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PBD Exam 3
PBD Exam 3 Dr.Peris Materials
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11/18/2010

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Term
What are the 6 diagnostic criteria for Schizophrenia?
Definition

1. Characteristic symptoms

2. Social/occupational dysfunction

3. Duration

4. Schizoaffective and Mood Disorder exclusion

5. Substance/general medical condition exclusion

6. Relationship to a Pervasive developmental disorder

Term
What are the characteristic symptoms of Schizophrenia?
Definition

1. Positive symptoms

2. Negative symptoms

3. Cognitive symptoms

Term
Positive symptoms are symptoms that these Schizo indiviuals have that normal people dont.  What kind of characterisitcs do they show?
Definition

Delusions

Hallucinations

Catatonia

Term
Negative symptoms of Schizo are those that normal people do have, but Schizo individuals dont. What are some examples?
Definition

affective flattening

Alogia (dont talk)

Avolition (lack of motivation)

Term
Examples of Cognitive symptoms are
Definition

1.Neologisms

2. Incoherence

Term
In order to have characteristic symptoms of Schizophrenia you must have 1 _____________ plus  1 more of any other symptom.
Definition
positive
Term
For Schizo to be diagnosed as soical/occupational dysfunction you need to have __________ or more areas of functioning markedly ______ the level achieved prior to onset.
Definition

1. 1

2. below

Term
What is the duration needed to dianose someone with Schizophrenia?
Definition
At least 6 months including at least 1 month of positive symptoms.
Term
True/False:  To be diagnosed with Schizophrenia you have to rule ourt Schizoaffective Disorder and Mood Disorder wiht psychotic features.
Definition
True
Term
True/False:  To diagnose someone with Schizophrenia, you dont have to rule out physiological effects of a drug or medical condition.
Definition

False.

You do have to rule these effects.

Term
If there is a history of social disorders then to diagnose Schizophrenia, ____________ symptoms must be present for at least __________.
Definition

Characteristic symptoms

1 month

Term
What is the incidence of Schizophrenia world-wide?
Definition
1-2%
Term
What is the age of onset for Schizophrenia?
Definition

In the late teens or early 20s.

 

The peak onset 18-25

Term
What is the % of suicide rate for Schizophrenia?
Definition
10%
Term
What are the established risk factors for Schizophrenia?
Definition

1. Genetics

2. Gestational/ Birth complications

3. Winter Birth

4. Early history of ADHD

Term
If you have a first degree relative with Schizophrenia then what is your % risk?
Definition
10%
Term
If both your parents have Schizophrenia then what is % risk?
Definition
40%
Term
If you are dizygotic twin ______; Monozygotic twins your % risk is ___________.
Definition

10%

50%

Term
What kind of gestational and or birth complications can lead to Schizophrenia?
Definition

Flu

nutrition

Term
True/False:  There is an excess of summer births among schizophrenics!
Definition
False; it is winter births
Term
True/ False: If you have an early history of ADHD you are at a greater risk for Schizophrenia.
Definition
True
Term
List the positive symptoms of Schizophrenia?
Definition

1. Hallucinations

2. Delusions

3. Disorganized speech/formal thought disorder

4. Disorganized/ bizarre/ catatonic behavior

Term
If someone has positive symptoms for Schizophrenia there said to have this kind of Schizophrenia:
Definition
Paranoid
Term
List the Negative symptoms of Schizophrenia.
Definition

1. Alogia (dont talk)

2. Affective blunting (no emotion)

3. Anhedonia (no pleasure)

4. Avolition/amotivational

5. Asocial

 

(-) = A.A.A.A.A

Term
Those who have negative symptoms of Schizophrenia then they are said to have this type:
Definition
Disorganized
Term
List the Cognitive Defects associated with Schizophrenia.
Definition

1. Tangentiality

2. Loss of goals

3. Incoherence

4. Looseness of associations (word salad)

5. Neologisms

Term
The brains of peeps with Schizo, there is a ____________ in nueornal size in corticolimbic structures.
Definition
decrease
Term
Fill in the blank:  In the brain of Schizo peeps, there is a slight reduction in the _______________ ____________ ________ ____________
Definition
Neocortical gray matter volume.
Term
True/False: Schizo peeps have ventricular enlargement.
Definition
True
Term
True/False:  There is a decreased metabolic activity in prefrontal cortex.
Definition
True
Term
The Dopamine Hypothesis states what 2 things?
Definition

1. That the Mesolimbic has excess DA which causes positive psychotic symptoms.

 (increase in the NAc)

 

2. The Mesocortical has a deficiet in DA which is involved in negative symptoms and cognitive defects.

(decrease in Pre-frontal Cortex)

Term
The Glutamate Hypothesis states that the loss of _________ receptors mimic ____________ and _____________.
Definition

1. NMDA

2. Negative symptoms

3. Cognitive defects

Term
Schizophrenia is due to an imbalance of D2, D3 and D4 receptors.  Which NTs is responsible for this imbalance?
Definition
5HT-2A/C
Term
For someone to be diagnosed with depression/affective disorders you must have ____________ for at least __________
Definition

1. 5 symptoms

2. 2 weeks

Term
What are some symptoms of major depression?
Definition

1. Depressed mood (irrability in teens)

2. Anhedonia

3. Weight gain or loss

4. Insomnia or hypersomnia

5. Psychomotor agitation or retardation

6. Fatigue/ loss of energy

7. Feeling worthlessness or unfounded guilt

8. Indecisive, unable to think or concentrate

9. Recurrent thoughts of death/ suicide.

Term
What are the risk factors involved for depression?
Definition

1. Women are 2x more likely

2. There is 1.5-3x risk with positive family history

3. Martial status (Separated/ divorced males have higher rates; married males have lower rates.  Married females = higher rates)

4. There is an increased risk 6 months postpartum

5. There is increased risk with negative life events and early parental death.

Term
What is the prevalence of Bipolar? And is there a genetic component?
Definition

1.5 % worldwide, Males = females rates

If you have a first degree relative you have a 10% chance, but monozygotic twins have 80%.  So there is a genetic component.

