031315 schizophrenia Flashcards

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1
Q

onset of schizophrenia usually occurs

A

in late teens. usually INSIDIOUS

men get onset earlier than women

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2
Q

Bleuler’s four As

A

associations-loose

affect (incongruence-pt will talk about sad subject and laugh)

autism- not “autism”. difficulty telling what’s on outside and what’s on inside (delusions, hallucinations)

ambivalence-hard time making decisions

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3
Q

Schneider’s “first rank symptoms”

A

not specific to schizophrenia

broadcasting (what they are thinking can be heard by others), thought withdrawal, voices arguing or commenting, somatic passivity (catatonia-if you raise their hand they will leave it there)

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4
Q

characteristic symptoms of schizophrenia (DSM V)

A

delusions (beliefs)

hallucinations

disorganizd speech (derailment, incoherence)

grossly disorgnized or catatonic behavior

negative symptoms (affect, alogia, avolition)

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5
Q

other symptoms of schizophrenia

A

social or occupational dysfxn

duration (continuous signs of disturbance persist for at least 6 months)

schizoaffective and mood disorder exclusion

substance/general medical condition exclusion

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6
Q

cognitive symptoms of schizophrenia

A

impaired abstract thinking
impaired problem solving
disturbed memory

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7
Q

theories of schizophrenia’s etiology

A
genetic predisposition 
anatomic changes (enlarge lateral ventricles, increased width of third ventricle, sulcal enlargement)

physiologic changes (dorsolateral prefrontal cortex poorly activated, thalamus and cerebellum may be involved)

biochemical factors (dopamine D2 receptors blocked by all antipsychotics)

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8
Q

negative symptoms of schizophrenia

A
social isolation
withdrawal
poor grooming
anaergy
loss of interest
blunted affect
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9
Q

tx for schizophrenia

A

medication is primary tx
atypical antipsychotics preferred over old antipsychotics

psychosocial interventions (housing, case management w emphasis on med compliance and community involvement, supportive psychotherapy, job training)

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10
Q

prognosis of schizophrenia

A

exacerbations and remissions common
residual impairment when not active phase
positive symptoms less severe over time
neg symptoms more severe over time

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11
Q

long term prognosis for schizophrenics

A

20-30% lead somwhat normal lives
20-30% have moderate symptoms
40-60% significantly impaired

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