Neuroscience Exam #2 - Anxiety

Melanie Grynsztejn
Quiz by Melanie Grynsztejn, updated more than 1 year ago
Melanie Grynsztejn
Created by Melanie Grynsztejn about 3 years ago
18
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Description

Quiz on Neuroscience Exam #2 - Anxiety, created by Melanie Grynsztejn on 03/27/2018.

Resource summary

Question 1

Question
Anxiety disorders facts:
Answer
  • Highest prevalence of any mental health disorder
  • More prevalent in women
  • <45 years old
  • Divorced, separated
  • Adolescents

Question 2

Question
Age of onset for anxiety disorders is
Answer
  • Early adulthood
  • Adulthood
  • Elderly
  • Childhood or early adolescene

Question 3

Question
Which of the following is NOT a medical rule out for anxiety
Answer
  • Endocrine disorders
  • Neoplastic disorders
  • Hepatic disorders
  • Lyme disease
  • Hypersensitivity reactions
  • Autoimmune disorders
  • Pulmonary disorders
  • Cardiovascular disorders
  • Neurological disorders

Question 4

Question
DSM Anxiety Disorders include [blank_start]anxiety[blank_end] disorders, [blank_start]obsessivecompulsive[blank_end] disorders and [blank_start]trauma or stressor related[blank_end] disorders
Answer
  • anxiety
  • bipolar
  • obsessivecompulsive
  • mood
  • trauma or stressor related
  • personality disorders

Question 5

Question
Eustress vs. Distress: remember stress isn't always negative [blank_start]Eustress:[blank_end] Motivating, short-term, exciting [blank_start]Distress:[blank_end] Short- or long-term, perceived as beyond coping ability, unpleasant
Answer
  • Eustress:
  • Distress:
  • Eustress:
  • Distress:

Question 6

Question
“Anxiety and fear are cousins but not twins. [blank_start]Fear[blank_end] sees a threat. [blank_start]Anxiety[blank_end] imagines one.” – Max Lucado
Answer
  • Fear
  • Anxiety

Question 7

Question
Neuroanatomy of anxiety. Which parts of the brain are involved. [blank_start]Prefrontal cortex[blank_end] [blank_start]orbitofrontal cortex[blank_end] [blank_start]ventromedial prefrontal cortex[blank_end] [blank_start]limbic system[blank_end]
Answer
  • Prefrontal cortex
  • ventral tegmental area
  • orbitofrontal cortex
  • mammillary bodies
  • ventromedial prefrontal cortex
  • limbic system

Question 8

Question
In neuroanatomy of anxiety, what is the function of the prefrontal cortex
Answer
  • Executive functioning, planning, decision making
  • Predicting consequences
  • Understanding social behavior
  • Control impuses and regulates mood

Question 9

Question
In the neuroanatomy of anxiety, the [blank_start]orbitofrontal[blank_end] cortex controls impulses, regulates mood, and drives moral judgment
Answer
  • orbitofrontal

Question 10

Question
Which is not a feature of the limbic system
Answer
  • 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

Question 11

Question
[blank_start]Ventromedial prefrontal[blank_end] cortex is in charge of reward processing – think and visceral response to emotions
Answer
  • Ventromedial prefrontal

Question 12

Question
[blank_start]Hippocampus[blank_end] -Spatial navigation. Memory formation/storage [blank_start]Amygdala[blank_end] – Processes emotional stimuli. Receives information about physical needs. Initiates behavioral response [blank_start]Hypothalamus[blank_end] – Receives unprocessed sensory input. Connects endocrine system to nervous system via pituitary gland [blank_start]Thalamus[blank_end] – sensory processing. Hub of information transfer. Directs sensory input for processing
Answer
  • Hippocampus
  • Amygdala
  • Hypothalamus
  • Thalamus

Question 13

Question
The [blank_start]hippocampus[blank_end]: 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
Answer
  • hippocampus

Question 14

Question
Neuroanatomy of the hippocampus in anxiety
Answer
  • 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

Question 15

Question
The hippocampus is related to stress sensitivity and resiliency. A [blank_start]large[blank_end] hippocampus is protective agains anxiety disorders. A [blank_start]small[blank_end] hippcampus has increased risk of PTSD in the context of trauma
Answer
  • large
  • small
  • large
  • small

