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Perception The process of organizing and interpreting sensory information to give meaning to our environment. Bottom-up processing An approach where perception starts with sensory input and works up to the brain's integration of this information. Top-down processing Information processing guided by higher-level mental processes, drawing on experience and expectations to construct perceptions. Schema A concept or framework that organizes and interprets information. Perceptual set A mental predisposition to perceive one thing and not another. Gestalt psychology Emphasizes that we often perceive the whole rather than the sum of the parts. Closure The perceptual tendency to mentally fill in gaps in a visual image to perceive objects as wholes. Figure and ground The organization of the visual field into objects (figures) that stand out from their surroundings (ground). Proximity The perceptual tendency to group together visual and auditory events that are near each other. Similarity The perceptual tendency to group together elements that seem alike. Attention The focusing of mental resources on select information. Selective attention The focusing of conscious awareness on a particular stimulus. Cocktail party effect The ability to focus auditory attention on a particular stimulus while filtering out other stimuli. Inattentional blindness Failing to see visible objects when attention is directed elsewhere. Change Blindness Failing to notice changes in the environment. Binocular depth cues Depth cues, such as retinal disparity, that depend on the use of two eyes. Retinal disparity A binocular cue for perceiving depth by comparing images from the retinas in the two eyes. Convergence A binocular cue for perceiving depth by the extent to which the eyes converge inward when looking at an object. Monocular depth cues Depth cues, such as interposition and linear perspective, available to either eye alone. Relative clarity A monocular cue for perceiving depth; hazy objects are seen as farther away than sharp, clear objects. Relative size A cue that allows determining the closeness of objects to an object of known size. Texture gradient A gradual change from coarse to fine texture signaling increasing distance. Linear perspective Parallel lines appear to converge with distance. Aptitude tests Tests designed to predict a person's future performance; aptitude is the capacity to learn. Fixed mindset The idea that we have a set amount of an ability that cannot change. Growth mindset The belief that one's skills and qualities can change and improve through effort and dedication. Explicit memory Memory of facts and experiences that one can consciously know and 'declare.' Episodic memory The collection of past personal experiences that occurred at a particular time and place. Semantic memory Memory for factual information. Implicit memory Retention independent of conscious recollection. Procedural memory A type of long-term memory of how to perform different actions and skills. Prospective memory Remembering to perform a planned action or recall a planned intention at some future point in time. Long-term potentiation An increase in a cell's firing potential after brief, rapid stimulation. Believed to be a neural basis for learning and memory. Working memory model A model that suggests that memory involves a series of active, temporary memory stores that manipulate information. Working memory A newer understanding of short-term memory that involves conscious, active processing of incoming auditory and visual-spatial information, and of information retrieved from long-term memory. Central executive The part of working memory that directs attention and processing. Phonological loop The part of working memory that holds and processes verbal and auditory information. Visuospatial sketchpad The part of working memory that holds visual and spatial information. Multi-store model A model of memory that suggests information passes through three stages: sensory memory, short-term memory, and long-term memory. Sensory memory The immediate, very brief recording of sensory information in the memory system. Iconic memory A momentary sensory memory of visual stimuli; a photographic or picture-image memory lasting no more than a few tenths of a second. Echoic memory A momentary sensory memory of auditory stimuli; if attention is elsewhere, sounds and words can still be recalled within 3 or 4 seconds. Short-Term Memory Activated memory that holds a few items briefly before the information is stored or forgotten. Long-Term Memory The relatively permanent and limitless storehouse of the memory system. Includes knowledge, skills, and experiences. Automatic processing Unconscious encoding of incidental information, such as space, time, and frequency, and of well-learned information. Effortful processing Encoding that requires attention and conscious effort. Encoding The processing of information into the memory system—for example, by extracting meaning. Storage The retention of encoded information over time. Retrieval The process of getting information out of memory storage. Levels of processing model The theory that deeper levels of processing result in longer-lasting memory codes. Shallow encoding Processing information based on its surface characteristics. Deep encoding Processing information based on its meaning and the significance of the information. Mnemonic devices Memory aids, especially those techniques that use vivid imagery and organizational devices. Method of loci A mnemonic device that involves imagining placing items around a room or along a route. Chunking-Grouping Organizing items into familiar, manageable units; often occurs automatically. Categories-Grouping Grouping information into categories that share common attributes. Hierarchies-Grouping Organizing items into a hierarchy, starting with general categories and working down to specific examples. Spacing effect The tendency for distributed study or practice to yield better long-term retention than is achieved through massed study or practice. Massed practice Cramming information all at once. It is less effective than spaced practice. Distributed practice Spacing the study of material to be remembered by including breaks between study periods. Serial position effect Our tendency to recall best the last and first items in a list. Primacy effect The tendency to remember information at the beginning of a body of information better than the information that follows. Recency effect The tendency to remember information that is presented last. Maintenance rehearsal Repeating information over and over to keep it active in short-term memory. Elaborative rehearsal A method of transferring information from short-term to long-term memory by making that information meaningful in some way. Memory retention The ability to retain information over time through the storage and retrieval of information. Autobiographical memory The memory for events and facts related to one's personal life story. Retrograde amnesia An inability to retrieve information from one's past. Anterograde amnesia An inability to form new memories. Alzheimer's disease A progressive and irreversible brain disorder characterized by gradual deterioration of memory, reasoning, language, and, finally, physical functioning. Infantile amnesia The inability to retrieve memories from much before age 3. Recall A measure of memory in which the person must retrieve information learned earlier, as on a fill-in-the-blank test. Recognition A measure of memory in which the person need only identify items previously learned, as on a multiple-choice test. Retrieval cues Stimuli that aid the recall or recognition of information stored in memory. Context-dependent memory The theory that information learned in a particular situation or place is better remembered when in that same situation or place. Mood-congruent memory The tendency to recall experiences that are consistent with one's current good or bad mood. State-dependent memory The theory that information learned in a particular state of mind (e.g., drunk, sober) is more easily recalled when in that same state of mind. The forgetting curve A graph showing retention and forgetting over time. Encoding failure The failure to process information into memory. Proactive interference The disruptive effect of prior learning on the recall of new information. Retroactive interference The disruptive effect of new learning on the recall of old information. Tip-of-the-tongue phenomenon The temporary inability to remember something you know, accompanied by a feeling that it's just out of reach. Repression The basic defense mechanism that banishes from consciousness anxiety-arousing thoughts, feelings, and memories. Misinformation effect Incorporating misleading information into one's memory of an event. Source amnesia Attributing to the wrong source an event we have experienced, heard about, read about, or imagined. Constructive memory The process by which memories are influenced by the meaning we give to events. Memory consolidation The neural storage of a long-term memory. Imagination inflation The increased confidence in a false memory of an event following repeated imagination of the event. Health Psychology A branch of psychology that focuses on how physical activities, psychological traits, and social relationships affect overall health and illness. Stress The process by which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging. Hypertension High blood pressure, often associated with stress, which can increase the risk of heart and kidney diseases and stroke. Immune Suppression Reduction in the effectiveness of the immune system, which can be caused by various forms of stress. Stressors Events or conditions in your surroundings that may trigger stress. Daily Hassles Everyday minor events that cause stress, such as traffic jams or overwhelming chores. Significant Life Changes Major life transitions like moving, leaving a job, or divorcing, which can be stressful. Catastrophes Unpredictable, large-scale events that cause significant stress and alter the lives of many people. Eustress (motivating) Positive stress which results from striving toward a challenging goal. Distress (debilitating) Negative stress that can make a person sick or keep a person from reaching a goal. Adverse Childhood Experiences (ACEs) Potentially traumatic events that occur in childhood and can have negative, lasting effects on health and well-being. General Adaptation Syndrome (GAS) The three-stage process (alarm, resistance, exhaustion) that describes the physiological changes the body goes through when under stress. Alarm Reaction Phase The initial reaction to a stressor, activating the body's defense systems. Resistance Phase The body's response after the initial shock of a stressful event, where the body attempts to return to normal functioning. Flight-Fight-Freeze Response A physiological reaction that occurs in response to a perceived harmful event, attack, or threat to survival. Exhaustion Phase The third stage of the GAS, during which the body depletes its resources in responding to a prolonged stressor. Tend-and-Befriend Theory A theory that suggests people seek social support and tend to others in times of stress. Problem-focused Coping Strategies aimed at tackling the cause of stress in practical ways which directly tackle the problem causing the stress. Emotion-focused Coping Strategies aimed at relieving or managing the emotional distress associated with stress. Positive Psychology The scientific study of human strengths and virtues that enable individuals and communities to thrive. Subjective Well-being An individual's own assessment of their happiness and satisfaction with life. Resilience The ability to mentally or emotionally cope with a crisis or to return to pre-crisis status quickly. Posttraumatic Growth Positive psychological change experienced as a result of adversity and other challenges in order to rise to a higher level of functioning. Positive Emotions Feelings that engage us, elevate us, and promote growth and well-being. Gratitude A feeling of thankfulness and appreciation, especially in response to someone doing something kind or helpful. Signature Strengths & Virtues Character strengths and virtues that are personally fulfilling, intrinsic to one's identity, and contribute to the collective well-being. Categories of Virtues Broad categories that encompass character strengths, such as wisdom, courage, humanity, justice, temperance, and transcendence. Abnormal Psychology The study of psychological disorders, including their symptoms, etiology (i.e., their causes), and treatment. Clinical Psychology A branch of psychology that studies, assesses, and treats people with psychological disorders. Psychology Student Syndrome A phenomenon where psychology students begin to believe they have the disorders they are studying. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) The updated manual that describes and categorizes mental disorders in order to improve diagnoses, treatment, and research. International Classification of Mental Disorders (ICD) A standard diagnostic tool for epidemiology, health management, and clinical purposes. It is maintained by the World Health Organization (WHO) and covers a broad range of health conditions, including psychological conditions. Deviation In psychology, typically refers to departing from the norm, which can either be statistical, social, or functional in nature. Distress Negative stress that can lead to anxiety, depression, and potentially to physical problems. Dysfunction Abnormal functioning, as opposed to normal functioning, often used to refer to individual behaviors or the functioning of social systems. Eclectic Approach An approach to clinical practice that involves selecting the best treatment techniques from various disciplines based on the client's unique problems, strengths, and preferences. Behavioral Perspective Focuses on how we learn observable responses and how the environment impacts those responses. Psychodynamic Perspective Emphasizes the influence of the unconscious mind on behavior and the importance of childhood experiences. Humanistic Perspective Focuses on the importance of being your true self in order to lead the most fulfilling life. Cognitive Perspective Focuses on how we encode, process, store, and retrieve information. Evolutionary Perspective How the natural selection of traits promotes the perpetuation of one's genes. Sociocultural Perspective Examines how the social environments and cultural upbringing influence an individual's behavior and thoughts. Biological Perspective Explores the links between brain and mind, and how the body and brain enable emotions, memories, and sensory experiences. Biopsychosocial Model An integrated approach that incorporates biological, psychological, and social-cultural levels of analysis to better understand health and illness. Diathesis-Stress Model Suggests that a person may be predisposed for a psychological disorder that remains unexpressed until triggered by stress. Stigma Disapproval or discrimination against a person based on perceivable social characteristics that serve to distinguish them from other members of society. Anxiety Disorders Mental health disorders characterized by significant feelings of anxiety and fear. Specific Phobia An anxiety disorder characterized by irrational and persistent fear of a specific object, situation, or activity. Acrophobia Fear of heights. Arachnophobia Fear of