Neuroscience Exam #2 - Anxiety

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Frage 1 von 85

Anxiety disorders facts:

Wähle eine oder mehr der folgenden:

Highest prevalence of any mental health disorder
More prevalent in women
<45 years old
Divorced, separated
Adolescents

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Frage 2 von 85

Age of onset for anxiety disorders is

Wähle eine der folgenden:

Early adulthood
Adulthood
Elderly
Childhood or early adolescene

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Frage 3 von 85

Which of the following is NOT a medical rule out for anxiety

Wähle eine der folgenden:

Endocrine disorders
Neoplastic disorders
Hepatic disorders
Lyme disease
Hypersensitivity reactions
Autoimmune disorders
Pulmonary disorders
Cardiovascular disorders
Neurological disorders

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Frage 4 von 85

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DSM Anxiety Disorders include ( anxiety, bipolar ) disorders, ( obsessivecompulsive, mood ) disorders and ( trauma or stressor related, personality disorders ) disorders

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Frage 5 von 85

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Eustress vs. Distress: remember stress isn't always negative
( Eustress:, Distress: ) Motivating, short-term, exciting
( Eustress:, Distress: ) Short- or long-term, perceived as beyond coping ability, unpleasant

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Frage 6 von 85

“Anxiety and fear are cousins but not twins. ❌ sees a threat. ❌ imagines one.” – Max Lucado

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Fear

Anxiety

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Frage 7 von 85

Neuroanatomy of anxiety. Which parts of the brain are involved.
❌ ❌ ❌ ❌

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Prefrontal cortex

ventral tegmental area

orbitofrontal cortex

mammillary bodies

ventromedial prefrontal cortex

limbic system

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Frage 8 von 85

In neuroanatomy of anxiety, what is the function of the prefrontal cortex

Wähle eine oder mehr der folgenden:

Executive functioning, planning, decision making
Predicting consequences
Understanding social behavior
Control impuses and regulates mood

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Frage 9 von 85

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In the neuroanatomy of anxiety, the cortex controls impulses, regulates mood, and drives moral judgment

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Frage 10 von 85

Which is not a feature of the limbic system

Wähle eine der folgenden:

Structures between the cerebral hemisphere and the brainstem
Not a discrete “system” but rather a collection of anatomically-related structures with varying functions
Center for emotional responsiveness, motivation, memory, olfaction, safety
Phylogenetically ancient, paleomammalian brain
Controls moral judgement and controls impulses

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Frage 11 von 85

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cortex is in charge of reward processing – think and visceral response to emotions

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Frage 12 von 85

❌ -Spatial navigation. Memory formation/storage
❌ – Processes emotional stimuli. Receives information about physical needs. Initiates behavioral response
❌ – Receives unprocessed sensory input. Connects endocrine system to nervous system via pituitary gland
❌ – sensory processing. Hub of information transfer. Directs sensory input for processing

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Hippocampus

Amygdala

Hypothalamus

Thalamus

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Frage 13 von 85

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The :
Shifts short-term memory to long-term memory
Encodes our memory with emotions by interacting with amygdala
Interacts with amygdala to encode emotional memories
Active in imaging studies during fearful situations

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Frage 14 von 85

Neuroanatomy of the hippocampus in anxiety

Wähle eine oder mehr der folgenden:

Seahorse-shaped structure in medial temporal lobe
Receives input from neurotransmitter systems and sends output to the rest of the brain
Memory formation and storage
Related to stress sensitivity and resiliency
Structures between the cerebral hemisphere and the brainstem

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Frage 15 von 85

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The hippocampus is related to stress sensitivity and resiliency. A ( large, small ) hippocampus is protective agains anxiety disorders. A ( large, small ) hippcampus has increased risk of PTSD in the context of trauma

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Frage 16 von 85

The amygdala has three groups, a medial group, a basal-lateral group, and a central group. Which group has connections with the hypothalamus and the brain stem, cues the endocrine system response, and influences expression of emotion, and triggers the autonomic nervous system?

Wähle eine der folgenden:

Medial
Basal-lateral
Central group

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Frage 17 von 85

Neuroendocrine pathways for the HPA (hypothalamic-pituitary-adrenal) axis. Let's review as this is probably an exam question:
Activated by ❌
Hypothalamus releases ❌
CRF binds to receptors on ❌
❌ is released
ACTH binds to receptors on ❌
❌ are released!

