Which dopamine pathway is responsible for the positive symptoms of schizophrenia?
Mesolimbic pathway
Nigrostriatal pathway
Tuberoinfundibular pathway
Mesocortical pathway
The Correct Answer is A
A. Mesolimbic pathway is associated with reward, motivation, and emotions and is hyperactive in schizophrenia, leading to positive symptoms such as hallucinations, delusions, and disorganized thinking. Antipsychotic medications work by blocking dopamine (D2) receptors in this pathway, reducing psychotic symptoms.
B. Nigrostriatal pathway controls motor function and coordination. Dopamine blockade in this pathway leads to extrapyramidal symptoms (EPS) such as tremors, rigidity, and tardive dyskinesia, which are common side effects of first-generation antipsychotics (typical antipsychotics).
C. Tuberoinfundibular pathway regulates prolactin secretion. Dopamine inhibits prolactin release, so blocking D2 receptors with antipsychotics leads to increased prolactin levels, causing gynecomastia, galactorrhea, and menstrual irregularities.
D. Mesocortical pathway is responsible for cognition, motivation, and emotional regulation. In schizophrenia, this pathway is hypoactive, contributing to negative symptoms such as apathy, social withdrawal, and cognitive impairment.
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Related Questions
Correct Answer is C
Explanation
A. Gabapentin is an anticonvulsant and neuropathic pain medication that has no role in treating enuresis. It works by modulating calcium channels and is primarily used for seizures, neuropathic pain, and restless leg syndrome.
B. Laxatives. While constipation can contribute to enuresis by exerting pressure on the bladder, laxatives do not directly treat bedwetting. Instead, addressing constipation may help reduce nocturnal enuresis in some cases.
C. Desmopressin (DDAVP) is the first-line pharmacologic treatment for enuresis. It is a synthetic analog of antidiuretic hormone (ADH, vasopressin) that reduces night-time urine production, making it effective for nocturnal enuresis (bedwetting) in children.
D. SSRIs. Selective serotonin reuptake inhibitors (SSRIs) are used for depression, anxiety, and OCD but have no primary role in enuresis treatment. In some cases, they may actually cause urinary retention or incontinence as a side effect rather than improving enuresis.
Correct Answer is D
Explanation
A. Clozapine (Clozaril) is a second-generation (atypical) antipsychotic with a high risk of weight gain, metabolic syndrome, and sedation due to its strong antagonism of histamine (H1) and serotonin (5-HT2C) receptors. It can also cause sexual dysfunction due to its impact on dopamine and prolactin levels.
B. Olanzapine (Zyprexa) has a significant risk of weight gain and metabolic side effects, similar to clozapine. It is known to cause hyperlipidemia, insulin resistance, and increased appetite, contributing to obesity. Sexual dysfunction can occur but is less common than with prolactin-elevating antipsychotics.
C. Haloperidol (Haldol) is a first-generation (typical) antipsychotic with a high risk of sexual dysfunction due to prolactin elevation from strong dopamine (D2) receptor blockade. While it has a lower risk of weight gain than atypical antipsychotics, it carries a high risk of extrapyramidal symptoms (EPS).
D. Aripiprazole (Abilify) is a partial dopamine agonist and has the lowest risk of weight gain among atypical antipsychotics. It also has a minimal impact on prolactin levels, reducing the risk of sexual dysfunction. Due to its unique mechanism, it is often preferred for patients concerned about metabolic side effects and sexual health.
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