spiders. Agoraphobia Fear of open or crowded spaces. Panic Disorder An anxiety disorder that consists of sudden, overwhelming attacks of terror. Ataque de nervios A cultural syndrome primarily seen in Latin Americans, involving symptoms of intense emotional upset, acute anxiety, fear, or anger. Social Anxiety Disorder A chronic mental health condition in which social interactions cause irrational anxiety. Taijin Kyofusho A Japanese culture-specific syndrome characterized by an intense fear that one's body, body parts, or bodily functions give others a negative impression. Generalized Anxiety Disorder An anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal. Obsessive-Compulsive Disorders Disorders involving intrusive obsessions and compulsions which impede daily life. Obsessions Persistent ideas, thoughts, or impulses that are unwanted and inappropriate and cause marked distress. Compulsions Repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession. Hoarding Disorder A disorder characterized by the persistent difficulty discarding or parting with possessions, regardless of their actual value. Trauma and Stressor-Related Disorders Disorders related to the exposure to a traumatic or stressful event. Posttraumatic Stress Disorder A disorder characterized by failure to recover after experiencing or witnessing a terrifying event. Depressive Disorders Disorders that involve the presence of sad, empty, or irritable mood, accompanied by physical and cognitive changes that significantly affect the individual's capacity to function. Major Depressive Disorder A mood disorder causing a persistent feeling of sadness and loss of interest. Persistent Depressive Disorder A form of depression that is less severe than major depressive disorder but more chronic. Bipolar Disorder A disorder associated with episodes of mood swings ranging from depressive lows to manic highs. Bipolar Cycling The process of cycling through episodes of mania and depression in bipolar disorder. Bipolar I Disorder A type of bipolar spectrum disorder characterized by the occurrence of at least one manic episode. Bipolar II Disorder A type of bipolar disorder marked by milder episodes of hypomania that alternate with periods of severe depression. Neurodevelopmental Disorders A group of conditions with onset in the developmental period, often before school age, that are characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning. Attention-Deficit/Hyperactivity Disorder (ADHD) A chronic condition including attention difficulty, hyperactivity, and impulsiveness. Autism Spectrum Disorder (ASD) A disorder that affects communication and behavior. Feeding and Eating Disorders Disorders characterized by abnormal or disturbed eating habits, which negatively affect a person's health. Anorexia Nervosa An eating disorder characterized by an abnormally low body weight, intense fear of gaining weight, and a distorted perception of body weight. Bulimia Nervosa An eating disorder characterized by binge eating followed by purging. Schizophrenic Spectrum Disorders A range of disorders that involve psychosis, including schizophrenia. Delusions False beliefs, often of persecution or grandeur, that may accompany psychotic disorders. Delusions of Persecution The belief that others are out to get one. Delusions of Grandeur A false belief that one is more important or influential than they really are. Hallucinations False sensory experiences, such as seeing something in the absence of an external visual stimulus. Disorganized Thinking A symptom of psychosis, manifested as illogical or incoherent thought and speech. Disorganized Speech A style of talking involving incoherence and a lack of typical logical patterns. Word Salad A confused or unintelligible mixture of seemingly random words and phrases. Disorganized Motor Behavior Includes a variety of unusual behaviors including problems with goal-directed behavior leading to difficulties performing activities of daily living. Catatonia A state of unresponsiveness to one's outside environment, usually including muscle rigidity, staring, and inability to communicate. Flat Affect A lack of emotional responsiveness. Dopamine Hypothesis The theory that schizophrenia results from an excess of dopamine activity. Positive Symptoms Symptoms of schizophrenia that are excesses of behavior or occur in addition to normal behavior; hallucinations, delusions, and disorganized speech. Negative Symptoms Symptoms of schizophrenia that are marked by deficits in functioning, such as apathy, lack of emotion, and slowed speech and movement. Dissociative Disorders Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings. Dissociative Amnesia A disorder characterized by the sudden and extensive inability to recall important personal information, usually of a traumatic or stressful nature. Dissociative Fugue A rare dissociative disorder in which a person loses awareness of their identity or other important autobiographical information and also engages in some form of unexpected travel. Dissociative Identity Disorder A disorder characterized by the presence of two or more distinct personality states. Personality Disorders Psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning. Cluster A Personality Disorders Odd, eccentric thinking or behavior (including paranoid, schizoid, and schizotypal personality disorders). Paranoid Personality Disorder Type of personality disorder characterized by extreme distrust and suspicion of others. Schizoid Personality Disorder A personality disorder characterized by persistent avoidance of social relationships and little expression of emotion. Schizotypal Personality Disorder A personality disorder characterized by severe social anxiety, thought disorder, paranoid ideation, derealization, transient psychosis, and often unconventional beliefs. Cluster B Personality Disorders Dramatic, overly emotional or unpredictable thinking or behavior (including antisocial, borderline, histrionic, and narcissistic personality disorders). Antisocial Personality Disorder A personality disorder characterized by a lack of conscience for wrongdoing, even toward friends and family. Histrionic Personality Disorder A personality disorder characterized by excessive emotionality and attention seeking. Narcissistic Personality Disorder A disorder in which a person has an inflated sense of self-importance. Borderline Personality Disorder A personality disorder characterized by severe instability in emotions and self-image, along with impulsive and reckless behavior. Cluster C Personality Disorders Anxious, fearful thinking or behavior, including avoidant, dependent, and obsessive-compulsive personality disorders. Avoidant Personality Disorder A personality disorder characterized by social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Dependent Personality Disorder A personality disorder characterized by psychological dependence on other people. Obsessive-Compulsive Personality Disorder A personality disorder characterized by preoccupation with orderliness, perfection, and control. Deinstitutionalization The release of institutionalized individuals from institutional care to community-based care. Evidence-Based Interventions Treatments based on scientific evidence. Cultural Humility An approach to engagement across cultures emphasizing openness and self-awareness of one's own cultural identities. Therapeutic Alliance The relationship between a healthcare professional and a client. Conformity Adjusting one's behavior or thinking to coincide with a group standard. Normative Social Influence Influence resulting from a person's desire to gain approval or avoid disapproval. Social Norms Expected standards of conduct, which influence behavior. Social Comparison Evaluating one's abilities and opinions by comparing oneself to others. Relative Deprivation The perception that one is worse off relative to those with whom one compares oneself. Upward Social Comparison Comparing oneself with others who are better off. Downward Social Comparison Comparing oneself with others who are worse off. Informational Social Influence Influence resulting from one's willingness to accept others' opinions about reality. Obedience Following the directives of authority. Social Facilitation Improved performance on simple or well-learned tasks in the presence of others. Group Polarization The enhancement of a group's prevailing inclinations through discussion within the group. Groupthink The mode of thinking that occurs when the desire for harmony in a decision-making group overrides a realistic appraisal of alternatives. Bystander Effect The tendency for any given bystander to be less likely to give aid if other bystanders are present. Diffusion of Responsibility Diminished sense of responsibility among group members to act because others are seen as equally responsible. Social Loafing The tendency for people in a group to exert less effort when pooling their efforts toward attaining a common goal than when individually accountable. Deindividuation The loss of self-awareness and self-restraint occurring in group situations that foster arousal and anonymity. Attribution Theory The theory that we explain someone's behavior by crediting either the situation or the person's disposition. Dispositional Attributions Attributing behavior to the person's disposition and traits. Situational Attributions Attributing behavior to the environment. Explanatory Style A person's habitual way of explaining events, typically assessed along three dimensions: internal/external, stable/unstable, and global/specific. Optimistic Explanatory Style Explaining bad events as results of temporary, external causes. Pessimistic Explanatory Style Explaining bad events as results of stable, internal causes. Fundamental Attribution Error The tendency for observers, when analyzing others' behavior, to underestimate the impact of the situation and to overestimate the impact of personal disposition. Actor-Observer Bias The tendency to attribute one's own actions to external causes while attributing other people's behaviors to internal causes. Self-Serving Bias A readiness to perceive oneself favorably. Internal Locus of Control The perception that one controls one's own fate. External Locus of Control The perception that chance or outside forces beyond one's personal control determine one's fate. Altruism Unselfish regard for the welfare of others. Social Responsibility Norm An expectation that people will help those needing their help. Stereotype A generalized belief about a group of people. Confirmation Bias The tendency to interpret new evidence as confirmation of one's existing beliefs or theories. Belief Perseverance Clinging to one's initial conceptions after the basis on which they were formed has been discredited. Self-Fulfilling Prophecy A belief that leads to its own fulfillment. Prejudice An unjustifiable and usually negative attitude toward a group and its members. Discrimination Unjustifiable negative behavior toward a group and its members. Implicit Attitudes Attitudes that influence a person's feelings and behavior at an unconscious level. Just-World Phenomenon The tendency for people to believe the world is just and that people therefore get what they deserve. Out-Group Homogeneity Bias Perception of out-group members as more similar to one another than are in-group members. In-Group Bias The tendency to favor one's own group. Mere Exposure Effect The phenomenon that repeated exposure to novel stimuli increases liking of them. Ethnocentrism Evaluating other cultures according to the standards and customs of one's own culture. Collectivism Giving priority to the goals of one's group and defining one's identity accordingly. Multiculturalism The practice of valuing and respecting differences in culture. Superordinate Goals Shared goals that override differences among people and require their cooperation. Social Traps A situation in which conflicting parties, by each rationally pursuing their self-interest, become caught in mutually destructive behavior. Persuasion The process of creating, reinforcing, or changing people's beliefs or actions. Elaboration Likelihood Model A theory of how persuasive messages lead to attitude changes. Central Route of Persuasion Attitude change path in which interested people focus on the arguments and respond with favorable thoughts. Peripheral Route of Persuasion Attitude change path in which people are influenced by incidental cues, such as a speaker's attractiveness. Halo Effect The tendency to draw a general impression about an individual on the basis of a single characteristic. Foot-in-the-Door Technique The tendency for people who have first agreed to a small request to comply later with a larger request. Door-in-the-Face Technique The strategy of getting someone to agree to a modest request by first asking them to agree to a much larger request that they will likely turn down. False Consensus Effect The tendency to overestimate the extent to which others share our beliefs and behaviors. Cognitive Dissonance The theory that we act to reduce the discomfort we feel when two of our thoughts are inconsistent. Industrial-Organizational (I/O) Psychologists Psychologists who apply psychology's principles to the workplace. Instincts A complex behavior that is rigidly patterned throughout a species and is unlearned. Drive-Reduction Theory The idea that a physiological need creates an aroused tension state (a drive) that motivates an organism to satisfy the need. Homeostasis The tendency to maintain a balanced or constant internal state; the regulation of any aspect of body chemistry, such as blood glucose, around a particular level. Ghrelin Hormone secreted by an empty stomach; sends 'I'm hungry' signals to the brain. Leptin Hormone secreted by fat cells; when abundant, causes brain to increase metabolism and decrease hunger. Hypothalamus A neural structure lying below the thalamus; directs several maintenance activities (eating, drinking, body temperature), helps govern the endocrine system via the pituitary gland, and is linked to emotion and reward. Pituitary Gland The endocrine system's most influential gland. Under the influence of the hypothalamus, the pituitary regulates growth and controls other endocrine glands. Belongingness The human emotional need to be an accepted member of a group. Arousal Theory The theory that people are motivated to maintain an optimal level of alertness and physical and mental activation. Yerkes-Dodson Law The principle that performance increases with arousal only up to a point, beyond which performance decreases. Sensation-Seeking Theory The search for experiences and feelings that are varied, novel, complex, and intense. Thrill Seeking Pursuing activities that provide a rush of adrenaline. Adventure Seeking Engaging in unusual and exciting activities. Disinhibition Acting impulsively, without considering the consequences. Boredom Susceptibility Tendency to experience boredom and frustration when not engaged in stimulating activities. Incentive Theory A theory that states that behavior is motivated by a desire for reinforcement or incentives. Extrinsic Motivation A desire to perform a behavior to receive promised rewards or avoid threatened punishment. Self-Determination Theory A theory of motivation that is concerned with the beneficial effects of intrinsic motivation and the harmful effects of extrinsic motivation. Intrinsic Motivation A desire to perform a behavior effectively for its own sake. Lewin's Motivational Conflicts Theory A theory that describes situations in which