NR 546 Test Your Knowledge Quizzes Weeks 1-7
(including midterm) Quiz Rationals
I will provide rationale statements for the quiz questions. You will note that there
are more than 5 listed this is because the quiz testbank is larger than 5 questions
and the additional information can help you prepare for the final and direct your
study.
Week 1 quiz
• The amygdala is associated with anxiety and perception of odors.
• The hippocampus is involved in memory and anxiety. The amygdala is
associated with anxiety and perception of odors. The prefrontal cortex is
associated with executive function. The thalamus is associated with motor
command processing
• The client’s cognitive status can result in an ethical concern if the client is
unable to self-determine care or is a danger to self or others. Ability to pay
is not an ethical issue.
• basal ganglia are a group of structures involved in voluntary motor
movements. Basal ganglia are also involved in cognition and emotion.
• Limbic system is associated with emotion and learning
• hippocampi are associated with long term memory
• Wernicke's area is associated with speech comprehension. Review
activity
• the dorsolateral prefrontal cortex (DLPFC) is concerned with higher level
functioning. The VLPFC is involved with motor inhibition the IFG contains
Broca's area which is associated with speech production understanding
grammar. Pliska Ch. 8
• the OFC is involved in decision making and social behavior with a focus on
punishment and rewards. The OFC inhibits and activates the amygdala and is
, activated when a risk assessment is required. Some behaviors associated
with the OFC include sex, sugar, pain, social humiliation, money, rewards,
fame, and aggression. The amygdala will identify a threat and then the OFC
will determine the risk or benefit of an action based on past experience.
Pliska Ch. 8, p.158
• At this time, 20 % of the world’s population is suffering from a
neurologic and/or psychiatric disorder.
Week 2 Clinical Tips & Pearls
All Sections
No unread replies.No replies.
Hello NR546 students, here are some clinical pearls and quiz bank rationales for
you.
• G protein linked systems, one of the signal transduction cascades, pass the
message from a first receptor to a second messenger .
• Glutamate is an excitatory neurotransmitter. (NEI glutamate video- the
glutamate sisters)
• CYP 3A4 is one of the 5 most important NT which include CYP 1A2, 2D6, 2C9,
2C19, 3A4. Dosing adjustments may be required. Stahl p. 46-
51.
• Smoking induces CYP1A2. Stahl p.48
• partial agonist- drug does not fully activate receptors; antagonist- drug
binds to receptor but does not activate a response; inverse agonist- drug
cause opposite effect of the agonist ;agonist- ;agonist- drug binds to the
receptor and activates a biological response
• G protein Linked systems and ion channel linked cascades are
triggered by neurotransmitters. Stahl p. 11
• Propagation of an action potential to the axon terminal is mediated by
voltage-sensitive sodium channels. Influx of sodium through voltage-
sensitive sodium channels at the axon terminal leads to opening of voltage-
, sensitive calcium channels, also at the axon terminal. Influx of calcium
through the open voltage sensitive calcium channels leads to docking of
synaptic vesicles and secretion of neurotransmitter into the synapse.
• Agonists cause ligand-gated ion channels to open more frequently.
• The communication between neurons at synapses is mediated by
neurotransmitter molecules and is therefore chemical. Stahl p. 6
• Transcription factors are proteins that bind to promoter sequences of
DNA to turn gene expression on and off.
• chemical neurotransmission is the foundation of psychopharmacology
Week 3 Clinical Pearls & Rationales
All Sections
No unread replies.No replies.
Hello NR546 students, please review the following clinical pearls and rationales to
prepare for our midterm exam.
• Major current hypothesis for the cause of schizophrenia proposes that
glutamate activity at N-methyl-d-aspartate (NMDA) receptors is
hypofunctional due to abnormalities in the formation of glutamatergic NMDA
synapses during neurodevelopment. Stahl p. 107
• EPSs manifest when dopamine receptor occupancy within the basal
ganglia reaches approximately 80% as the dopamine-mediated inhibition
of movement is now disinhibited (Refer to pathophysiology and the basal
ganglia model of movement)Stahl p.133 . See figure 5-4
• Risperidone has the highest risk for galactorrhea. Review
tuberofundiular pathway Stahl p.95
• clozapine is documented to decrease risk of suicide in schizophrenic
clients. Stahl p. 181
• "Aripiprazole is associated with the lowest risk weight gain.