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corticotropin-releasing factor (CRF)

anterior pituitary gland

Adrenocorticotropic hormone (ACTH)

adrenal cortex

Cortisol and adrenaline

stress

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Frage 18 von 85

Function of the HPA axis is SAFETY & PROTECTION

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 19 von 85

Cortisol

Wähle eine oder mehr der folgenden:

Released for several hours after exposure to stressor
Increases glucose in the bloodstream and enhances the brain’s use of glucose
Suppresses nonessential functions such as digestion, reproduction, and growth processes
At sufficient concentrations, cortisol exerts negative feedback to hypothalamus and homeostasis returns
Lasts for only minutes after exposure to stressor
Decreases glucose in the bloodstream

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Frage 20 von 85

Adrenaline Increases ❌ rate, ❌ pressure, respiratory ❌ and ❌ metabolism

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heart

blood

rate,

carbohydrate

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Frage 21 von 85

Chronic/prolonged stress = repeated/sustained HPA axis activation

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 22 von 85

❌: γ-amino-butyric-acid (GABA)
❌ Glutamate
❌
Serotonin
Norepinephrine
Dopamine

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Calming NT

Excitatory NT:

Monoaminergic neurotransmitters

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Frage 23 von 85

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Excessive activity causes anxiety, agitation, and seizures

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Frage 24 von 85

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Benzodiazepines increase activity at amygdala and PFC

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Frage 25 von 85

Wähle von der Dropdown-Liste, um den Text zu vervollständigen.

( GABA, Glutamate ) Principal inhibitory neurotransmitter
( GABA, Glutamate ) Principal excitatory neurotransmitter
( GABA, Glutamate ) Decreases neurons’ electrical excitability
( Glutamate, GABA ) Increases neurons’ electrical excitability
( Glutamate, GABA ) Necessary for attention/coordination
( GABA, Glutamate ) Calm, relaxation, sleep

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Frage 26 von 85

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Enhancing 5-HT input to the amygdala can ( reduce, increase ) anxiety/fear

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Frage 27 von 85

Serotonin

Wähle eine oder mehr der folgenden:

Primarily found in GI tract, blood platelets, and CNS
Involved in regulation of mood, appetite, sleep, memory, learning
Inhibitory effect on some amygdalar outputs
Excitatory effect on some aygdalar outputs
Primarily found in the brain

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Frage 28 von 85

Norepinephrine

Wähle eine oder mehr der folgenden:

Mobilizes the brain and body for action
Lowest during sleep, rises during wakefulness
NE output from locus coeruleus enhances memory, attention, arousal
Peaks during fight-or-flight: Increases heart rate/BP, release of glucose from energy stores, inhibits GI motility
NE output from ventral tegmental area enhances memory, attention, arousal

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Frage 29 von 85

Dopamine

Wähle eine oder mehr der folgenden:

Significant in reward-motivated behavior
Pleasurable experiences cause dopamine release: sex, food/appetite, addictive substances
Involved in some motor control, GI motility, insulin production, and hormone regulation

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Frage 30 von 85

Catecholamine-O-methyltransferase (COMT) met genetic allele:

Wähle eine oder mehr der folgenden:

Enzyme which degrades dopamine and norepinephrine
COMT genotypes implicated in expression of anxiety and depression
Enzyme degraded serotonin and dompamine

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Frage 31 von 85

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Met genotype: ( Lower, Higher ) COMT activity = ( higher, lower ) NT levels = ( excessive, decreased ) NT release under stress = WORRIER
Val genotype: ( Higher, Lower ) COMT activity = ( lower, higher ) NT levels = ( decreased, excessive ) NT release under stress = WARRIOR

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Frage 32 von 85

Which gene regulates the HPA axis and monoaminergic signaling

Wähle eine der folgenden:

5-HTTLPR: Serotonin transporter
Catecholamine-O-methyltransferase (COMT)
Methylenetetrahydrofolate reductas

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Frage 33 von 85

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The ( short (S), long (L) ) allele of 5-HTTLPR: Serotonin transporter puts a patient as risk for anxiety

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Frage 34 von 85

What environmental factors play a part in increasing anxiety?