conflicting motivations produce indecision and difficulty. Approach-Approach Conflicts Conflict that results from having to choose between two attractive alternatives. Avoidance-Avoidance Conflicts Conflict that results from having to choose between two distasteful alternatives. Approach-Avoidance Conflicts Conflict that results when a single action or event has both attractive and unattractive features. Emotion A response of the whole organism, involving (1) physiological arousal, (2) expressive behaviors, and (3) conscious experience. Affect A broad range of feelings that people experience. Facial-Feedback Hypothesis The idea that facial expressions can influence emotions as well as reflect them. Display Rules Culturally determined rules about which nonverbal behaviors are appropriate to display. Elicitors Stimuli that trigger emotional responses. Broaden-and-Build Theory of Emotion Theory proposing that happiness predisposes us to think more openly. Universal Emotions Basic emotions that are expressed by all cultures around the world such as happiness, sadness, fear, disgust, anger, and surprise. Psychodynamic Theory A view that explains personality in terms of conscious and unconscious forces, such as unconscious desires and beliefs. Preconscious Mind The level of consciousness that is not currently in focal awareness. Unconscious Mind A reservoir of mostly unacceptable thoughts, wishes, feelings, and memories. Denial Psychoanalytic defense mechanism by which people refuse to believe or even to perceive painful realities. Displacement Defense mechanism that shifts sexual or aggressive impulses toward a more acceptable or less threatening object or person. Projection Defense mechanism by which people disguise their own threatening impulses by attributing them to others. Rationalization Defense mechanism that offers self-justifying explanations in place of the real, more threatening, unconscious reasons for one's actions. Reaction Formation Defense mechanism by which the ego unconsciously switches unacceptable impulses into their opposites. Regression Defense mechanism in which an individual faced with anxiety retreats to a more infantile psychosexual stage. Repression Defense mechanism by which anxiety-provoking thoughts and feelings are forced to the unconscious. Sublimation Defense mechanism by which people re-channel their unacceptable impulses into socially approved activities. Humanistic Psychology A historically significant perspective that emphasized the growth potential of healthy people. Unconditional Regard An attitude of total acceptance toward another person. Self-Actualizing Tendency The human motive toward realizing our inner potential. Social-Cognitive Theory Views behavior as influenced by the interaction between people's traits (including their thinking) and their social context. Reciprocal Determinism The interacting influences of behavior, internal cognition, and environment. Self-Concept All our thoughts and feelings about ourselves, in answer to the question, 'Who am I?' Self-Efficacy One's sense of competence and effectiveness. Self-Esteem One's feelings of high or low self-worth. Trait Theories Theories that endeavor to describe the characteristics that make up human personality in an effort to predict future behavior. Big Five Theory The theory that there are five basic personality traits: openness, conscientiousness, extraversion, agreeableness, and neuroticism (emotional stability). Personality Inventories A questionnaire (often with true-false or agree-disagree items) on which people respond to items designed to gauge a wide range of feelings and behaviors; used to assess selected personality traits. Factor Analysis A statistical procedure that identifies clusters of related items (called factors) on a test; used to identify different dimensions of performance that underlie one's total score. Openness to Experience One of the five factors; willingness to try new things and be open to new experiences. Conscientiousness One of the five factors; a tendency to show self-discipline, act dutifully, and aim for achievement. Extraversion One of the five factors; energy, positive emotions, and the tendency to seek stimulation and the company of others. Agreeableness One of the five factors; a tendency to be compassionate and cooperative rather than suspicious and antagonistic towards others. Behavioral Perspective Emphasizes learning and behavior in explaining thoughts, feelings, and actions. Associative Learning Making connections between events to learn. Habituation Becoming less responsive to a repeated stimulus. Classical Conditioning Pairing two stimuli to elicit a response. Unconditioned Stimulus (UCS) Naturally triggers a response without learning. Conditioned Stimulus (CS) Initially neutral, triggers a conditioned response. Acquisition Initial learning stage where a response is established. Extinction Diminishing of a conditioned response. Spontaneous Recovery Reappearance of an extinguished response after a pause. Stimulus Discrimination Ability to differentiate between stimuli. Stimulus Generalization Conditioned stimulus evokes similar responses. Higher-Order Conditioning Pairing a conditioned stimulus with a new one. Counterconditioning Uses conditioning to change responses to triggers. Taste Aversion Avoidance of food associated with discomfort. One-Trial Conditioning Learning with only one pairing of stimulus and response. Biological Preparedness Inclination to form associations between stimuli and responses. Operant Conditioning Learning through rewards and punishments. The Law of Effect Behaviors with favorable consequences are repeated. Reinforcement Strengthens behavior it follows. Primary Reinforcers Innately reinforcing stimuli satisfying biological needs. Secondary Reinforcers Gains reinforcing power through association. Punishment Event decreasing behavior it follows. Shaping Positive reinforcement of behavior patterns. Instinctive Drift Tendency to revert to instinctive behaviors. Fine Motor Coordination The ability to make small, precise movements, typically involving the coordination of the hands and fingers with the eyes. Gross Motor Coordination The ability to make large, general movements, such as crawling and walking. Maturation Biological growth processes that enable orderly changes in behavior, relatively uninfluenced by experience. Reflexes Automatic responses to sensory stimuli, like grasping a finger tightly with the hands. Rooting Reflex A baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple. Visual Cliff A laboratory device for testing depth perception in infants and young animals. Critical Periods Specific time periods during which an organism must experience stimuli in order to develop normally. Sensitive Periods Times in development when a person is particularly open to certain kinds of experiences. Imprinting The process by which certain animals form strong attachments during early life. Growth Spurt A rapid increase in growth during puberty. Puberty The period of sexual maturation, during which a person becomes capable of reproducing. Primary Sex Characteristics The body structures (ovaries, testes, and external genitalia) that make sexual reproduction possible. Secondary Sex Characteristics Nonreproductive sexual traits, such as female breasts and hips, male voice quality, and body hair. Menarche The first menstrual period. Spermarche The first ejaculation. Menopause The time of natural cessation of menstruation; also refers to the biological changes a woman experiences as her ability to reproduce declines. Sex The biologically influenced characteristics by which people define males and females. Gender The socially influenced characteristics by which people define men and women. Socialization The process by which people learn the norms, rules, and information of a culture or society. Jean Piaget A psychologist known for his study of cognitive development in children. Sensorimotor Stage The first stage in Piaget's theory of cognitive development, from birth to about 2 years of age, during which infants know the world mostly in terms of their sensory impressions and motor activities. Object Permanence The awareness that things continue to exist even when not perceived. Preoperational Stage The second stage in Piaget's theory, from about 2 to 7 years of age, during which a child learns to use language but does not yet comprehend the mental operations of concrete logic. Mental Symbols Internal depictions of information that the mind can manipulate. Chronosystem In Bronfenbrenner's theory, this system encompasses changes over time in child development. Authoritarian Parenting A parenting style characterized by high demands and low responsiveness. Parents with this style have very high expectations of their children, yet provide very little in the way of feedback and nurturance. Authoritative Parenting A parenting style characterized by high demands and high responsiveness. Parents with this style set limits and enforce rules but also listen to their children. Permissive Parenting A parenting style characterized by low demands with high responsiveness. These parents tend to be very loving, yet provide few guidelines and rules. Attachment Styles Patterns of attachment, defined by different ways of interacting and behaving in relationships. Secure Attachment An attachment style characterized by trust, a lack of concern with being abandoned, and the view that one is worthy and well liked. Insecure Attachment Attachment styles characterized by fear of abandonment and the feeling that one's needs might not be met. Avoidant Attachment An attachment style characterized by difficulty in learning to trust others. Anxious Attachment An attachment style where individuals are often anxious about the stability of their relationships. Disorganized Attachment An attachment style characterized by a lack of clear attachment behavior. Temperament A person's characteristic emotional reactivity and intensity. Separation Anxiety Emotional distress seen in many infants when they are separated from people with whom they have formed an attachment. Contact Comfort The physical and emotional comfort that an infant receives from being in physical contact with its mother. Parallel Play Activity in which children play side by side without interacting. Pretend Play Play involving imaginary people and situations; also called fantasy play, dramatic play, or imaginative play. Egocentrism The inability to differentiate between self and other. More specifically, it is the inability to understand that others have different feelings, desires, and perspectives from one's own. Imaginary Audience A concept in adolescent psychology where an individual believes that his or her behavior is the main focus of others' attention and concern. Personal Fable An adolescent's belief that they are unique and protected from harm. Social Clock The culturally preferred timing of social events such as marriage, parenthood, and retirement. Emerging Adulthood A phase of the life span between adolescence and full-fledged adulthood which encompasses late adolescence and early adulthood, generally ages 18 to 25. Stage Theory of Psychosocial Development (Erikson) Erik Erikson's theory that identifies eight stages through which a healthily developing human should pass from infancy to late adulthood. Trust vs. Mistrust The first stage of Erik Erikson's theory of psychosocial development. This stage occurs between birth and approximately 18 months of age. During this stage, the infant learns if they can trust the world to fulfill their needs. Autonomy vs. Shame and Doubt The second stage of Erik Erikson's stages of psychosocial development. This stage occurs between the ages of 18 months to approximately 3 years. The child learns to be independent and confident or experiences shame and doubt about their abilities. Initiative vs. Guilt The third stage of Erik Erikson's stages of psychosocial development. This stage occurs during the preschool years, between the ages of 3 to 5 years. Children begin to assert control and power over their environment. Industry vs. Inferiority The fourth stage of Erik Erikson's stages of psychosocial development. This stage occurs between the ages of 5 and 12 years. Children learn to cope with new social and academic demands, success leads to a sense of competence, while failure results in feelings of inferiority. Identity vs. Role Confusion The fifth stage of Erik Erikson's stages of psychosocial development. This stage occurs during adolescence, from about 12-18 years. During this stage, adolescents explore their independence and develop a sense of self. Intimacy vs. Isolation The sixth stage of Erik Erikson's theory of psychosocial development. This stage occurs during young adulthood between the ages of approximately 19 and 40 years. Young adults need to form intimate, loving relationships with other people. Generativity vs. Stagnation The seventh stage of Erik Erikson's theory of psychosocial development. This stage takes place during middle adulthood between the ages of approximately 40 and 65. Individuals establish careers, settle down within relationships, begin families, and develop a sense of being a part of the bigger picture. Integrity vs. Despair The eighth and final stage of Erik Erikson's stages of psychosocial development. This stage occurs during old age and is focused on reflecting back on life. Adverse Childhood Experiences (ACEs) Potentially traumatic events that occur in childhood (0-17 years), such as experiencing violence, abuse, or neglect, witnessing violence in the home or community, and having a family member attempt or die by suicide. Achievement (adolescent development) In the context of identity development, this term refers to the successful integration of various aspects of self-concept, based on explorations of roles, values, and beliefs. Diffusion (adolescent development) A status of identity development where an individual has not yet experienced a crisis or made any commitments. They are undecided and uninterested in occupational and ideological choices. Foreclosure (adolescent development) A status of identity development where an individual has made a commitment without experiencing a crisis. This occurs when people commit to roles or values without exploring alternatives. Moratorium (adolescent development) A status of identity development where an individual is in the midst of a crisis but whose commitments are either absent or are only vaguely defined. Racial/Ethnic Identity An individual's awareness and experience of being a member of a racial or ethnic group, including the degree to which one's cultural, historical, and social aspects of identity are embraced. Sexual Orientation An inherent or immutable enduring emotional, romantic, or sexual attraction to other people. Religious Identity An individual's sense of belonging to a religious group, along with the importance of this group membership as it pertains to one's sense of self. Occupational Identity How a person identifies themselves based on their job or career choices and how they feel those roles impact their personal identity. Familial Identity The part of an individual's identity that is formed by the relationships they have with their family members. Possible Selves The aspect of oneself that includes all the ideas of what one might become, what one hopes to become, and what one is afraid of becoming. Evolutionary Perspective A way of looking at human behavior that emphasizes the role of natural selection and survival of the fittest in shaping