Which dopamine pathway is responsible for negative symptoms of schizophrenia?
Mesolimbic pathway
Nigrostriatal pathway
Tuberoinfundibular pathway
Mesocortical pathway
The Correct Answer is D
A. Mesolimbic pathway is responsible for reward, motivation, and emotion. In schizophrenia, hyperactivity of this pathway leads to positive symptoms such as hallucinations, delusions, and disorganized thinking.
B. Nigrostriatal pathway regulates motor control. Dopamine blockade in this pathway leads to extrapyramidal symptoms (EPS) such as tremors, rigidity, and tardive dyskinesia, which are side effects of first-generation antipsychotics (typical antipsychotics).
C. Tuberoinfundibular pathway controls prolactin secretion. Dopamine inhibits prolactin release, so blocking D2 receptors with antipsychotics leads to hyperprolactinemia, causing gynecomastia, galactorrhea, and menstrual irregularities.
D. Mesocortical pathway is responsible for cognition, motivation, and emotional regulation. In schizophrenia, hypoactivity of this pathway is linked to negative symptoms such as apathy, anhedonia, social withdrawal, and cognitive impairment. Antipsychotics that block dopamine further worsen these symptoms, making negative symptoms more difficult to treat.
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Correct Answer is C
Explanation
A. Depressed type. Schizoaffective disorder, depressive type, involves schizophrenia symptoms (delusions, hallucinations, disorganized thinking) along with major depressive episodes. There is no history of mania or hypomania, distinguishing it from the bipolar type.
B. Unspecified type. Schizoaffective disorder, unspecified type, is used when the clinician determines that the patient meets criteria for schizoaffective disorder but does not clearly fit into the bipolar or depressive subtypes.
C. Anxiety type. There is no "anxiety type" of schizoaffective disorder. While individuals with schizoaffective disorder may experience anxiety, it is not a defining feature. Anxiety disorders are separate conditions and do not define a subtype of schizoaffective disorder.
D. Bipolar type. Schizoaffective disorder, bipolar type, is diagnosed when schizophrenia symptoms occur alongside manic or mixed episodes, with or without depressive episodes. This distinguishes it from the depressive type, which lacks manic symptoms.
Correct Answer is B
Explanation
A. Restlessness and unable to sit still. This describes akathisia, a movement disorder characterized by an intense feeling of restlessness, often seen as a side effect of antipsychotic medications.
B. Muscle spasms on the face, eyes, neck, and tongue. Dystonia is characterized by sudden, involuntary muscle contractions, often affecting the face, neck (torticollis), eyes (oculogyric crisis), tongue, and jaw. It is a common extrapyramidal side effect (EPS) of antipsychotic medications, particularly first-generation antipsychotics.
C. Tongue rolling and lip smacking. These are hallmark symptoms of tardive dyskinesia, a late-onset movement disorder caused by long-term use of dopamine-blocking agents. It involves involuntary, repetitive movements of the mouth, face, and limbs.
D. Tremors at rest, bradykinesia, and shuffling gait. These symptoms are characteristic of Parkinsonism, an extrapyramidal side effect of dopamine-blocking medications. It mimics Parkinson’s disease and includes rigidity, tremors, and slow movements.
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