Wähle eine oder mehr der folgenden:

Physical/sexual trauma
Substance abuse
Chronic chaos/neglect
Adverse Childhood Experiences (ACE)
VUSN PMHNP program
News that the world is facing a tequila shortage

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Frage 35 von 85

Substance-Induced Anxiety Disorders can be caused by the following drugs except

Wähle eine der folgenden:

Sympathomimetics (pseudophedrine)
Stimulants (Methylphenidate, Amphetamines)
Benzodiazepines
System and anabolic steroids
Drugs of abuse (cocaine, amphetamaines, hallucinogens, substance withdrawal)
Atypical antipsychotics

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Frage 36 von 85

Panic disorder usually starts before the age of 24 and usually has lots of comorbidities as patients try to self-medicate

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 37 von 85

DSM-5 Criteria for Panic Disorder include recurrent UNEXPECTED panic attacks, followed by 1 month of:

Wähle eine oder mehr der folgenden:

Persistent concern
Worry about implications or consequences of panic attacks
Maladaptive changes in behavior
Walks on the beach doing yoga

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Frage 38 von 85

Agoraphobia is fear of situations with

Wähle eine der folgenden:

Large wide open spaces
Too many people or large crowds
Escape is difficult or embarrassing

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Frage 39 von 85

Neuroanatomy of panic disorder includes:
❌ glucose uptake in amygdala, hippocampus, and thalamus
❌ frontal lobe activity

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Elevated

Decreased

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Frage 40 von 85

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Neurotransmitter pathways in panic disorder:
( Decreased, Increased ) GABA concentrations, elevated glutamatergic signaling
( Decreased, Increased ) serotonin receptor binding, increased norepinephrine concentration

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Frage 41 von 85

Panic disorder is the most heritable of all anxiety disorders with first-degree relatives of patient with panic DO means that patient has 7X increased risk

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 42 von 85

Neuroendocrine pathways in panic disorder include:
(on exam study guide)

Wähle eine oder mehr der folgenden:

Elevated baseline cortisol = anticipatory anxiety
Hypersensitive to situations that trigger HPA axis activation
Decreased baseline cortisol = anticipatory anxiety
Hyposensitive to situations that trigger HPA axis activation

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Frage 43 von 85

Specific phobia (like clowns) is the most common anxiety disorder, women twice as likely to suffer as men, and typical age of onset is childhood to adolescence

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 44 von 85

Specific phobia is a persistent fear of clearly discernible objects or situations that provoke immediate anxiety and cause social or occupational impairement

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 45 von 85

Specific Phobia
Neuroanatomy: activation of ❌, decreased ❌

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amygdala

prefrontal cortex response

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Frage 46 von 85

Social anxiety disorder is twice as likely in women as men, onset is childhood or adolescence and is often seen with MDD or substance abuse disorders

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 47 von 85

DSM 5 criteria for social anxiety disorder is a persistent fear of situations in which exposure to unfamiliar people o scrutiny is possible. Fear that actions will expose anxiety or possible humiliation or embarrassment.

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 48 von 85

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Neuroanatomy of Social Anxiety Disorder:
( Hyperactive, Hypoactive ) prefrontal cortex - misinterpreting social cues
( Hyperreactive, Hypoactive ) amygdala - receives sensory information before analysis and signals the sympathetic nervous system

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Frage 49 von 85

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Genetics of social anxiety disorder involve Serotonin transporter (5-HTT) which governs reuptake of serotonin into the neuron. The allele is involved in increased risk of anxiety and depression in context of stressful environment, Increased startle response and a stronger amygdala activation in response to angry faces

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Frage 50 von 85

Generalized anxiety disorder has the youngest age of onset for an anxiety disorder

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 51 von 85

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Excessive worries/anxiety for at least ( 6 months, 3 months )s. Worry about a number of events, situations, activities. Difficulty controlling the worry.

