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Wayne Shared "NB3" - 129 Picmonics

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NB3

Kluver-Bucy Syndrome
Bilateral Amygdala Lesion
Associated with HSV-1
Hyperorality
Hypersexuality
Disinhibited Behavior
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1 min
NMDA Receptor
Learing and Memory
Activated by Glutamate
Glycine Co-activation
Requires Partial Membrane Depolarization
Open Cation Channels
Ca2+ Influx Generates NO
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Anxiety Disorders
Panic Disorder
One Month
Selective Serotonin Reuptake Inhibitor (SSRI) Overview
Cognitive Behavior Therap
Agoraphobia
Fear of Public Places
>2 situations for >6 months
Social Phobia
CBT #1
SSRI
Proponalol
Stranger Anxiety Develops
Separation Anxiety
Age 1 Year
Generalized Anxiety
6 Months -
Benzo for Acute
Psychotherapy
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Anxiety Assessment
Mild
Increased Alertness
Heightened Perception
Moderate
Perception Narrowed
Short Attention Span
Shaking
Severe
Ineffective Problem Solving
Automatic Behavior
Hyperventilation
Panic
Hallucinations
Inability to Function or Communicate
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2 mins
Obsessive-Compulsive Disorder (OCD)
Assessment
Repetitive and Intrusive Thoughts
Suppressed by Thought or Action
Interferes with Daily Functioning
May or May Not Be Aware
Interventions
Cognitive Behavioral Therapy (CBT)
Selective Serotonin Reuptake Inhibitors (SSRIs)
Clomipramine
Venlafaxine
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3 mins
Posttraumatic Stress Disorder (PTSD)
Assessment
Re-experience Traumatic Event
Flashbacks
Nightmares
Avoidance
Self-destructive Behaviors
Considerations
Assess Suicide Risk
Actively Listen to Stories
Anxiety Medications
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2 mins
Social anxiety disorder
Diagnosis
>1 social situations for >6 months
embarrassment
humiliation
Social situations avoided
marked imapairment
Subtype specifier: Performance only
Treatment
SSRI/SNRI
Cognitive-behavioral therapy
Beta blocker or benzodiazepine for performance-only subtype
Selective mutism
Selective mutism
Refusal to speak at school can impair both academic and social development and should not be considered normal shyness
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Anxiety Disorders
Generalized Anxiety Disorder
Generalized Anxiety
Anxiety> 6 months of 3 of the following, unrelated to specific cause
Adjustment disorder: Emotional symptoms causing impairment following psychosocial stressor
H: Hyperarousal
Adjustment disorder (results from non-traumatic event)
Treat pharmacologically based on symptoms
Mix of depressive/anxious symptoms
Onset within 3 months of stressor
Over within 6 months of stressor ending
Psychotherapy
E: Energy loss
R: Restlessness
S: Sleep disturbances
WATCHERS
T: Tension in muscles
C: Ceoncentration Difficulty
PTSD/Acute Stress Disorder
PTSD
Disturbance lasts> 1 month
Acute Stress Disorder
Symptom onset within 1 month of event
Over within a month of onset (2 months of event)
SSRIs or SNRIs
Cognitive behavioral therapy
PTSD and ASD= Same symptoms, different time course
PTSD and ASD= Same symptoms, different time course
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Somatic Symptom and Related Disorders
Conversion Disorder
Conversion Disorder
Loss of sensory or motor function
Often following acute stressor
More common in young females
Globus sensation
Most spontaneously recover
CBT if no spontaneous recovery
Illness Anxiety Disorder (hypochondriasis)
Illness anxiety
Preocupation/fear of having serious illness despite medical reassurance
CBT
Somatic Symptom Disorder
Somatic Symptom Disorder
Variety of complaints in 1+ organ systems
Persistent and disproportional anxiety about symptoms
Treatment: Regular appointments with PCP
No physical symptoms
Obsessive Compulsive Personality Disorder commonly comorbid
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Etiology of Schizophrenia
Viruses, Malnutrition, Fetal Hypoxia
Enlargement of Lateral Ventricles
Small Hippocampus
Overexpression of D2 receptors
Young Adult (20-30 Years)
Risk of Suicide
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Neuroimaging findings in psychiatric disorders
Autism Increased total brain volume
Obsessive Compulsive Disorder (OCD) and ADHD orbitofrontal cortex & striatum
Putamen
Panic Decreased volume of amygdala
Posttraumatic Stress Disorder (PTSD)
Decreased hippocampal volume
Schizophrenia
Decreased volume of the hippocampus and amygdala
Enlargement of cerebral ventricles
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Parkinsons
autosomal recessive (6) and dominant (4)
Clinical signs
DDX
Non-motor features
Features above the neck
Pharm treatment
Drug-induced parkinsonism (obv reversible)
Biomarkers of PD
Side effects of long-term Ldopa use
Genes associated with PD
Types of tremor
gait abnormalities
Alzeimers disease - microscopic features
Huntingtons Disease
Features suggesting non-parkinsons
Multiple Sclerosis
Alzeimers disease - general features
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Barbiturates
Barb- Drug Names
Indications
Seizure Treatment
Anesthesia Induction
Mechanism of Action
Increased Duration of Cl- Channel Opening
Decrease Neuron Firing
Side Effects
Sedation
Cardiovascular and Respiratory Depression
CNS Depression
P450 inducer
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2 mins
Phenobarbital (Barbiturates)
Mechanism
Barbiturate
Indications
Seizures
Side Effects
Ataxia
Paradoxical Excitement
Fatigue/Drowsiness
Considerations
Monitor Plasma Levels
High Potential for Abuse
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1 min
Benzodiazepines Overview
Indications
First Line for Status Epilepticus
Anesthesia Induction
Anxiety
Eclampsia
Detoxification
Mechanism of Action
'-zepam' and '-zolam" Suffix
Increase Frequency of Cl- Channel Opening
Side Effects
Decrease REM Sleep
CNS Depression
Dependence
Antidote
Flumazenil for Overdose
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2 mins
Benzodiazepine Antidote
Antidote
Flumazenil
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40 secs
Triazolam (Halcion)
Mechanism
Rapid-Onset Benzodiazepine
Indications
Insomnia
Side Effects
Rebound Insomnia
Respiratory Depression
Hypotension
Paradoxical Excitement
Amnesia
Confusion
Contraindications
Pregnancy
Considerations
Short-Term Administration
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2 mins
Nonbenzodiazepine Hypnotics
Indications
Insomnia
Mechanism of Action
Short Half-Life
Acts on BZ1 GABA receptor
Less dependence
Drugs
Zolpidem (Ambien)
Side Effects
Ataxia, confusion
Antidote
Flumazenil for Overdose
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1 min
Buspirone
Indications
Generalized Anxiety
Mechanism of Action
Releases Dopamine and NE
Stimulates 5-HT1A receptors
Side Effects
Low Side Effect Profile
Safer with Alcohol than Other Anxiolytics
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1 min
Trazodone
Indications
Insomnia
Depression
Mechanism of Action
Inhibit Serotonin Reuptake
Alpha-1 Blocker
Histamine (H1) Blocker
Side Effects
Sedation
Orthostatic Hypotension
Dry Mouth
Priapism
Arrhythmias
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2 mins

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