1ST BM RECALLS Flashcards
Approximately how many percent of patients treated with any antipsychotic achieve remission?
None of the above
70 percent
30 percent
100 percent
100 percent
He compiled data to support the idea that schizophrenia occurred more often among persons
with asthenic (i.e., slender, lightly muscled physiques), athletic, or dysplastic body types rather than
among persons with pyknic (i.e., short, stocky physiques) body types
Adolf Meyer
Karl Jaspers
Ernst Kretschmer
Kurt Schneider
Ernst Kretschmer
He was interested in the phenomenology of mental illness and the subjective feelings of patients with mental illness. His work paved the way toward trying to understand the psychological meaning of schizophrenic signs and symptoms such as delusions and hallucinations
Kurt Schneider
Ernst Kretschmer
Karl Jaspers
Adolf Meyer
Karl Jaspers
the founder of psychobiology, saw schizophrenia as a reaction to life stresses. It was a maladaptation that was understandable in terms of the patient’s life experiences
Adolf Meyer
Karl Jaspers
Ernst Kretschmer
Kurt Schneide
Adolf Meyer
Recent studies have also demonstrated that nicotine may decrease positive symptoms such as
hallucinations in schizophrenia patients by its effect on nicotine receptors in the brain that reduce
the perception of outside stimuli, especially noise. In that sense, smoking is a form of selfmedication
a. True
b. False
a. True
This neurotransmitter has been implicated because of its role in causing the prominent anhedonia (the impaired capacity for emotional gratification and the decreased ability to experience
pleasure) seen in Schizophrenia.
Norepinephrine
Serotonin
Dopamine
GABA
Norepinephrine
It has a regulatory effect on dopamine activity, and the loss of its inhibitory activity could lead to
the hyperactivity of dopaminergic neurons
Substance P
GABA
Serotonin
Norepinephrine
GABA
He/she postulated that schizophrenia resulted from developmental fixations early in life. These
fixations produce defects in ego development, and he postulated that such defects contributed to
the symptoms of schizophrenia
Harry Stack Sullivan
Paul Federn
Margaret Mahler
Sigmund Freud
Sigmund Freud
He/she hypothesized that the defect in ego functions permits intense hostility and aggression to
distort the mother–infant relationship, which leads to eventual personality disorganization and
vulnerability to stress
Margaret Mahler
Harry Stack Sullivan
Paul Federn
Sigmund Freud
Paul Federn
He/she viewed schizophrenia as a disturbance in interpersonal relatedness. The patient’s
massive anxiety creates a sense of unrelatedness that is transformed into parataxic distortions,
which are usually, but not always, persecutory
Sigmund Freud
Paul Federn
Margaret Mahler
Harry Stack Sullivan
Harry Stack Sullivan
He/she describes Schizophrenia as resulting from distortions in the reciprocal relationship between the infant and the mother. The child is unable to separate from, and progress beyond, the closeness and complete dependence that characterize the mother–child relationship in the oral phase of development. As a result, the person’s identity never becomes secure
Margaret Mahler
Harry Stack Sullivan
Sigmund Freud
Margaret Mahler
A hypothetical family in which children receive conflicting parental messages about their
behavior, attitudes, and feelings.
Pseudomutual and pseudohostile families
Expressed emotion
Double bind
Schism and skewed families
Double bind
Parents or other caregivers may behave with overt criticism, hostility, and overinvolvement
toward a person with schizophrenia.
With this dynamic relapse rate for schizophrenia is high
Double bind
Pseudomutual and pseudohostile families
Expressed emotion
Schism and skewed families
Expressed emotion
In such families, a unique verbal communication develops, and when a child leaves home and
must relate to other persons, problems may arise. The child’s verbal communication may be
incomprehensible to outsiders
Double bind
Pseudomutual and pseudohostile families
Schism and skewed families
Expressed emotion
Pseudomutual and pseudohostile families
The Dopamine Receptor Antagonists (DRAs) are effective when approximately how much of
dopamine D2 receptors in the brain are occupied?
72%
62%
52%
None of the above
72%
A potentially fatal side effect of Dopamine Receptor Anatagonist (DRA) treatment that can occur
at any time during the course of treatment
Seizure
None of the above
Neuroleptic Malignant Syndrome
Orthostatic Hypotension
Neuroleptic Malignant Syndrome
Blockade of histamine H1 receptors is the usual cause of sedation
associated with DRAs
True
False
True
Side effect mediated by adrenergic blockade and occurs most frequently during the first few days of treatment. Tolerance often develops for this side effect, which is why initial dosing of these drugs is lower than the usual therapeutic dose
Seizure
None of the above
Neuroleptic Malignant Syndrome
Orthostatic Hypotension
Orthostatic Hypotension
Both men and women taking DRAs can experience anorgasmia and decreased libido.
