Schizo

Question 1

DSM

Answer 1

At least 2 sx w/i 1 mo (at least one is: hallucinations, delusion, disorganized speech)
- disorganized behaviour

B- low lvl of fx
C- at least persist for 6 mo (prodromal to residual)
D- not by meds / subs
E- pt with ASD must have prominent sx to dx
F- exclude schizoaffective, delusion d/o

Question 2

RF

Answer 2

• family hx
• personality (schizotypal, schizoid)
• obs cx (PE, prem, hypoxia)
• CNS infx
• cannabis

Question 3

Bad prognosis

Answer 3

• single, male,
• early onset, progressive
• poor premorbid adjustment
• poor social support
• poor premorbid fx
• cognitive impair

Question 4

Resistance schizo

Answer 4

Poor respond to 2 antipsychotic (6-8weeks) after adequate dose and compliance

Question 5

EPS

Answer 5

• akathisia (diazepam/propranolol)
• acute Dystonia (IM Kemadrin)
• parkinsonism (T. Artane 2-5mg)
• tardive dyskinesia (clozapine)

Question 6

Brief psychotic d/o- at least 1 criteria A

Schizophreniform- fulfill criteria A

Schizophrenia

Answer 6

• at least 1 day, less than 1 mo (no prodromal phase)
• more than 1 mo. <6 mo
• > 6mo

Question 7

Schizoaffective

Answer 7

Mood sx develop concurrently with schizo sx but

Psychosis must present independently for 2 weeks

Question 8

Ddx of pacing

Answer 8

• akathisia
• commanding AH
• delusion of control
• anxious d/t subs withdrawal
• distress H

Question 9

First rank

Answer 9

• AH (3rd person, running commentary, thought echo)
• DOC
• Somatic passivity
• Thought possession
• Delusional perception

Question 10

Ddx of schizo

Answer 10

• brief psychotic d/o
• schizophreniform
• schizoaffective
• MDD/ bipolar with psychosis
• drug induced psychosis
• psychosis d/t AMC

Question 11

AMC (

Answer 11

Tumour, encephalitis, stroke, TLE

Hyper/Hypothyroid
Hyper parathyroid

Renal/ hepatic failure

Question 12

Indication of clozapine

Answer 12

• TRS
• tardive dyskinesia
• recurrent suicide
• aggressive
• substance abuse
• persistent positive sx at least 2 yrs

Question 13

Indication of ect in schizo

Answer 13

• catatonia
• schizoaffective
• with good response to previous ect
• poor response to meds

Question 14

When there is 2 AP

Answer 14

• change AP so to taper down previous dose

- add oral AP to pt on depot

Question 15

Management of schizo

Answer 15

• aim
• treat as
• BPSS model
  1. Bio: AP
  2. Psychosocial:
  family intervention,
  psychoeducation,
  Supportive
  social skill training (Self care, conflict solve, make friends, conversation skill, assertiveness)
  CRT (improve cognitive fx d/t generalized cerebral atrophy)
  CBT- of pt having partial insight

Question 16

Ddx of pacing

Answer 16

• akathisia
• commanding AH
• delusion of control
• anxious d/t subs withdrawal
• distress H

Question 17

First rank

Answer 17

• AH (3rd person, running commentary, thought echo)
• DOC
• Somatic passivity
• Thought possession
• Delusional perception

Question 18

Ddx of schizo

Answer 18

• brief psychotic d/o
• schizophreniform
• schizoaffective
• MDD/ bipolar with psychosis
• drug induced psychosis
• psychosis d/t AMC

Question 19

AMC (

Answer 19

Tumour, encephalitis, stroke, TLE

Hyper/Hypothyroid
Hyper parathyroid

Renal/ hepatic failure

Question 20

Indication of clozapine

Answer 20

• TRS
• tardive dyskinesia
• recurrent suicide
• aggressive
• substance abuse
• persistent positive sx at least 2 yrs

Question 21

Indication of ect in schizo

Answer 21

• catatonia
• schizoaffective
• with good response to previous ect
• poor response to meds

Question 22

When there is 2 AP

Answer 22

• change AP so to taper down previous dose

- add oral AP to pt on depot

Question 23

Management of schizo

Answer 23

• aim
• treat as
• BPSS model
  1. Bio: AP
  2. Psychosocial:
  family intervention,
  psychoeducation,
  Supportive
  social skill training (Self care, conflict solve, make friends, conversation skill, assertiveness)
  CRT (improve cognitive fx d/t generalized cerebral atrophy)
  CBT- of pt having partial insight