Exam 4 Notes

Glutamate and Substance P are excitatory

Dementia Hypotheses

Anxiety Hypotheses

GENERAL ANXIETY DISORDER (GAD)

PTSD HYPOTHESES

ANXIETY DISORDER COMORBIDITIES

GAD	Panic Disorder (PD)	Social Anxiety Dis. (SAD)	PTSD	OCD
MDD Other Psychiatric Disease	Chronic: Personality, Mood, Anxiety Disorder	Anxiety, Depression, SUD	Depression, SUD, suicide attempts	depression
6 months 3+ criteria	attack followed by concern behavioral changes after 1 month 4+	6 months	1 month 1+ intrution symp 1 or both avoidance 2 + negativity 1 or both avoid stimuli	1 > hour per day
~ 35 y/o	women	women 14-16	women & SUD risk factor	risk suicide pregnancy

Physical Brain Alterations in Anxiety Disorders

Panic Disorder	Social Anxiety Disorder (SAD)
smaller Amygdala & Temporal Lobes	Amygdala, Orbital Frontal Regions, Hippocampus
Decreased cerebral glucose metabolism in the amygdala, hippocampus, thalamus, and brainstem
Reduced sensitivity BZD Receptors —> decreased GABA Reduced Serotonin 1A receptor —> GABA	Decreased Dopamine Overactive Serotonin NE: Anxious temperament

SEIZURES

FOCAL (one side)	GENERALIZED (both)
Bilateral	Unilateral
Consciousness based on awareness	All lose consciousness EXCEPT Myoclonic

PAIN

TYPES OF PAIN

ORGANISMS

SINUSITIS

ACUTE OTITUS MEDIA

PHARYNGITIS

VIRAL

Rhinovirus
Influenza
Coronavirus
Respiratory Synctial Virus (RSV)
Adenovirus

more common

RHINOVIRUS
Corona
Adenoviru
HSV (herpes)
Influenza
Parainfluenza
Epstein-Barr Virus (EBV)

BACTERIAL

P. Aeruginiosa
Methicillin-Resistant S. Aureus (MRSA)

Streptococcus Pneumoniae
Haemophilus Influenzae
Moraxella Catarrhalis

Strep Pyogenes

	Meningitis
Viral	Enterovirus Herpes HIV
Bacterial	P. meningitidis S. pneumoniae L monocytogenes Gram neg (e.coli, klebs, enterro)
Fungi	cryptococcus

Substance Use Disorder

	WITHDRAW ONSET	RECEPTORS	Symptoms
OPIOIDS	Short-acting (heroin, fentanyl): 8 - 24 hours Long-acting (methadone): 24 - 36 hours Acute withdrawal phase: 3 - 14 days Post acute phase: weeks-months	Mu, Kappa, Delta	intox: pinpoint pupils withdraw: dilation, tachy/hyper, respiratory failure → cardiac arrest
ALCOHOL	4-12 hours peak 2nd day resolves 4-5 days	GABA	intox: withdraw: tachy/hyper, delirium, seizure Wernicke (confusion, loss muscle coordination, coma/death) Korsakoff psychosis: memory loss, no new memories, hallucinations
NICOTINE	24 hours lasts days - weeks		Hedonic Dysregulation
Benzodiazepines		GABA	intox: memory, slurred speech, bloodshot eyes withdraw: agitate, hyper/tachy, tremors, seizures, hallucinations
COKE		Alpha & Beta Adrenergic	cardiac arrest & seizures intox: dilates, tachy/hyper withdraw: brady, tremors, fatigue