front 1
| back 1 A distorted or nonexistent sense of reality |
front 2 Postitive symptom clusters of schizophrenia | back 2 Hyperdopaminergic - Suspiciousness - Delusions - Hallucinations - Conceptual disorganization |
front 3 Negative symptom clusters of schizophrenia | back 3 Hypodopaminergic - Affective flattening - Alogia - Anhedonia - Avolition |
front 4 Cognitive symptom clusters of schizophrenia | back 4 Impaired attention Impaired working memory Impaired executive function |
front 5 How does neuronal migration contribute to the pathogenesis of schizophrenia | back 5 Affects positioning of neurons for local signaling. Abnormal positioning affects signaling |
front 6 How does synaptogensis contribute to the pathogenesis of schizophrenia | back 6 Ability to form synapses is critical for normal neurodevelopment |
front 7 How does synaptic DA availability contribute to the pathogenesis of schizophrenia | back 7 Expression of enzymes that metabolize DA (catechol-O-methyltransferase) can reduce DA availability |
front 8 How does glutamate and DA neurotransmission contribute to the pathogenesis of schizophrenia | back 8 Proper coordination of communication mediated by Glu and DA neurons is critical for normal neurodevelopment |
front 9 How does neuronal signaling contribute to the pathogenesis of schizophrenia | back 9 Higher number of loss of function mutations of SETD1A* gene compared to healthy people |
front 10 What are effects of expression of loss function mutations of SETD1A gene? | back 10 Loss of function leads to development of neurons with fewer than normal spines needed to relay signals compared to the normal neurons Fewer spines leads to dysfunctional neurons causing loss of cognitive function |
front 11 Describe role of mesocortical dopamine pathways | back 11 Mesocortical Pathway: Cognitive and executive function |
front 12 Reduced firing of dopaminergic neurons in this pathway leads to which symptom cluster of schizophrenia | back 12 Negative symptoms (hypodopaminergic) |
front 13 Glutamate hypothesis states that increased glutamate activity may contribute to the increased DA release in mesolimbic pathway | back 13 True |
front 14 Which dysfunctions associated with schizophrenia are related to defects in mesolimbic pathway? | back 14 Mesolimbic pathway: Regulation of emotional behavior POSITIVE symptoms: hyperdopaminergic |
front 15 Haloperidol, fluphenazine, trifluperazine, and thiothixene are associated with higher rates of extra-pyramidal side effects (EPSs), akathisia, hyperprolactinemia and have fewer side effects associated with M1, H1, and α1 effects | back 15 True |
front 16 D2 receptor antagonism by antipsychotic drugs in which DA pathway reduces positive symptoms? | back 16 Mesolimbic pathway |
front 17 D2 receptor antagonism by antipsychotic drugs which DA pathway can result in EPS? | back 17 Nigrostriatal pathway |
front 18 D2 receptor antagonism by typical antipsychotics which DA pathway can increase prolactin levels? | back 18 Tuberoinfundibular pathway |
front 19 D2 receptor antagonism by typical antipsychotics which DA pathway can cause or worsen negative and cognitive symptoms | back 19 Mesocortial pathway |
front 20 Treating a patient with schizophrenia with a dopamine antagonist can successfully treat their positive symptoms by reducing dopamine signaling in the mesolimbic pathway. However, these agents can worsen the negative and cognitive symptoms. Explain why | back 20 Because D2 antagonism blocks D2 receptors throughout the brain worsening cognitive symptoms (mesocortical pathway), cause EPS (nigrostriatal), and increase prolactin (tuberoinfundibular) |
front 21 US Boxed Warning for chlorpromazine is for which adverse effect this drug? | back 21 INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS |
front 22 One adverse effect of chlorpromazine is aspiration of vomit. What is the mechanism underlying this adverse effects? | back 22 Because chlorpromazine suppresses the cough reflex |
front 23 Clozapine is an agonist at alpha-adrenergic, histamine H1, cholinergic, and other dopaminergic and serotonergic receptors | back 23 False- Antagonist |
front 24 Why clozapine is available only through a restricted program under a Risk Evaluation Mitigation Strategy (REMS)? | back 24 Because of severe risk of neutropenia |
front 25 Why clozapine should be used with caution in patients with decreased gastrointestinal motility, urinary retention, BPH, xerostomia, or visual problems? | back 25 Because it may cause anticholinergic effects (constipation, xerostomia, blurred vision, urinary retention) |