Question 16

Question
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?
Answer
  • Medial
  • Basal-lateral
  • Central group

Question 17

Question
Neuroendocrine pathways for the HPA (hypothalamic-pituitary-adrenal) axis. Let's review as this is probably an exam question: Activated by [blank_start]stress[blank_end] Hypothalamus releases [blank_start]corticotropin-releasing factor (CRF)[blank_end] CRF binds to receptors on [blank_start]anterior pituitary gland[blank_end] [blank_start]Adrenocorticotropic hormone (ACTH)[blank_end] is released ACTH binds to receptors on [blank_start]adrenal cortex[blank_end] [blank_start]Cortisol and adrenaline[blank_end] are released!
Answer
  • corticotropin-releasing factor (CRF)
  • anterior pituitary gland
  • Adrenocorticotropic hormone (ACTH)
  • adrenal cortex
  • Cortisol and adrenaline
  • stress

Question 18

Question
Function of the HPA axis is SAFETY & PROTECTION
Answer
  • True
  • False

Question 19

Question
Cortisol
Answer
  • 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

Question 20

Question
Adrenaline Increases [blank_start]heart[blank_end] rate, [blank_start]blood[blank_end] pressure, respiratory [blank_start]rate,[blank_end] and [blank_start]carbohydrate[blank_end] metabolism
Answer
  • heart
  • blood
  • rate,
  • carbohydrate

Question 21

Question
Chronic/prolonged stress = repeated/sustained HPA axis activation
Answer
  • True
  • False

Question 22

Question
[blank_start]Calming NT[blank_end]: γ-amino-butyric-acid (GABA) [blank_start]Excitatory NT:[blank_end] Glutamate [blank_start]Monoaminergic neurotransmitters[blank_end] Serotonin Norepinephrine Dopamine
Answer
  • Calming NT
  • Excitatory NT:
  • Monoaminergic neurotransmitters

Question 23

Question
Excessive [blank_start]glutamate[blank_end] activity causes anxiety, agitation, and seizures
Answer
  • glutamate

Question 24

Question
Benzodiazepines increase [blank_start]GABA[blank_end] activity at amygdala and PFC
Answer
  • GABA

Question 25

Question
[blank_start]GABA[blank_end] Principal inhibitory neurotransmitter [blank_start]Glutamate[blank_end] Principal excitatory neurotransmitter [blank_start]GABA[blank_end] Decreases neurons’ electrical excitability [blank_start]Glutamate[blank_end] Increases neurons’ electrical excitability [blank_start]Glutamate[blank_end] Necessary for attention/coordination [blank_start]GABA[blank_end] Calm, relaxation, sleep
Answer
  • GABA
  • Glutamate
  • GABA
  • Glutamate
  • GABA
  • Glutamate
  • Glutamate
  • GABA
  • Glutamate
  • GABA
  • GABA
  • Glutamate

Question 26

Question
Enhancing 5-HT input to the amygdala can [blank_start]reduce[blank_end] anxiety/fear
Answer
  • reduce
  • increase

Question 27

Question
Serotonin
Answer
  • 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

Question 28

Question
Norepinephrine
Answer
  • 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

Question 29

Question
Dopamine
Answer
  • 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

Question 30

Question
Catecholamine-O-methyltransferase (COMT) met genetic allele:
Answer
  • Enzyme which degrades dopamine and norepinephrine
  • COMT genotypes implicated in expression of anxiety and depression
  • Enzyme degraded serotonin and dompamine

Question 31

Question
Met genotype: [blank_start]Lower[blank_end] COMT activity = [blank_start]higher[blank_end] NT levels = [blank_start]excessive[blank_end] NT release under stress = WORRIER Val genotype: [blank_start]Higher[blank_end] COMT activity = [blank_start]lower[blank_end] NT levels = [blank_start]decreased[blank_end] NT release under stress = WARRIOR
Answer
  • Lower
  • Higher
  • higher
  • lower
  • excessive
  • decreased
  • Higher
  • Lower
  • lower
  • higher
  • decreased
  • excessive

