COMMON DIAGNOSIS AND MANAGEMENT IN
ACUTE CARE MIDTERM CERTIFICATION
EVALUATION SCRIPT 2026 TESTED QUESTIONS
AND FULL SOLUTION
◉ Schizophrenia Answer: a disturbance that must last for 6 months
or longer, including at least one month of positive symptoms or
negative symptoms
-neurodevelopmental, brain disorder
-psychological condition involving chronic or repeated episodes of
psychosis
cause: combination of genetics and environmental factors
DX: based on clinical interview
◉ psychosis Answer: set of symptoms in which a person's mental
capacity, affective response, and capacity to recognize reality,
communicate, and relate to others is impaired
◉ Symptoms of psychosis: Answer: -delusions & hallucinations
(Hallmarks)
-disorganized speech
-disorganized behavior
-distortions of reality
,-inappropriate or very strong emotions or apathy
-negative symptoms: diminished emotional expression and
decreased motivation
◉ area of the brain thought to be responsible for the positive
symptoms of schizophrenia is the ____________. one of the neuronal
pathways known to be affected here is the ___________ from the
_____________ and the _____________. Answer: limbic system, mesolimbic
pathway, ventral tegmental area (VTA), nucleus accumbens
◉ schizophrenia: the dopamine theory Answer: suggests that in the
mesolimbic pathway, neurons from the VTA (ventral tegmental area)
release higher than normal levels of dopamine into the synaptic cleft
at the NAC (nucleus accumbens).
-More dopamine binds to the D2 dopamine receptors in the NAC.
This is thought to be the cause of positive symptoms
◉ Schizophrenia: dopamine and mesocortical system Answer: area
of the brain thought to be responsible for negative symptoms of
schizophrenia, prefrontal cortex
-mesocortical pathway goes from the VTA (ventral tegmental area)
to the PFC (prefrontal cortex)
-dysregulation of dopamine between these two areas of the brain
results in the negative and cognitive symptoms
,◉ Dopamine pathway: mesolimbic Answer: location: Ventral
tegmental area (VTA) within midbreain to the nucleus accumbens
(NA) in the limbic system
function: regulates emotional behaviors & associated with reward,
motivation, pleasure
symptoms: overactivation causes (+) symptoms and may be a
downstream consequence of prefrontal cortex dysfunction &
glutamate activity in the hippocampus
◉ Dopamine pathway: mesocortical Answer: location: ventral
tegmental area (VTA) to the prefrontal cortex (PFC). Specifically
affecting dorsolateral prefrontal cortex (DLPFC) & ventromedial
prefrontal cortex (VMPFC)
function: regulates cognition, executive function, emotions, affect.
DLPFC-cognitive, (-) symptoms
VMPFC-affective & (-) symptoms
symptoms: hypoactivation of pathway may cause (-), cognitive, &
affective symptoms
, ◉ dopamine pathway: nigrostriatal Answer: location: projects from
substantia nigra (in midbrain) to basal ganglia (striatum & globus
pallidus)
function: part of extrapyramidal nervous system, controls posture &
voluntary motor movements
symptoms: imbalance of pathways causes movement disorders.
Common disorders-parkinson's and tremor.
Low dopamine in basal ganglia-akathisia & dystonia.
Hyperactivation of pathway-tics, dyskinesias, chorea.
Chronic blockade of D2 pathway-tardive dyskinesia.
◉ dopamine pathway: tuberinfundibular Answer: location: projects
from hypothalamus to anterior pituitary gland
function: dopamine inhibits prolactin release from pituitary
symptoms: disruption of pathway causes prolactin level to rise
resulting in gynecomastia & galactorrhea.
Females-amenorrhea
Both may get sexual dysfunction
ACUTE CARE MIDTERM CERTIFICATION
EVALUATION SCRIPT 2026 TESTED QUESTIONS
AND FULL SOLUTION
◉ Schizophrenia Answer: a disturbance that must last for 6 months
or longer, including at least one month of positive symptoms or
negative symptoms
-neurodevelopmental, brain disorder
-psychological condition involving chronic or repeated episodes of
psychosis
cause: combination of genetics and environmental factors
DX: based on clinical interview
◉ psychosis Answer: set of symptoms in which a person's mental
capacity, affective response, and capacity to recognize reality,
communicate, and relate to others is impaired
◉ Symptoms of psychosis: Answer: -delusions & hallucinations
(Hallmarks)
-disorganized speech
-disorganized behavior
-distortions of reality
,-inappropriate or very strong emotions or apathy
-negative symptoms: diminished emotional expression and
decreased motivation
◉ area of the brain thought to be responsible for the positive
symptoms of schizophrenia is the ____________. one of the neuronal
pathways known to be affected here is the ___________ from the
_____________ and the _____________. Answer: limbic system, mesolimbic
pathway, ventral tegmental area (VTA), nucleus accumbens
◉ schizophrenia: the dopamine theory Answer: suggests that in the
mesolimbic pathway, neurons from the VTA (ventral tegmental area)
release higher than normal levels of dopamine into the synaptic cleft
at the NAC (nucleus accumbens).
-More dopamine binds to the D2 dopamine receptors in the NAC.
This is thought to be the cause of positive symptoms
◉ Schizophrenia: dopamine and mesocortical system Answer: area
of the brain thought to be responsible for negative symptoms of
schizophrenia, prefrontal cortex
-mesocortical pathway goes from the VTA (ventral tegmental area)
to the PFC (prefrontal cortex)
-dysregulation of dopamine between these two areas of the brain
results in the negative and cognitive symptoms
,◉ Dopamine pathway: mesolimbic Answer: location: Ventral
tegmental area (VTA) within midbreain to the nucleus accumbens
(NA) in the limbic system
function: regulates emotional behaviors & associated with reward,
motivation, pleasure
symptoms: overactivation causes (+) symptoms and may be a
downstream consequence of prefrontal cortex dysfunction &
glutamate activity in the hippocampus
◉ Dopamine pathway: mesocortical Answer: location: ventral
tegmental area (VTA) to the prefrontal cortex (PFC). Specifically
affecting dorsolateral prefrontal cortex (DLPFC) & ventromedial
prefrontal cortex (VMPFC)
function: regulates cognition, executive function, emotions, affect.
DLPFC-cognitive, (-) symptoms
VMPFC-affective & (-) symptoms
symptoms: hypoactivation of pathway may cause (-), cognitive, &
affective symptoms
, ◉ dopamine pathway: nigrostriatal Answer: location: projects from
substantia nigra (in midbrain) to basal ganglia (striatum & globus
pallidus)
function: part of extrapyramidal nervous system, controls posture &
voluntary motor movements
symptoms: imbalance of pathways causes movement disorders.
Common disorders-parkinson's and tremor.
Low dopamine in basal ganglia-akathisia & dystonia.
Hyperactivation of pathway-tics, dyskinesias, chorea.
Chronic blockade of D2 pathway-tardive dyskinesia.
◉ dopamine pathway: tuberinfundibular Answer: location: projects
from hypothalamus to anterior pituitary gland
function: dopamine inhibits prolactin release from pituitary
symptoms: disruption of pathway causes prolactin level to rise
resulting in gynecomastia & galactorrhea.
Females-amenorrhea
Both may get sexual dysfunction