True
False
True
Severely agitated and violent patients, regardless of diagnosis, may be treated with DRAs.
True
False
True
About two thirds of agitated, elderly patients with various forms of dementia improve when given
a DRA
True
False
True
DRAs may lower the seizure threshold. Low-potency drugs are thought to be more epileptogenic than are high-potency drugs
True
False
True
Central Anticholinergic Effects of DRAs include
all of the above
disorientation to time, person, and place
severe agitation
hallucinations
all of the above
The term atypical is used because these drugs differ in their side effect profiles, most notably a lower risk of extrapyramidal side effects (EPS), and have spectra of action that are broader than those of the DRAs
True
False
True
Where the Serotonin-Dopamine Antagonists (SDAs) differ from older antipsychotic drugs is their
higher ratio interactions with serotonin receptor subtypes, most notably the 5-HT2A subtype, as well
as with other neurotransmitter systems.
True
False
True
About 10 percent of patients with schizophrenia exhibit outwardly aggressive or violent behavior, and the SDAs are effective for treatment of such aggression.
True
False
True
Risperidone and Olanzapine have been used to control aggression and self-injury in children.
True
False
True
Which of the following is not a First-Generation Antipsychotic?
Chlorpromazine
Haloperidol
Fluphenazine decanoate
Risperidone
Risperidone
Which of the following is not a Second-Generation Antipsychotic?
Quetiapine
Aripiprazole
Levomepromazine
Clozapine
Levomepromazine
In Shared Psychotic Disorder, the individual who first has the delusion (the primary case) is often chronically ill and typically is the influential member of a close relationship with a more suggestible person (the secondary case) who also develops the delusion
True
False
True
The delusion that a familiar person has been replaced by an impostor.
Intermetamorphosis
None of the above
Capgras syndrome
Cotard syndrome
Capgras syndrome
Shared psychotic disorder may be a type of schizophrenia, a type of mood disorder, or the simultaneous
expression of each
True
False
True
Type of schizophrenia characterized by a marked regression to primitive, disinhibited, and unorganized behavior.
Residual
Paranoid
Disorganized
Catatonic
Disorganized
Type of schizophrenia characterized by preoccupation with one or more delusions or frequent
auditory hallucinations.
Paranoid
Disorganized
Catatonic
Residual
Paranoid
Type of schizophrenia characterized by continuing evidence of the schizophrenic disturbance in the absence of a complete set of active symptoms or of sufficient symptoms to meet the diagnosis of another type of schizophrenia.
Residual
Catatonic
Disorganized
Paranoid
Residual
ype of Schizophrenia marked by disturbance in motor function; this disturbance may involve stupor, negativism, rigidity, excitement, or posturing.
Residual
Paranoid
Disorganized
Catatonic
Catatonic
Derailment or loose associations is an example of.
Delusions
Hallucinations
Disorganized speech
Grossly disorganized or catatonic behavior
Disorganized speech
Resistance to instructions or negativism is an example of.
Grossly disorganized or catatonic behavior
Hallucinations
Delusions
Disorganized speech
Grossly disorganized or catatonic behavior
Diminished emotional expression is a
Positive psychotic symptom
Negative psychotic symptom
Negative psychotic symptom
Decreased ability to experience pleasure from positive stimuli or a degradation in the recollection
of pleasure previously experienced.
Alogia
Asociality
Avolition
Anhedonia
Anhedonia
Decrease in motivated, self-initiated purposeful activities.
Avolition
Alogia
Anhedonia
Asociality
Avolition
Diminished speech output
Alogia
Anhedonia
Avolition
Asociality
Alogia
Lack of interest in social interactions.
Anhedonia
Asociality
Alogia
Avolition
Asociality
Which of the following antipsychotic medications is a long-acting injectable preparation.
Quetiapine
Clozapine
Fluphenazine decanoate
Amisulpride
Fluphenazine decanoate
In Schizophreniform disorder, most estimates of progression to schizophrenia range between 60
and 80 percent
True
False
True
Norman Cameron described seven situations that favor the development of delusional disorders. These include
an increased expectation of receiving sadistic treatment
situations that increase distrust and suspicion social isolation
all of the above
all of the above
Risks associated with Delusional Disorder
Recent immigration
All of the above
Advanced age
Family history
All of the above
Good prognostic features for Brief Psychotic Disorder
Family history of Schizophrenia
None of the above
Severe precipitating stressor Insidious onset of symptoms
Severe precipitating stressor
Pathognomonic sign of Schizophrenia
Delusions
Hallucinations
None of the above
Disorganized speech
None of the above
Clozapine has a number of side effects that make it a difficult drug to administer. The most serious is a risk of agranulocytosis.
True
False
True
Treatment during the acute phase focuses on alleviating the most severe psychotic symptoms.
