EXAM 2 Study Guide Flashcards
Definition: A set of symptoms in which a person’s mental capability, affective response and the capacity to recognize reality, communicate and relate it to others are impaired
Psychosis
What are these Symptoms of?
Delusions, Hallucinations, Disorganized Speech, Disorganized Behavior, Gross Distortions of Reality
Psychosis
Definition: A false belief of judgment about external reality, held despite incontrovertible evidence to the contrary, occurring especially in mental conditions
Delusion
What are types of delusions?
- Persecution
- Reference
- Grandiosity
- Somatic
What is the most common type of hallucination?
auditory
What is the most common type of delusions?
Persecutory
What are persecutory delusions?
where an individual may believe that they are being targeted or harmed
Definition: sensory perceptions without an external stimulus
Hallucinations
What are perceptual distortions?
reporting that familiar things and people seem different to someone even though they are not different
True or false:
Both hallucinations and perceptual distortions can happen with any of the 5 senses
True
What are the following examples of?
- rigid posture
- signs of tension
- inappropriate grins or giggles
- repetitive gestures
- mumbling to oneself
- glancing around as if they’re hearing voices
motor disturbances
What are the symptoms of paranoid psychosis?
- paranoid projection
- hostile belligerence
- grandiose expression
what is paranoid projection?
delusional beliefs that people are talking about/conspiring against you
what is hostile belligerence?
Verbal expression of hostility
ex: being overly rude and hostile in inappropriate situations
What is grandiose expression?
super big ego where they think they’re superior to everyone in the room
What type of psychosis do these symptoms represent?
- conceptual disorganization
- irrelevant or incoherent answers
- drifting from the subject
- using neologisms
- repeating certain words or phrases
- disorientation
- excitement (expressing feeling without restraint)
Disorganized Excited Psychosis
What are the symptoms of depressive psychosis?
- apathy
- retardation
- slowed speech
- very quiet when speaking
- fixed facial expressions
- anxious
- self punishment/ self blame
how long do symptoms of schizophrenia need to last for before making a diagnosis?
6 months
how long do the following symptoms need to last before classifying schizophrenia?
- delusions
- hallucinations
- disorganized speech
- grossly disorganized or catatonic behavior
- negative symptoms
1 month
What percentage of chance is it for a monozygotic twin to get schizophrenia if their twin has it?
48% likely
What percentage of chance is it for a sibling (non-twin) to get schizophrenia if their sibling has it?
9%
What are the five subcategories of schizophrenia?
- positive symptoms
- negative symptoms
- Cognitive symptoms
- aggressive/hostile symptoms
- depressive and anxious symptoms
Positive symptoms
involve excess of normal function
negative symptoms
a reduction of normal function
Cognitive symptoms
involves issues with thoughts and attention
aggressive/hostile symptoms
problems with impulse control
depressive and anxious symtpoms
involved depression and anxiety
Primary vs Secondary symptoms of schizophrenia
Primary: caused by the disorder
Secondary: caused by outside factors such as the drug
What are the 5 A’s associated with negative symptoms?
- Alogia
- Avolition
- Associability
- Anhedonia
- Affective blunting/flattening
What is Alogia?
dysfunction of communication
What is Avolition?
a reduction in desire, motivation, or persistence
What is Associability?
reduction in social drive and interaction
What is Anhedonia?
reduction in the ability to experience pleasure
What is Affective blunting/flattening?
restriction in the range and density of emotional expression
What are indoleamines derived from?
tryptophan
What is an example of an indoleamine?
serotonin
What are catecholamines derived from?
tyrosine
What is the first step of catecholamine biosynthesis?
L-tyrosine -> L-dopa
via tyrosine hydroxylase
What is the second step of catecholamine biosynthesis?
L-dopa -> Dopamine
via dopa-decarboxylase
What is the third step of catecholamine biosynthesis?
Dopamine -> Norepinephrine
via dopamine beta hydroxylase
What is the fourth step of catecholamine biosynthesis?
Norepinephrine -> Epinephrine
via Phenylethanolamine-N-methyltransferase (PNMT)
What is End Product Inhibition?
