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MRCPSYCH_Paper B_MENTOR & More_Dr. ART > Psychosis - 2 > Flashcards

Psychosis - 2 Flashcards

1
Q

Sleep changes in schizophrenia?

A

short REM latency
Recuded Slow wave sleep

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2
Q

male to female ration schizo

A

1:1

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3
Q

international annual prevalence of schizophrenia

A

0.33%

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4
Q

annual prevalence of psychotic disorders in the UK

A

.4%

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5
Q

the incidence of schizophrenia internationally

A

.20/1000/year

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6
Q

what increases risk of psychosis in an individual?

A

-Person distressed
-Decline in social functioning
in addition to
transient or attenuated psychotic symptoms OR
Family history of psychosis OR
Behaviours suggestive of psychosis

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7
Q

what is 1st line of treatment in acute psychosis?

A

antipsychotics (1st or 2nd gen)
CBT w/ or w/out family intervention

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8
Q

what assessments to be done before Rx in acute psychosis?

A
  • Weight
  • Waist circumstance
  • Pulse and blood pressure
  • FBG, HbA1c, Lipid profile and Prolactine
    -Assess any movement disorder
    -Assess any nutritional status
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9
Q

when do we assess ECG too before Rx of acute psychosis?

A

IF required by medication’s SPC
IF there is a cardiovascular risk
IF a patient is being admitted

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10
Q

is loading dose recommended in acute psychosis?

A

no?

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11
Q

how long antipsychotic trial takes in acute psychosis?

A

4-6 weeks

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12
Q

what should you tell patient if you initiate chlorpromazine?

A

it may cause photosensitivity
so patient might need to apply sun screen

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13
Q

when can you offer clozapine?

A

if patient did not responded well to adequest dose of two antipsychotic (one at least non-clozapine)

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14
Q

how long Rx should last?

A
  • 1-2 years following initiation or there is resk of relapse
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15
Q

what are options for smoking cessation in acute psychotics?

A

-Nicotine replacement therapy
-Bupropion
-Varenicline

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16
Q

what non-pharma approach can reduce psychotic symptoms?

A

CBT
TMS
Family and patient psychoeducation
Social skill training
Early intervention

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17
Q

enumerate negative sympomts one more time?

A

social withdrawal
apathy
lack of energy
alogia
flattening of affect
anhedonia

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18
Q

which antipsychotic has most robust support for effectiveness with primary negative symptoms?

A

Amisulpride

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19
Q

low or high social class a risk for schizophrenia?

A

low

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20
Q

what hypotheses have tried to explain relation between low social class and schizophrenia?

A
  • Environmental exposure higher in low class (workplace conditions, nutrition..)
  • Selection drift hypothesis = inability to compete for good jobs etc.
21
Q

Learning disability and schizophrenia?

A

LD has 3 times more risk than public

22
Q

is there any racial difference for schizophrenia prevalence?

A

no?

23
Q

what did AESOP study found about ethnic difference in schizophrenia prevalence?

A

African-Caribbean population has high rates

24
Q

male : female ratio for schizophrenia

A

maybe female more

25
Q

TRUE or False
Male with schizophrenia are more likely to get married.

A

FALSE

Females are.

26
Q

Risk of developing schizophrenia in public

A

1%

27
Q

Risk of developing schizophrenia in first cousin

A

2%

28
Q

Risk of developing schizophrenia in grandchildren

A

5%

29
Q

Risk of developing schizophrenia in parents

A

6%

30
Q

Risk of developing schizophrenia in siblings

A

9%

31
Q

Risk of developing schizophrenia in children

A

13%

32
Q

Risk of developing schizophrenia in fraternal twin

A

17%

33
Q

Risk of developing schizophrenia in identical twin?

A

48%

34
Q

relation between winter and schizophrenia?

A

born in winter is 5-15% more chance of schizophrenia

35
Q

urban or rural increase risk of schizophrenia?

A

Urban

36
Q

do obstetric complication increase risk of schizophrenia?

A

yes

37
Q

relative risk for developing schizophrenia in first generation migrants

A

2.7

38
Q

relative risk for developing schizophrenia in 1st and 2nd generation of migrants combined?

A

2.9

39
Q

relative risk for developing schizophrenia in immigrant from developing countries

A

3.3

40
Q

relative risk for developing schizophrenia in immigrant from countries with majory black vs non whites

A

4.8

41
Q

what risk factors have good evidence for schizophrenia?

A
  • Prenatal nutritional deprivation
    -Prenatal brain injury
    -Prenatal influenza
42
Q

Protective factors for schizophrenia?

A

Positive rearing experience
Antipsychotic medication
Education about relapse prevention

43
Q

factors associated with negative outcomes

A
  • Longer untreated duration
  • Early & insidious onset
  • Male
  • Prom. negative symptoms
  • Family Hx
  • Low IQ, socioeconomic or social status
  • Sign. Pscy. hx
    -Continued substance misuse
44
Q

how many year earlier patients with schizophrenia die?

A

10-20 years

45
Q

common cause of premature death in patients with schizphrenia?

A

suicide
accident
pneumonia
cardiovascular disease

46
Q

how many fold suicide is increased in schizophrenia?

A

9 folds

47
Q

how many folds pneumonia risk is increased in schizophrnia

A

7 folds

48
Q

does clozapine & antipsychotics in general reduce mortality rate in schizophrenia?

A

yes

MRCPSYCH_Paper B_MENTOR & More_Dr. ART (62 decks)

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