front 26 Atypical antipsychotics have been associated with development of hyperglycemia; in some cases, may be extreme and associated with ketoacidosis, hyperosmolar coma, or death. | back 26 True |
front 27 Which antipsychotic agents have higher rates of EPSs, akathisia, hyperprolactinemia | back 27 1. Haloperidol 2. Fluphenazine 3. Trifluperazine 4. Thiothixene |
front 28 Which antipsychotics are 5HT2A and D2 antagonists? | back 28
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front 29 Antipsychotic agents are in pregnancy class B or C | back 29 True |
front 30 Actions of antipsychotics agents on which receptors lead to extrapyramidal symptoms? | back 30 DA antagonist inhibit receptors in the nigrostriatal pathway leading to excess Ach release leading to the EPS |
front 31 List the 4 movement disorders that constitute the extrapyramidal side effects of antipsychotics. | back 31
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front 32 How does DA regulate Ach release in nigrostriatal pathway? How do antipsychotics change this DA- mediated regulation of Ach release? What are the consequences of altered Ach release in nigrostriatal pathway | back 32
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front 33 Mania has two poles or extremes, high mood and low mood. A person with mania can experience extreme changes in mood, from high mood (also known as a manic or hypomanic episode) to low mood (also known as a depressive episode). | back 33 False- Bipolar disorder |
front 34 List anticonvulsants and second-generation antipsychotics used in alternative or adjunctive treatments for bipolar disorder | back 34 1. Lamotrigine 2. CBZ |
front 35 List second-generation antipsychotics used in alternative or adjunctive treatments for bipolar disorder | back 35 1. Aripiprazole 2. Quetiapine |
front 36 Inhibition of which enzyme involved in transcriptional regulation results in mood stabilizing effects of Li | back 36 GSK-3 |
front 37 How do thiazides and osmotic diuretics affect renal excretion of Li? | back 37
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front 38 The most common adverse effects of lithium is fine postural hand tremor. How would you minimize it? | back 38
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front 39 What will you do avoid adverse effects of lithium such as incoordination, ataxia, or slurred speech? | back 39
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front 40 Which adverse effect of lithium is magnified by concurrent use of antipsychotic drugs? | back 40
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front 41 Describe the mechanism underlying reduced EPSE produced by SGA: | back 41 Increasing DA in the nigrostriatal areas |
front 42 Describe the mechanism underlying reduced negative symptoms produced by SGA: | back 42 Improving DA in the prefrontal cortex |
front 43 Describe the mechanism underlying reduced deptressionproduced by SGA: | back 43 Increasing DA in the ventromedial prefrontal cortex |
front 44 Chlorpromazine use can lead to hypotension. Identify receptors for each of these side effects. | back 44 a1-adrenergic antagonism |
front 45 Which adverse effects are common for chlorpromazine and clozapine? | back 45
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front 46 Which agent has high α1 adrenergic affinity | back 46 Chlorpromazine |
front 47 Which antipsychotics are first-generation medium- and high-potency D2 antagonists? | back 47
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front 48 Which antipsychotics are D2 partial agonists | back 48
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front 49 Which antipsychotic agents have a greater risk of causing hypotension | back 49
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front 50 Which antipsychotic agents have a greater risk of QT interval prolongation; torsade de pointes | back 50
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front 51 Which two enzymes in inositol recycling pathway does Li affect? How do these effects lead to improvement in bipolar disorder? | back 51
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front 52 Inhibition of which enzyme involved in transcriptional regulation results in mood stabilizing effects of valproate? | back 52
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front 53 Inhibition of which enzyme leads to lithium-induced nephrogenic diabetes insipidus? How can be treated? | back 53
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front 54 NSAIDs and ACEi lead to lithium retention? T/F | back 54 True |