Term
Bipolar Disorder is the alternation of ________ and ____________.
Definition
Depression and Mania
Term
Unipolar Disorder involves cycles of ____________ only.
Definition
Depression
Term
Unipolar Disorder can be ____________, _______________ or ______________.
Definition

Atypical

Melancholic

Dysthymia

Term
You are diagnosed with Atypical unipolar is you have ___________ and _____________.
Definition

Hypersomnia (sleep alot)

Overeat

Term
Melancholic Unipolar disorder deals with _______ and __________.
Definition

Insomnia (sleep too little)

Anorexia (eat too little)

Term
Dysthymia Unipolar disorder has milder symptoms that last more than ____________.
Definition
2 years
Term
Seasonal Affective Disorder (SAD) is depression that occurs
Definition

during the winter months. 

It usually occurs in the Northerns because they have a disregulation of melatonin and get less light.

Term
True/False:  Premenstrual Dysphoric Disorder is a Major Affective disorder.
Definition
True
Term
What is the criteria for manic episode?
Definition
A distinct period of abnormally and persistently elevated or irritable mood with at least 3 symptoms.
Term
What are the symptoms for manic episodes?
Definition

1. inflated self esteem or grandiosity

2. More talkative or pressure to keep talking

3. Subjective feelings that thoughts are racing

4. Distractability

5. Increased goal-directed behavior

6. Psychomotor agitation

7. excessive involvement in risky activities.

8. Mood disturbances so severe that cause marked impairment in occupational or social functioning or hospitalization to prevent harm to self or others.

Term
Some pathophysiologic Mechanisms for Unipolar Depression are:
Definition

1. Monoamine deficiency theory

2. Receptor regulation or coupling defects

3. Faulty signal transduction mechanisms

4. Alterations in nueronal growth factor production

5. Neurokinin Hypothesis

Term
Most drugs used for Depression are uptake inhibitors that increase the levels of __________ and ___________.
Definition

5 HT

NE

 

Term
Patients who are suicide victims with major depression have increased ____________ somatodendritic autoreceptors and __________ postsynaptic receptors.
Definition

5 HT1A

5 HT-2

Term
The Neurokinin hypothesis is a defect in ___________ or ____________ receptors.
Definition

Substance P

Neurokinin 1

Term
In the Hypothalamic- pituitary- adrenal axis about 1/2 the patients with depression exhibit ___________________ that abates when mood normalizes-- this is a clear link to stress mechanisms.
Definition

Cortisol Hypersecretion

 

(if depressed = higher CRF = higher cortisol)

Term
In the Hypothalamic- Pituitary- Thyroid -Axis, depressive symptoms are common with _________________, or ______.
Definition

Hypothyroidism

T3

Term
In depression there is a shorter ___________ to REM and an ________ REM duration.
Definition

Latency

increased

 

(REM occurs earlier and lasts longer)

Term
True/False: If you have major depression, sleep deprivation can result in a transient improvement in mood.
Definition
True
Term
Addiction can be classified by its ____________, _____________ and _____________.
Definition

1. Tolerance

2. Physical dependence

3. Abuse Liability

Term
Addiction tolerance is when you
Definition
have to increase the dose in order to produce the original response.
Term
What types of Addiction tolerance are there?
Definition

1. Dispositional

2. Functional

3. Learned

4. Cross tolerance

5. Reverse tolerance - sensitization

Term
Dispositional Tolerance in addiction Changes the drugs ________________ which means there is a ____________ concentration at the site of action.
Definition

Pharmacokinetics

lower

 

(there is an increase in excretion, decrease in absorption or increase in metabolism)

Term
Functional tolerance in addiction changes a body's _____________ to the drug, which means the concentration is the ____________ at the site of action.
Definition

response

same

Term
True/False: Learned tolerance is environmentally dependent . The brain has conditioned responses linked to environmental cues.
Definition
True
Term
True/False:  Cross tolerance occurs when a different drug is used but is still in the same class as the other.  Ex: Alcohol and Barbituates.
Definition
True
Term

Reverse Tolerance is aka _____________, which means the more you take of the drug the ________ its effect. 

An ex: is cocaine.

Definition

Sensitization

higher

Term
In addicts with Physical dependence, they __________________________
Definition
must take the drug to prevent withdrawal.
Term
In dealing with addiction, what is abstinence syndrome?
Definition
It is the opposite of initial drug effects and its severity is often determined by pharmacokinetics.  it is probably based on pharmacodynamic tolerance.  If you decreaes the half life you have worse abstinence.
Term
Abuse liability leads to _________________
Definition
substance dependence
Term
In addiction, Abuse liability depends on ___________, ___________ and _____________.
Definition

the agent

the user

the environment

Term
In addiction, reinforcing effects in the agents increase
Definition
DA in the NAc
Term
True/False: The pharmacokinetic variable is not important in addiction.
Definition
False; the route, onset, and duration is very important in the pharmacokinetic.
Term
If you have an opiate _______ binds on ________ and shuts off inhibition, which leads to excess DA release.
Definition

mu

GABA

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