Psychosis

Question 1

Positive symptoms
(Over-active functioning)

Answer 1

Hallucinations

Delusions

Disorganised thinking, speech and behaviour

Question 2

Negative symptoms
(Loss of functioning)

Answer 2

Lack of motivation

Poor self care

Blunted emotions

Reduced speech putlet

Anhedonia - loss of pleasure capacity

Question 3

2 theories of schizophrenia

Answer 3

Dopamine hypothesis..
Over-activity of dopaminergic neurons

Glutamate hypothesis = increased

Underactivity of NMDA receptors

Question 4

Dopaminergic pathways related to symptoms

Answer 4

Mesolimbic = reward, emotional behaviours > POSITIVE SYMPTOMS

Mesocortical = cognition > NEGATIVE SYMTPOMS

Nigrostrialtal = control motor movements > EPS

Tuberoinfundibular = normally inhibit prolactin release (increased in schizophrenia)

Question 5

What are EXTRAPYRAMIDAL SIDE EFFECTS EPS

Answer 5

Sedation
Weight gain
Raised prolactin
Dyslipidaemia
Hypersalivation
QT interval prolongation
anticholinergic effects
Sexual dysfunction
Blood dyscrasias
Orthostatic hypotension

Question 6

What is NEUROLEPTIC MALIGNANT SYNDROME

Answer 6

FATAL SIDE EFFECT OF OLD ANTIPSYCHOTICS
- high temps
- muscle rigidity
- confusion
- autonomic instability
- raised WBC count and CK (muscle breakdown)
- dehydration, Cardiac arrest = death

Question 7

Hyperprolactinaemia

Answer 7

Antagonism of D2 receptors (tuberinfundibular) = elevation of prolactin = inhibits GnRD and release of oestrogen snd progesterone = galactorrhoea, amenorrhoea, gynaecomastia, impotence

Question 8

Examples of
First gen ANTIPSYCHOTICS LAIs

Answer 8

Fluphenazine
Flupentixol
Zuclopenthixol
Haloperidol

• delivered by IM
• ARE ESTERS

Question 9

SGA - Long acting injectable

Name 1

Answer 9

Risperidone

Question 10

Choices of antipsychotics for

FIRSR EPISODE PSYCHOSIS

Answer 10

Amisulpride
Aripiprazole
Olanzapine
Quetiapine
Risperidone

Question 11

Do not use which antipsychotic in first episode psychosis

Answer 11

Olanzapine