schizophrenia Flashcards
capgrass syndrome
people replaced by imposters
fregoli syndrome
people replaced by one person
DeClerambault syndrome
public figure in love with you
neoligisms
terminology unique to themselves
key features of delirium
clouding of consciousness, visual hallucinations, impaired conc/memory
first rank symptoms of schizophrenia
auditory hallucinations, thought disorder, passivity phenomena, delusions
how many first rank symptoms and 2nd rank symptoms need to be present in order to have diagnosis of schizophrenia
1 st rank symtom and at least 2 second rank symptoms
examples of its generation anti-psychotics
haloperidol and chlorpromazine
2nd generation anti- psychotics
clozapine, rispiredone, quetiapine and olanzapine
name the 5 dopamine pathways
meso-limbic mesocortical tuberoinfundibulnar nitro-striatal hypothalamospinal
what dopamine receptor is being targeted in schizophrenia
D2
what dopamine receptor does clozapine act on
D4
what % of dopamine receptors are aimed to be blocked in schizophrenia
60-80%
what side effects are seen from blocking the nigrastriatal pathway
EXTRA PYRAMIDAL SIDE EFFECTS
acute dystonia
Parkinsonism
tardive dyskinesia
how would you manage EPSE from use of anti-psychotics
addition of anti-cholinergic eg Procyclidine
Neuroleptic malignant syndrome is a result of the blocking of what dopamine receptors
- hypothalamic pathway hippocampal dopamine receptors
what is neuroleptic malignant syndrome
increased muscle tone, pyrexia , changing pulse and Bp which lead to acute renal failure coma and then death
what blood markers would be increased in neuroleptic malignant syndrome
increased WCC and CK
treatment of neuroleptic malignant syndrome
- stop anti-psychotics
- rapid cooling and renal support
- skeletal muscle relaxants - dontroline
- dopamine agonist - bromocriptine
blockage of the tuberoinfundibulnar pathway would cause
Prolactin increase as norm inhibited by dopamine
what is akathisia and blocking of what dopamine pathway causes it ? treatment?
restless eg restless leg. due to hypothalamospinal pathway and treat with 1st - propranolol and 2nd clonazepam
side effects of clozapine
agranulocytosis, myocarditis, constipation , egt gain, sedation and excess saliva
how must clozapine be monitored
WBC count weekly for 6 months. then fortnight for next 6 months then ever month subsequently
how many anti-psychotics must be trailled before using clozapine
2 antipsychotics
what would be. seen on CT in schizophrenia
enlarged ventricles, reduced frontal lobe volume and grey matter, decreased activation of specific tasks
what dopamine receptor is the most abundant
D1
what do dopamine receptors D2,3,4 do ?
inhibit adenyl cyclase and inhibit voltage gated calcium channels and open k channels
