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GENETIC REASONS FOR ADHD COULD INCLUDE THESE 2 THINGS.
DEFECT IN DRD4 GENE
OVEREXPRESSION OF DAT GENE
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EXCESSIVE MOTOR ACTIVITY, DIFFICULTY CONCENTRATING, AND IMPULSIVITY ARE 3 BEHAVIORS INDICATING WHAT?
ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)
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THE CATECHOLAMINE HYPOTHESIS FOR ADHD SAYS WHAT 2 MAIN THINGS ARE RESPONSIBLE FOR ADHD?
LOW DOPAMINE
LOW NOREPINEPHRINE
BOTH MAINLY IN THE FRONTAL CORTEX
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WHICH OF THE FOLLOWING 2 CAN LEAD TO ADHD LIKE SYMPTOMS?
-LOW ACTIVITY OF THE CONNECTIONS FROM THE FRONTAL LOBE TO SUBCORTICAL AREAS (BASAL NUCLEI).
-REDUCED VOLUME OF PREFRONTAL CORTEX, CAUDATE PUTAMEN, AND GLOBUS PALLIDUS ON THE RIGHT SIDE.
BOTH
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WHAT PART OF THE BRAIN REGULATES SUSTAINED ATTENTION AND PROBLEM SOLVING RELATED TO ADHD?
DLPFC (DORSO-LATERAL PRE-FRONTAL CORTEX)
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WHAT PART OF THE BRAIN REGULATES SELECTIVE ATTENTION RELATED TO ADHD?
DORSAL ACC (ANTERIOR CINGULATE CORTEX)
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WHAT PART OF THE BRAIN REGULATES MOTOR HYPERACTIVITY AS RELATED TO ADHD?
- PREFRONTAL MOTOR CORTEX AND
- SUPPLEMENTARY MOTOR CORTEX
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WHAT PART OF THE BRAIN REGULATES IMPULSIVITY AS RELATED TO ADHD?
ORBITAL FRONTAL CORTEX
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THE PRE-FRONTAL CORTEX RECEIVES NORADRENERGIC INPUTS FROM WHERE?
THE PRE-FRONTAL CORTEX RECEIVES DOPAMINERGIC INPUTS FROM WHERE?
LOCUS COERULEUS OF THE PONS (IN MIDBRAIN)
SUBSTANTIA NIGRA/VENTRAL TEGMENTAL AREA COMPLEX (IN MIDBRAIN)
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SIDE EFFECTS OF ADHD PSYCHOSTIMULANTS WOULD BE?
SATIETY (APPETITE SUPPRESSION)
RAS ACTIVATION CAUSING WAKEFULLNESS AND INSOMNIA
INCREASED DA IN THE NUCLEUS ACCUMBENS (PLEASURE CENTER) CAN LEAD TO POSSIBLE ADDICTION IN SOME OF THESE
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THE CORTICO-STRIATAL-THALAMIC-CORTICAL CIRCUITS
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THIS STAGE OF AMNESIA INCLUDES ANALGESIA, AMNESIA, AND EUPHORIA.
STAGE 1 ANESTHESIA: ANALGESIA
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THIS STAGE OF ANESTHESIA INCLUDES EXCITEMENT, DELIRIUM, AND COMBATIVE BEHAVIOR.
STAGE 2 ANESTHESIA: EXCITEMENT
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THIS STAGE OF ANESTHESIA INCLUDES UNCONSCIOUSNESS WITH REGULAR RESPIRATION AND DECREASED EYE MOVEMENT.
STAGE 3 ANESTHESIA: SURGICAL ANESTHESIA
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THIS STAGE OF ANESTHESIA INCLUDES RESPIRATORY ARREST, CARDIAC DEPRESSION OR ARREST, AND NO EYE MOVEMENT.
STAGE 4 ANESTHESIA: MEDULLARY DEPRESSION
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A LOWER SOLUBILITY OF INHALED ANESTHETICS WOULD DO WHAT TO ONSET (RATE OF INDUCTION OF ANESTHESIA) AND OFFSET (RATE OF RECOVERY FROM ANESTHESIA)?
NOTE: DO NOT CONFUSE THIS CONCEPT WITH POTENCY!
INCREASE BOTH ONSET AND OFFSET
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OF ALL THE INHALED ANESTHETICS, WHICH HAS THE FASTEST ONSET AND OFFSET? WHY?
NOTE: DO NOT CONFUSE THIS WITH POTENCY!
