schizophrenia

Question 1

capgrass syndrome

Answer 1

people replaced by imposters

Question 2

fregoli syndrome

Answer 2

people replaced by one person

Question 3

DeClerambault syndrome

Answer 3

public figure in love with you

Question 4

neoligisms

Answer 4

terminology unique to themselves

Question 5

key features of delirium

Answer 5

clouding of consciousness, visual hallucinations, impaired conc/memory

Question 6

first rank symptoms of schizophrenia

Answer 6

auditory hallucinations, thought disorder, passivity phenomena, delusions

Question 7

how many first rank symptoms and 2nd rank symptoms need to be present in order to have diagnosis of schizophrenia

Answer 7

1 st rank symtom and at least 2 second rank symptoms

Question 8

examples of its generation anti-psychotics

Answer 8

haloperidol and chlorpromazine

Question 9

2nd generation anti- psychotics

Answer 9

clozapine, rispiredone, quetiapine and olanzapine

Question 10

name the 5 dopamine pathways

Answer 10

meso-limbic
mesocortical
tuberoinfundibulnar
nitro-striatal 
hypothalamospinal

Question 11

what dopamine receptor is being targeted in schizophrenia

Answer 11

D2

Question 12

what dopamine receptor does clozapine act on

Answer 12

D4

Question 13

what % of dopamine receptors are aimed to be blocked in schizophrenia

Answer 13

60-80%

Question 14

what side effects are seen from blocking the nigrastriatal pathway

Answer 14

EXTRA PYRAMIDAL SIDE EFFECTS
acute dystonia
Parkinsonism
tardive dyskinesia

Question 15

how would you manage EPSE from use of anti-psychotics

Answer 15

addition of anti-cholinergic eg Procyclidine

Question 16

Neuroleptic malignant syndrome is a result of the blocking of what dopamine receptors

Answer 16

• hypothalamic pathway hippocampal dopamine receptors

Question 17

what is neuroleptic malignant syndrome

Answer 17

increased muscle tone, pyrexia , changing pulse and Bp which lead to acute renal failure coma and then death

Question 18

what blood markers would be increased in neuroleptic malignant syndrome

Answer 18

increased WCC and CK

Question 19

treatment of neuroleptic malignant syndrome

Answer 19

1. stop anti-psychotics
2. rapid cooling and renal support
3. skeletal muscle relaxants - dontroline
4. dopamine agonist - bromocriptine

Question 20

blockage of the tuberoinfundibulnar pathway would cause

Answer 20

Prolactin increase as norm inhibited by dopamine

Question 21

what is akathisia and blocking of what dopamine pathway causes it ? treatment?

Answer 21

restless eg restless leg. due to hypothalamospinal pathway and treat with 1st - propranolol and 2nd clonazepam

Question 22

side effects of clozapine

Answer 22

agranulocytosis, myocarditis, constipation , egt gain, sedation and excess saliva

Question 23

how must clozapine be monitored

Answer 23

WBC count weekly for 6 months. then fortnight for next 6 months then ever month subsequently

Question 24

how many anti-psychotics must be trailled before using clozapine

Answer 24

2 antipsychotics

Question 25

what would be. seen on CT in schizophrenia

Answer 25

enlarged ventricles, reduced frontal lobe volume and grey matter, decreased activation of specific tasks

Question 26

what dopamine receptor is the most abundant

Answer 26

D1

Question 27

what do dopamine receptors D2,3,4 do ?

Answer 27

inhibit adenyl cyclase and inhibit voltage gated calcium channels and open k channels