Matthew Coulson
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Psychosis and Schizophrenia lecture given on 15/10/2018. Includes neurobiology descriptions of antipsychotics.

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Matthew Coulson
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Psychosis & Schizophrenia

Question 1 of 34

1

Brian believes that his parents are trying to poison him because the government are controlling them. Which psychopathology term is most appropriate?

Select one of the following:

  • Grandiose delusion

  • Ideas of reference

  • Paranoid delusion

  • Auditory hallucination

  • loosening of associations

Explanation

Question 2 of 34

1

When Brian listens to the radio he can hear voices from elsewhere in the room telling him he must not think about the military information he has been given

Select one of the following:

  • Functional hallucination

  • Gustatory hallucination

  • Passivity of thought

  • Thought insertion

  • Reactive affect

Explanation

Question 3 of 34

1

Which of the following describes the belief that one's thoughts or actions are controlled by an external agent?

Select one of the following:

  • Passivity of thought

  • Thought insertion

  • Reactive affect

  • Paranoid delusion

  • Loosening of associations

Explanation

Question 4 of 34

1

Brian believes that news articles on the television about world leaders’ phones being tapped are actually talking about him as he holds important government information

Select one of the following:

  • Nihilistic delusion

  • Ideas of reference

  • Flight of ideas

  • Auditory hallucination

  • Visual hallucination

Explanation

Question 5 of 34

1

Schizophrenia is known to have a 78% heritability

Select one of the following:

  • True
  • False

Explanation

Question 6 of 34

1

What is heritability?

Select one of the following:

  • Likelihood of developing a trait if your monozygotic twin has it

  • Likelihood of developing a trait if your parent has it

  • Proportion of observable differences in a trait between individuals in a population that is due to genetic differences

  • Proportion of the range of genes involved in a multifactorial trait that you need to have in order to develop the trait

  • Likelihood of individuals with the trait having a genetic predisposition to it

Explanation

Question 7 of 34

1

Select from the dropdown list to complete the text.

Schizophrenia is known to be caused by viral illness in the ( 2nd, 1st, 3rd ) trimester of pregnancy

Explanation

Question 8 of 34

1

Taking heroin makes an individual very liable to drug-induced psychosis

Select one of the following:

  • True
  • False

Explanation

Question 9 of 34

1

Patients with schizophrenia tend to have enlarged ventricles in their brain

Select one of the following:

  • True
  • False

Explanation

Question 10 of 34

1

The reductions in cerebral grey matter seen in schizophrenia patients is attributable to reduced arborisation, which is ...

Select one of the following:

  • Neuronal loss in grey matter

  • Reduced dendritic communication with other neurons due to fewer number of dendrites

  • Slowed neuronal conduction due to neuronal damage

Explanation

Question 11 of 34

1

How many layers of grey matter exist in the brain?

Select one of the following:

  • 6

  • 5

  • 9

  • 4

Explanation

Question 12 of 34

1

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Things that cause an increase of ( dopamine, serotonin, noradrenaline ) in the brain are known to cause a psychotic state in humans.

Explanation

Question 13 of 34

1

Fill the blank space to complete the text.

The mesolimbic pathway (reward system) originates in the area of the midbrain.

Explanation

Question 14 of 34

1

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Blockade of dopamine receptors in the ( nigrostriatal, tuberoinfundibular, mesolimbic ) pathway can cause some of the symptoms associated with antipsychotics such as Haloperidol, for example dystonia, parkinsonian symptoms and akathisia

Explanation

Question 15 of 34

1

Select from the dropdown list to complete the text.

The Nigrostriatal Pathway originates in the ( Substantia Nigra, Lentiform Nucleus, Globus Pallidus, Putamen, Caudate Nucleus ) and projects to the Dorsal Striatum

Explanation

Question 16 of 34

1

Atypical Antipsychotic:
Typical Antipsychotic:

Drag and drop to complete the text.

    Haloperidol
    Quetiapine
    Phenytoin

Explanation

Question 17 of 34

1

Is olanzapine a typical or atypical antipsychotic?

Select one of the following:

  • Typical

  • Atypical

Explanation

Question 18 of 34

1

Select from the dropdown lists to complete the text.