This phase usually lasts from
1 to 2 weeks
None of the above
4 to 8 weeks
3 to 6 months
4 to 8 weeks
Low-potency antipsychotics are often associated with sedation and postural hypotension, particularly when they are administered intramuscularly.
True
False
True
Intramuscular ziprasidone and olanzapine are similar to their oral counterparts in not causing
substantial extrapyramidal side effects during acute treatment .
True
False
True
In the stable or maintenance phase, the illness is in a relative stage of remission. The goals during this phase are to prevent psychotic relapse and to assist patients in improving their level of functioning.
True
False
True
During the maintenance phase, how many percent of patients with Schizophrenia receiving
treatment will experience a relapse within 1 year?
90 percent
None of the above
50 percent
16 to 23 percent
16 to 23 percent
Without medications in the maintenance phase, how many percent of patients with Schizophrenia receiving treatment will experience a relapse?
30 to 40 percent
53 to 72 percent
None of the above
10 to 20 percent
53 to 72 percent
It is generally recommended that multi-episode patients receive maintenance treatment for at
least 5 years, and many experts recommend pharmacotherapy on an indefinite basis
True
False
True
Regarding non-compliance to treatment in Schizophrenia
All of the above
An estimated 40 to 50 percent of patients become noncompliant within 1 or 2 years
Noncompliance with long-term antipsychotic treatment is very high
Compliance increases when long-acting medication is used instead of oral medication
All of the above
Strategies for poor responders to pharmacotherapy in Schizophrenia
4- to 6-week trial on an adequate dose of an antipsychotic
monitoring the plasma concentration of the drug to confirm adequate dosage
raising the dose of the drug if necessary
all of the above
all of the above
Managing the extrapyramidal symptoms (EPS) of antipsychotics include.
reducing the dose of the antipsychotic
adding an anti-Parkinson medication changing the patient to a Serotonin-Dopamine Antagonist (SDA)
all of the above
all of the above
He used the term démence précoce to describe deteriorated patients whose illnesses began in
adolescence.
None of the above
Benedict Morel
Eugene Bleuler
Emil Kraepelin
Benedict Morel
Peak age of onset of Schizophrenia in men.
After 45 years old
25 to 35 years old
None of the above
10 to 25 years old
10 to 25 years old
He translated démence précoce into dementia precox, a term that emphasized the change in cognition (dementia) and early onset (precox) of the disorder.
Emil Kraepelin
None of the above
Benedict Morel
Eugene Bleuler
Emil Kraepelin
He coined the term schizophrenia, which replaced dementia precox in the literature.
Benedict Morel
Eugene Bleuler
Emil Kraepelin
None of the above
Eugene Bleuler
The four A’s of Schizophrenia: associations, affect, autism, and ambivalence
True
False
True
The lifetime prevalence of schizophrenia is about
10 percent
1 percent
0.1 percent
None of the above
1 percent
Schizophrenia is equally prevalent in men and women.
a. True
b. False
a. True
Peak age of onset of Schizophrenia in women
25 to 35 years old
After 45 years old
None of the above
10 to 25 years old
25 to 35 years old
Late-onset Schizophrenia usually occurs
None of the above
After age 45 years
After age 35 years
After age 25 years
After age 45 years
First-degree biological relatives of persons with schizophrenia have a ten times greater risk for developing the disease than the general population
a. True
b. False
a. True
Infection and birth season are biological predisposing factors in the development of Schizophrenia later in life. Persons who develop schizophrenia are more likely to have been born in the
a. winter and early spring
b. late spring and summer
c. summer
d. none of the above
a. winter and early spring
Apart from smoking-associated mortality, nicotine decreases the blood concentrations of some antipsychotics
a. True
b. False
a. True
The prevalence of schizophrenia has been correlated with local population density in cities with populations of more than 1 million people. This is due to
social stressors in urban settings
exposure to viruses in high population densities
there is no correlation to population densities none of the above
social stressors in urban settings
Excessive dopamine release in patients with schizophrenia has been linked to the severity of negative psychotic symptoms
a. True
b. False
b. False
dopamine-positive
The symptoms of schizophreniform are similar to those of schizophrenia; however, with schizophreniform disorder, the symptoms last for at least
1 month to less than 6 months
1 month but less than 3 months At least 6 months
1 day to less than 1 month
1 month to less than 6 months
The concept of schizophreniform disorder was introduced in 1939 by
Emil Kraeplin
Gabriel Langfeldt
None of the above
Eugene Bleuler
Gabriel Langfeldt
The following statements are true regarding the epidemiology of Schizophreniform Disorder
All of the above
fivefold greater rate of schizophreniform disorder has been found in men than in women
1-year prevalence rate of 0.09 percent and a lifetime prevalence rate of 0.11 percent have been reported
most common in adolescents and young adults and is less than half as common as schizophrenia
All of the above
The relatives of patients with schizophreniform disorders are more likely to have mood disorders than are the relatives of patients with schizophrenia
a. true
b. false
a. true
Several studies have shown that patients with schizophreniform disorder, as a group, have more affective symptoms (especially mania) and a better outcome than patients with schizophrenia
a. true
b. false
a. true
One of the differences of Schizophreniform Disorder from Schizophrenia is its
psychotic symptoms
rapid onset and lacks a long prodromal phase
none of the above
insidious onset
rapid onset and lacks a long prodromal phase
In Schizophreniform Disorder, how many psychotic symptoms must be present?
