The pathophysiology of schizophrenia includes theories about abnormalities in neurotransmission. Which of the following has been suggested as a pathological basis for schizophrenia?
Excess dopamine in the mesolimbic pathway
Increased dopamine in the mesocortical pathway
Increased serotonin
Decreased glutamate
The Correct Answer is A
Choice A reason: Excess dopamine activity in the mesolimbic pathway is strongly associated with the positive symptoms of schizophrenia, such as hallucinations and delusions. This theory forms the basis for the use of antipsychotic medications, which block dopamine receptors to reduce these symptoms.
Choice B reason: Decreased dopamine activity in the mesocortical pathway, not increased, is linked to the negative and cognitive symptoms of schizophrenia. This includes apathy, social withdrawal, and impaired executive function.
Choice C reason: While serotonin may play a modulatory role in schizophrenia, particularly in the mechanism of atypical antipsychotics, it is not the primary neurotransmitter implicated in the core pathophysiology of the disorder.
Choice D reason: Hypofunction of glutamate, particularly at NMDA receptors, has been proposed as a contributing factor to schizophrenia. However, this theory is still under investigation and is not as well-established as the dopamine hypothesis.
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Correct Answer is D
Explanation
Choice A reason: Electroconvulsive therapy is typically reserved for severe depression, catatonia, or treatment-resistant mood disorders. It is not first-line for acute psychosis, especially in a young adult with paranoid delusions.
Choice B reason: Alprazolam is a benzodiazepine used for anxiety and panic disorders. It is not appropriate for treating psychosis and may worsen disinhibition or aggression in psychotic patients.
Choice C reason: Fluoxetine is an SSRI used for depression and anxiety disorders. It does not address the core symptoms of schizophrenia or acute psychosis, such as delusions and paranoia.
Choice D reason: Ziprasidone is an atypical antipsychotic effective in treating schizophrenia and acute psychotic episodes. It targets dopamine and serotonin receptors, helping to reduce delusions, hallucinations, and agitation. It is appropriate for managing the patient’s paranoid psychosis.
Correct Answer is B
Explanation
Choice A reason: HIV is not an autoimmune disorder. Autoimmune diseases involve the immune system attacking the body's own tissues, whereas HIV is a viral infection that targets and destroys immune cells, specifically CD4+ T lymphocytes.
Choice B reason: HIV infects CD4+ T cells and macrophages, leading to progressive depletion of these cells. This impairs both cell-mediated and humoral immunity, rendering the host susceptible to opportunistic infections and certain malignancies. The virus integrates into host DNA and replicates, gradually weakening the immune system.
Choice C reason: Tickborne illnesses such as Lyme disease or babesiosis are unrelated to HIV. They are caused by different pathogens and have distinct transmission routes and pathophysiology.
Choice D reason: HIV is not a nosocomial infection. It is primarily transmitted through blood, sexual contact, and vertical transmission from mother to child. Nosocomial infections are acquired in healthcare settings and typically involve bacteria like MRSA or Pseudomonas.
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