Lecture 24 Flashcards

1
Q

What are positive symptoms of schizophrenia?

A

Delusions, hallucinations, disordered thought and speech

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2
Q

What are negative symptoms of schizophrenia?

A

Flat effect, alogia, anhedonia, asociaity, avolition

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3
Q

What is alogia?

A

Lack of additional, unprompted content in normal speech

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4
Q

What is anhedonia?

A

Inability to feel pleasure in normally pleasurable activity

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5
Q

What is avolition?

A

The decrease in the motivation to initiate and perform self-directed purposeful activities

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6
Q

What is schizophrenia usually associated with?

A

Depression, substance abuse, suicide and life expectancy reduced by 10-12 years

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7
Q

What is the pathology of schizophrenia?

A

Increased levels of dopamine in the mesolimbic pathway

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8
Q

What is the incidence of schizophrenia?

A

0.6% of population worldwide!

Can start at any age, peak onset early twenties

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9
Q

What are the causes of schizophrenia?

A

Genetics: 50% concordance in monozygotic twins (DISC1)
Environment: 50% concordance in monozygotic twins
Developmental: infection in utero, poor diet, asphyxia
Social factors: environment, stress relationships
Drug abuse: e.g. cannabis, cocaine, (cause or effect?)
Dopamine hypothesis (excessive D2R stimulation)
Reduced NMDAR function

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10
Q

What do mice with reduced NMDAR function exhibit?

A

Excessive motor activity
Stereotypy (continuously pacing around etc)
Deficits in social and sexual interactions (Excape behavior is exaggerated in mutated mice)
Symptoms that are ameliorated by typical and atypical antypsychotics

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11
Q

What consists of the mesolimbic pathway?

A

Substantia nigra stimulates the striatum

Ventral tegmental area stimulates the frontal lobe

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12
Q

What are treatments for schizophrenia?

A

Antipsychotics (typical and atypical) more effective in treating positive symptoms
Intense psychotherapy, social support
Recovery and improvement in symptoms in over 50%

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13
Q

What are symptoms of depression?

A
Lowered mood
Anhedonia
Avolition
Altered appetite
Hyposomnia/Hypersomnia
Worthlessness and guilt
Reduced ability to concentrate
Recurrent thoughts of death
Reduced life span
3-7% risk of suicide
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14
Q

What is the pathology of depression?

A

Reduced hippocampal volume
Vascular lesions
Reduced BDNF

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15
Q

What is the incidence of depression?

A

3% Japan, 18% USA - average 10%
May not reflect actual people with depression but attitudes toward depression
Women are twice as affected as men
Massive cost to society

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16
Q

What is defined as a stroke?

A

Neurological deficit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours

17
Q

How is a stroke different from a transient ischaemic attack?

A

Transient ischemic attack has stroke-like symptoms but resolve within 24 hours

  • Brain function ceases 60-90 seconds of an ischaemic event
  • irreversible brain damage if ischaemic event > 3 hours duration
  • neurological deficit related to site and extent of damage
18
Q

What are two main types of stroke?

A

Ischaemic and Haemorrhagic

19
Q

What are types if ischaemic strokes?

A

Embolus (wandering clot)
Thrombus (locally-formed clot)
Systemic hypoperfusion (e.g. heart)
Venous thrombosis

20
Q

What is the definition of a haemorrhagic stroke?

A

Entry of blood into CNS via rupture of blood vessel/sinus or an aneurysm

21
Q

What are types of haematomas in the brain?

A

Epidural
Subdural
Subarachnoid
Intracerebral

22
Q

What is an epidural haematoma?

A

Traumatic damage to a meningeal artery of dural venous sinus (e.g. blow to the head)

23
Q

What is a subdural haematoma?

A

Caused by rapid movement of head causing tearing of the cerebral vein as it enters a dural venous sinus

24
Q

What is a subarachnoid haematoma?

A

Is caused by damage (e.g. aneurysm) to a cerebral artery or into the subarachnoid space

25
Q

What is an intracerebral haematoma?

A

Cause by damage of a blood vessel within the brain

26
Q

What is the incidence of stroke?

A

10% of deaths worldwide
2nd leading cause of death (1st heart disease, 3rd cancer)
95% occur in people over 45 years of age

27
Q

What are risk factors for stroke?

A
High blood pressure
 - disputable
 - why it is a risk factor is unknown
High cholesterol
Diet 
Physical inactivity
Drugs of abuse (alcohol, cigarettes, cocaine, amphetamine)
28
Q

What are treatments for stroke?

A
Preventative
 - Antocoagulants; carotid angioplasty
 - Endarterectomy; diet/lifestyle
Acute ischemic
 - thrombolysis (tissue plasminogen activators (within 3 hours); thrombectomy, angioplasty, stenting)
Acute haemorrhagic
 - surgery
Chronic post stroke
 - control of hypertension; aspirin; physical and occupational therapy
29
Q

What are symptoms of Alzheimer’s?

A

Short-term memory loss
Progressive apathy, confusion, irritability, mood swings, long-term memory loss, withdrawal, loss of bodily functions, death within 7 years of diagnosis

30
Q

What is the pathology of Alzheimer’s?

A

Profound loss of neurons
Plaques (amyloid)
Neurofibrillary tangles (hyperphosphorylated tau)

31
Q

What is the incidence of Alzheimer’s?

A

1.5-2%

Worldwide cost: 160 billion USD per year

32
Q

What are causes of Alzheimer’s?

A

Age: 10% over 65, 50% over 85
Genetics but predominantly for early onset e.g. ApoE4 gene variant
Trauma e.g. stroke
High blood pressure/hypercholesteremia (but statins ineffective)
Environemental factors e.g. food Aluminium, supplements in coffee drinks

33
Q

What are treatments for Alzheimer’s?

A

Treating symptoms:
Acetyl cholinesterase inhibitors, NMDAR antagonists e.g. memantine
Against risk:
NSAIDs and caffeine intellectual stimulation, diet and exercise