Let's do a question. Your 28-year old male cousin has recently
been diagnosed with schizophrenia. Select the true statement.
A, untreated szhizophrenics have low levels of brain dopamine.
B, untreated schizophrenics have high levels of serotonin receptors.
C, all drugs in schizophrenia act at the D2 receptor. And D,
an unintended side effect of high doses of antipsychotic
medications can be Parkinson's disease or a Parkinsonian kind
of syndrome with bradykinesia and a masked face. Right, the answer is D.
There is a couple of things that I want to point out in terms
of strategies for writing exams. Whenever you see a really long answer
in your choices, generally speaking take a good
hard look at that long answer because it's usually the right one.
Sometimes it saves you a little bit of time. Alright, question
number 2. A 30-year old female presents with pressured speech,
hyperactivity, and mild confusion. She was diagnosed with mania.
You want to start her on lithium. Select the false statement.
A, lithium is safe in pregnancy. B, lithium may interact with
her oral contraceptive medication. C, lithium reduces amine
biosynthesis by inhibiting the production of inositol triphosphate.
And D, lithium is minimally excreted by the kidney and requires
blood monitoring. The answer is A, lithium is safe in pregnancy.
Remember we are picking the false statement. The USMLE
and to a lesser extent the Canadian exams are very tricky in
these double negative or false statement questions, and they are hard.
So remember that when you have false on your stem, circle false
3 or 4 times so that you remember that you are picking the wrong answer.
Lithium is not safe in pregnancy. Lithium may interact with
almost any medication out there. Lithium does reduce amine biosynthesis
by inhibiting the production of ITP3. And lithium is minimally
excreted by the kidney, but it does require aggresive blood monitoring.
Well that's it for the antipsychotic medications.
Study them well and I wish you well on your exams.