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1
Q

What are positive symptoms of schizophrenia?

A

Delusions, hallucinations, disordered thought and speech

2
Q

What are negative symptoms of schizophrenia?

A

Flat effect, alogia, anhedonia, asociaity, avolition

3
Q

What is alogia?

A

Lack of additional, unprompted content in normal speech

4
Q

What is anhedonia?

A

Inability to feel pleasure in normally pleasurable activity

5
Q

What is avolition?

A

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

6
Q

What is schizophrenia usually associated with?

A

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

7
Q

What is the pathology of schizophrenia?

A

Increased levels of dopamine in the mesolimbic pathway

8
Q

What is the incidence of schizophrenia?

A

0.6% of population worldwide!

Can start at any age, peak onset early twenties

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

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

11
Q

What consists of the mesolimbic pathway?

A

Substantia nigra stimulates the striatum

Ventral tegmental area stimulates the frontal lobe

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%

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
14
Q

What is the pathology of depression?

A

Reduced hippocampal volume
Vascular lesions
Reduced BDNF

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

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