our actions. Natural Selection A process where organisms better adapted to their environment tend to survive and produce more offspring. Nature Refers to the genetic or hereditary influences on behavior and traits. Nurture Refers to the environmental influences that shape behavior and traits after conception. Twin Studies Research that compares the similarities between identical and fraternal twins to understand the influence of genetics versus environment. Adoption Studies Studies that compare adopted children to their adoptive and biological parents to understand genetic and environmental influences. Family Studies Research that examines behavioral patterns or genetic markers across generations within families. Heredity The passing on of physical or mental traits genetically from one generation to another. Genetic Predisposition The increased likelihood of developing a particular disease or behavior based on a person's genetic makeup. Eugenics A controversial historical movement aimed at improving the genetic composition of the human race. Cerebral Cortex The outermost layer of the brain involved in high-level functions such as thought, language, and memory. Association Areas Parts of the brain that integrate different types of information from the senses and link it with stored memories. Lobes of the Brain Regions of the brain differentiated by their functions, including frontal, parietal, occipital, and temporal lobes. Frontal Lobes Areas of the brain involved in complex processes like reasoning, planning, and emotion. Prefrontal Cortex The part of the frontal lobes directly behind the forehead, involved in decision-making and self-control. Executive Functioning Higher-level cognitive processes including thinking, planning, and problem-solving. Motor Cortex The part of the brain that controls voluntary movements. Parietal Lobes Areas of the brain that process sensory information such as touch, temperature, and pain. Somatosensory Cortex A part of the parietal lobes that processes sensory input from various body areas. Occipital Lobes The part of the brain that processes visual information. Temporal Lobes Areas of the brain involved in processing auditory information and encoding memory. Corpus Callosum A large band of neural fibers that connects the left and right cerebral hemispheres and allows communication between them. Brainstem The central trunk of the brain continuing downward to form the spinal cord. Medulla The base of the brainstem that controls vital life-sustaining functions like heartbeat and breathing. Reticular Activating System A network of neurons in the brainstem that plays a role in waking and sleep. Cerebellum A part of the brain at the back of the skull that coordinates and regulates muscular activity. Limbic System A complex system of nerves and networks in the brain, controlling basic emotions and drives. Reward Center Brain regions that regulate the experience of pleasure, particularly related to survival and reward. Thalamus A structure deep within the brain that relays sensory signals to the cerebral cortex. Hypothalamus A small region at the base of the brain that directs several functions, including temperature regulation and energy maintenance. Pituitary Gland A gland at the base of the brain that controls growth and development. Hippocampus A part of the limbic system involved in learning and memory. Amygdala A structure in the limbic system involved in emotion, particularly fear and aggression. Nervous System The network of nerve cells and fibers that transmits nerve impulses between parts of the body. Central Nervous System The part of the nervous system consisting of the brain and spinal cord. Peripheral Nervous System All the nerves that lie outside the brain and spinal cord. Autonomic Nervous System The part of the nervous system responsible for control of the bodily functions not consciously directed, like breathing and the heartbeat. Sympathetic Nervous System The part of the autonomic nervous system that prepares the body for rapid action in emergencies. Parasympathetic Nervous System The part of the autonomic nervous system that calms the body and conserves energy. Somatic Nervous System The part of the peripheral nervous system associated with voluntary control of body movements via skeletal muscles. Neurons The basic working units of the brain, specialized cells that transmit information to other nerve cells, muscle, or gland cells. Glial Cells Cells in the nervous system that support, nourish, and protect neurons. Motor Neurons Neurons that carry outgoing information from the brain and spinal cord to the muscles and glands. Sensory Neurons Neurons that carry incoming information from the sensory receptors to the brain and spinal cord. Interneurons Neurons within the brain and spinal cord that communicate internally and intervene between the sensory inputs and motor outputs. Reflex Arc A neural pathway that controls a reflex action. Neural Transmission The process by which neurons communicate with each other by sending electrical or chemical signals. Threshold The level of stimulation required to trigger a neural impulse. Action Potential A neural impulse; a brief electrical charge that travels down an axon. All-or-Nothing Principle The rule that neurons are either on or off. Depolarization A change in a cell's membrane potential, making it more positive. Refractory Period A period immediately following stimulation during which a nerve or muscle is unresponsive to further stimulation. Resting Potential The state of the neuron when not firing a neural impulse. Reuptake A neurotransmitter's reabsorption by the sending neuron. Multiple Sclerosis (MS) A disease in which the immune system eats away at the protective covering of nerves. Myasthenia Gravis A chronic autoimmune disease that affects the neuromuscular junction and produces serious weakness of voluntary muscles. Neurotransmitters Chemicals transmitting information across synapses to dendrites of receiving neurons. Excitatory Neurotransmitters Chemical messengers increasing the likelihood of neuron firing an action potential. Glutamate An excitatory neurotransmitter strengthening synaptic connections between neurons. Inhibitory Neurotransmitters Chemical messengers decreasing the likelihood of neuron firing an action potential. GABA A major inhibitory neurotransmitter in the brain. Dopamine A neurotransmitter influencing movement, learning, attention, and emotion. Serotonin A neurotransmitter affecting mood, hunger, sleep, and arousal. Endorphins Neurotransmitters influencing the perception of pain or pleasure. Substance P A neurotransmitter involved in transmitting pain messages to the brain. Acetylcholine A neurotransmitter enabling learning, memory, and triggering muscle contraction. Hormones Chemicals produced by glands regulating activities of different body cells. Ghrelin A hormone stimulating appetite, increasing food intake, and promoting fat storage. Leptin A hormone helping regulate energy balance by inhibiting hunger. Melatonin A hormone regulating sleep-wake cycles. Oxytocin A hormone acting as a neurotransmitter, influencing social behavior and emotion. Adrenaline A hormone released in response to physical or mental stress. Norepinephrine A hormone and neurotransmitter involved in arousal and fight-or-flight response. Plasticity The brain's ability to change and adapt due to experience. Split Brain Research Studies on patients with severed corpus callosum to understand brain hemisphere functions. Contralateral Hemispheric Organization Arrangement where the brain's right hemisphere controls the left side of the body and vice versa. Hemispheric Specialization Control of distinct functions by the brain's right and left hemispheres. Linguistic Processing Brain functions involved in understanding and producing language. Broca's Area Frontal lobe area directing muscle movements involved in speech. Broca's Aphasia Condition from damage to Broca's area causing impaired speaking and writing. Opioids A class of drugs including heroin and prescription pain relievers. Heroin An opioid drug made from morphine, derived from opium poppy plants. Tolerance Diminishing drug effect with regular use, necessitating larger doses. Addiction Compulsive craving for drugs or behaviors despite adverse consequences. Withdrawal Symptoms post cessation of drug intake in addicted individuals. Sensation Reception and representation of stimulus energies by sensory receptors. Transduction Conversion of stimulus energies into neural impulses in sensation. Perception Organization and interpretation of sensory information for object recognition. Absolute Threshold Minimum stimulus energy to detect a stimulus 50% of the time. Just-noticeable Difference Smallest difference in stimulus intensity detectable by a sense. Sensory Adaptation Decrease in sensitivity to constant stimulation levels. Weber's Law Principle that stimuli must differ by a constant proportion for detection. Synesthesia Condition where one sense is perceived as if by additional senses. Retina Light-sensitive eye surface with rods, cones, and neural processing layers. Blind Spot Point where optic nerve exits the eye, lacking receptor cells. Visual Nerve Nerve transmitting neural impulses from the eye to the brain. Lens Transparent eye structure behind the pupil, aiding image focus. Accommodation Process of lens shape change for focusing on near or far objects. Nearsightedness Clear vision for close objects but blurry for distant ones. Farsightedness Clear vision for distant objects but blurry for close ones. Photoreceptors Rods and cones in the retina converting light into neural signals. Rods Photoreceptors detecting black, white, and gray for peripheral vision. Cones Photoreceptors concentrated for daylight vision, color, and detail. Trichromatic Theory Theory of three color receptors in the retina for color perception. Opponent-process Theory Theory of opposing processes in color vision enabling perception. Psychology the scientific study of mental processes and behavior. Mental Processes Thoughts, feelings, and motives that each of us experiences privately but that cannot be directly observed. Behavior Any action that people can observe or measure Confirmation Bias The tendency to favor information that confirms your existing beliefs. Hindsight Bias The feeling after something happens that you knew it was going to happen. Overconfidence Being more confident than correct; overestimating the accuracy of your beliefs. Empirical Evidence Information from experiments or observations rather than theories. Scientific Method A step-by-step method for conducting research. Hypothesis A prediction that you can test through study and experimentation. Falsifiable Something that can be proven wrong through tests. Peer Review The process of having other experts examine your work to check its validity. Replication Repeating a study to see if the same results are obtained. Reliability The consistency of a research study or measuring test. Validity The accuracy of a test or research to measure what it claims to measure. The American Psychological Association (APA) A major organization for psychologists in the United States. Research Design The plan for a research study, determining how to collect and analyze data. Methodology The specific procedures or techniques used to identify, select, process, and analyze information about a topic. Quantitative Data Data that can be counted or measured and given a numerical value. Qualitative Data Data that describes qualities or characteristics. Likert Scales A scale used to represent people's attitudes or feelings; respondents specify their level of agreement to a statement. Structured Interviews Interviews where everyone is asked the same questions in the same way. Survey Technique A method of gathering information by asking questions to people. Wording Effect How the way a question is phrased can influence the answers given. Social Desirability Bias: The tendency of respondents to answer questions in a manner that will be viewed favorably by others. Naturalistic Observation Watching behaviors occur naturally without interfering. Case Study A detailed examination of a single subject or group. Correlational Research A study that investigates the relationship between two variables to determine if they vary together. Third Variable Problem A situation where an unseen variable affects the results of a study. Scatterplot A graph in which the values of two variables are plotted along two axes, the pattern of the resulting points revealing any correlation present. Correlation Coefficient A number between -1 and 1 that describes the strength and direction of a relationship between variables. Positive Correlation A relationship where if one variable increases, the other does too. Negative Correlation A relationship where if one variable increases, the other decreases. Experimental Method: A method where the researcher manipulates one variable to see if it affects another. Independent Variable The variable that is changed or controlled in a scientific experiment. Dependent Variable The variable that is tested and measured in a scientific experiment. Confounding Variable An extra variable that wasn't accounted for that could affect the results of an experiment. Operational Definitions Clearly defining how you will measure your variables in research. Experimental Group The group in an experiment that receives the variable being tested. Control Group The group in an experiment that does not receive the test variable. Random Assignment Assigning participants to experimental and control groups by chance, which helps ensure that any differences observed after the treatment are due to the treatment and not a preexisting difference. Placebo Effect A change in a participant's illness or behavior that results from a belief that the treatment will have an effect, rather than the actual treatment. Experimenter Bias When a researcher's expectations influence the outcome of a study. Single-Blind Study When the participants do not know whether they are receiving the treatment or not. Double-Blind Study When neither the participants nor the researchers know who is receiving a particular treatment. Placebo Condition A condition in which participants receive a placebo instead of the actual treatment. Sample A group of subjects selected from a larger population for study. Representative Sample: A randomly chosen sample of subjects from a larger population that accurately reflects the characteristics of the larger population. Random Sample A sample that fairly represents a population because each member has an equal chance of being included. Sample Bias A sample that does not accurately represent the population from which it was drawn. Generalizability The extent to which research findings can be applied to larger populations. Statistics The science of collecting, analyzing, presenting, and interpreting data. Descriptive Statistics Statistics that summarize data, such as mean or standard deviation Inferential Statistics: Statistics used to infer the properties of a population, based on a sample of data. Measure of Central Tendency: A statistical measure that describes the center of a data set; includes mean, median, and mode. Mean The average of a set of numbers. Median The middle number in a set of numbers arranged in order. Mode The number that appears most frequently in a data set. Range The difference between the highest and lowest values in a data set. Normal Curve A bell-shaped curve that shows data distribution; most scores fall near the middle. Regression to the Mean The phenomenon that extreme values in data tend to be closer to the average on subsequent measurements. Positive Skew When more scores fall on the low side of the scale and tail on the high side. Negative Skew When more scores fall on the high side of the scale and tail on the low side. Standard Deviation A measure of how spread out numbers are around the mean. Percentile Rank The percentage of scores in a distribution that a specific score is greater than. Bimodal Distribution A distribution of data with two modes or peaks. Statistical Significance The likelihood that a result from data collected by an experiment is not due to chance. Effect Sizes A measure of the strength of the relationship between two variables. Meta Analysis A method of combining data from many different research studies. Institutional Review Boards (IRB) Groups of people responsible for reviewing proposed research to ensure that it is ethical. Informed Consent Permission granted in the knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits. Informed Assent Agreement by a minor or other not able to give legal consent to participate in the activity. Confidentiality Keeping information given by participants in a research study private. Deception Misleading participants about the true purpose of a study or the events that will transpire. Confederates Actors who take part in a study pretending to be real participants. Debriefing Explaining to participants at the end of a study the true purpose of the study and exactly what transpired.