Question 32

Question
Which gene regulates the HPA axis and monoaminergic signaling
Answer
  • 5-HTTLPR: Serotonin transporter
  • Catecholamine-O-methyltransferase (COMT)
  • Methylenetetrahydrofolate reductas

Question 33

Question
The [blank_start]short (S)[blank_end] allele of 5-HTTLPR: Serotonin transporter puts a patient as risk for anxiety
Answer
  • short (S)
  • long (L)

Question 34

Question
What environmental factors play a part in increasing anxiety?
Answer
  • Physical/sexual trauma
  • Substance abuse
  • Chronic chaos/neglect
  • Adverse Childhood Experiences (ACE)
  • VUSN PMHNP program
  • News that the world is facing a tequila shortage

Question 35

Question
Substance-Induced Anxiety Disorders can be caused by the following drugs except
Answer
  • Sympathomimetics (pseudophedrine)
  • Stimulants (Methylphenidate, Amphetamines)
  • Benzodiazepines
  • System and anabolic steroids
  • Drugs of abuse (cocaine, amphetamaines, hallucinogens, substance withdrawal)
  • Atypical antipsychotics

Question 36

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

Question 37

Question
DSM-5 Criteria for Panic Disorder include recurrent UNEXPECTED panic attacks, followed by 1 month of:
Answer
  • Persistent concern
  • Worry about implications or consequences of panic attacks
  • Maladaptive changes in behavior
  • Walks on the beach doing yoga

Question 38

Question
Agoraphobia is fear of situations with
Answer
  • Large wide open spaces
  • Too many people or large crowds
  • Escape is difficult or embarrassing

Question 39

Question
Neuroanatomy of panic disorder includes: [blank_start]Elevated[blank_end] glucose uptake in amygdala, hippocampus, and thalamus [blank_start]Decreased[blank_end] frontal lobe activity
Answer
  • Elevated
  • Decreased

Question 40

Question
Neurotransmitter pathways in panic disorder: [blank_start]Decreased[blank_end] GABA concentrations, elevated glutamatergic signaling [blank_start]Decreased[blank_end] serotonin receptor binding, increased norepinephrine concentration
Answer
  • Decreased
  • Increased
  • Decreased
  • Increased

Question 41

Question
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
Answer
  • True
  • False

Question 42

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

Question 43

Question
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
Answer
  • True
  • False

Question 44

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

Question 45

Question
Specific Phobia Neuroanatomy: activation of [blank_start]amygdala[blank_end], decreased [blank_start]prefrontal cortex response[blank_end]
Answer
  • amygdala
  • prefrontal cortex response

Question 46

Question
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
Answer
  • True
  • False

Question 47

Question
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.
Answer
  • True
  • False

Question 48

Question
Neuroanatomy of Social Anxiety Disorder: [blank_start]Hyperactive[blank_end] prefrontal cortex - misinterpreting social cues [blank_start]Hyperreactive[blank_end] amygdala - receives sensory information before analysis and signals the sympathetic nervous system
Answer
  • Hyperactive
  • Hypoactive
  • Hyperreactive
  • Hypoactive

Question 49

Question
Genetics of social anxiety disorder involve Serotonin transporter (5-HTT) which governs reuptake of serotonin into the neuron. The [blank_start]short[blank_end] 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
Answer
  • short

Question 50

Question
Generalized anxiety disorder has the youngest age of onset for an anxiety disorder
Answer
  • True
  • False

Question 51

Question
Excessive worries/anxiety for at least [blank_start]6 month[blank_end]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
Answer
  • 6 months
  • 3 months

Question 52

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

Question 53

Question
5-HTTLPR [blank_start]short[blank_end]-allele carriers are highly sensitive to environmental threats. Hypervigilance
Answer
  • short

Question 54

Question
The following are all forms of obsessive-compulsive disorders:
Answer
  • 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

Question 55

Question
Tourette's Syndrome is a frequent comorbidity of obsessive compulsive disorder
Answer
  • True
  • False

Question 56

Question
The following are all true about OCD DSM-5 criteria
Answer
  • 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