• All pines are associated with weight gain. Though not associated with
large weight gain, lurasidone is not associated with less weight gain in
the same way as aripiprazole. Week 3 lecture "
• Haldol is a first-generation antipsychotic, which can cause a dystonic
reaction.
, • Although individual effects may vary from patient to patient, in general
conventional antipsychotics share the same primary mechanism of action
and do not differ much in their therapeutic profiles. There are, however,
differences in secondary properties, such as degree of muscarinic,
histaminergic, and/or alpha-adrenergic receptor antagonism, which can
lead to different side-effect profiles. Stahl
p.131 (including table 5-1 and Figure 5-2).
• Nearly all atypical antipsychotics (also known as 2nd generation) have an
affinity for blocking serotonin 2A receptors that is equal to or greater than
their affinity for blocking dopamine 2 receptors. The “pines” – clozapine,
olanzapine, quetiapine, and asenapine – all bind much more potently to the
serotonin 2A receptor than they do to the dopamine 2 receptor. The
“dones” – risperidone, paliperidone, ziprasidone, iloperidone, and
lurasidone – also bind more potently to the serotonin 2A receptor than to
the dopamine 2 receptor or show similar potency at both receptors. Stahl
p.141-143
• The tuberoinfundibular pathway is associated with
hyperprolactinemia Stahl p. 136
• The mesolimbic pathway is associated with positive symptoms. The
mesocortical pathway is associated with negative symptoms. The
nigrostriatal pathway is part of the extrapyramidal nervous system and
associated with extrapyramidal symptoms (EPS). the tuberoinfundibular
pathway is associated with hyperprolactinemia
• Clozapine is not a first line treatment, it is used when other antipsychotics
fail. Stahl, 182.After failure of two sequential adequate trials of
antipsychotic monotherapy, the recommended and evidence- based
treatment strategy is to switch to clozapine. Stahl p. 182
• Clozapine is one of the only antipsychotics that does not cause dystonia .
The other medications are not known for causing dystonia.
• Clozapine, though the gold standard, is the last medication you would
prescribe, it is for treatment resistant cases due to the serious side
effects which include agranulocytosis, myocarditis and seizures.
• Due to agranulocytosis, clozapine requires frequent CBCs. Know the
required frequency for lab draws.
(including midterm) Quiz Rationals
I will provide rationale statements for the quiz questions. You will note that there
are more than 5 listed this is because the quiz testbank is larger than 5 questions
and the additional information can help you prepare for the final and direct your
study.
Week 1 quiz
• The amygdala is associated with anxiety and perception of odors.
• The hippocampus is involved in memory and anxiety. The amygdala is
associated with anxiety and perception of odors. The prefrontal cortex is
associated with executive function. The thalamus is associated with motor
command processing
• The client’s cognitive status can result in an ethical concern if the client is
unable to self-determine care or is a danger to self or others. Ability to pay
is not an ethical issue.
• basal ganglia are a group of structures involved in voluntary motor
movements. Basal ganglia are also involved in cognition and emotion.
• Limbic system is associated with emotion and learning
• hippocampi are associated with long term memory
• Wernicke's area is associated with speech comprehension. Review
activity
• the dorsolateral prefrontal cortex (DLPFC) is concerned with higher level
functioning. The VLPFC is involved with motor inhibition the IFG contains
Broca's area which is associated with speech production understanding
grammar. Pliska Ch. 8
• the OFC is involved in decision making and social behavior with a focus on
punishment and rewards. The OFC inhibits and activates the amygdala and is
, activated when a risk assessment is required. Some behaviors associated
with the OFC include sex, sugar, pain, social humiliation, money, rewards,
fame, and aggression. The amygdala will identify a threat and then the OFC
will determine the risk or benefit of an action based on past experience.
Pliska Ch. 8, p.158
• At this time, 20 % of the world’s population is suffering from a
neurologic and/or psychiatric disorder.
Week 2 Clinical Tips & Pearls
All Sections
No unread replies.No replies.
Hello NR546 students, here are some clinical pearls and quiz bank rationales for
you.
• G protein linked systems, one of the signal transduction cascades, pass the
message from a first receptor to a second messenger .
• Glutamate is an excitatory neurotransmitter. (NEI glutamate video- the
glutamate sisters)
• CYP 3A4 is one of the 5 most important NT which include CYP 1A2, 2D6, 2C9,
2C19, 3A4. Dosing adjustments may be required. Stahl p. 46-
51.
