Module 1A

Question 1

Physiology

Question 2

Neuroanatomy

Question 3

Epidemiology

Answer 3

M=W
1st appearance 16-30yo
W age of onset 5yr later
1% aussies
increase risk of mort/ suicide (10-20yr decreased life expectancy)

Question 4

Pathophysiology

Question 5

Positive Symptoms (DHDG)

Answer 5

Delusions
Hallucinations
Disorganised thinking
Grossly disorganised / abnormal motor behaviour

Question 6

Negative symptoms (5 As)

Answer 6

Affective flattening
Alogia (limited speech)
Avolition (limited goals)
Anhedonia (limited feeling)
Attentoial impairment (innatentivness)

Question 7

Cognitive Symptoms (3)

Answer 7

understanding [poor executive functioning (absorb/ interpret info)]
memory (inability to retain/ apply info)
learning( attentional impairment)

overlap wth neg symptoms
hard to recognise as part of disorder
impair px ability to lead a normal life

Question 8

What are the 4 neurotransmission pathways involved in schizophrenia

Answer 8

1. Mesolimbic Pathway
2. Mesocortical Pathway

Question 9

Over activation of mesolimbic Pathway

Answer 9

Excess DA in limbic areas
leads to saturation of D2
account for positive symptoms (delusions/ hallucinations)

Question 10

Compare 1st gen and 2nd gen antipsychotics.

Answer 10

Both antagonise d2 receptor

atypical also act as antagonist at 5ht2a receptor

Question 11

Under activation of mesocortical pathway

Answer 11

da hypoactivtiy in mesocortical pathway = cognitive, negative and affective sympomts

improvement of positive sympoms comes at cost of worsening cognitive, negative and affective symptoms

Question 12

Nigrostriatal Dopamine Pathway

Answer 12

controls motor function and movement

untreated: is normal

treated: blocking d2 prevents da binding = Extrapyramidal Symptoms (eps)/ involuntary symptoms

progongled blocking of d2 = causes neuron to upregulate d2, = facial and tongue movements.

Question 13

Tuberofundibular Dopamine Pathway

Answer 13

hypothalamus to posterior pitu. (controls prolactin)

normal in untreated

d2 antag, reduce activity
cause proalctice levels to rise
increase breast secretions and irregular menstrual periods

Question 14

What does 5ht2a-r regulate?

Answer 14

DA release

Question 15

What happens when serotonin binds to the 5ht2a-r? And therefore what is the outcome of 2nd Gen drugs?

Answer 15

receptors are on dopamine neurons. After binding DA neuron inhibited providing breaking action on da release.

Therefore, atypical antipsychotics cause DA release.

Question 16

Which action predominates?

Answer 16

Depends on region of the brain