Question 57

Question
OCD is real anatomical issue
Answer
  • True
  • False

Question 58

Question
In obsessive compulsive disorder there is [blank_start]orbitofrontal[blank_end] cortex overactivity but smaller volume which leads to context-related processing and response inhibition
Answer
  • orbitofrontal

Question 59

Question
In obsessive compulsive disorder there is abnormal activity in [blank_start]cortico-striatal-thalamo-cortical (CSTC)[blank_end] feedback loop. These circuits use “direct” (excitatory) or “indirect” (inhibitory) routes from cortex through [blank_start]basal ganglia[blank_end] to [blank_start]thalamus.[blank_end]
Answer
  • cortico-striatal-thalamo-cortical (CSTC)
  • basal ganglia
  • thalamus.

Question 60

Question
CSTC or "worry" loop is involved in obsessive compulsive disorder. It includes the [blank_start]basal ganglia[blank_end] which nuclei grouped together based on interconnected roles in movement and cognition. It includes Includes [blank_start]globus pallidus[blank_end], putamen, caudate nucleus. Specifically the striatum Includes [blank_start]putamen[blank_end] and caudate nucleus.
Answer
  • basal ganglia
  • globus pallidus
  • putamen

Question 61

Question
In obsessive compulsive disorder, the CSTC loop receives input to [blank_start]basal ganglia[blank_end] from [blank_start]cortex[blank_end] and [blank_start]thalamus[blank_end]
Answer
  • basal ganglia
  • cortex
  • thalamus

Question 62

Question
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
Answer
  • True
  • False

Question 63

Question
“Direct” basal ganglia pathway: Direct projections from [blank_start]striatum[blank_end] to [blank_start]globus pallidus[blank_end] Increases [blank_start]excitatory[blank_end] thalamic input to the cortex Turns [blank_start]up[blank_end] motor activity
Answer
  • striatum
  • globus pallidus
  • excitatory
  • inhibitory
  • up
  • down

Question 64

Question
The [blank_start]"direct"[blank_end] basal ganglia pathway is involved in the activation of tics, compulsions, and obsessions. It is [blank_start]overactive[blank_end] in OCD.
Answer
  • "direct"
  • "indirect"
  • overactive
  • underactive

Question 65

Question
“Indirect” basal ganglia pathway has [blank_start]Indirect[blank_end] projections from [blank_start]striatum[blank_end] to [blank_start]globus pallidus[blank_end] [blank_start]Inhibitory[blank_end] effect on [blank_start]thalamus[blank_end] and frontal cortex
Answer
  • Indirect
  • striatum
  • globus pallidus
  • Inhibitory
  • excitatory
  • thalamus
  • hippocampus

Question 66

Question
"Direct" basal ganglia pathway is the "gas" and the "indirect" basal ganglia is the brake when it comes to motor activity
Answer
  • True
  • False

Question 67

Question
OCD occurs when delicate balance between inhibition and excitation of basal ganglia pathway is disrupted
Answer
  • True
  • False

Question 68

Question
Neuroanatomy of OCD involves Increased activity in CSTC circuit running from [blank_start]frontal cortex[blank_end] to [blank_start]striatum[blank_end] to [blank_start]globus pallidus[blank_end] to [blank_start]thalamus[blank_end] and back to [blank_start]cortex[blank_end]
Answer
  • frontal cortex
  • striatum
  • globus pallidus
  • thalamus
  • cortex

Question 69

Question
In OCD, there is increased Increased activity in prefrontal cortex, basal ganglia, and [blank_start]amygdala[blank_end]
Answer
  • amygdala

Question 70

Question
What is the treatment for OCD
Answer
  • 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

Question 71

Question
Serotonin, dopamine and glutamate are involved in OCD. There are [blank_start]reduced[blank_end] serotonin transporters in midbrain. There is [blank_start]increased[blank_end] dopamine. There is [blank_start]increased[blank_end] glutamate.
Answer
  • reduced
  • increased
  • increased
  • decreased
  • increased
  • decreased

Question 72

Question
Considering what we know about 5HT, DA, and Glu in OCD, which drugs are most effective
Answer
  • 5HT drugs
  • DA antagonists
  • Antipsychotics
  • Stimulants