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Primary adrenal insufficiency = problem at level of adrenal glands Causes? Addison’s disease Pathophys? Autoimmune destruction of the adrenal glands Associated with hyperpigmentation POMC is precursor to both ACTH and MSH PAI → lack of negative feedback → high ACTH Lab findings? ACTH high Aldosterone low Destruction of zona glomerulosa Renin high Hypotension → RAAS activation Electrolytes Na+ low, K+ high CBC Eosinophils high Pathophys? Glucocorticoids → eosinophil apoptosis. Lack of glucocorticoids cause eosinophilia. Dx? Cosyntropin testing → no rise in cortisol Adrenal glands aren’t working, so no response to ACTH. Tx? prednisone/hydrocortisone/dexamethasone + fludrocortisone (mineralocorticoid) Stress-dose steroids for surgery, serious illness, etc. Secondary adrenal insufficiency = problem at level of pituitary, reduced ACTH release Causes? MC is prolonged steroid use → ACTH suppression Sheehan’s syndrome (infarction of pituitary) pregnancy Pituitary tumors (ACTH-producing tumor) Lab findings? ACTH low Anterior pituitary is being inhibited Aldosterone normal Zona glomerulosa under control of RAAS system Renin normal Electrolytes Na+ & K+ unaffected (Aldosterone levels are normal) CBC Neutrophilia due to demargination (if pt was recently taking steroids) Dx? Cosyntropin testing → rise in cortisol Adrenal gland is functional Tx? Glucocorticoids Do not need to replace mineralocorticoids since adrenals are functional and aldosterone is under RAAS control Stress-dose steroids for surgery, serious illness, etc. AI with a history of nuchal rigidity and purpuric skin lesions → Waterhouse-Friedrichson syndrome Pathophys? AI 2/2 hemorrhagic infarction of the adrenal glands in the context of Neisseria meningitidis infection Adrenal synthesis enzymes If the enzyme starts with 1 → HTN (high mineralocorticoids) and hypokalemia If the second # is 1 → virilization (high androgens) E.g. 11-beta hydroxylase deficiency → HTN & virilization E.g. 21 hydroxylase deficiency → virilization only E.g. 17-alpha hydroxylase deficiency → HTN only B12 deficiency Where does B12 come from? Animal products VS folic from plants Physiology R factor in saliva binds to B12 and protects it from acidity in the stomach. R factor protector -B12 travels to the duodenum. Parietal cells produce intrinsic factor, which travels to the duodenum. Pancreatic enzymes cleave B12 from R factor and B12 then binds IF. B12-IF complex is reabsorbed in the terminal ileum Reabsorption where? Terminal ileum Causes of B12 deficiency Extreme vegan Pernicious anemia Pancreatic enzyme deficiency Cystic Fibrosis Can’t cleave B12 from R factor Crohn’s Affects terminal ileum Lab markers Homocysteine HIGH MethlyManoicAcid HIGH Presentation? Megaloblastic anemia Subacute combined degeneration (of dorsal columns + lateral corticospinal tract) Peripheral neuropathy Dx of pernicious anemia? anti-IF Ab Folate deficiency Where does folate come from? Leafy things Causes of folate deficiency Poor diet (e.g. alcoholics, elderly) Phenytoin Lab markers Homocysteine HIGH MMA normal Presentation? Megaloblastic anemia Prophylaxis in HIV+ patients CD4 < 200 → PCP TMP-SMX, inhaled pentamidine, dapsone, atovaquone CD4 < 100 → Toxoplasm Treat: TMP-SMX CD4 < 50 → MAC Treat: Azithromycin If live in endemic area, CD4 < 250 → Coccidioides Immitis E.g. Arizona, Nevada, Texas, California Treat: Itraconazole If live in endemic area, CD4 < 150 → Histoplasma Capsulatum E.g. Kentucky, Ohio, Missouri Treat: Itraconazole Diabetes insipidus Dx? Water deprivation test Measure serum osmolality & urine osmolality Deprive pt of water Remeasure serum osmolality & urine osmolality If urine osmolality doesn’t go up → suspect DI Central DI → deficiency of ADH Pathophys? Supraoptic nucleus not making enough ADH Dx? Give desmopressin → urine osmolality increases significantly Nephrogenic DI → kidneys are not responding to ADH Dx? Give desmopressin → urine osmolality doesn’t change much Tx? Hydrochlorothiazide Unless 2/2 lithium, use amiloride or triametere Causes? Lithium SSRIs Carbamazepine Demeclocycline Tx of normovolemic hypernatremia? D5W to correct free water deficit Divine says NS, but most other resources I found said correct free water deficit Tx of hypovolemic hypernatremia? Give NS first until normal volume, then give D5W Consequence of correcting hypernatremia too rapidly? Cerebral edema Osteoarthritis Presentation? Old person with joint pain that gets worse throughout the day Risk Factr? Obesity vs decreases osteoporosis Imaging findings? Joint space narrowing Subchondral sclerosis Subchondral cysts Osteophytes Arthrocentesis findings? <2000 cells Tx? 1st line acetaminophen 2nd line NSAID (e.g. naproxen) 3rd line joint replacement surgery Returned from a business conference 1 week ago + Fever + Nonproductive cough + Abdominal pain + Hyponatremia → Legionella Dx? Urine antigen Tx? FQ or macrolide MaCroLide mnemonic = Mycoplasma, Chlamydia, Legionella What are the common causes of atypical PNA? Mycoplasma, Legionella, Chlamydia MC cause? Mycoplasma CXR findings? Interstitial infiltrates HY associations C. Psittaci → birds C. Burnetii → cows, goats, sheet Mycoplasma → college student w/ walking pneumonia Midsystolic click heard best at the apex. → mitral valve prolapse “Stenosnap & Proclick” Risk Factor? Connective tissue disease Marfarn Ehlers-Danlos ADPKD bilateral renal masses Classic demographic? Young woman psychiatric Pathophys? Myxomatous degeneration MVP vs aortic dissection: cystic medial necrosis Exam maneuvers Anything that increase amount of blood in LV → murmur softer Increase preload Increase afterload Anything that decreases amount of blood in LV → murmur louder Dx? Echo Scaly, itchy skin with yellowish crusting in the winter. → seborrheic dermatitis Tx? Topical antifungals e.g. ketoconazole or selenium sulfide shampoo Classic disease distribution? Hair → e.g. cradle cap Eyebrows Episodic/intermittent HTN + HA → pheochromocytoma Genetic disease associations MEN2A MEN2B VHL in brain (hemangioma) NF-1 growth in skin Pathophys? Catecholamine-secreting tumor Location? Adrenal medulla Posterior mediastinum Organ of Zuckerkandl (chromaffin cells along the aorta) Dx? 1st step: urine metanephrines If elevated → CT abdomen If nothing found on CT → MIBG scan Tx? Alpha blocker (e.g. phenoxybenzamine, phenotaline) THEN beta blocker Most common cause of a Lower GI Bleed in the elderly → diverticulosis Dx? Colonoscopy or barium enema Recall that you acutely do a CT scan for diverticulitis, then 6 weeks later colonoscopy to r/o cancer Ppx? Eat fiber Megaloblastic anemias Blood smear findings? Hypersegmented neutrophils MCV > 100 Classic patient demographic with folate deficiency? Alcoholics Elderly person with poor nutrition Folate synthesis inhibitors Pt with molar pregnancy → methotrexate Pulmonary issue? Pulmonary fibrosis HIV+ pt with ring-enhancing lesions → pyrimethamine-sulfadiazine Pyrimethamine inhibits DHFR AIDS pt on ppx for toxo → TMP-SMX TMP inhibits DHFR Use of leucovorin? Rescue bone marrow in setting of methotrexate toxicity Mechanism? Folinic acid analog CMV presentations Esophagitis → linear ulcers Colitis → post-transplant pt Retinitis → HIV pt with CD4 < 50 Congenital CMV → periventricular calcifications + hearing loss calcifications elsewhere → toxo Histology? Owl’s eye intranuclear inclusions Tx? Gancicyclovir Resistance? UL97 kinase mutation Tx for resistance? foscarnet CD4 < 200 + severe peripheral edema + frothy urine. → FSGS in HIV pt Variant classic in HIV+ pts? Collapsing variant Tx? Steroids + cyclophosphamide + ACE-I Indinavir AE? Kidney stones triad of fever, rash, and eosinophiluria → acute interstitial nephritis Drugs cause? Penicillins Tx? Stop the drug! Can add steroids if severe Vitamin D metabolism Liver converts Vit D to calcidiol (25OH-Vit D). Calcidiol goes to kidney. Alpha-1 hydroxylase converts calcidiol to calcitriol (1,25-OH Vit D). Common causes of Vitamin D deficiency CKD → 1-alpha hydroxyalse deficiency Liver disease → can’t make calcidiol CF → malabsorption Crohn’s → malabsorption Osteomalacia vs Rickets Osteomalacia in adults Rickets in kids Tx? Calcium + vit D Lab findings? Ca++ low Phos low Low in liver disease High in kidney disease (kidneys can’t get rid of phos) PTH high (2ary hyperpara) vs liver dx PTH low Alk phos Aspiration pneumonia Risk Factor? Alcoholism Dementia Neuromuscular problems (e.g. MG, ALS) Bugs? Anaerobes foul smelling Bacteroides FUsobacterium Peptostreptococcus Klebsiella → currant jelly sputum alcoholic Tx? Clindamycin CURB-65 criteria Purpose? Who to admit Cutoff? 2+ → hospitalize C = confusion U = uremia (BUN > 20) R = RR > 30 B = BP < 90/60 Age > 65 Drugs commonly used in PNA treatment Ceftriaxone Levofloxacin fluoroquinolone Macrolides - great for atypical PNA Pharmacological management of pulmonary arterial HTN Endothelin antagonists Bosentan ambrisentan PDE-5 inhibitors Sildenafil Tadalafil Prostacyclin analogs Iloprost Epoprostenol Treprostinil Causes? Young female → idiopathic PAH Mutation? BMPR2 55 yo F presents with a 5 week history of a rash on her forehead. PE reveals scaly macules with a sandpaper texture. → actinic keratosis Risk Factor? Sun exposure Tx? Topical 5-FU Possible dangerous sequelae? Squamous cell carcinoma Most likely disease sequelae? Resolution 1ary hyperparathyroidism 2ary hyperparathyroidism 3ary hyperparathyroidism Autonomous PTH production Causes? Adenoma Parathyroid hyperplasia PTH high Ca++ high Phos low Low Ca++ → PTH production Causes? CKD PTH high Ca++ low Phos high PTH production despite normalized of Ca++ levels Causes? CKD s/p transplant PTH high Ca++ high Phos low Tx? Parathyroidectomy (remove 3.5 glands) Cinacalcet (CSR modulator) Hypercalcemia Presentation? bones, stones, groans, psychic overtones Tx? 1st step: Normal Saline Hypercalcemia of malignancy → bisphosphonates EKG finding? Shortened QT Periumbilical pain that migrates to the right lower quadrant. → appendicitis PE findings? McBurney’s point tenderness Psoas sign (flex hip pain) Obturator sign (pain with internal rotation of hip) Rovsing’s sign (palpation of LLQ → pain in RLQ) Dx? CT scan Pregnant → US Kid → US Tx? Surgery Classic drug and viral causes of aplastic anemia. Drugs? Carbamazepine Chloramphenicol Viral? Parvovirus B19 (single stranded DNA virus) Fanconi anemia Pathophys? Problems with DNA repair Fanconi anemia vs Fanconi syndrome Fanconi anemia → cytopenias + thumb anomalies + short stature + cafe-au-lait spots Fanconi syndrome → type 2 RTA (proximal) CD4 count of 94 + MRI revealing ring enhancing lesions in the cortex → toxoplasmosis Tx? Pyrimethamine-sulfadiazine Rescue agent for pt who becomes leukopenic with treatment? leucovorin Who should get steroids? Increased ICP For PCP pneumonia: O2 sat < 92 PaO2 < 70 A-a gradient > 35 Ppx? TMP-SMX for CD4 < 100 Congenital toxo Hydrocephalus Chorioretinitis Intracranial calcifications Classic methods of transmission? handling cat litter Lupus nephritis Associated autoantibody? anti-dsDNA Classic “immunologic” description? “Full house” pattern Tx? Steroids + cyclophosphamide Osteoporosis Screening population? women > 65 Screening modality? DEXA scan Dx? T-score < -2.5 Risk Factor? Postmenopauseal Low BMI Smoking Alcohol Preventive strategies? Weight bearing exercise Smoking cessation Reduce alcohol consumption Tx? 1st line: bisphosphonates + Ca/Vit D supplementation Raloxifene (SERM) Agonist in bone Blocker Antagonist in breast Classic locations of osteoporotic fractures Vertebral compression fracture Hip fracture Name the PNA Red currant jelly sputum. → Klebsiella Rust colored sputum. → Strep pneumo PNA in an alcoholic. → Klebsiella Post viral PNA with a cavitary CXR lesion. → Staph aureus PNA in a patient that has chronically been on a ventilator. → Pseudomonas MC cause of Community Acquired Pneumonia. → Strep pneumo Pharmacological management of MRSA. Vancomycin Clindamycin Linezolid Ceftaroline (5th gen cephalosporin) Tigecycline, tertracycline Pharmacological management of Pseudomonas. Ceftazidime (only 3rd gen cephalosporin) Cefepime (4th gen cephalosporin) Pip-tazo Fluoroquinolones Carbapenems Aztreonam Aminoglycosides JVD and exercise intolerance in a patient with a recent history of an URI. → dilated cardiomyopathy 2/2 viral myocarditis MC cause? Coxsackie B VS Coxsackie A: Hand foot mouth dx Drug causes myocarditis Clozapine Anthracyclines Prevention? Dexrazoxane (iron chelator) Trastuzumab reversible tx for breast cancer Classic cause in a patient with recent history of travel to S. America? Chagas T. Cruzi Potential sequelae? Achalasia Dilated cardiomyopathy Megacolon (2/2 degeneration of myenteric plexus) Massive skin sloughing (45% BSA) in a patient that was recently started on a gout medication? TEN Dx? <10% BSA → SJS >30% BSA → TEN Tx? STOP the drug IVF Topical abx to prevention infection Tetany and a prolonged QT interval in a patient with recent surgical treatment of follicular thyroid carcinoma. → hypocalcemia due to removal of parathyroids Recurrent viral infections + QT prolongation + tetany → DiGeorge syndrome Pathophys? Failure of development of 3rd/4th pharyngeal pouches Trousseau and Chvostek signs. Trousseau → inflation of BP cuff causes carpopedal spasm Chvostek → taping on cheek causes facial muscle spasm Hypocalcemia that is refractory to repletion → consider hypomagnesemia Electrolyte/drug causes of prolonged QT intervals Electrolytes? Hypocalcemia Hypomagnesemia Hypokalemia Drugs? Macrolides FloroQunlones Haloperidol Ondensatron Methadone Hypoalbuminemia and Ca balance Hypoalbumenia → decrease in total body Ca++, no change in ionized Ca++ Drop of 1 in albumin → add 0.8 to Ca++ Abdominal pain radiating to the back → acute pancreatitis Causes? #1 = Gallstones #2 = Alcohol Hypertriglyceridemia Hypercalcemia Scorpion sting Handlebar injuries Lab markers? Lipase - most sensitive Amylase Physical exam signs in pancreatitis. Cullen’s sign = periumbilical ecchymosis Grey Turner sign = flank ecchymosis Tx? NPO + IVF + pain control Meperidine is a good agent because it doesn’t cause sphincter of Oddi spasms Management of gallstone pancreatitis Dx? US then ERCP Tx? DELAYED cholecystectomy What if the patient becomes severely hypoxic with a CXR revealing a “white out” lung? ARDS noncardiogenic pulm edema PCWP? <18 mmHg NORMAL 20 yo M with red urine in the morning + hepatic vein thrombosis + CBC findings of hemolytic anemia. → paroxysmal nocturnal hemoglobinuria Pathophys? Defect in GPI anchors, which attach CD55 and CD59 to cell (they prevent complement from destroying RBC) Sleep → hypoventilation → mild respiratory acidosis → activation of complement cascade Gene mutation? PIGA Dx? Flow cytometry Tx? Eculizumab (terminal complement inhibitor) Vaccine required? pnemococal Neisseria meningitidis Chronic diarrhea and malabsorption in a HIV+ patient + detection of acid fast oocysts in stool. → cryptosporidium parvum Acid-fast organisms Cryptosporidium TB MAC Nocardia Dx? Stool O&P Tx? Nitazoxanide Route of transmission? Contaminated water Muddy brown casts on urinalysis in a patient with recent CT contrast administration (or Gentamicin administration for a life threatening gram -ve infection) → Acute Tubular Necrosis Woman with morning joint stiffness > 1 hr → Rhematoid Arthritis. Antibodies? Rheum Factor (IgM against IgG) anti-CCP - more specific HLA? DR4 Pathophys? IgM constant region activates complement → inflammation → formation of pannus (hypertrophied synovium) → damage to cartilage and bone Caplan syndrome = RA + pneumoconiosis Felty syndrome = RA + neutropenia + splenomegaly (“RANS”) Classic hand/finger findings/distribution? MCP & PIP joints of hands (DIP joints spared) Imaging findings? Symmetric joint space narrowing Tx? Methotrexate (DMARDs) If no response → TNF alpha inhibitor (e.g. infliximab) Required testing prior to starting methotrexate? PFTs Required testing prior to starting infliximab? TB Hep B/Hep C Differentiating Strep pharyngitis from Infectious Mononucleosis LND distribution Anterior cervical → Strep Posterior cervical → Mono Disease onset Acute → Strep Over weeks → Mono Organ involvement Splenomegaly → Mono Pt with sore throat takes amoxicillin and gets rash → mono NOT allergic rxn! CENTOR criteria C = absence of Cough E = tonsillar Exudates N = nodes/anterior cervical lymphadenopathy T = temp (fever) OR <15 → +1 >=45 → -1 Using CENTOR score 0/1 → don’t test, don’t treat 2/3 → rapid antigen test Positive → treat Negative → throat culture 4/5 → treat empirically Tx of Strep pharyngitis? Amoxillcin If PCN allergic → azithromycin Potential sequelae of Strep pharyngitis RF - preventable with abx PSGN Endocarditis MC cause of endocarditis? IVDU Bug? Staph aureus Valve? tricuspid Prosthetic valve endocarditis Bug? Staph epidermidis Endocarditis after dental procedure? Viridans group streptococci Strep viridans, Strep mitis, Strep mutans, Strep sanguineous Patient with malar rash and echo showing vegetations on both sides of the mitral valve → Libman-Sacks endocarditis Presentation? Fever + night sweats + new murmur Splinter hemorrhages Roth spots (retinal hemorrhages) Painless Janeway lesions + painful Osler nodes (immune phenomenon) Dx? 1st step: blood cultures TEE Tx? Abx that include Staph aureus coverage (e.g. vancomycin) for WEEKS Bugs implicated in culture negative endocarditis HACEK H = haemophilus A = actinobacillus C = cardiobacterium E = eikenella K = kingella Coxiella burnetii Blood cultures in a patient with endocarditis reveal S. Bovis (or S. Gallolyticus bacteremia). NBS? Colonoscopy Who needs antibiotic prophylaxis? Hx endocarditis Prosthetic valve Unrepaired cyanotic congenital dz Heart transplant with valve dysfunction Erythematous salmon colored patch with silvery scale on the elbows and knees. → psoriasis Tx? Topical steroids If this patient presents with joint pain (especially in the fingers)? Psoriatic arthritis Imaging? Pencil-and-cup deformity Tx? NSAIDs T of 104 + tachycardia + new onset Afib in a patient with a history of Graves disease. → thyroid storm Lab findings? TSH low T3/T4 high Tx? 1st step: propranolol 2nd step: PTU Then: Prednisone Potassium iodide (Lugul’s solution) Wolff-Chaikoff effect → large amounts of iodine inhibit thyroid hormone synthesis Biopsy revealing tennis racket shaped structures in cells of immune origin. → Langerhans cell histiocytosis Electron microscopy? Birbeck granules (tennis rackets) Marker? S100 Small bowel obstruction in a HIV patient with purple macules on the face, arms, and lower extremities. → Kaposi’s sarcoma Bug? HHV8 Tx? HAART Pathophys of vascular lesions? Overexpression of VEGF Fever + rash + eosinophiluria 10 days after a patient started an antistaphylococcal penicillin. → acute interstitial nephritis Tx? STOP drug + steroids SLE SOAP BRAIN MD S = serositis O = oral ulcers A = arthritis P = photosensitivity B = blood disorders (cytopenias) R = renal A = ANA/anti-dsDNA I = immunologic N = neurologic findings M = malar rash D = discoid rash Type 2 vs 3 HSRs in lupus Type 2 → cytopenias Type 3 → all other manifestations Lupus Ab? ANA anti-dsDNA anti-Smith Lupus nephritis → full house pattern on IF Antiphospholipid antibody syndrome → recurrent pregnancy losses Pathophys? Thrombosis of the uteroplacental arteries. MC cause of death in lupus patients? What I’ve read recently: CV disease Per Divine: Treated → infection Untreated → renal dz Also 40x risk MI Endocarditis in lupus pt? Libman-Sacks endocarditis Neonatal 3rd degree heart block → neonatal lupus Maternal autoimmune dz? Sjogren’s SLE Ab? anti-SSA/anti-Ro anti-SSB/anti-La Tx? Steroids Cyclophosphamide Hydroxychloroquine → good for skin lesions Pulmonary abscesses Bugs? Staph Anaerobes Klebsiella RF? Alcoholism Elderly Post-viral pneumonia MC location of aspiration pneumonia? Superior segment of RLL Chest pain worsened by deep inspiration and relieved by sitting up in a patient with a recent MI or elevated creatinine or URI or RA/SLE. → pericarditis EKG findings? Diffuse ST elevations + PR depression PE finding? Friction rub (“scratchy sound on auscultation”) A few days after MI → fibrinous pericarditis Weeks after MI → Dressler’s Tx? NSAIDS Consider adding on colchicine Cardiac tamponade Beck’s triad = hypotension + JVD + muffled heart sounds EKG findings? Electrical alternans Type of shock? Obstructive cardiogenic (Amboss) CO low SVR high PCWP high Tx? Pericardiocentesis or pericardial Pearly lesion with telangiectasias on the ear in a farmer. → Basal Cell Carcinoma MC type skin cancer Location? Upper lip Dx? Biopsy Tx? Mohs surgery Cold intolerance in a 35 yo white F → hypothyroidism MC cause? Hashimoto’s Histology? lymphoid follicles w/ active germinal centers Lab findings? TSH high T3/T4 low Ab? anti-TPO Anti-thyroglobulin HLA? DR3/DR5 Tx? Levothyroxine Future complication? thyroid lymphoma Massive hematemesis in a patient with a history of chronic liver disease. → ruptured varices Pathophys? L gastric vein has anastomosis with azygos veins. Increased portal pressure → backward flow from L gastric veins to azygous vein (which empties into SVC). Acute tx? IVF + octreotide + ceftriaxone/cipro + EGD w/ ligation/banding Do NOT give a beta blocker for acute tx Prophalaxsis? Beta blocker + spironolactone Other manifestations of elevated portal pressures Caput medusa Internal hemorrhoids Tx for cirrhotic coagulopathies? FFP If uremia → give desmopressin Note: Desmopressin = ADH analog → so, it can cause AE of hyponatremia 2/2 SIADH Hemophilia A Pathophys? deficiency of factor 8 Inheritance? XLR Coag labs? Bleeding time normal PTT HIGH b/c clotting problem PT normal Hemophilia B Pathophys? deficiency of factor 9 Inheritance? XLR Coag labs? Bleeding time normal PTT HIGH PT normal Hemophilia C Pathophys? deficiency of factor 11 Inheritance? AR Coag labs? Bleeding time normal PTT HIGH PT normal Bernard Soulier Syndrome Pathophys? Deficiency of GpIb Coag labs? Bleeding time HIGH PTT normal PT normal Glanzmann Thrombasthenia Pathophys? Deficiency of GpIIbIIIa Coag labs? Bleeding time HIGH PTT normal PT normal Von Willebrand’s disease Pathophys? Deficiency of vWF Inheritance? AD Coag labs? Bleeding time HIGH PTT HIGH vWF is a protecting group for factor 8 PT normal ITP Pathophys? Ab against GpIIbIIIa Classic pt? Pt with SLE Tx? Observation Steroids IVIG Splenectomy TTP Pathophys? Deficiency in ADAMTS13 enzyme → cannot cleave vWF multimers → activation of platelets → thrombosis → thrombocytopenia Presentation? microangiopathic hemolytic anemia + thrombocytopenia + renal failure + fever + neurologic problems Tx? Plasma exchange transfusion****** HUS Bugs? Shigella or E. coli O157:H7 Presentation? Fever+ microangiopathic hemolytic anemia + thrombocytopenia + renal failure + neurologic Platelet deficiency vs coagulation factor bleeds Platelet deficiency → mucosal bleeds, petechiae, heavy menses Coag factor deficiency bleeds → hemarthrosis Why do patients with CKD develop coagulopathy? Uremia → platelet dysfunction Tx? Desmopressin Note: Desmopressin = ADH analog → so, it can cause AE of hyponatremia 2/2 SIADH Exercising caution with transfusion in patients with Bernard Soulier syndrome Do NOT give transfusion that includes platelets They can have an anaphylactic rxn to GpIb (since they don’t have GpIb) Oropharyngeal candidiasis. RF? HIV Chronic ICS use TNF inhibitor Micro finding? Germ tubes at 37 C Tx oral candidiasis? Nystatin swish-and-swallow Tx invasive candidiasis? Amphotericin B Prevention of Amphotericin B toxicity? Liposomal formulation Pleural effusions Light’s criteria (must meet all 3 to be considered transudative!) LDH < 2/3 ULN LOW Pleural LDH/serum LDH < 0.6 LOW Pleural protein/serum protein < 0.5 LOW Causes of transudative effusion CHF Cirrhosis Nephrotic syndrome Note: Per UW 2021: Mechanism of transudate effusion? Decreased pulmonary artery oncotic pressure, e.g. hypoalbuminemia in nephrotic syndrome Increased pulmonary capillary hydrostatic pressure, e.g. volume overload in heart failure Causes of exudative effusion Malignancy Cancer Parapneumonic effusion Tb Note: Per UW 2021: Mechanism of exudate effusion? Inflammatory increased in vascular permeability of membrane (increased flow of interstitial edema into pleural space) Unique cause of both transudative & exudative effusions? PE Classic Pleural Effusion findings? Decreased breath sounds Dullness to percussion Decreased tactile fremitus Tx? Chest tube Chylothorax = lymph in the pleural space Pathophys? Obstruction of thoracic duct or injury to the thoracic duct Pleural fluid findings? High Triglycerides Holosystolic murmur heard best at the apex with radiation to the axilla in a patient with a recent MI. → mitral regurg 2/2 papillary muscle rupture Dx? Echo Why widely split S2? Aortic valve is closing earlier (LV is emptying into both aorta & LA) Maneuvers that increase intensity Increase preload (putting more blood in that can be regurgitated) Increase afterload Decubitus ulcers RF? Elderly Paraplegic Fecal/urinary incontinence Poor nutrition Staging Stage 1 = non-blanchable erythema Tx? Repositioning q2hrs Stage 2 = loss of epidermis + partial loss of dermis Tx? Occlusive dressing superficial Stage 3 = involves entire dermis, extending to subQ fat Does NOT extend past fascia Tx? Surgical debridement Stage 4 = muscle/tendon/bose exposed Tx? Surgical debridement General tx strategies? Repositioning + good nutritional support Marjolin’s ulcer = non-healing wound that is actually squamous cell carcinoma T1DM Pathophys? Autoimmune destruction of pancreas Ab? anti-GAD 65 (glutamic acid decarboxylase) anti-IA2 (islet tyrosine phosphatase 2) Islet cell autoantibodies Insulin autoantibodies Dx? A1c > 6.5% (twice) Fasting BG >= 126 (twice) Oral glucose tolerance test >= 200 (twice) Sxs of DM + random glucose > 200 Tx? Long-acting insulin + mealtime insulin Long-acting Glargine Detemir Rapid-acting Lispro Aspart Glulisine 3 HY complications Nephropathy Retinopathy & cataracts Neuropathy Chronic DM care A1c q3 months Foot exam annually Eye exam annually Microalbumin:Cr ratio annually Nephroprotection in DM? ACE-I GI bleed algorithm 1st step: ABCs + 2 large-bore IVs + IVFs 2nd step: NG lavage Clear fluid → go deeper Blood → UGIB → upper endoscopy Bilious fluid → have ruled out UGIB → proceed to colonoscopy See source → intervene as needed See nothing → CT angiography for large bleed Tagged RBC scan for smaller bleed Antiplatelet Pharmacology Aspirin Mechanism? Irreversibly inhibits COX-1 and COX-2 Clopidogrel/ticlopidine = P2Y12 (ADP receptor) blockers Mechanism? Inhibit platelet activation Abciximab/eptifibatide/tirofiban = GpIIbIIIa receptor blockers Mechanism? Inhibit platelet aggregation Ristocetin cofactor assay Issues with adhesion step → abnormal result Abnormal ristocetin cofactor assays: Von Willebrand disease Bernard Soulier disease Normal ristocetin cofactor assay: Glanzmann Thrombasthenia Von Willebrand disease effects on PTT? Increased Pathophys? vWF is a protecting group for Factor 8. Treatment of VWD? Desmopressin Mechanism? Increases release of vWF from Weibel-Palade bodies of endothelial cells Note: Desmopressin = ADH analog → so, it can cause AE of hyponatremia 2/2 SIADH HSV1 vs HSV2. Oral herpes → HSV1 Genital herpes → HSV2 Dx? PCR (most up-to-date) Tzanck smear (outdated, not very sensitive, nonspecific) → intranuclear inclusions Brain area affected by HSV encephalitis? Temporal lobes CSF findings in HSV encephalitis? RBCs******* Tx herpes encephalitis? Acyclovir AE? Crystal nephropathy Can’t see, can’t pee, can’t climb a tree. → reactive arthritis HLA? B27 Classic bug? Chlamydia Tx? steroids Need abx? Only if ongoing infection Can’t see, can’t pee, can’t hear a bee → Alport syndrome Inheritance? X-linked dominant Tx of NG & CT NG → treat empirically for both → ceftriaxone + azithro/doxy CT → azithro/doxy Hypovolemic Septic Neurogenic Cardiogenic CO low PCWP low SVR high*** CO high PCWP normal SVR low Tx? norepi CO low SVR low CO low PCWP high*** SVR high*** Tx anaphylactic shock? epinephrine Melanomas ABCDE A = asymmetry B = irregular borders C = color variation D = diameter > 6 mm E = evolving Dx? Full-thickness biopsy Excisional for small lesions Punch for larger lesions Most important prognostic factor → Breslow depth DM pharmacology Lactic acidosis → metformin Decreases hepatic gluconeogenesis → metformin Hold before CT w/ contrast → metformin Weight gain → sulfonylureas & TZDs (-glitizones) Diarrhea → acarbose & migliton Inhibits disaccharidases (can’t reabsorb disaccharides) Recurrent UTIs → SGLT-2 inhibitors Weight loss → GLP-1 agonists (e.g. liraglutide, exenatide) & DPP4 inhibitors (-gliptins) Contraindicated in pt with HF → TZDs PPAR-gamma receptor found in kidney → water retention Contraindication in pt with MTC → GLP-1 agonists Biggest risk of hypoglycemia? Sulfonylureas RF esophageal adenocarcinoma Barrett’s esophagus RF esophageal squamous cell carcinoma Smoking Drinking Achalasia Location esophageal adenocarcinoma? Lower 1/3 Location esophageal squamous cell carcinoma? Upper 2/3 MC US? Adenocarcinoma MC worldwide? Squamous cell carcinoma Presentation? Dysphagia to solids → dysphagia to liquids Dx? EGD Staging? CT scan or esophageal US Factor V Leiden Pathophys? Resistance to protein C Dx? Activated Protein C resistance assay Patient needs super large doses of heparin to record any changes in PTT → AT-III deficiency Recall that heparin is a AT-III activator 35 yo with a hypercoagulable disorder that does not correct with mixing studies. → antiphospholipid antibody disorder Anaphylaxis in a patient with a long history of Hemophilia A → Ab against factor 8 that cause type 1 HSR with transfusion Hx of hemophilia, diagnosed 5 years ago. Before you would give them factor 8 concentrate and PTT would normalize. Now they’re requirizing larger doses of factor 8 to normalize PTT. → inhibitor formation (antibodies against clotting factors) Skin necrosis with Warfarin → protein C/S deficiency Prothrombin G20210 mutation → overproduction of factor II Rash in dermatomal distribution → VZV infection Contraindications to VZV vaccination? Pregnant woman Kid < 1 year Severe immunosuppression (e.g. HIV with CD4 < 200) Tx? Acyclovir If resistant, foscarnet Tzanck smear findings? Intranuclear inclusions Shingles vaccination guidelines? Adults over 60 #1 cause of ESRD in the US → DM nephropathy Histology? Kimmelsteil-Wilson nodules #2 cause of ESRD in the US → hypertensive nephropathy Pt with BP 240/150. How fast should you lower BP? 25% in first 24 hrs Drugs for hypertensive emergencies? Nicardipine Clevidipine Nitroprusside AE? Cyanide poisoning Tx? Amyl nitrate + thiosulfate OR hydroxocobalamin Labelol Renal protective medications in patients with DKD or hypertensive nephropathy? ACE-I Anemia + Cranial Nerve deficits + Thick bones + Carbonic Anhydrase 2 deficiency + Increased TRAP + Increased Alkaline Phosphatase. → osteopetrosis Pathophys? Carbonic anhydrase is defective → osteoclasts cannot produce acid to resorb bone Tx? IFN-gamma Osteoclasts are a specialized macrophage IFN-gamma is an activator of macrophages Clinical diagnostic criteria for Chronic Bronchitis Diagnostic criteria? 