NITROUS OXIDE, IT IS THE LEAST SOLUBLE
NOTE: ALTHOUGH NITROUS OXIDE HAS THE FASTEST ONSET, IT ALSO HAS VERY LOW POTENCY (MEANING A LOT OF IT IS REQUIRED FOR THERAPEUTIC EFFECT)
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OF ALL THE INHALED ANESTHETICS, WHICH ONE HAS THE SLOWEST ONSET AND LONGEST DURATION? WHY?
HALOTHANE, BECAUSE IT IS THE MOST SOLUBLE
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WHAT ARE THE 3 BASIC MOA IN GENERAL ANESTHETICS? (3 RECEPTORS/AGONIST OR BLOCKER)
GABAa IONOTROPIC RECEPTOR AGONIST
GLYCINE IONOTROPIC RECEPTOR AGONIST
GLUTAMATE NMDA IONOTROPIC RECEPTOR BLOCKER (KETAMINE ESPECIALLY WORKS BY THIS MOA)
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INHALED GENERAL ANESTHETICS TEND TO HAVE 2 MOA IN ADDITION TO THE BASIC 3 (WHICH ARE GABAa STIMULATION, GLYCINE STIMULATION, AND GLUTAMATE NMDA BLOCKING), WHAT ARE THEY?
HYPERPOLARIZATION OF K+ CHANNELS
LOWERING THE DURATION FOR NICOTINIC ACETYLCHOLINE RECEPTOR CHANNELS TO BE OPEN
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ALL OF THE INHALED ANESTHETICS, EXCEPT FOR NITROUS OXIDE (THE LEAST SOLUBLE AND FASTEST ACTING) AND HALOTHANE (THE MOST SOLUBLE AND SLOWEST ACTING/LONGEST LASTING) SHARE THIS BASIC CHEMICAL STRUCTURE PROPERTY.
ETHERS C-0-C
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WHAT ARE THE 2 MAJOR FORMS OF ELIMINATION FOR INHALED ANESTHETICS?
EXHALED UNCHANGED
- HEPATIC METABOLISM BY CYPS
- (MOSTLY CYP2E1)
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THIS IS THE CONCENTRATION OF ANESTHETIC THAT RESULTS IN IMMOBILITY IN 50% OF PATIENTS.
WHAT DOES A HIGH VALUE FOR THIS CONCENTRATION MEAN? GIVE AN EXAMPLE DRUG THAT MEETS THIS CRITERIA.
MAC (MINIMUM ALVEOLAR CONCENTRATION)
- HIGH MAC VALUE=LOW POTENCY
- EX: NITROUS OXIDE
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INHALED ANESTHETICS HAVE WHAT EFFECT ON ARTERIAL BLOOD PRESSURE?
WHAT ABOUT RESPIRATORY VENTILATION?
WHAT ABOUT PARTIAL PRESSURE OF CO2?
LOWER
LOWER (ARE ACTUALLY BRONCHODILATORS)
INCREASE
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WHAT WOULD INHALED ANESTHETICS DO TO METABOLIC RATE?
TO CEREBRAL BLOOD FLOW?
LOWER METABOLIC RATE
- INCREASE CEREBRAL BLOOD FLOW
- (INCREASING RISK OF INTRACRANIAL PRESSURE)
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TRANSMISSION PROBLEMS IN WHICH PART OF THE BRAIN WOULD LIKELY CAUSE DEPRESSED MOOD AND CONCENTRATION PROBLEMS?
FRONTAL CORTEX
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TRANSMISSION PROBLEMS IN WHICH PART OF THE BRAIN COULD LIKELY CAUSE UNWARRANTED THOUGHTS OF DEATH OR GUILT?
LIMBIC SYSTEM IN BASAL GANGLIA
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LOSS OF APPETITE/WEIGHT GAIN, AND LOSS OF SENSE OF PLEASURE COULD POSSIBLY BE ATTRIBUTED TO TRANSMISSION PROBLEMS IN WHICH PART OF THE BRAIN?
THE HYPOTHALAMUS
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INSOMNIA COULD BE CAUSED BY TRANSMISSION PROBLEMS IN WHICH PART OF THE BRAIN?
THE RAS IN THE BRAINSTEM
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PSYCHOMOTOR RETARDATION COULD BE ATTRIBUTED TO TRANSMISSION PROBLEMS IN WHICH AREA OF THE BRAIN?
CEREBELLUM AND BASAL GANGLIA
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CHRONIC ANXIETY ISSUES LIKELY ARISE FROM TRANSMISSION PROBLEMS IN WHAT AREA OF THE BRAIN?
LIMBIC SYSTEM
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