Question 73

Question
A patient with OCD will be in a hyperglutamatergic state in prefrontal regions and have elevated glutamate in cerebrospinal fluid
Answer
  • True
  • False

Question 74

Question
An [blank_start]earlier[blank_end] onset of OCD is indicative of a higher risk of heritability
Answer
  • earlier
  • later

Question 75

Question
Of the following comorbidities with seen OCD, which has the highest incidence of PTSD
Answer
  • TBI
  • Substance abuse disorders
  • Depression and anxiety disorders

Question 76

Question
DSM 5 criteria for PTSD involve exposure to [blank_start]trauma[blank_end], [blank_start]re-experiencing,[blank_end] [blank_start]avoidance[blank_end], [blank_start]negative alterations in mood/cognition[blank_end], and [blank_start]increased arousal.[blank_end]
Answer
  • trauma
  • re-experiencing,
  • avoidance
  • negative alterations in mood/cognition
  • increased arousal.

Question 77

Question
The neuroanatomy of the PTSD involves: [blank_start]Reduced[blank_end] volume of hippocampus and frontal cortex Amygdala [blank_start]hyperresponsiveness[blank_end] [blank_start]Decreased[blank_end] activity in PFC
Answer
  • Reduced
  • Increased
  • hyperresponsiveness
  • hyporesponsiveness
  • Decreased
  • Increasedp

Question 78

Question
The following NT are involved in PTSD EXCEPT:
Answer
  • Dopamine
  • Norepinephrine
  • Serotonin
  • Glutamate

Question 79

Question
Which drug exhibits inhibitory effects on glutamate transmission and thus is good for PTSD
Answer
  • Topiramate
  • Aripiprazole
  • Venlafaxine

Question 80

Question
Glutamate
Answer
  • 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

Question 81

Question
What medication should you not give to PTSD because of the unremitting elevation in NE in the CSF of patients with PTSD?
Answer
  • Bupropion
  • Citalopram
  • Venlafaxine
  • Fluoxetine

Question 82

Question
In PTSD, patients have a [blank_start]decreased[blank_end] cortisol concentrations and a/n [blank_start]flattened[blank_end] cortisol slope
Answer
  • decreased
  • increased
  • flattened
  • elevated

Question 83

Question
Treatment for anxiety disorders include:
Answer
  • SSRI
  • NDRI
  • BZ
  • Anticonvulsants
  • Antipsychotics
  • CBT
  • Mindfulness based stress reduction
  • EMDR

Question 84

Question
MOA of BZ in anxiety involves BZ [blank_start]increasing[blank_end] the efficiency of GABA to [blank_start]decrease[blank_end] the excitability of neurons. BZ bind to the y sub-unit of the [blank_start]GABA-A[blank_end] receptor. Binding causes a structural modification of the receptor that results in an increasein GABA-A activity. The result is an [blank_start]increase[blank_end] in the frequency of the [blank_start]Cl-[blank_end] channel (making the cell more negative) and [blank_start]inhibiting[blank_end] the action potential.
Answer
  • increasing
  • decrease
  • GABA-A
  • increase
  • Cl-
  • inhibiting

Question 85

Question
Chronic/prolonged stress = repeated/sustained HPA axis activation which causes: [blank_start]Musculoskeletal:[blank_end] Chronic muscle tension, tension headaches, migraines [blank_start]Respiratory:[blank_end] Exacerbation of existing conditions (asthma, emphysema, etc.) [blank_start]Cardiovascular:[blank_end] Increased risk of heart attack, hypertension, stroke [blank_start]Endocrine:[blank_end] Increased risk of diabetes in vulnerable populations [blank_start]Gastrointestinal:[blank_end] Acid reflux, ulcers, diarrhea, constipation, nausea/vomiting Reproductive: [blank_start]Male:[blank_end] Impaired testosterone production and sperm maturation, impotence [blank_start]Female:[blank_end] Irregular menstrual cycles, impaired sexual desire
Answer
  • Musculoskeletal:
  • Respiratory:
  • Cardiovascular:
  • Endocrine:
  • Gastrointestinal:
  • Male:
  • Female:
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