2 years 3 months/year of chronic cough PFT findings FEV1 low FEV1/FVC ratio low RV high TLC high Which PFT market can differentiate CB from emphysema? DLCO DLCO normal → CB DLCO low → emphysema ****** Tx acute exacerbation? Abx + bronchodilators + corticosteroids (“ABCs”) Prevention? Stop smoking! Afib #1 RF? Mitral stenosis #1 RF MS? Rheumatic fever #1 RF CAD and AAA: smoking #1 RF stroke and aortic dissection: HTN MC arrhythmia in hyperthyroidism → Afib MC site of ectopic foci in Afib → pulmonary veins EKG findings? “Irregularly irregular” + no P waves Location of emboli formation? LA appendage Who should be cardioverted back to sinus rhythm? New onset (<48 hrs) Afib Anticoagulated for 3 weeks + TEE negative for clot Afib that’s refractory to medical therapy Afib & HDUS Q on T phenomenon? Depolarization during T wave (repolarization) can cause QT prolongation → Torsades → death Prevention? SYNCHRONIZED cardioversion Tx? Rate control Beta blockers ND-CCB (e.g. verapamil, diltiazem) Rhythmic control Amiodarone Reducing stroke risk in Afib? Anticoagulation for CHA2DS2VASc score >= 2 Anticoagulation options Valvular cause (e.g. MS) → warfarin Any other cause → warfarin or NOAC (apixiban) Reversal of AC Warfarin → Vit K, four-factor PCC Heparin → protamine sulfate Dabigatran → idarucizumab Crusty, scaly, ulcerating lesion with heaped up borders → squamous cell carcinoma Classic location? Below Lower lip Precursor lesion? Actinic keratosis What if it arises in a scar or chronic wound? Marjolin ulcer Hypothermia + hypercapnia + non pitting edema + hyponatremia + HR of 35 + hypotension in a patient with a history of papillary thyroid cancer → myxedema coma Tx? Levothyroxine + steroids Lab findings? TSH high T3/T4 low LDL high Acute onset “dermatologic” breakout in a patient with a recent history of weight loss and epigastric pain. → Leser–Trélat sign associated with visceral malignancy pancreatic cancer Lymph node associations Supraclavicular → Virchow’s node Periumbilical → Sister Mary Joseph What are mets to the ovaries called? Kruckenberg tumor Classic bug associated with gastric cancer? H. pylori (MALToma) Classic histological finding in the diffuse type of gastric cancer? Signet ring cells RBCs without central pallor + elevated MCHC + anemia. → hereditary spherocytosis Inheritance? AD Pathophys? Deficiency of spectrin, ankyrin, or band 3.2 Intravascular or extravascular hemolysis? Extravascular (RBCs bound by IgG, attacked by splenic macrophages) Dx? Osmotic fragility test Eosin-5-maleimide Acidified glycerol lysis test Tx? Splenectomy Post-splenectomy preventative care? Strep pneumo Hinflue vaccine Neisseria Septic shock Hemodynamic parameters CO high SVR low PCWP normal MvO2 high Tx? IVF + norepi + broad-spectrum abx (cover MRSA + Pseudomonas) E.g. vanc + pip-tazo E.g
Updated 101d ago
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Depolarization
Updated 109d ago
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Central - brain and spinal cord Peripheral - everything else soma - body dendrites - the fingers that extend from the soma or cell body afferent - from the body to the central nervous system (sensory information) Sensory info - coming into the CNS (from the body) Afferent neuron Interneuron - in between CNS and PNS Motor info - coming out of the CNS (to the body) Efferent neuron Neurons: nerve cells Receive information in dendrites Information flows through the axon Eventually reaches an effector Synapse: gap between two neurons Synaptic terminals Glial cells Support the neurons Schwann cells & Oligodendrocytes Myelin sheath On the axon Function: prevents cross-talk and accelerates the speed of action potential Schwann cell - produces myelin sheath in PNS Oligodendrocytes - produces myelin sheath in CNS Like an octopus: many arms wrapping around different / same neurons unlike Schwann cell Node of Ranvier - space in between schwann cells Saltatory conduction Presence of node of Ranvier allows jumping of signals → much faster nerve impulse jumps from node to node Grey matter - cell body, dendrites, synapses White matter - myelinated axons (white color comes from lipid) Dorsal root ganglion Large collection of afferent neurons near the spinal cord Cell body Location is different in Sensory vs. peripheral neurons Sensory neurons - cell body in dorsal root ganglion Peripheral neurons - cell body in gray matter (make sure to know how to identify which microscope took what kind of pictures) SEM vs. TEM SEM - outer surface TEM - inner matter, more detail? Interneurons Help with more complicated types of signals such as reflex Non-decremental action potential: does not die out over space Energy at first same as energy at the end Nerve impulse Resting membrane potential: Inside of axon is -70 mV due to negatively charged proteins inside Inside: potassium outside: sodium Ions cannot diffuse in and out of membrane: requires proteins to allow exchange Depolarization (sodium influx) Threshold hit: open voltage gated sodium channel → facilitated diffusion of sodium ions (NA+) into the cells → inner charge becomes more positive Repolarization (potassium efflux) Voltage gated potassium channels open a little later → facilitated diffusion of potassium ions (K+) to out of the cells → inner charge becomes more negative hillock Refractory period Absolute: absolutely will not get an action potential during this period Relative: membrane potential lower than -70mV → can get an action potential depending on the size of the stimulus because it requires a bigger stimulus to reach the threshold Sodium-potassium pump Active transport (against concentration gradient) resets the sodium and potassium to allow the nerve impulse to happen again pumps 3 sodium out, pumps 2 potassium in Intensity is indicated by the frequency of action potentials Ex. very hot - thousands of action potentials Ex. nice and warm - some action potentials
Updated 424d ago
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fdjksl afdjs klejfsieofwjnervous system the body's speedy, electrochemical communication network, consisting of all the nerve cells of the peripheral and central nervous systems three critical features of the nervous system They receive input from the surrounding world. They process the info from the surroundings. They initiate responses to the internal and external environments, when necessary. neuron a nerve cell; the basic building block of the nervous system dendrites Branchlike parts of a neuron that are specialized to receive information. cell body Largest part of a typical neuron; contains the nucleus and much of the cytoplasm axon the extension of a neuron, ending in branching terminal fibers, through which messages pass to other neurons or to muscles or glands glial cell cells in the nervous system that support, nourish, and protect neurons nerves bundled axons that form neural "cables" connecting the central nervous system with muscles, glands, and sense organs how many neurons die everyday? 9,000 When neurons die can they be replaced? no what can kill neurons? alcohol intake, inhaling gas fumes neurons are what kind of cell eukaryotic what does the cell body contain nucleus, mitochondria, endoplasmic reticulum, and so on What does a dendrite do? receives information what does the axon do? carries impulses away from the cell body what does the cell body do? process information sciatic nerve nerve extending from the base of the spine down the thigh, lower leg, and foot How many more glial cells are there than neurons? 9x Do glial cells divide? yes glial cells act as a barrier for harmful things entering the brain blood brain barrier Blood vessels (capillaries) that selectively let certain substances enter the brain tissue and keep other substances out how is the blood brain barrier broken down hypertension, radiation, some infectious organisms sensory neurons neurons that carry incoming information from the sensory receptors to the brain and spinal cord. stimulations like temp, touch, taste, smell, light or sound motor neurons neurons that carry outgoing information from the brain and spinal cord to the muscles and glands Interneurons neurons within the brain and spinal cord that communicate internally and intervene between the sensory inputs and motor outputs. peripheral nervous system network of sensory cells modified to receive info from the environment and motor pathways that transmit signals to effectors, the muscles and glands capable of responding to that stimulus sensory pathway nerves coming from the sensory organs to the CNS consisting of afferent neurons motor pathways In the peripheral nervous system, common routes by which motor nerve impulses are transmitted. somatic nervous system the division of the peripheral nervous system that controls the body's skeletal muscles (voluntary) autonomic nervous system the part of the peripheral nervous system that controls the glands and the muscles of the internal organs (such as the heart). Its sympathetic division arouses; its parasympathetic division calms. (involuntary) sensory neurons alert the brain of a stimulus motor neurons help the brain to execute a response reflex signal that skips the brain, and goes to stimulate the motor neuron. direct sensory response autonomic nervous system helps us with homeostasis sympathetic nervous system the division of the autonomic nervous system that arouses the body, mobilizing its energy in stressful situations parasympathetic nervous system the division of the autonomic nervous system that calms the body, conserving its energy dendrites recieve signals from external stimuli two ways dendrites receive stimuli through motor neurons and interneurons connecting with other neurons or directly from external stimulus resting potential of neuron its stable, negative charge when the cell is inactive action potential of neuron a very brief shift in a neuron's electrical charge that travels along an axon resting potential is produced as proteins within the neurons plasma membrane pump sodium ions out of the cell and potassium ions into the cell what ion goes into the cell potassium what ion goes out of the cell sodium how does the pumping of ions affect the charge of the cell? more positive on the outside more negative on the inside greater positive charge out of the cell makes the cell polarized when stimulated dendrites briefly open ion channels made of proteins which allow charged ions down the concentration gradient concentration gradient A difference in the concentration of a substance across a distance. when ion channels open the negative charge inside the cell is temporarily changed either decreasing or increasing changes in the cells electrical charge converge from the dendrites to the cell body when charges converge that is called action potential terminal buttons Small knobs at the end of axons that secrete chemicals called neurotransmitters axon terminals (terminal buttons) doe what i response to action potential release contents of vesicles, small sacks of chemicals inside the axon terminal into the space between cells which can influence nearby cells myelin sheath A layer of fatty tissue segmentally encasing the fibers of many neurons; enables vastly greater transmission speed of neural impulses as the impulse hops from one node to the next. as the action potential moves down the axon ion channels allow positively charged ions to rush in changing the charge to positive. other ion channels allow positively charged ions to rush out what restores the action potential ion channels letting the influx of positively charged ions to rush put Where are ion channels concentrated in the gaps in the myelin sheath fatty myelin is what color white fatty myelin shows up as white when tightly packed together regions of the brain with many cell bodies and dendrites appear what color gray multiple sclerosis myelin sheath destruction. disruptions in nerve impulse conduction little myelin causes the neurons to lose its ability to conduct electrical impulses which makes it harder for the brain to send signals to muscles synapse the junction between the axon tip of the sending neuron and the dendrite or cell body of the receiving neuron at a synapse and neurons interacts with another cell What happens at a synapse? When a nerve impulse reaches the synapse at the end of a neuron, it cannot pass directly to the next one. Instead, it triggers the neuron to release a chemical neurotransmitter. The neurotransmitter drifts across the gap between the two neurons. sacs called vesicles release neurotransmitters into the synaptic cleft synaptic cleft The narrow gap that separates the presynaptic neuron from the postsynaptic cell. what happens when the action al potential reaches the axon terminal? little sacks called vesicles merge with axon cell membrane axon cell membrane presynaptic membrane the vesicles open and release chemicals called neurotransmitters neurotransmitters send a signal to the cell receiving the signal after sending a signal to a cell the neurotransmitters diffuse away and binds to nearby receptor sites after neurotransmitters diffuse the gates open in the post synaptic cell membrane and the signal enters the post synaptic cell after the signal enters a new neurotransmitter is released from the post synaptic cell receptors and is recycled or broken down what are neurotransmitters broken down by enzymes found in the synaptic cleft when a postsynaptic cell is a muscle cell it contracts when a postsynaptic cell is a gland it secretes how do neurotransmitters affect the neuron by causing it to fire on its own action potential or receives the likelihood of it firing on its own action potential what a neurotransmitter does to a neuron is decided by receptor the ability for neurons to not fire helps with filtering overwhelming sensory info such as a concert Acetylcholine A neurotransmitter that enables learning and memory and also triggers muscle contraction Acetylcholine is released by motor neurons at the point where they synapse with muscle cells Botulinum toxin an acetylcholine antagonist; prevents