Three or more of the following:
Restless/on edge
Easily fatigued
Difficulty concentrating
Irritability
Muscle tension
Sleep disturbance

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Frage 52 von 85

Neuroendocrine pathways of generalized anxiety disorder include all the following EXCEPT:

Wähle eine der folgenden:

Perception of sustained threat
Chronic activation of HPA axis
Acute activation of HPA axis
More physiologically dysregulated state at baseline
Exaggerated physiological reactivity to fearful stimuli

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Frage 53 von 85

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5-HTTLPR -allele carriers are highly sensitive to environmental threats. Hypervigilance

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Frage 54 von 85

The following are all forms of obsessive-compulsive disorders:

Wähle eine oder mehr der folgenden:

Body dysmorphic disorder - fixated on a part of their body they hate
Trichotillomania – hair pulling compulsion and anxiety. A lot with trauma
Hoarding Disorder – afraid that they might need something
Cookiewinemania - an unnatural obsession with wanting cookies and wine

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Frage 55 von 85

Tourette's Syndrome is a frequent comorbidity of obsessive compulsive disorder

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 56 von 85

The following are all true about OCD DSM-5 criteria

Wähle eine oder mehr der folgenden:

Recurrent obsessive thoughts - Persistent ideas, thoughts, images, impulses that are perceived as intrusive and distressing
Compulsive behaviors - Repetitive behaviors or mental acts that are meant to reduce stress NOT bring pleasure
Time-consuming, cause impairment

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Frage 57 von 85

OCD is real anatomical issue

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 58 von 85

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In obsessive compulsive disorder there is cortex overactivity but smaller volume which leads to context-related processing and response inhibition

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Frage 59 von 85

In obsessive compulsive disorder there is abnormal activity in ❌ feedback loop. These circuits use “direct” (excitatory) or “indirect” (inhibitory) routes from cortex through ❌ to ❌

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cortico-striatal-thalamo-cortical (CSTC)

basal ganglia

thalamus.

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Frage 60 von 85

CSTC or "worry" loop is involved in obsessive compulsive disorder. It includes the ❌ which nuclei grouped together based on interconnected roles in movement and cognition. It includes Includes ❌, putamen, caudate nucleus. Specifically the striatum Includes ❌ and caudate nucleus.

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basal ganglia

globus pallidus

putamen

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Frage 61 von 85

In obsessive compulsive disorder, the CSTC loop receives input to ❌ from ❌ and ❌

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basal ganglia

cortex

thalamus

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Frage 62 von 85

In obsessive compulsive disorder, the CSTC or "worry" loop has two pathways. The "direct" basal ganglia and the "indirect' basal ganglia pathway that are antagonistic to each other

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 63 von 85

“Direct” basal ganglia pathway:
Direct projections from ❌ to ❌
Increases ❌ thalamic input to the cortex
Turns ❌ motor activity

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striatum

globus pallidus

excitatory

inhibitory

down

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Frage 64 von 85

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The ( "direct", "indirect" ) basal ganglia pathway is involved in the activation of tics, compulsions, and obsessions. It is ( overactive, underactive ) in OCD.

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Frage 65 von 85

“Indirect” basal ganglia pathway has ❌ projections from ❌ to ❌
❌ effect on ❌ and frontal cortex

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Indirect

striatum

globus pallidus

Inhibitory

excitatory

thalamus

hippocampus

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Frage 66 von 85

"Direct" basal ganglia pathway is the "gas" and the "indirect" basal ganglia is the brake when it comes to motor activity

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 67 von 85

OCD occurs when delicate balance between inhibition and excitation of basal ganglia pathway is disrupted

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 68 von 85

Neuroanatomy of OCD involves Increased activity in CSTC circuit running from ❌ to ❌ to ❌ to ❌ and back to ❌

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frontal cortex

striatum

globus pallidus

thalamus

cortex

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Frage 69 von 85

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In OCD, there is increased Increased activity in prefrontal cortex, basal ganglia, and

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Frage 70 von 85

What is the treatment for OCD

Wähle eine oder mehr der folgenden:

Surgical intervention where the CSTC loop is cut off via a cingulotomy. This disrupts the transmission from the frontal cortex
Very aggressive and high doses of SSRI
Talking common sense into the patient and telling the patient that the fears aren't real

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Frage 71 von 85

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Serotonin, dopamine and glutamate are involved in OCD. There are ( reduced, increased ) serotonin transporters in midbrain. There is ( increased, decreased ) dopamine. There is ( increased, decreased ) glutamate.

