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BRAIN AND BEHAVIOUR 2 > Schizophrenia > Flashcards

Schizophrenia Flashcards

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1
Q

What are the different types of schizophrenia?

A

Paranoid, disorganised, catatonic, undifferentiated and residual

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2
Q

What are the positive symptoms of schizophrenia?

A

Hallucinations, delusions, agitation and disorganised thinking

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3
Q

What are the negative symptoms of schizophrenia?

A

Introversion, apathy and low-self esteem

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4
Q

What are the cognitive symptoms of schizophrenia?

A

Poor memory, attention deficit and executive dysfunction

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5
Q

How can you diagnose schizophrenia?

A

Two or more of the following (present for significant portion during one month): delusions, hallucinations, disorganised speech, grossly disorganised behaviour and negative symptoms (affective flattening)

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6
Q

How do you test for frontal cortical dysfunction?

A

Wisconsin card sorting test

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7
Q

What is the concordance rate of schizophrenia?

A

50% between identical twins

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8
Q

What genes are associated with schizophrenia?

A

BDNF (neurotrophic factor), COMT (dopaminergic transmission), DAOA (glutamatergic transmission), Neuregulin 1 (neuroplasticity), dysbindin (D2 receptors)

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9
Q

What structural changes may you see in an MRI of those with schizophrenia?

A

Slightly larger ventricles and smaller mesial temporal lobe

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10
Q

How does blood flow change in those with schizophrenia?

A

Decrease in blood flow to the prefrontal cortex and an increase in blood flow to the thalamus and cerebellum

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11
Q

What is Kraepilinian dichotomy?

A

A progressive, deteriorating course of schizophrenia where there is loss of brain matter, and is a form of neurodegeneration

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12
Q

Why do symptoms of schizophrenia tend to develop around the age of 20?

A

Due to abnormalities int he later stages of neural maturation when the prefrontal cortex is developing around the age of 20

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13
Q

How does schizophrenia affect the mesolimbic and mesocortiyal pathways?

A

Hyperactivity in the mesolithic and hyperactivity in the mesocortical pathways (dopaminergic pathways)

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14
Q

What is the major drug target for schizophrenia?

A

D2 receptor, but dopamine receptors broadly

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15
Q

What are the first line treatments for schizophrenia?

A

Atypical antipsychotics (antagonise 5-HT2)

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16
Q

Why is clozapine a particularly good atypical antipsychotic drug?

A

It can be used in drug resistance

17
Q

How does clozapine work?

A

Blocks D4 receptors with high affinity to act as an atypical antipsychotic

18
Q

What are the side-effects of typical antipsychotics?

A

Extrapyramidal effects (such as parkinsonism and tardive dyskinesia), QT interval prolongation, sudden death and hyperprolactinaemia

19
Q

Why are atypical antipsychotics preferable to typical antipsychotics most of the time?

A

Less extrapyramidal effects (acute dystopias, parkinsonisms, tardive dyskinesias

20
Q

What is the cause of the extrapyramidal effects of typical antipsychotics?

A

The drugs require 60% occupancy of D2 to work but if there is greater than 80% this causes side-effects (very narrow therapeutic window)

21
Q

What are the side-effects of atypical antipsychotics?

A

Weight gain, hyperglycaemia, insulin resistance, dyslipidaemia and cardiovascular disease

22
Q

What is neuroleptic malignant syndrome?

A

Potentially lethal complication with symptoms of hyperpyrexia, muscle rigidity, tremor and confusion

23
Q

What is tardive dyskinesia?

A

Irreversible complication which involves the involuntary movement of the lips, jaw and face (grimacing), constant chewing or tongue thrusting

24
Q

What is the most common cause of tardive dyskinesia?

A

Taking typical antipsychotics for longer than a few months or years

25
Q

How may targeting the NMDA receptor be used in schizophrenia?

A

Schizophrenia is also associated with decreased glutamatergic transmission in the brian so potentiating the activity of NMDA receptor to resolve positive and negative symptoms

BRAIN AND BEHAVIOUR 2 (31 decks)

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