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Sem 3 Neuro > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

How much of the population does schizophrenia affect?

A

→ 1%

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2
Q

What gender is affected more?

A

→ men are more affected

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3
Q

What are positive symptoms in schizophrenia?

A

→ increase in abnormal behaviour in addition to normal behaviour

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4
Q

What are negative symptoms in schizophrenia?

A

→ absence of normal behaviour

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5
Q

What are cognitive symptoms in schizophrenia?

A

→ problems with thought processes

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6
Q

What are examples of positive symptoms?

A

→ hallucinations
→ delusions
→ disorganised thought/speech
→ movement disorders

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7
Q

What are examples of negative symptoms?

A 
→  social withdrawal
→  anhedonia
→  lack of motivation
→  poverty of speech 
→  emotional flatness
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8
Q

What are examples of cognitive symptoms?

A

→ impaired working memory
→ impaired attention
→ impaired comprehension

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9
Q

How long must symptoms last for?

A

→ 6 months

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10
Q

If an identical twin has schizophrenia what is the likelihood of the other twin having it?

A

→ 50%

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11
Q

What are 3 candidate genes for schizophrenia?

A

→ COMT
→ DISC1
→ GRM3

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12
Q

What are 4 pregnancy complications that can lead to schizophrenia?

A

→ low birth weight
→ premature birth
→ asphyxia
→ influenza

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13
Q

What are the 4 types of stress that can contribute to schizophrenia?

A

→ moving country
→ bereavement
→ loss of job/home/relationship
→ physical/emotional/sexual abuse

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14
Q

What kind of drug use can contribute?

A

→ cannabis
→ amphetamine
→ cocaine
→ LSD

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15
Q

What is the evidence for the dopamine hypothesis for schizophrenia?

A

→ DA is only released in mesocortical and mesolimbic not nigrostriatal
→ D2 agonists produce stereotyped behavior
→ Reserpine depletes DA and controls +ve symptoms
→ antagonist of the D2 receptor has antipsychotic effects
→ Amphetamine increases DA release in schizophrenics which makes the disease worse

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16
Q

What is the evidence against the dopamine hypothesis?

A

→ No change in DA receptors in drug free patients

→ No change in CSF HVA concentration

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17
Q

What are the 3 structural differences in schizophrenic brains?

A

→ brain is slightly smaller
→ grey matter is reduced
→ enlarged ventricles and smaller hippocampus

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18
Q

What are the 6 reasons that contribute to the pathophysiology of schizophrenia?

A 
→ Dopamine hypothesis
→ Brain structure differences
→ Hypofrontality
→ NMDA receptor hypofunction
→ Oxidative Stress
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19
Q

WHat is hypofrontality?

A

→ Reduced blood flow to the frontal cortex → reduced activity

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20
Q

What is the evidence for the glutamate hypothesis?

A

→ NMDA antagonists (PCP and ketamine) cause hallucinations and psychotic symptoms
→ Decreased glutamate receptor density in the prefrontal cortex
→ transgenic mice have decreased NMDA receptors and have decreased social interactions

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21
Q

What does NMDA hypofunction enhance and reduce?

A

→ enhances mesolimbic DAergic activity

→ reduces GABA striatal neuron activity

22
Q

What are the effects of Glutamate and Dopamine on GABA receptors?

A

→ Glutamate - excitatory

→ dopamine - inhibitory

23
Q

What does too little glutamate and too much dopamine cause in the brain?

A

→ uninhibited sensory input to limbic areas

24
Q

What is the evidence of the effect of 5-HT on schizophrenia?

A

→ LSD - partial 5-HT agonist causes hallucinations
→ many antipsychotics antagonise 5-HT receptors
→ 5-HT activates DA pathways

25
Q

What does 5-HT2A antagonism cause?

A

→ antipsychotic effect

→ reduce movement disorder side effects

26
Q

What is the main current theory for schizophrenia?

A

→ over stimulation mesolimbic of D2 receptors
→ Hypoactivity of frontal cortical D1 receptors
→ reduced pre frontal glutaminergic activity
→ 5-HT involved

27
Q

What are the two categories of antipsychotics?

A

→ typicals

→ atypicals

28
Q

What do typicals do?

A

→ antagonise D2 receptors

29
Q

What do atypicals do?

A

→ 5-HT2A agonists and D2 agonists

30
Q

Why are atypicals better than typicals?

A

→ they produce fewer side effects and are more effective at treating the negative symptoms
→ typicals are only effective in treating positive symptoms

31
Q

What are the effects of a D2 blockade on the nigrostriatal pathway?

A

→ Parkinsonian like symptoms
→ Dystonia
→ Akinesia
→ Tardive Dyskinesia

32
Q

What are the endocrine effects of a D2 blockade?

A

→ Breast swelling
→ Lactation
→ Impotence

33
Q

What are the effects of a D2 blockade on the mesocortical pathway?

A

→ Loss of motivation and reward pathways

→ sedation

34
Q

What are the effects of a D2 blockade on mesolimbic pathway?

A

→ Decreased hallucination and treats positive symptoms

35
Q

What other receptors do antipsychotics block other than D2?

A

→ Muscarinic
→ histamine
→ alpha adrenoceptos
→ 5-HT

36
Q

What is the effect of an alpha adrenoceptor blockade?

A

→ Postural hypotension
→ nasal congestion
→ hypothermia

37
Q

What is the effect of a muscarinic blockade?

A

→ Dry mouth
→ blurred vision
→ constipation
→ urinary retention

38
Q

What is the effect of blocking H1 and 5-HT?

A

→ H1 - sedation

→ 5-HT weight gain + photosensitisation

39
Q

What does prolactin do?

A

→ promotes milk production

40
Q

What are two schizoaffective disorders?

A

→ schizophrenia

→ bipolar

41
Q

What is the phase before the disease characterized by?

A

→ social isolation
→ interest in fringe cults
→ social withdrawal

42
Q

What are the 4 phases of schizophrenia?

A

→ prodrome - late teens/early twenties mistaken for depression and anxiety
→ Active acute phase - onset of positive symptoms, differentiation between what is and isn’t real is difficult
→ remission - returning to normality
→ Relapse

43
Q

What are the requirements for a schizophreniform disease?

A

→ positive symptoms for at least a month but under 6 months

44
Q

What are the 4 kinds of auditory hallucinations?

A

→ voices talking about them in 3rd person
→ voicew talking to them
→ voices giving running commentary
→voiced echoing thoughts

45
Q

What is a delusion?

A

→ a fixed belief not consistent with cultural norms

46
Q

What are the two states of behavior that schizophrenics exhibit?

A

→ hyperactivity - destructiveness

→impulsive behavior - murder

47
Q

What cognitive defects do schizophrenics have?

A

→Decreased responsiveness to emotional issues.
→Incongruous affect
→Expression of affect inappropriate to circumstances.

48
Q

What are negative symptoms caused by?

A

→ decreased dopamine activity in the mesocortical system
→ decrease in D1
→ Decrease in glutamate (NMDA)

49
Q

What are positive symptoms caused by?

A

→ Increased dopamine activity in the mesolimbic pathway

→ Increased D2

50
Q

What is the mesolimbic pathway?

A

→ VTA to
→ nucleus accumbens
→ amygdala
→ hippocampus

51
Q

What is the mesocortical pathway?

A

→ VTA to cortex

52
Q

What is the tuberohypophyseal pathway?

A

→ dopamine in anterior pituitary inhibiting the release of prolactin

Sem 3 Neuro (21 decks)

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