P Lizer Lecture 1
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- What are the 5 axes of the DSM-IV-TR?
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I - primary psych diagnosis
II - personality and developmental disorders
III - physical or general medical disorder
IV - psychological stressors
V - global assesment of functioning (GAF) -
What does a GAF score of 61-70 represent?
41-50?
11-20? -
Mild sx
Serious sx
Danger of hurting self or others - Components of the AMSIT Mental Status Exam?
-
Appearance, behavior & speech
Mood and affect
Sensorium
Level of Intellectual functioning
Thought process - Rating scale for schizophrenia?
- Brief Psychiatric Rating Scale (BPRS)
- Rating scale for mood disorders?
- Beck Depression Inventory (BDI), Hamiltion Depression Rating Scale (HAMD)
- Rating scale for anxiety?
- Hamiltion Anxiety Rating Scale (HAMA)
- Rating scale for dementia?
- MMSE
- Rating scale for OCD?
- Yale-Brown Obsessive Compulsive Scale (YBOCS)
- Rating scale for tardive dyskinesia?
- Abnormal Involuntary Movement Scale (AIMS)
- Fx of cerebrum's frontal lobe?
- personality, memory, reasoning, concentration...Alzheimer's, depression, mania
- Fx of cerebrum's parietal lobe?
- Sensory processing...Alzheimer's
- Fx of cerebrum's occiptal lobe?
- visual recognition
- Fx of cerebrum's temporal lobe?
- speech, written/verbal/visual cueing...Alzheimer's, depression, mania
- Disease associated with cerebral cortex?
- Huntington's
- Disease associated with basal ganglia?
- Parkinson's
- Disease associated with limbic system?
- Alzheimer's
- Where do ACh tracts begin?
- cell bodies at base of frontal lobe
- Enzymes that break down ACh?
- acetylcholinesterase & butyrlcholinesterase
- Where do NE tracts begin?
- locus coeruleus
- Enzyme that breaks down NE?
- COMT and MOA
- Location of ALPHA 1 receptors?
- brain, heart, smooth muscle
- Effects of ALPHA 1 agonism?
- increased NE, increased BP, vasoconstriction, orgasm, tachycardia
- Examples of ALPHA 1 agonist?
- NE, epi, phenylepherine, Sudafed
- Effects of ALPHA 1 antagonism?
- decreased NE, decreased BP with reflex tachycardia
- Examples of ALPHA 1 antagonists?
- prazosin, TCAs, chlorpromazine
- Location of ALPHA 2 receptors?
- brain, pancreas, smooth muscle
- Effects of ALPHA 2 agonism?
- inhibits NE release, decreased BP
- Example of ALPHA 2 agonist?
- clonidine
- Effects of ALPHA 2 antagonists?
- block autoreceptors and increase NE
- Example of ALPHA 2 antagonist?
- yohimbine
- Location of BETA 1 receptors?
- heart, brain
- Effects of BETA 1 agonism?
- increased HR
- Examples of BETA 1 agonists?
- epi, dobutamine, isoproterenol
- Location of BETA 2 receptors?
- lungs, brain, skeletal muscle
- Effects of BETA 2 agonism?
- bronchodilation, uterine muscle contraction, increased blood sugar, vasodilation
- Effects of BETA 1 and 2 antagonists?
- decreased BP and HR, peripheral vasoconstriction
- Example of BETA antagonists?
- propranolol
- Effects of H1 receptors in hypothalamus?
- inhibit appetite, increase wakefulness, motion sickness, vertigo
- Anxiety and depression related to what histamine receptor family?
- 1A
- Migraine related to what histamine receptor family?
- 1D
- Hallucinations related to what histamine receptor family?
- 2B
- Appetite related to what histamine receptor family?
- 2C
- Peristalsis related to what histamine receptor family?
- 4
- Where do serotonin tracts begin?
- raphe nuclei cell bodies
- Serotonin involved in?
- emotions, cognition, sleep, appetite, sexual behavior, CV, cranial vessels
- Sx of serotonin deficiency?
- depression, obsession, compulsion, anxiety, panic, phobias, food cravings, aggression
- Sx of serotonin excess?
- anxiety, insomnia, GI disturbances, cardiac valve dysfunction
- Sx of serotonin syndrome?
- fever, tremor, coma, seizures, death
- Sx associated with decreased dopamine?
- parkinson's, decreased attention, hypersomnia, cravings, anhedonia, psuedodementia
- Sx associated with dopamine overactivity?
- pyschosis, schizophrenia
- 4 Tracts of Dopamine and their Fx
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Nigrostriatal: movement
Tuberinfundibular: prolactin release
Mesolimbic: memory, emotion
Mesocortical: emotion, social function - Effects of GABA-a stimulation?
- Cl influx, hyperpolarization, decreased cell excitability
- Defect with decreased ACh?
- Alzheimer's
- Defect with increased Dopamine?
- schizophrenia
- Defect with decreased Dopamine?
- Parkinson's, substance abuse
- Defect with decreased NE?
- depression
- Defect with decreased serotonin?
- depression, OCD
- Defect with decreased GABA?
- Anxiety
- Defect with increased Glutamate?
- bipolar, psychosis from neurotoxicity