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Frage 72 von 85

Considering what we know about 5HT, DA, and Glu in OCD, which drugs are most effective

Wähle eine oder mehr der folgenden:

5HT drugs
DA antagonists
Antipsychotics
Stimulants

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Frage 73 von 85

A patient with OCD will be in a hyperglutamatergic state in prefrontal regions and have
elevated glutamate in cerebrospinal fluid

Wähle eins der folgenden:

WAHR
FALSCH

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Frage 74 von 85

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An ( earlier, later ) onset of OCD is indicative of a higher risk of heritability

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Frage 75 von 85

Of the following comorbidities with seen OCD, which has the highest incidence of PTSD

Wähle eine der folgenden:

TBI
Substance abuse disorders
Depression and anxiety disorders

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Frage 76 von 85

DSM 5 criteria for PTSD involve exposure to ❌, ❌ ❌, ❌, and ❌

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trauma

re-experiencing,

avoidance

negative alterations in mood/cognition

increased arousal.

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Frage 77 von 85

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The neuroanatomy of the PTSD involves:
( Reduced, Increased ) volume of hippocampus and frontal cortex
Amygdala ( hyperresponsiveness, hyporesponsiveness )
( Decreased, Increasedp ) activity in PFC

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Frage 78 von 85

The following NT are involved in PTSD EXCEPT:

Wähle eine der folgenden:

Dopamine
Norepinephrine
Serotonin
Glutamate

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Frage 79 von 85

Which drug exhibits inhibitory effects on glutamate transmission and thus is good for PTSD

Wähle eine der folgenden:

Topiramate
Aripiprazole
Venlafaxine

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Frage 80 von 85

Glutamate

Wähle eine oder mehr der folgenden:

Role in hippocampal-related learning and amygdala- related emotional processing
Processing distortion related to inappropriate glutamate signaling
Elevated glucose uptake in amygdala, hippocampus, and thalamus

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Frage 81 von 85

What medication should you not give to PTSD because of the unremitting elevation in NE in the CSF of patients with PTSD?

Wähle eine der folgenden:

Bupropion
Citalopram
Venlafaxine
Fluoxetine

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Frage 82 von 85

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In PTSD, patients have a ( decreased, increased ) cortisol concentrations and a/n ( flattened, elevated ) cortisol slope

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Frage 83 von 85

Treatment for anxiety disorders include:

Wähle eine oder mehr der folgenden:

SSRI
NDRI
BZ
Anticonvulsants
Antipsychotics
CBT
Mindfulness based stress reduction
EMDR

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Frage 84 von 85

MOA of BZ in anxiety involves BZ ❌ the efficiency of GABA to ❌ the excitability of neurons. BZ bind to the y sub-unit of the ❌ receptor. Binding causes a structural modification of the receptor that results in an increasein GABA-A activity. The result is an ❌ in the frequency of the ❌ channel (making the cell more negative) and ❌ the action potential.

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increasing

decrease

GABA-A

increase

Cl-

inhibiting

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Frage 85 von 85

Chronic/prolonged stress = repeated/sustained HPA axis activation which causes:
❌ Chronic muscle tension, tension headaches, migraines
❌ Exacerbation of existing conditions (asthma, emphysema, etc.)
❌ Increased risk of heart attack, hypertension, stroke
❌ Increased risk of diabetes in vulnerable populations
❌ Acid reflux, ulcers, diarrhea, constipation, nausea/vomiting
Reproductive:
❌ Impaired testosterone production and sperm maturation, impotence
❌ Irregular menstrual cycles, impaired sexual desire

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Musculoskeletal:

Respiratory:

Cardiovascular:

Endocrine:

Gastrointestinal:

Male:

Female:

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	Erstellt von Melanie Grynsztejn vor mehr als 8 Jahre

Quiz am Neuroscience Exam #2 - Anxiety, erstellt von Melanie Grynsztejn am 27/03/2018.

