Schizophrenia Pathology and Aetiology
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Questions and Answers

What is the primary characteristic of cortical pyramidal cells in schizophrenia?

  • Variable dendritic length and spine density
  • No change in dendritic length and spine density
  • Increased dendritic length and spine density
  • Reduced dendritic length and spine density (correct)
  • What is the main theory that explains the positive symptoms of schizophrenia?

  • Dopamine hypofunction
  • Dopamine hyperactivity (correct)
  • GABA receptor dysfunction
  • Serotonin imbalance
  • What is the primary difference between typical and atypical antipsychotic drugs?

  • Typical antipsychotics are more commonly used, while atypical antipsychotics are less commonly used
  • Typical antipsychotics are more specific to dopamine D2 receptors, while atypical antipsychotics are more specific to serotonin receptors
  • Typical antipsychotics are more effective, while atypical antipsychotics have more side effects
  • Typical antipsychotics are developed pre-1980s, while atypical antipsychotics are developed post-1980s (correct)
  • What is the side effect of typical antipsychotic drugs due to the block of dopamine transmission within the nigrostriatal pathway?

    <p>Pseudoparkinsonism</p> Signup and view all the answers

    What is the result of chronic use of typical antipsychotic drugs on dopamine D2 receptors?

    <p>Up-regulation of dopamine D2 receptors</p> Signup and view all the answers

    What is the common side effect of atypical antipsychotic drugs that affects glucose metabolism?

    <p>Insulin resistance</p> Signup and view all the answers

    What is the age range when schizophrenia typically emerges?

    <p>Adolescence or young adult life</p> Signup and view all the answers

    What is the suggested role of dopamine in schizophrenia?

    <p>Dopamine hyperactivity underlies positive symptoms</p> Signup and view all the answers

    What is the effect of amphetamine on patients with schizophrenia?

    <p>It induces psychotic-like symptoms</p> Signup and view all the answers

    What is the mechanism of action of typical antipsychotic drugs?

    <p>They act as antagonists for DA D2 and a-adrenoceptor</p> Signup and view all the answers

    What is the side effect of atypical antipsychotic drugs that affects the immune system?

    <p>Leucopenia or agranulocytosis</p> Signup and view all the answers

    What is the term for the abnormal movements of the face, tongue, and limbs caused by chronic use of typical antipsychotic drugs?

    <p>Tardive dyskinesia</p> Signup and view all the answers

    What is the primary neuroanatomical feature of schizophrenia?

    <p>Reduced cortical grey matter</p> Signup and view all the answers

    What is the potential trigger for the development of schizophrenia during adolescence?

    <p>All of the above</p> Signup and view all the answers

    What is the primary mechanism of action of atypical antipsychotic drugs?

    <p>Antagonism of serotonin 5-HT2 receptors</p> Signup and view all the answers

    What is the primary cognitive symptom of schizophrenia?

    <p>Impaired attention</p> Signup and view all the answers

    What is the potential long-term consequence of typical antipsychotic drug use?

    <p>Tardive dyskinesia</p> Signup and view all the answers

    What is the primary advantage of atypical antipsychotic drugs over typical antipsychotic drugs?

    <p>Fewer extrapyramidal side effects</p> Signup and view all the answers

    Study Notes

    Schizophrenia

    • Emerges in adolescence or young adulthood
    • Characterized by reduced cortical grey matter, supporting neurodegeneration within the cortex
    • Cortical pyramidal cells show reduced dendritic length and spine density

    Aetiology

    • Genetic predisposition
    • Environmental risk factors:
      • Cannabis exposure
      • Urban living
      • Stress during adolescence
      • Maternal factors:
        • Prenatal infections
        • Malnutrition

    Clinical Signs

    • Categorized into:
      • Positive symptoms:
        • Delusions
        • Abnormal behavior
        • Hallucinations
        • Illusions
        • Thought disorder
      • Negative symptoms:
        • Social withdrawal
        • Disorganized speech
        • Lack of drive
        • Flattened emotions
      • Cognitive symptoms:
        • Attention
        • Executive function
        • Learning
        • Memory

    Dopamine Hypothesis

    • Key evidence: dopamine hyperactivity underlies positive symptoms
    • Amphetamine induces stereotyped psychotic-like symptoms in patients
    • Increased number of D2 dopamine receptors in schizophrenic brains

    Antipsychotic Drugs

    Typical Antipsychotics

    • Developed pre-1980s
    • Examples:
      • Chlorpromazine
      • Haloperidol
    • Mechanism of action:
      • Act as antagonists for DA D2
      • Also affect a-adrenoceptor > dopamine D1
    • Only tackles positive symptoms
    • Lag in clinical relief (reason unknown)

    Atypical Antipsychotics

    • Developed from 1980s onwards
    • Examples:
      • Clozapine
      • Olanzapine
      • Risperidone
    • Mechanism of action:
      • Act as antagonists for 5-HT2 > DA-D4 ≥ DA-D2 = DA-D1 = a-adrenoceptor = mACh = Histamine H1

    Side Effects of Antipsychotic Drugs

    Typical Antipsychotics

    • Extra-pyramidal side effects:
      • Pseudoparkinsonism (stooped posture, bradykinesia, rigidity, tremors)
      • Acute dystonias (facial grimacing, muscle spasms of face, neck + back)
      • Akathisia (restless, feet rock back + forth)
      • Tardive dyskinesia (protruding tongue, lip smacking, facial dyskinesia, involuntary movements of limbs)

