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Psychiatry (Calum) > Psychosis: basic sciences > Flashcards

Psychosis: basic sciences Flashcards

1
Q

What structural brain features are seen in a patient with poor prognosis?

A

reduced frontal lobe volume
reduced frontal lobe grey matter
enlarged lateral ventricles

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2
Q

What happens to grey matter volume in schizophrenic patients?

A

Reduced

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3
Q

In schizophrenia, grey matter loss occurs in focal points - T/F?

A

False - widely distributed

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4
Q

Neuronal loss causes the grey matter reduction in schizophrenia - T/F?

A

False - reduced arborisation causes grey matter loss.

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5
Q

What imaging modality is used to investigate white matter in the brain?

A

Diffusion tensor imaging

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6
Q

is it possible to diagnose schizophrenia by radiology?

A

No - normal variation in healthy brain structure precludes this.

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7
Q

Is ventricular enlargement progressive when found at diagnosis?

A

No - non-progressive

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8
Q

Is gliosis a common feature of schizophrenia?

A

No

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9
Q

Which neurotransmitter is commonly thought to be responsible for the pathology in schizophrenia?

A

dopamine - drugs which release dopamine in the brain induce a psychotic state in man.

AMPHETAMINE

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10
Q

Why can dopamine receptor antagonists be used to treat schizophrenia?

A

it is assumed that schizophrenia is related to overactivity in dopamine pathways of the brain.

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11
Q

What are the 3 main dopaminergic pathways in the brain?

A

nigrostriatal

mesolithic/cortical

tuberinfundibular

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12
Q

What is the function of the D1 receptor family?

A

stimulate cAMP

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13
Q

What is the function of D2 receptor family? (D2,3,4)

A

inhibit adenylyl cyclase

inhibit voltage-activated Ca2+ channels

open K+ channels

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14
Q

Which drugs inhibit D2 receptors?

A

haloperidol

raclopride

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15
Q

Which receptors does raclopride block?

A

D2 + D3

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16
Q

Where are D1 and D2 receptors found?

A

limbic and striatal areas

17
Q

Where are D5 receptors found?

A

hippocampus

hypothalamus

18
Q

Where are D4 receptors found?

A

midbrain

amygdala

19
Q

Which medication acts as an antagonist to D4 receptors?

A

Clozapine

20
Q

What happens in subcortical dopamine hyperactivity?

A

psychosis

21
Q

Which gene alterations are identified in psychotic brain pathology?

A

neuregulin

dysbindin

DISC-1

22
Q

What is neuregulins role?

A

a signalling protein that mediates cell-cell interactions and plays critical roles in growth and development

23
Q

What is the role of dysbindin?

A

essential for adaptive neural plasticity

24
Q

What is the function of DISC-1?

A

involved in neurite outgrowth and cortical development through its interaction with other proteins

25
Q

What are some examples of typical antipsychotics?

A 
chlorpromazine 
thioridazine 
fluphenazine 
haloperidol 
primozide
26
Q

in antipsychotics, the blockade of D2 is immediate, and clinical effect if instant - T/F?

A

False - blockade is immediate and clinical effect is delayed.

27
Q

What is beneficial about atypical antipsychotics?

A

less likely to cause extrapyramidal side-effects

better efficacy against negative symptoms

effective in refractory patients

28
Q

Name some atypical antipsychotic drugs

A 
clozapine 
aripiprazole 
risperidone 
quetiapine 
olanzapine
29
Q

What are some common side effects of D2 blockade?

A

EPSE

Hyperprolactinaemia

30
Q

What side-effects are caused by Serotonin blockade

A

metabolic syndrome - modulate immune response and inflammation.

weight gain may partially involve antagonist activity at 5-HT2C

31
Q

What side-effects are seen in histamine blockade?

A

sedation

increased appetite

32
Q

What are the side-effects of alpha adrenergic blockade?

A

increased BP and HR

postural hypotension

33
Q

What effects are seen in muscarinic receptor blockade?

A

dry mouth
constipation
urinary retention
dizziness

34
Q

What are common side effects of clozapine?

A

weight gain

tiredness

35
Q

Which serious side-effect of clozapine renders continuous monitoring appropriate?

A

agranulocytosis

36
Q

How often is a full blood count done in clozapine patients?

A

weekly for first 6m
fortnightly for next 6m
every four weeks thereafter
for one month after stopping clozapine

37
Q

Can clozapine induce myocarditis?

A

Yes

Psychiatry (Calum) (26 decks)

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