Melvin Flashcards

1
Q

Who has the highest risk of having schizophrenia in a family

A

identical twins ~50%

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2
Q

What genetics are in schizophrenia

A

MHC locus on chromosome 6

express C4A causes increased risk

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3
Q

What dopamine abnormalities are seen in schizophrenia

A

increased DA neuron activity in limbic system (+ symptoms)

decreased DA neuron activity in prefrontal area (- symptoms)

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4
Q

What is decreased other than certain dopamine neurons in schizophrenia

A

glutamate (causes cognitive deficits)

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5
Q

What would you see on imaging of someone with schizophrenia

A

englargement of lateral ventricles

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6
Q

What is required for diagnosis of schizophrenia

A

2 symptoms within 1 month over 6 months

delusions
hallucinations
disorganized speech
disorganized behavior
negative symptoms
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7
Q

What type of hallucination is most common in schizophrenia

A

auditory commands

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8
Q

negative symptoms of schizophrenia

A
  • flat affect
  • lost sense of self
  • avolition-difficulty initiating and doing goals
  • poverty of thought and speech
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9
Q

What causes the most issues in schizophrenia

A

cognitive symptoms

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10
Q

onset for schizophrenia

A

bimodal 20s and then 40s for women

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11
Q

Good prognosis for schizophrenia

A
  • abrupt onset
  • positive symptoms
  • female
  • presence of mood symptoms
  • family history of disorder
  • good premorbid function
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12
Q

Poor prognosis for schizophrenia

A
  • insidious onset
  • negative symptoms
  • poor cognitive performance
  • CT abnormalitites
  • Lack of mood symptoms
  • childhood onset
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13
Q

Schizoaffective disorder diagnosis

A

major mood disorder plus schizophrenia

And

delusions and hallucinations for 2+ weeks in absence of mood episode

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14
Q

When is a breif psychotic disorder diagnosed

A

1 symptom with

duration 1 day- 1 month

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15
Q

When is schizophreniform disorder diagnosed

A

2 symptoms with

duration 1 month- 6 months

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16
Q

What is a delusional disorder

A

1 delusion but retaining functioning behavior

17
Q

What is capgras syndrome

A

belief that individuals or pets have been replaced by imposters

sometimes cannot recognize faces

18
Q

What is delusional parasitosis disorder

A

Aka Ekboms or morgellons

patient believes they are infested with parasites

19
Q

What type of therapy do you use for schizophrenia

A

individual supportive therapy

group therapy

20
Q

Contraindications for ECT

A

No absolute contraindications

21
Q

What is ECT

A

controlled seizure from a pulsed current

22
Q

What form of ECT is the best option

A

unilateral is the best with minimal side effects

23
Q

What side effects can occur from ECT

A

antero and retrograde amnesia that resolves within 6 months

24
Q

What do we see clinically in ECT

A

Inc dopamine and serotonin

dec metabolic activity in frontal/cingulate cortex

increase in brain derived neurotrophic factor (BDNF)

25
Q

What does rTMS allow

A

noninvasice brain pathway stimulation with rapidly changing magnetic fields

26
Q

What is the 1st line treatment for seasonal major depression disorder

A

light therapy (min 10,000 lux)

27
Q

What is the combination of ECT and TMS

A

MST

28
Q

What area was discussed for deep brain stimulation

A

subcallosal cingulate gyrus