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As the provider, you are looking at genetic testing for your patient who you have diagnosed with depression. You know that the most noteworthy genes in MDD are (select all that apply):
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MTHFR
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SLC6A4
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BDNF
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ANK3
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CYP2D6
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Label the 5 major regions of dysfunction in depressed brains.
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The [blank_start]insula[blank_end] is a structure that sits on top of the caudate-putamen and interacts with amygdala, and plays a major role in the perception of pain.
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What functional processes in the brain, exacerbate PAIN in persons with MDD?
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White matter abnormalities
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Decreased volume in the hippocampus and PFC
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Altered regional blood flow
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emotion-related brain activation is shifted to the dorsal anterior insula
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T or F. The most current Monoamine Hypothesis posits that there are depleted monoamine levels (5HT, NE, DA) and these deficiencies can be measured in the plasma, CSF and brain tissue.
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The NT Receptor hypothesis posits that abnormalities in the receptors for monoamine NT's leads to [blank_start]depression[blank_end]. Further, deficient activity of monoanime NT's causes [blank_start]upregulation[blank_end] of postsynaptic NT receptors.
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Which important signal conduction cascades are triggered by neurotransmitters?
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In the Second Messenger Malfunction Theory, problems in the [blank_start]2nd[blank_end] messenger system can [blank_start]impair[blank_end] neurotransmitter function [blank_start]without[blank_end] changes in monoamine levels or receptor numbers. This results in a [blank_start]downstream[blank_end] impact on gene expression.
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2nd
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1st
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impair
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increase
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without
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with
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downstream
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upstream
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Serotonin is a monoamine, specifically an [blank_start]indoleamine[blank_end].
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5HT is produced in the [blank_start]raphe[blank_end] nuclei.
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Disruption to the normal connection of serotonergic nuclei to this system, is thought to contribute to depression?
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Match the monoamine circuit to its function(s):
5HT:
[blank_start]Affect[blank_end]
[blank_start]Anxiety[blank_end]
[blank_start]Distress[blank_end]
[blank_start]Behavioral Inhibition[blank_end]
NE
[blank_start]Arousal[blank_end]
[blank_start]Responsiveness[blank_end]
[blank_start]Alerting Signals[blank_end]
DA
[blank_start]Reward[blank_end]
[blank_start]Interest[blank_end][blank_start]Motivation[blank_end]
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Affect
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Anxiety
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Distress
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Behavioral Inhibition
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Arousal
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Responsiveness
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Alerting Signals
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Reward
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Interest
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Motivation
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The PMHNP is explaining to her patient the role of 5HT in depression, specifically the "Behavioral Inhibition" system. What is the best explanation of this system below?
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It is linked to pleasure and reward, and this becomes overactive in depression, decreasing inhibition.
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It is linked to the stimulus of the PFC, and subsequently behavioral arousal
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It is tuned to responding to fear or anxiety producing stimuli
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NE is a monoamine, specifically a [blank_start]catecholamine[blank_end].
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NE in the CNS is produced in the [blank_start]nucleus[blank_end] [blank_start]locus[blank_end] [blank_start]ceruleus[blank_end].
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Put the correct statement below:
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NE stimulates the NA, then the PFC and then the VTA
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NE stiumulates the PFC, then the VTA and then the NA
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NE stimulates the VTA, then the PFC and then the NA
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NE stimulates the PFC, then the amygdala and the the NA
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NE is modulated by which part of the brain?
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PFC
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Nucleus Accumbens
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Locus Coeruleus
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Amygdala
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Dopamine is a monoamine, specifically a [blank_start]cathecolamine[blank_end].
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The [blank_start]mesolimbic[blank_end] pathway is involved in pleasure and reward; stimulation of this pathway results in a sense of pleasure.
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The [blank_start]mesocortical[blank_end] pathway is involved in motivational behavior, and is tied to pleasure and reward.
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Monoamine Hypothesis Made Simple for Patient Education-Label the functions with the correct neurotrasmitter.
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Alertness, Energy
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Attention, Motivation, Pleasure, Reward
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Obsessions and Compulsions
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The most used neurotransmitter in the nervous system is [blank_start]glutamate[blank_end].
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What is the MOA of ketamine, and the reason why it may be useful in the treatment of depression?
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It activates glutamate in the limbic system, mitigating the resulting dysfunction in the balance of glutamate receptor activation
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It blocks the excitatory post synaptic response of glutamate.
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NMDA is one of the main receptors for glutamate, and ketamine is an NMDA receptor blocker.
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Label the HPA Axis diagram sequentially with the correct parts of the brain:
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Hypothalamus
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Anterior Pituitary
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Adrenal Cortex
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Chronic exposure to stress & high levels of [blank_start]glucocorticoids[blank_end] leads to neuronal atrophy and death.
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glucocorticoids
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cytokeines
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T of F. One of the effects of chronic stress is decreased neurogenesis and hippocampal atrophy.
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Cytokines can (select all that apply):
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Induce changes in mood and CNS function
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impact neurotrasmitter metabolism
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can cross the blood-brain barrier to have neurotoxic effects causing neuronal death
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Cause psyhcosis
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Play a not yet fully understood role in OCD
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Two the likely risk genes in Bipolar are the [blank_start]CACNA1C[blank_end] and [blank_start]ANK3.[blank_end]
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CACNA1C
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SLC6A4
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ANK3.
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BDNF
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T or F. Genes = Probabilism not determinism.
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In bipolar disorder, there is thought to be decreased size and activity in the [blank_start]PFC[blank_end] (use the abbreviation) and [blank_start]limbic[blank_end] hyperactivity.
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In bipolar disorder, hippocampus volume is [blank_start]decreased[blank_end].
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In mania frontal activity is most [blank_start]decreased[blank_end] and limbic activity is most [blank_start]increased.[blank_end]
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In bipolar mania, which neurotransmitter have greater activity (select all that apply)?
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What is the Kindling Theory of Bipolar?
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Your brain is like a slow, burning pile of smoldering sticks
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Easily combustible small sticks or twigs used for starting a fire.
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A process by which a brain event is both initiated and its recurrence made more likely. Essentially more vulnerable to future episodes.
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This is a nice graphic for neurocircuitry of depression
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Nice graphic for Bipolar.
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Additional helpful graphic
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Simple Neurotransmitter Explanation
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Neurotransmitter Imbalance Chart
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Last one...there were just so many helpful charts out there!