A regulatory mechanism where the end product of a pathway inhibits an enzyme involved in its own synthesis
What is the rate limiting step of Catecholamine biosynthesis?
Tyrosine Hydroxylase
What enzyme does End Product Inhibition?
Tyrosine Hydroxylase
What do MAO and catechol methyltransferase both inactivate
catecholamines
What are isoenzymes?
closely related enzymes aka in the same enzyme family
What is MAO-A selective for?
serotonin and norepinephrine
What is MAO-B selective for?
it acts on a broader spectrum of phenylamines
Does MAO-A or MAO-B break down dopamine?
MAO-B
Out of the 5, which dopamine receptors are D1-like?
D1 and D5
D1-like receptors are ____ protein coupled which leads to activation of adenylyl cyclase and an _____ of CAMP
Gs; increase
Which dopamine receptors are D2-like?
D2, D3, and D4
D2-like receptors are ___ protein coupled which leads to the Inhibition of adenylyl cyclase and a _____ of CAMP
Gi; decrease
Name the five dopamine pathways
- mesocortical
- mesolimbic
- nigrostriatal
- tuberoinfundibular
- thalamus-dopamine system
What is the mesocortical pathway for?
Cognitive functions
What is the mesolimbic pathway for?
pleasure and reward
What is the nigrostriatal pathway for?
movement
what is the tuberoinfundibular pathway for?
prolactin release
What is the thalamus-dopamine pathway for?
sensory information
What is the dopamine hypothesis for schizophrenia?
Drugs that increase dopamine will enhance/produce positive psychotic symptoms, and drugs and decrease dopamine will decrease or stop positive psychotic symptoms
Which dopamine pathways does the dopamine hypothesis for schizophrenia involve?
mesolimbic pathway
Conventional antipsychotics are D2 receptor agonist or antagonists?
antagonist
The __________ pathway is associated with the negative symptoms due to a deficiency in dopamine
mesocortical
What does Neuroleptic Induced Deficit Syndrome refer to?
negative symptoms being worsened by drugs that reduce dopamine
What specifically is the extrapyramidal system involved in?
involuntary motor actions
What does hyperactivity of the extrapyramidal system induce?
- chorea
- dyskinesia
- tics
What does dopamine deficiency in the extrapyramidal system induce?
- rigidity
- akinesia
- bradykinesia
What is characterized by repetitive, involuntary, purposeless movement that involves the nigrostriatal pathway?
tardive dyskinesia
What can cause tardive dyskinesia?
chronic treatment with neuroleptics that block dopamine receptors and cause upregulation
What is hyperprolactinemia?
increased prolactin levels
What three things is hyperprolactinemia associated with?
- galactorrhea
- amenorrhea
- sexual dysfunction
What is galactorrhea?
spontaneous flow of milk from the breast that is not associated with childbirth or nursing
What is amenorrhea?
absence of a menstrual period in a woman of reproductive age
a blockade of what receptor reduced extrapyramidal symptoms?
muscarinic receptor
Do dopamine and acetylcholine receptors interact with one another at muscarinic receptors?
yes
Are kinate receptors excitatory or inhibitory?
Both!
- Post-synaptically, they are excitatory
- Presynaptically, they are inhibitory
mGluR group 1 receptors are (pre/post)-synaptic and are (excitatory/inhibitory)
post; excitatory
mGluR groups 2 and 3 are both pre and postsynaptic and are strictly ____________-
inhibitory
What do enlarged ventricles, reduced gray matter, and less volume of the amygdala and hippocampus indicate?
schizophrenia
is schizophrenia associated with apoptosis, necrosis, or gliosis?
apoptosis
What is oxidative stress?
damage to cells caused by reactive oxygen species (ROS)
What is Superoxide?
it is a ROS and a free radical, meaning it has unpaired valence electrons and is unstable
What are the three forms of superoxide and where are are they active
- SOD-1 (cytoplasm)
- SOD-2 (mitochondria)
- SOD-3 (extracellular space)
What is an antagonists that inhibits NMDA?
ketamine
