Chap. 9 - SZO, the basics Flashcards
Psychotic implies…
Impaired or deficient reality testing
Hallucinations
False sensory experiences without the presence of a stimulus
Delusions
Fixed, false beliefs maintained despite evidence to the contrary
Illusions
Misperceptions of actual stimuli
SZO risk in general population
1%
SZO risk if both parents have SZO
40%
Monozygotic concordance in SZO
50%
SZO - SNP or CNV?
SNP
Intrauterine insults that may lead to SZO
Toxins, including viruses
Oxygen deprivation
Malnutrition
Substance use
Three brain structures that are smaller in the SZO individual
Hippocampus
Frontal and temporal lobes
These brain structures are enlarged in the SZO individual
Ventricles
In SZO, DA is increased in the _____ pathway and decreased in the _____ pathway
Excess DA in the mesolimbic
Decreased DA in the mesocortical
In SZO….
Glutamate is increased or decreased?
GABA is increased or decreased?
Glutamate increased
GABA decreased
In SZO, serotonin is increased or decreased?
Decreased
SZO - higher rates in urban or rural areas?
Urban
SZO - higher rates in first-born or children or later-born?
First-born
SZO and men:
Onset?
More or less negative sx than women?
Prognosis and response to tx better or worse than women?
Onset 18-25
More negative sx than women
Worse prognosis and worse tx response than women
More hallucinations and delusions - men or women?
Women
Hypnopompic hallucinations
False perceptions upon waking up
Not considered pathological
Hypnogogic hallucinations
False perceptions as one is falling asleep
Not considered pathological
Positive sx respond better to typicals or atypicals?
Typicals
Positive sx are an excess or deficit of normal brain fxn?
Excess
Positive sx are caused by:
Increased or decreased? DA in the mesolimbic or mesocortical? pathway
Increased DA in the mesolimbic
Negative sx respond better to typicals or atypicals?
Atypicals
Negative sx are an excess or deficit of normal brain fxn?
Deficit
Negative sx are caused by:
Increased or decreased? DA in the mesolimbic or mesocortical? pathway
Decreased DA in the mesocortical
Sx must persist for __ months for dx of SZO
6 months
Later age of SZO onset = better or worse prognosis?
Better prognosis
Disorganized SZO is the most/least? severe type, and paranoid type is the most/least? sever type
Disorganized is most severe
Paranoid is least severe
Echolalia
Repeating the last heard words of others
Exhopraxia
Imitation of observed behavior or movements
Astereognosis
Loss of ability to recognize form of an object by touch
Dysdiadochokinesia
Impairment of ability to perform rapidly alternating movements
Structurally speaking, the only noted enlargements in the SZO brain are in the _____ _____
Lateral ventricles
Clozaril - you must monitor ___ labs q __ weeks for __ months, then q __ weeks for __ months, then q __ weeks for how long?
WBC/neuts q week for 6 months, then q 2 weeks for 6 months, then q 4 weeks forever
Seroquel - monitor what lab primarily?
LFTs
Zyprexa - 4 monitors
BMI
Waist circumference
FBG
Lipids
Geodon - monitor what parameter?
QTc
Abilify - monitor labs, or is this a pretty neutral drug?
Fairly neutral
SGAs, in the mesolimbic pathway, will _____ dopamine, thereby _____ positive sx
block dopamine, reducing positive sx
SGAs, in the mesocorticol pathway, will _____ dopamine, thereby _____ negative sx
increase dopamine, reducing negative sx
In the nigrostriatal pathway, as DA increases, ACh _____
decreases
EPS is caused by increased or decreased ACh?
increased
In the tuberoinfundibular pathway, as dopamine is blocked (or, decreases) then prolactin is _____, causing _____.
Prolactin increases, causing galactorrhea
Hyperprolactemia in women may cause….(4)
Sexual side effects
Galactorrhea
Amenorrhea
Bone demineralization (if post-menopausal and not on estrogen)
Because the FGAs block dopamine in the mesocortical pathway, these drugs actually made the _____ symptoms worse
Negative symptoms
