Chap. 9 - SZO, the basics

Question 1

Psychotic implies…

Answer 1

Impaired or deficient reality testing

Question 2

Hallucinations

Answer 2

False sensory experiences without the presence of a stimulus

Question 3

Delusions

Answer 3

Fixed, false beliefs maintained despite evidence to the contrary

Question 4

Illusions

Answer 4

Misperceptions of actual stimuli

Question 5

SZO risk in general population

Answer 5

1%

Question 6

SZO risk if both parents have SZO

Answer 6

40%

Question 7

Monozygotic concordance in SZO

Answer 7

50%

Question 8

SZO - SNP or CNV?

Answer 8

SNP

Question 9

Intrauterine insults that may lead to SZO

Answer 9

Toxins, including viruses
Oxygen deprivation
Malnutrition
Substance use

Question 10

Three brain structures that are smaller in the SZO individual

Answer 10

Hippocampus

Frontal and temporal lobes

Question 11

These brain structures are enlarged in the SZO individual

Answer 11

Ventricles

Question 12

In SZO, DA is increased in the _____ pathway and decreased in the _____ pathway

Answer 12

Excess DA in the mesolimbic

Decreased DA in the mesocortical

Question 13

In SZO….
Glutamate is increased or decreased?
GABA is increased or decreased?

Answer 13

Glutamate increased

GABA decreased

Question 14

In SZO, serotonin is increased or decreased?

Answer 14

Decreased

Question 15

SZO - higher rates in urban or rural areas?

Answer 15

Urban

Question 16

SZO - higher rates in first-born or children or later-born?

Answer 16

First-born

Question 17

SZO and men:
Onset?
More or less negative sx than women?
Prognosis and response to tx better or worse than women?

Answer 17

Onset 18-25
More negative sx than women
Worse prognosis and worse tx response than women

Question 18

More hallucinations and delusions - men or women?

Answer 18

Women

Question 19

Hypnopompic hallucinations

Answer 19

False perceptions upon waking up

Not considered pathological

Question 20

Hypnogogic hallucinations

Answer 20

False perceptions as one is falling asleep

Not considered pathological

Question 21

Positive sx respond better to typicals or atypicals?

Answer 21

Typicals

Question 22

Positive sx are an excess or deficit of normal brain fxn?

Answer 22

Excess

Question 23

Positive sx are caused by:

Increased or decreased? DA in the mesolimbic or mesocortical? pathway

Answer 23

Increased DA in the mesolimbic

Question 24

Negative sx respond better to typicals or atypicals?

Answer 24

Atypicals

Question 25

Negative sx are an excess or deficit of normal brain fxn?

Answer 25

Deficit

Question 26

Negative sx are caused by: | Increased or decreased? DA in the mesolimbic or mesocortical? pathway

Answer 26

Decreased DA in the mesocortical

Question 27

Sx must persist for __ months for dx of SZO

Answer 27

6 months

Question 28

Later age of SZO onset = better or worse prognosis?

Answer 28

Better prognosis

Question 29

Disorganized SZO is the most/least? severe type, and paranoid type is the most/least? sever type

Answer 29

Disorganized is most severe | Paranoid is least severe

Question 30

Echolalia

Answer 30

Repeating the last heard words of others

Question 31

Exhopraxia

Answer 31

Imitation of observed behavior or movements

Question 32

Astereognosis

Answer 32

Loss of ability to recognize form of an object by touch

Question 33

Dysdiadochokinesia

Answer 33

Impairment of ability to perform rapidly alternating movements

Question 34

Structurally speaking, the only noted enlargements in the SZO brain are in the _____ _____

Answer 34

Lateral ventricles

Question 35

Clozaril - you must monitor ___ labs q __ weeks for __ months, then q __ weeks for __ months, then q __ weeks for how long?

Answer 35

WBC/neuts q week for 6 months, then q 2 weeks for 6 months, then q 4 weeks forever

Question 36

Seroquel - monitor what lab primarily?

Answer 36

LFTs

Question 37

Zyprexa - 4 monitors

Answer 37

BMI Waist circumference FBG Lipids

Question 38

Geodon - monitor what parameter?

Answer 38

QTc

Question 39

Abilify - monitor labs, or is this a pretty neutral drug?

Answer 39

Fairly neutral

Question 40

SGAs, in the mesolimbic pathway, will _____ dopamine, thereby _____ positive sx

Answer 40

block dopamine, reducing positive sx

Question 41

SGAs, in the mesocorticol pathway, will _____ dopamine, thereby _____ negative sx

Answer 41

increase dopamine, reducing negative sx

Question 42

In the nigrostriatal pathway, as DA increases, ACh _____

Answer 42

decreases

Question 43

EPS is caused by increased or decreased ACh?

Answer 43

increased

Question 44

In the tuberoinfundibular pathway, as dopamine is blocked (or, decreases) then prolactin is _____, causing _____.

Answer 44

Prolactin increases, causing galactorrhea

Question 45

Hyperprolactemia in women may cause....(4)

Answer 45

Sexual side effects Galactorrhea Amenorrhea Bone demineralization (if post-menopausal and not on estrogen)

Question 46

Because the FGAs block dopamine in the mesocortical pathway, these drugs actually made the _____ symptoms worse

Answer 46

Negative symptoms