At least 3
At least 2
At least 1
None of the above
At least 2
An indicator of poor prognosis in Schizophreniform Disorder
Emotional turmoil
None of the above
Negative symptoms
Confusion
Negative symptoms
Which of the following statements regarding the course and prognosis of Schizophreniform Disorder is true?
Most estimates of progression to schizophrenia range between 60 and 80 percent
Only 10 percent progress to Schizophrenia None of the above
It is a psychotic illness lasting more than 1 month and less than 3 months
Most estimates of progression to schizophrenia range between 60 and 80 percent
The following statements are true regarding the treatment of Schizophreniform Disorder
Hospitalization is often necessary Psychotherapy is usually necessary All of the above
treated by a 3- to 6-month course of antipsychotic drugs
All of the above
The data can be interpreted to indicate a physiological similarity between the psychosis of schizophrenia and the psychosis of schizophreniform disorder
Impaired striatal activity suppression limited to the left hemisphere during the Wisconsin Card Sorting Test
hyporesponsive skin conductances
enlargement of the cerebral ventricles
none of the above
Impaired striatal activity suppression limited to the left hemisphere during the Wisconsin Card Sorting Test
The following statements regarding the course of Schizophrenia are true
patients usually relapse, however, and the pattern of illness during the first 5 years after the diagnosis generally indicates the patient’s course
all of the above
after the first psychotic episode, a patient gradually recovers and may then function relatively normally for a long time
one of exacerbations and remissions
all of the above
Major distinction between schizophrenia and the mood disorders
response to medications
none of the above
failure to return to baseline functioning after each relapse
need for hospitalization
failure to return to baseline functioning after each relapse
Several studies have shown that over the 5- to 10-year period after the first psychiatric hospitalization for schizophrenia, only about
10 to 20 percent of patients can be described as having a good outcome
75 percent of patients can be described as having a good outcome
None of the above
50 percent of patients can be described as having a good outcome
10 to 20 percent of patients can be described as having a good outcome
The following indicate good prognosis in Schizophrenia
Young onset
Mood disorder symptoms
No precipitating factors Insidious onset
Mood disorder symptoms
The following indicate good prognosis in Schizophrenia
Negative symptoms
Acute onset
Many relapses
Family history of Schizophrenia
Acute onset
The following indicate good prognosis in Schizophrenia
Neurological signs and symptoms Divorced or widowed
Positive symptoms
Poor support systems
Positive symptoms
The following indicate poor prognosis in Schizophrenia
Late onset
Withdrawn, autistic behavior
Married status
Obvious precipitating factors
Withdrawn, autistic behavior
The following indicate poor prognosis in Schizophrenia
No precipitating factors
Family history of mood disorders
Good premorbid social, sexual and work histories
Good support systems
No precipitating factors
Indications for hospitalization in Schizophrenia
diagnostic purposes
for patients’ safety because of suicidal or homicidal ideation
stabilization of medications
all of the above
all of the above
The drugs used to treat schizophrenia have a wide variety of pharmacological properties, but all share the capacity to
antagonize postsynaptic dopamine receptors in the brain
antagonize postsynaptic serotonin receptors in the brain
antagonize presynaptic dopamine receptors in the brain
antagonize presynaptic serotonin receptors in the brain
antagonize postsynaptic dopamine receptors in the brain
The following statements are true regarding Schizophrenia
it probably comprises a group of disorders with heterogeneous etiologies
it includes patients whose clinical presentations, treatment response, and courses of illness vary
All of the above
Signs and symptoms are variable and include changes in perception, emotion, cognition, thinking,
and behavior
All of the above
Regarding hospitalization of patients with Schizophrenia, short stays of 4 to 6 weeks are just as effective as long-term hospitalizations, and hospital settings with active behavioral approaches produce better results than do custodial institutions
True
False
True
Hospital treatment plans for patients with Schizophrenia should be oriented toward practical issues of
self-care
quality of life
employment
all of the above
all of the above
the first antipsychotic introduced in 1952
chlorpromazine
clozapine
none of the above
haloperidol
chlorpromazine