    Atypical Antipsychotics

    • Side effects:
      • Sedation
      • Leucopenia or agranulocytosis
      • Weight gain
      • Impaired glycemic control causing insulin resistance

    Schizophrenia

    • Emerges in adolescence or young adulthood
    • Characterized by reduced cortical grey matter, supporting neurodegeneration within the cortex
    • Cortical pyramidal cells show reduced dendritic length and spine density

    Aetiology

    • Genetic predisposition
    • Environmental risk factors:
      • Cannabis exposure
      • Urban living
      • Stress during adolescence
      • Maternal factors:
        • Prenatal infections
        • Malnutrition

    Clinical Signs

    • Categorized into:
      • Positive symptoms:
        • Delusions
        • Abnormal behavior
        • Hallucinations
        • Illusions
        • Thought disorder
      • Negative symptoms:
        • Social withdrawal
        • Disorganized speech
        • Lack of drive
        • Flattened emotions
      • Cognitive symptoms:
        • Attention
        • Executive function
        • Learning
        • Memory

    Dopamine Hypothesis

    • Key evidence: dopamine hyperactivity underlies positive symptoms
    • Amphetamine induces stereotyped psychotic-like symptoms in patients
    • Increased number of D2 dopamine receptors in schizophrenic brains

    Antipsychotic Drugs

    Typical Antipsychotics

    • Developed pre-1980s
    • Examples:
      • Chlorpromazine
      • Haloperidol
    • Mechanism of action:
      • Act as antagonists for DA D2
      • Also affect a-adrenoceptor > dopamine D1
    • Only tackles positive symptoms
    • Lag in clinical relief (reason unknown)

    Atypical Antipsychotics

    • Developed from 1980s onwards
    • Examples:
      • Clozapine
      • Olanzapine
      • Risperidone
    • Mechanism of action:
      • Act as antagonists for 5-HT2 > DA-D4 ≥ DA-D2 = DA-D1 = a-adrenoceptor = mACh = Histamine H1

    Side Effects of Antipsychotic Drugs

    Typical Antipsychotics

    • Extra-pyramidal side effects:
      • Pseudoparkinsonism (stooped posture, bradykinesia, rigidity, tremors)
      • Acute dystonias (facial grimacing, muscle spasms of face, neck + back)
      • Akathisia (restless, feet rock back + forth)
      • Tardive dyskinesia (protruding tongue, lip smacking, facial dyskinesia, involuntary movements of limbs)

    Atypical Antipsychotics

    • Side effects:
      • Sedation
      • Leucopenia or agranulocytosis
      • Weight gain
      • Impaired glycemic control causing insulin resistance

    Schizophrenia

    • Emerges in adolescence or young adulthood
    • Characterized by reduced cortical grey matter, supporting neurodegeneration within the cortex
    • Cortical pyramidal cells show reduced dendritic length and spine density

    Aetiology

    • Genetic predisposition
    • Environmental risk factors:
      • Cannabis exposure
      • Urban living
      • Stress during adolescence
      • Maternal factors:
        • Prenatal infections
        • Malnutrition

    Clinical Signs

    • Categorized into:
      • Positive symptoms:
        • Delusions
        • Abnormal behavior
        • Hallucinations
        • Illusions
        • Thought disorder
      • Negative symptoms:
        • Social withdrawal
        • Disorganized speech
        • Lack of drive
        • Flattened emotions
      • Cognitive symptoms:
        • Attention
        • Executive function
        • Learning
        • Memory

    Dopamine Hypothesis

    • Key evidence: dopamine hyperactivity underlies positive symptoms
    • Amphetamine induces stereotyped psychotic-like symptoms in patients
    • Increased number of D2 dopamine receptors in schizophrenic brains

    Antipsychotic Drugs

    Typical Antipsychotics

    • Developed pre-1980s
    • Examples:
      • Chlorpromazine
      • Haloperidol
    • Mechanism of action:
      • Act as antagonists for DA D2
      • Also affect a-adrenoceptor > dopamine D1
    • Only tackles positive symptoms
    • Lag in clinical relief (reason unknown)

    Atypical Antipsychotics

    • Developed from 1980s onwards
    • Examples:
      • Clozapine
      • Olanzapine
      • Risperidone
    • Mechanism of action:
      • Act as antagonists for 5-HT2 > DA-D4 ≥ DA-D2 = DA-D1 = a-adrenoceptor = mACh = Histamine H1

    Side Effects of Antipsychotic Drugs

    Typical Antipsychotics

    • Extra-pyramidal side effects:
      • Pseudoparkinsonism (stooped posture, bradykinesia, rigidity, tremors)
      • Acute dystonias (facial grimacing, muscle spasms of face, neck + back)
      • Akathisia (restless, feet rock back + forth)
      • Tardive dyskinesia (protruding tongue, lip smacking, facial dyskinesia, involuntary movements of limbs)

    Atypical Antipsychotics

    • Side effects:
      • Sedation
      • Leucopenia or agranulocytosis
      • Weight gain
      • Impaired glycemic control causing insulin resistance

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    Description

    This quiz covers the pathology and aetiology of schizophrenia, including its emergence in adolescence, reduced cortical grey matter, and potential genetic and environmental risk factors. It also touches on the clinical signs and symptoms of the disorder.

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