Neuroscience Exam #2 - Anxiety

Frage 1 von 85

Anxiety disorders facts:

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Frage 2 von 85

Age of onset for anxiety disorders is

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Frage 3 von 85

Which of the following is NOT a medical rule out for anxiety

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Frage 4 von 85

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DSM Anxiety Disorders include anxiety bipolar( anxiety, bipolar ) disorders, obsessivecompulsive mood( obsessivecompulsive, mood ) disorders and trauma or stressor related personality disorders( trauma or stressor related, personality disorders ) disorders

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Frage 5 von 85

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Eustress vs. Distress: remember stress isn't always negative Eustress: Distress:( Eustress:, Distress: ) Motivating, short-term, exciting Eustress: Distress:( Eustress:, Distress: ) Short- or long-term, perceived as beyond coping ability, unpleasant

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Frage 6 von 85

“Anxiety and fear are cousins but not twins. ❌ sees a threat. ❌ imagines one.” – Max Lucado

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Frage 7 von 85

Neuroanatomy of anxiety. Which parts of the brain are involved. ❌ ❌ ❌ ❌

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Frage 8 von 85

In neuroanatomy of anxiety, what is the function of the prefrontal cortex

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Frage 9 von 85

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In the neuroanatomy of anxiety, the cortex controls impulses, regulates mood, and drives moral judgment

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Frage 10 von 85

Which is not a feature of the limbic system

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Frage 11 von 85

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cortex is in charge of reward processing – think and visceral response to emotions

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Frage 12 von 85

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Frage 13 von 85

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The : Shifts short-term memory to long-term memory Encodes our memory with emotions by interacting with amygdala Interacts with amygdala to encode emotional memories Active in imaging studies during fearful situations

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Frage 14 von 85

Neuroanatomy of the hippocampus in anxiety

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Frage 15 von 85

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The hippocampus is related to stress sensitivity and resiliency. A large small( large, small ) hippocampus is protective agains anxiety disorders. A large small( large, small ) hippcampus has increased risk of PTSD in the context of trauma

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Frage 16 von 85

The amygdala has three groups, a medial group, a basal-lateral group, and a central group. Which group has connections with the hypothalamus and the brain stem, cues the endocrine system response, and influences expression of emotion, and triggers the autonomic nervous system?

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Frage 17 von 85

Neuroendocrine pathways for the HPA (hypothalamic-pituitary-adrenal) axis. Let's review as this is probably an exam question: Activated by ❌ Hypothalamus releases ❌ CRF binds to receptors on ❌ ❌ is released ACTH binds to receptors on ❌ ❌ are released!

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Frage 18 von 85

Function of the HPA axis is SAFETY & PROTECTION

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Frage 19 von 85

Cortisol

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Frage 20 von 85

Adrenaline Increases ❌ rate, ❌ pressure, respiratory ❌ and ❌ metabolism

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DSM Anxiety Disorders include ( anxiety, bipolar ) disorders, ( obsessivecompulsive, mood ) disorders and ( trauma or stressor related, personality disorders ) disorders

Eustress vs. Distress: remember stress isn't always negative
( Eustress:, Distress: ) Motivating, short-term, exciting
( Eustress:, Distress: ) Short- or long-term, perceived as beyond coping ability, unpleasant

Neuroanatomy of anxiety. Which parts of the brain are involved.
❌ ❌ ❌ ❌

The :
Shifts short-term memory to long-term memory
Encodes our memory with emotions by interacting with amygdala
Interacts with amygdala to encode emotional memories
Active in imaging studies during fearful situations

The hippocampus is related to stress sensitivity and resiliency. A ( large, small ) hippocampus is protective agains anxiety disorders. A ( large, small ) hippcampus has increased risk of PTSD in the context of trauma

Neuroendocrine pathways for the HPA (hypothalamic-pituitary-adrenal) axis. Let's review as this is probably an exam question:
Activated by ❌
Hypothalamus releases ❌
CRF binds to receptors on ❌
❌ is released
ACTH binds to receptors on ❌
❌ are released!

❌: γ-amino-butyric-acid (GABA)
❌ Glutamate
❌
Serotonin
Norepinephrine
Dopamine

Enhancing 5-HT input to the amygdala can ( reduce, increase ) anxiety/fear

The ( short (S), long (L) ) allele of 5-HTTLPR: Serotonin transporter puts a patient as risk for anxiety