissistic

87
Q

Which personality disorders fall into cluster C?

A

WORRIED–>
Avoidant
Dependent
Obsessive-compulsive

88
Q
  • Distrust and suspiciousness
  • Others’ motives interpreted as malevolent
  • Reluctant to confide in others due to fear that it would be maliciously used against them
  • Holds grudges
  • Don’t take responsibility for their own feelings
  • Hostile, irritable, angry
  • Read negative meanings into neutral remarks
  • Perceive attacks on their character and is then quick to counteract
  • Suspect infidelity in partner
  • Litigious
A

paranoid PD

89
Q

Detachment from social relationships, restricted emotional expressions in interpersonal settings

§Seem cold, flattened.

Doesn’t desire close relationships

§Including family and sexual relationships
§Lack close friends/confidants

Solitary activities

Indifferent to praise or criticism

A

schizoid PD

90
Q

Social deficits, reduced capacity for close relationships

§Lack close friends

Cognitive or perceptual distortions and eccentricities in behavior

Magical thinking, odd beliefs, paranoid thinking

Bodily illusions

Peculiar appearance, inappropriate affect

Odd thinking/speech

A

schizotypal PD

91
Q

Disregard for and violation of others’ rights

Fails to conform to the law

Deceitful, manipulative

§For personal profit or pleasure

Impulsive

Lack remorse

§Indifferent to or rationalize hurting others

A

antisocial PD

92
Q

Unstable/chaotic relationships, self-image, and affects

§Alternate between idealizing and devaluing others
§I Hate You, Don’t Leave Me book

Marked impulsivity

§Potentially self-damaging areas (spending, sex, substance use)
§Unpredictable

Frantic efforts to avoid abandonment

§Many have a history of abandonment/abuse

A

borderline PD

93
Q

Excessive emotionality and attention seeking

§Rapidly shifting and shallow emotions

Uncomfortable when not the center of attention

§Theatrics, dramatic

Inappropriate sexually seductive and provocative behavior

§Uses physical appearance to draw attention to self

Speech is excessively impressionistic and lacking in detail

Suggestible, easily influenced by others

§Considers relationships to be more intimate than they are

A

histrionic PD

94
Q

Grandiose sense of self-importance

§Preoccupied with fantasies of unlimited success, power, brilliance, beauty
§Believes they’re “special” and can only relate to other high-status people

Requires excessive admiration

§Entitled

Lack empathy

§Exploit others to achieve their own needs
§Envious of others

Arrogant, haughty

A

narcissistic PD

95
Q

Social inhibition, feelings of inadequacy, hypersensitive to negative evaluation

Fears criticism, disapproval, or rejection

§Unwilling to get involved unless certain of being liked

Preoccupied with being criticized or rejected in social situations

Views self as unappealing or inferior

Reluctant to take personal risks or engage in new activities because they may prove embarrassing

A

avoidant PD

96
Q

Need to be taken care of that leads to submissive and clinging behavior and fears of separation

Difficulty making decisions

§Needs others to assume responsibility

Difficulty expressing disagreement

Excessive (even unpleasant) lengths to obtain nurturance and support

Uncomfortable or helpless when alone

Urgently seeks another relationship as a source of care and support when a close relationship ends

§Fears being left to take care of themselves

A

dependent PD

97
Q

Preoccupied with orderliness to the point where the major point of the activity is lost

§Rules, lists, order, organization, schedules

Perfectionism that interferes with task completion

Excessively devoted to work at the expense of leisure activities

Overconscientious, scrupulous, and inflexible about morality, ethics, or values

Rigid and stubborn

Preoccupied with mental/interpersonal control

§Unable to delegate tasks

A

obsessive compulsive PD

98
Q

what causes Gerstmann syndrome?

A

destruction of the inferior parietal lobe

Brain and Behavior (11 decks)

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