( Atypical, Typical ) antipsychotics are more likely to cause metabolic syndrome as a side effect
( Typical, Atypical ) antipsychotics are more likely to cause extrapyramidal symptoms as a side effect

Explanation

Question 19 of 34

1

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The action of Haloperidol is antagonism of mainly ( dopamine, serotonin, alpha, histamine, noradrenaline ) receptors

Explanation

Question 20 of 34

1

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The action of Olanzapine is mainly as an antagonist of ( serotonin, dopamine, noradrenaline, histamine, alpha ) receptors

Explanation

Question 21 of 34

1

Extrapyramidal side effects of typical antipsychotics are caused by a D2 blockade affecting which dopaminergic pathway?

Select one of the following:

  • Mesolimbic pathway

  • Tuberoinfundibular pathway

  • Nigrostriatal pathway

Explanation

Question 22 of 34

1

Match the extrapyramidal side effect to its description:
: Sudden onset painful involuntary muscle spasm, usually affecting the neck/back/eye
: Onset of tremor and muscle stiffness
: A feeling of inner restlessness and inability to stay still
: Involuntary, repetitive body movements (typically orofacial) that can include grimacing, sticking out the tongue or smacking the lips

Drag and drop to complete the text.

    Acute Dystonic Reaction
    Parkinsonism
    Akathisia
    Tardive Dyskinesia
    Drug-Induced Chorea

Explanation

Question 23 of 34

1

Which of the following extra-pyramidal symptoms typically takes years to develop (due to chronic antipsychotic use) and is very difficult to treat?

Select one of the following:

  • Acute Dystonic Reaction

  • Parkinsonism

  • Akathisia

  • Tardive Dyskinesia

Explanation

Question 24 of 34

1

Some of the extrapyramidal side effects an be successfully treated using which one of the following medication types?

Select one or more of the following:

  • Anticholinergics

  • Antidepressants

  • Anticonvulsants

  • Antiepileptics

Explanation

Question 25 of 34

1

Which two of the following extrapyramidal side effects can be easily treated via anticholinergic medications?

Select one or more of the following:

  • Acute Dystonic Reaction

  • Parkinsonism

  • Akathisia

  • Tardive Dyskinesia

Explanation

Question 26 of 34

1

Dopamine Blockade also affects the tuberoinfundibular dopaminergic pathway, leading to a buildup of which pituitary hormone?

Select one of the following:

  • Prolactin

  • Growth Hormone

  • LH

  • FSH

  • TSH

  • Oxytocin

  • Vasopressin

Explanation

Question 27 of 34

1

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Hyperprolactinaemia also causes lower oestrogen and testosterone levels, causing ( osteoporosis, osteoarthritis, coeliac disease, crohn's disease ).

Explanation

Question 28 of 34

1

Metabolic syndrome is a known complication of atypical antipsychotics such as olanzapine that antagonise serotonin receptors.

Metabolic syndrome can only be diagnosed when at least 3 of which 5 symptoms are present in a patient?

Select one or more of the following:

  • Central Obesity

  • Hypertension

  • Hyperglycaemia

  • High Serum Triglycerides

  • Low Serum HDL (cholesterol)

  • Low Serum LDL (cholesterol)

  • Hypoglycaemia

  • Hypotension

  • Hypothyroidism

  • Low Serum Calcium

Explanation

Question 29 of 34

1

Brian finds that the olanzapine helps him to sleep much better at night. Which neurotransmitter is primarily involved in this effect?

Select one of the following:

  • Serotonin

  • Acetylcholine

  • Dopamine

  • Noradrenaline

  • Histamine

Explanation

Question 30 of 34

1

After taking Haloperidol, Brian develops a tremor and muscular stiffness. Which neuroreceptors are primarily involved in this effect?

Select one of the following:

  • Serotonin

  • Acetylcholine

  • Dopamine

  • Noradrenaline

  • Histamine

Explanation

Question 31 of 34

1

Which antipsychotic is least likely to cause a recurrence of his parkinsonism?

Select one of the following:

  • Risperidone

  • Olanzapine

  • Chlorpromazine

  • Quetiapine

  • Zuclopentixol

Explanation

Question 32 of 34

1

Haloperidol antagonises dopamine receptors in the pituitary gland. Which side effect is caused by this?

Select one of the following:

  • Akathisia

  • Sexual Dysfunction

  • Acromegaly

  • Apathy

  • Sedation

Explanation

Question 33 of 34

1

Select from the dropdown list to complete the text.

After two failed trials of antipsychotics, which specific antipsychotic is usually given, under close observation?
( Clozapine, Mirtazapine, Cariprazine, Asenapine, Risperidone )

Explanation

Question 34 of 34

1

Fill the blank space to complete the text.

Patients taking Clozapine have their blood checked very often (once a week for first 6 months) as these patients are liable to developing , which could kill them.

Explanation

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