• Smoking induces CYP1A2. Stahl p.48
• partial agonist- drug does not fully activate receptors; antagonist- drug
binds to receptor but does not activate a response; inverse agonist- drug
cause opposite effect of the agonist ;agonist- ;agonist- drug binds to the
receptor and activates a biological response
• G protein Linked systems and ion channel linked cascades are
triggered by neurotransmitters. Stahl p. 11
• Propagation of an action potential to the axon terminal is mediated by
voltage-sensitive sodium channels. Influx of sodium through voltage-
sensitive sodium channels at the axon terminal leads to opening of voltage-
, sensitive calcium channels, also at the axon terminal. Influx of calcium
through the open voltage sensitive calcium channels leads to docking of
synaptic vesicles and secretion of neurotransmitter into the synapse.
• Agonists cause ligand-gated ion channels to open more frequently.
• The communication between neurons at synapses is mediated by
neurotransmitter molecules and is therefore chemical. Stahl p. 6
• Transcription factors are proteins that bind to promoter sequences of
DNA to turn gene expression on and off.
• chemical neurotransmission is the foundation of psychopharmacology
Week 3 Clinical Pearls & Rationales
All Sections
No unread replies.No replies.
Hello NR546 students, please review the following clinical pearls and rationales to
prepare for our midterm exam.
• Major current hypothesis for the cause of schizophrenia proposes that
glutamate activity at N-methyl-d-aspartate (NMDA) receptors is
hypofunctional due to abnormalities in the formation of glutamatergic NMDA
synapses during neurodevelopment. Stahl p. 107
• EPSs manifest when dopamine receptor occupancy within the basal
ganglia reaches approximately 80% as the dopamine-mediated inhibition
of movement is now disinhibited (Refer to pathophysiology and the basal
ganglia model of movement)Stahl p.133 . See figure 5-4
• Risperidone has the highest risk for galactorrhea. Review
tuberofundiular pathway Stahl p.95
• clozapine is documented to decrease risk of suicide in schizophrenic
clients. Stahl p. 181
• "Aripiprazole is associated with the lowest risk weight gain.
• All pines are associated with weight gain. Though not associated with
large weight gain, lurasidone is not associated with less weight gain in
the same way as aripiprazole. Week 3 lecture "
• Haldol is a first-generation antipsychotic, which can cause a dystonic
reaction.
, • Although individual effects may vary from patient to patient, in general
conventional antipsychotics share the same primary mechanism of action
and do not differ much in their therapeutic profiles. There are, however,
differences in secondary properties, such as degree of muscarinic,
histaminergic, and/or alpha-adrenergic receptor antagonism, which can
lead to different side-effect profiles. Stahl
p.131 (including table 5-1 and Figure 5-2).
• Nearly all atypical antipsychotics (also known as 2nd generation) have an
affinity for blocking serotonin 2A receptors that is equal to or greater than
their affinity for blocking dopamine 2 receptors. The “pines” – clozapine,
olanzapine, quetiapine, and asenapine – all bind much more potently to the
serotonin 2A receptor than they do to the dopamine 2 receptor. The
“dones” – risperidone, paliperidone, ziprasidone, iloperidone, and
lurasidone – also bind more potently to the serotonin 2A receptor than to
the dopamine 2 receptor or show similar potency at both receptors. Stahl
p.141-143
• The tuberoinfundibular pathway is associated with
hyperprolactinemia Stahl p. 136
• The mesolimbic pathway is associated with positive symptoms. The
mesocortical pathway is associated with negative symptoms. The
nigrostriatal pathway is part of the extrapyramidal nervous system and
associated with extrapyramidal symptoms (EPS). the tuberoinfundibular
pathway is associated with hyperprolactinemia
• Clozapine is not a first line treatment, it is used when other antipsychotics
fail. Stahl, 182.After failure of two sequential adequate trials of
antipsychotic monotherapy, the recommended and evidence- based
treatment strategy is to switch to clozapine. Stahl p. 182
• Clozapine is one of the only antipsychotics that does not cause dystonia .
The other medications are not known for causing dystonia.
• Clozapine, though the gold standard, is the last medication you would
prescribe, it is for treatment resistant cases due to the serious side
effects which include agranulocytosis, myocarditis and seizures.
• Due to agranulocytosis, clozapine requires frequent CBCs. Know the
required frequency for lab draws.
