Exam Questions and CORRECT Answers
theories of schizophrenia. - CORRECT ANSWER - Elevations of dopamine, epigenetics
(genes being turned on and off due to environment), eNMDA/ glutamate defective genes
inherited- environmental pressures turn on defective genes
mesocortical dopamine pathway - CORRECT ANSWER - Neg symptoms: 5 As alogia,
avolition, asociality, anhendonia, affective blunting, VTA to prefrontal cortex: cognitive
changes, slowing of thought (low levels of dopamine in mesocortical pathway), drugs target this
area to inc dopamine (because there is less dopamine)
tuberoinfundibular dopamine pathway - CORRECT ANSWER - inc prolactin, due to the
hypothamus, blocks dopamine, which in turn increases prolactin (inverse relationship with
dopamine (amenorrhea, galactorrhea (milk in breast)-risperidone
nigrostriatal dopamine pathway - CORRECT ANSWER - Movement disorders: tardive
dyskinesia, extrapyramidal symptoms, parkinsons's, slow brady-dyskinesia, tremors
mesolimbic dopamine pathway - CORRECT ANSWER - positive symptoms:
(hallucinations, rapid speech, delusions) hyperactivity in this pathway. The mesolimbic pathway,
sometimes referred to as the reward pathway, is a dopaminergic pathway in the brain.
conventional/typical antipsychotics - CORRECT ANSWER - haloperidol and
chlorpromazine (1st generation) tend to block dopamine D2 receptors in all of the dopaminergic
pathways of the brain.
atypical 2nd generations - CORRECT ANSWER - Less EPS, less movement disorders,
less side effects; Nonselectivity of receptor sites, serotonin (5HT) blocker also (stimulates
dopamine release further down in the brain), dopamine blocker (dopamine is not blocked as fully
as conventional antipsychotics)
, EPS - CORRECT ANSWER - Caused by blocking of dopamine D2 receptors (risperidone
inc'd risk of EPS in high doses)
tardive dyskinesia - CORRECT ANSWER - Low dopamine in the nigrostriatal ( d/t to
blockage of D2 receptors) long term antipsychotics esp 1st gen. lip smacking repetitive and
uncontrolled (d/c med or +/- clozapine)
Risperidone - CORRECT ANSWER - has highest risk of these EPS (esp in high doses)
NMS - CORRECT ANSWER - Medical emergency
High fevers, confusions, rigid muscles, low or variable BP, altered mental status, rapid breathing,
stiff, sweating, high HR: tx (3 d's )d/c antipsychotics/dantrolene/dopamine agonist
akathisia - CORRECT ANSWER - inability to sit still Inner restlessness, inc of movement
(can resolve over time)
Treat: beta blocker (propanolol),
Dystonia - CORRECT ANSWER - sustained muscular contraction oculogytric crisis
(anticholinergics)
Parkinsonism - CORRECT ANSWER - cogwheel rigidity, smacking, repetitive and
uncontrolled
contraindications long-acting injectable - CORRECT ANSWER - PO med first, check for
NMS, Parkinson's
Parkinson's tx - CORRECT ANSWER - benadryl and anticholinergic (benzotropine)
Beta blocker (lol) - CORRECT ANSWER - akathisia restlessness d/t low DA