release by terminal buttons. most toxic substance known what does botox do blocks release of acetylcholine so less contractions in muscles =less wrinkles glutamine involved with learning and memory, more sensitive to glutamine, better memory and learning dopamine influences movement, learning, attention, and emotion. loss of is responsible for parkinson's. chief of happiness serotonin Affects mood, hunger, sleep, and arousal who makes serotonin more? men cocaine a powerful and addictive stimulant, derived from the coca plant, producing temporarily increased alertness and euphoria. tricks pleasure center in brain and binds with presynaptic membrane where dopamine is usually reabsorbed from the synaptic cleft. blocks reuptake sites dopamine remains in cleft repeatedly stimulating it prozac and zoloft block serotonin from being reabsorbed and recycled by presynaptic cells which prolongs it affect Selective Serotonin Reuptake Inhibitors (SSRIs) a group of second-generation antidepressant drugs that increase serotonin activity specifically, without affecting other neurotransmitters morphine and heroin mimic endorphins and bind to receptor sites. in high doses gives endorphins rush which causes euphoria. slows down respiratory rate and can be fatal nicotine mimics acetylcholine by binding to the same receptors and release adrenaline and other stimulating chemicals. rapid surges the rapid depletions of these chemicals make smokers want another cigarette drugs become addictive because the body's think that there is more natural amounts of usual neurotransmitters. reduces sensitivity to drugs, needing more to have the same reaction DRD4 gene that encodes a certain class of dopamine receptor. It can be mutated for those seeking sensation, altering the mesolimbic pathway and the way sensations are rewarded caffeine a mild stimulant found in coffee, tea, and several other plant-based substances cellular waste products takes form of a variety of molecules such as adenosine adenosine when binds with receptor reduces the likelihood of a neuron initiating an action potential as more adenosine binds with more receptors we feel tired when we sleep cellular waste products are reabsorbed and recycled effects of alcohol slowed down reactions slurs speech by blocking receptors for glutamate, provides buzz by blocking dopamine reuptake, blocks pain by stimulating the release of endorphins, increases feeling of happiness by modifying the efficiency of serotonin receptors muscles generate force through contraction skeletal muscle is attached to bones by connective tissue and is controlled by individual neurons attached to each muscle fiber cardiac muscles causes the heart to pump blood blood through the body smooth muscle, involuntary, surrounds blood vessels and many internal organs which help to move blood, move food through digestive system myofibrils cylindrical organelle within muscle cells that can contract; contains repeating units, called sarcomeres in which the contraction takes place Sarcomere the fundamental unit of muscle contraction , made of actin myosin actin protein of muscle tissue; makes up the thin filaments myosin protein of muscle tissue, making up the thick filaments muscle fiber contraction Results from a sliding movement where the actin and myosin filaments merge using ATP. Globular portions of the myosin filaments can form cross-bridges with actin filaments. Reaction between actin and myosin filaments generates the force of contraction. First step of sarcomere contraction detach, link between myosin and a parallel action filament is broken as a molecule of ATP bonds to myosin Second step of sarcomere contraction reach, as the atp breaks down, energy released alters the shape of the myosin into a higher energy shape and myosin now reaches farther down the actin filament Third step of Sarcomere contraction reattach, the myosin reattaches to the actin filament at this new location Fourth step of Sarcomere contraction pull back, the myosin then snaps back to its original shape, pulling the actin filament as it does so and shorting the fiber relaxed sarcomere Actin & Myosin myofilaments lie side by side contracted sarcomere the Z lines are close together duration between contraction and relaxation is called twitch fast twitch muscle fibers that react quickly and fatigue quickly slow twitch type of muscle that contracts slowly and is fatigue resistant Oxytocin peptide hormone, produced in neurons within the hypothalamus and released by the posterior pituitary, influences trust in others, increases the social attachments, directs the ejection of breast milk, and contractions in the uterus during childbirth synthesis site of oxytocin hypothalamus target tissues of oxytocin uterus and mammary glands effect of oxytocin Effects uterus - uterine contractions during labor, direct myometrium, other effects are on limbic system in both men and women increased by touch - reflects on bonding and trust hormones chemical messengers that are manufactured by the endocrine glands, travel through the bloodstream, and affect other tissues two systems for carrying out communication nervous and endocrine endocrine system the body's "slow" chemical communication system; a set of glands that secrete hormones into the bloodstream endocrine cells produce regulatory hormones target cells cells that have receptors for a particular hormone endocrine glands Glands of the endocrine system that release hormones into the bloodstream endocrine gland examples pituitary, thyroid, parathyroid, adrenal, pineal hormones help regulate homeostasis pheromones Chemical signals released by an animal that communicate information and affect the behavior of other animals of the same species. such as sexual reproduction and territory marking step one of how a hormone affect a certain cell signal is sent by a hormone being released from a gland step two of how a hormone affects a certain cell signal is received, although the hormone has no effect on most tissues it comes in contact with, cells with the right receptor in their cytoplasm or on their plasma membrane receives the signal step three of how a hormone affects a certain cell cell responds, hormone binds to receptor, causes response in target cell, can be change in gene expression in nucleus, can cause cell to start or stop producing a certain protein, alter rate of producing protein amines hormones adrenaline, hormones that are synthesized from single amino acids polypeptide hormones insulin and glucagon, chains of amino acids steroid hormones estrogen and testosterone, lipids lipid Energy-rich organic compounds, such as fats, oils, and waxes, that are made of carbon, hydrogen, and oxygen. most amines and polypeptide hormones are — while lipids are not water soluble amines and polypeptide hormones — pass through memebrane cannot lipids —pass through membranes can amines and polypeptide hormones bind to receptors embedded within the cell membrane which can influence inside the cell steroids hormones bind to receptors within the cytoplasm or nucleus of the cell, always passes into nucleus once a steroid is in the nucleus it binds to DNA, influencing gene expression paracrine receptors target cell receptors for a specific hormone can be nearby hormones secreted by glands in one part of the body are able to regulate cell function in another part of the body Prostaglandins Modified fatty acids that are produced by a wide range of cells. dilation or construction of blood vessels and affecting tissue inflammation what does asprin do Inhibits prostaglandins, decreases inflammation, and slows transmission of pain to site of injury Hypothalamus underside of brain, functions as liaison between the nervous and endocrine systems and it receives input from neurons throughout the brain and rest of body. sends out appropriate hormones to regular nearly every aspect of the organisms physiology, including body temp, hunger. thirst, and water balance pituitary gland The endocrine system's most influential gland. Under the influence of the hypothalamus, the pituitary regulates growth and controls other endocrine glands. posterior pituitary gland also known as the neurohypophysis; it is made up of nervous tissue/neurons and stores and secretes 2 hormones made by the hypothalamus (oxytocin and ADH); it is controlled by action potentials from the hypothalamus antidiuretic hormone (ADH) influences the absorption of water by kidney tubules anterior pituitary produced many hormones such as TSH, LH, FSH, prolactin, ACTH Thyroid Stimulating Hormone (TSH) causes thyroid to produce thyroxine, important in cellular respiration Follicle-stimulating hormone (FSH) stimulates development of follicles in ovaries and sperm maturation Lutenizing hormone (LH) triggers ovulation and stimulates testosterone production, works with FSH prolactin stimulates mammary glands to produce milk Adrenocorticotropic hormone (ACTH) Stimulates adrenal glands to produce cortisol and other stress related hormones Corticotropin-releasing hormone (CRH) Promotes secretion of adrenocorticotropic hormone (ACTH) growth hormone several effects, stimulating liver to release chemicals that spur growth of bones, cartilage, and other tissues excessive production of growth hormone during childhood can cause extreme growth called gigantism increased exposure to growth hormone in adulthood results in hands, face, feet growing unusually absence of growth hormone dwarfism how is pituitary dwarfism treated if caught early? shots of human growth hormone pineal gland secretes melatonin regulates sleep cycles thyroid gland releases thyroxine, influences the rate and efficient of cellular metabolism, regulates calcium levels in blood parathyroid glands regulate calcium levels in blood adrenal glands release adrenaline and cortisol (prepares body for action), regulate organisms response to stress. sit right above kidneys. pancreas releases insulin and glucagon, maintains blood glucose levels wishing a narrow range gonads release the sex steroids, including testosterone, estrogen, and progesterone, responsible for numerous physical, behavioral, and emotional features, including much sexual behavior, development, and growth Under active thyroid fatigue and weight gain overactive thyroid jitteriness, rapid heartbeat, weight loss, irritability when iodine intake is low, the thyroid is unable to produce thyroxine which causes thyroid to swell Calcitonin Lowers blood calcium levels insulin A hormone produced by the pancreas or taken as a medication by many diabetics negative feedback A primary mechanism of homeostasis, whereby a change in a physiological variable that is being monitored triggers a response that counteracts the initial fluctuation. positive feedback Feedback that tends to magnify a process or increase its output. endocrine disrupters Chemicals that disrupt normal hormone functions Polychlorinated biphenyls (PCBs) A group of industrial compounds used to manufacture plastics and insulate electrical transformers, and responsible for many environmental problems. Phthalates found in cosmetics, deodorants, and many plastics used for food packaging, children's toys, and medical devices. Cause kidney & liver damage, cancer, and low sperm counts. Bisphenol A (BPA) a substance widely used in plastics and to line food and drink cans, which has raised health concerns because it is an estrogen mimic endocrine disrupters effect on mammals reproductive harm endocrine disrupters effect on fish reproductive functioning endocrine disrupters effect on invertebrates defective shells, masculinization of female genitalia, reducing fertility oxytocin posterior pituitary, uterus, breast, brain, reduce stress, more trusting "love hormone" antidiuretic hormone (ADH) posterior pituitary, kidneys, water retention in kidneys Thyroid Stimulating Hormone (TSH) anterior pituitary, thyroid, stimulates production of thyroxine, important in cellular respiration Follicle-stimulating hormone (FSH) anterior pituitary, ovaries, testes, stimulates ovary development and sperm maturation prolactin anterior pituitary, mammary glands, milk production growth hormone anterior pituitary, liver and other organs, stimulates release of chemicals that spur growth of bones, cartilage, and other tissues cortisol and adrenaline adrenal glands, smooth, cardiac, skeletal muscle, blood vessels, cell throughout body, imitates response to stress, regulates response to long term stress melatonin pineal gland, brain, regulate sleep cycle thyroxine thyroid, cells throughout body, influenced metabolic spew and efficiency calcitonin and parathyroid hormone thyroid, bones, causes bones to pick up excess calcium in blood insulin pancreas, liver, adipose tissue, skeletal muscle, take up glucose in blood which reduces its level glucagon pancreas, liver, adipose tissue, concert stored glycogen into glucose estrogen, testosterone, progesterone gonads, cells uterus, breasts, balls, puberty, pregnancy, sperm production, egg production heritable sensory autonomic neuropathy condition in which afflicted individual cannot feel pain sensory neurons affected by skin and joints affected by syphilis Interneurons are affected by parkinsons motor neurons are affected by polio Oligodendrocytes Type of glial cell in the CNS that wrap axons in a myelin sheath. Microglia Act as phagocytes, eating damaged cells and bacteria, act as the brains immune system astrocyte release gliotransmitters by expcytosis to send signals to neighboring neuron connectomes Map of the network of connections between neurons in the human brain resting potential -70 mV action potential +30 mV (depolarized) Channelopathies diseases and disorders that are the result of ion channel dysfunction Tetrodotoxin -Poisoning can result from ingestion of poorly prepared puffer fish (exotic sushi) -Highly potent toxin that binds fast voltage-gated Na+ channels in cardiac and nerve tissue, preventing depolarization - blocks action potential without changing resting potential (same mechanism as Lidocaine) -Causes nausea, diarrhea, paresthesias, weakness, dizziness, loss of reflexes. -Treatment is primarily supportive. epilepsy potassium channel mutations, muscle weakness the synapse excitatory neurotransmitters chemicals released from the terminal buttons of a neuron that excite the next neuron into firing inhibitory neurotransmitters chemicals released from the terminal buttons of a neuron that inhibit the next neuron from firing GABA An inhibitory neurotransmitter in the brain. caffeine — glutamine and — GABA activity increases, decreases Alcohol — GABA activity and — Glutamate activity increases, decreases functions of muscle generate movement, force, heat, homeostasis 2 mutates copies of them upstairs gene causes excess muscle build up muscle is composed of bundles of muscle fibers bundles of muscle fibers are composed of muscle fibers muscle fibers are composed of myofibrils myofibrils are composed of actin and myosin actin and myosin are composed of sarcomere slow fiber muscle is dark mest fast fiber muscle is light meat motor unit A motor neuron and all of the muscle fibers it innervates rigor mortis stiffness after death caused by lack of ATP, muscle remains in a state of contraction acromegaly abnormal enlargement of the extremities during adulthood when exposed to excess growth hormone Addison Disease low levels of cortisol, autoimmune disease, depression, dizziness, low blood glucose, low blood pressure chronic stress excess cortisol, high blood glucose, obesityfdwkqfejifijeoiefowojk
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