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schizophrenia (1) Flashcards

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1
Q

is schizo a split personality disorder?

A

no

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2
Q

is schizo a source of violence or danger

A

no

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3
Q

what is the hallmark of schizophrenia

A

psychosis

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4
Q

what is altered cognition, disorganized thoughts, and altered perception, impaired reality

A

psychosis

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5
Q

what is the age onset of schizo

A

late adolesence or early adult (15-25)

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6
Q

what classifies a schizo diagnosis as a childhood onset

A

before 15

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7
Q

what classifies a schizo diagnosis as a late onset

A

after 40

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8
Q

what is the prodromal phase of schizo

A

a “forewarning” phase

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9
Q

which phase of schizo has deteriorating function, social withdraw, functional impairment, sleep disturbance, anxiety, irritability, depression, poor concentration, and fatigue

A

prodromal

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10
Q

what are the DSM 5 criteria for schizophrenia

A

1) delusion
2) hallucination
3) disorganized speech
4) grossly disorganized or catatonic behavior
5) negative symptoms

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11
Q

how many of the DSM 5 criteria is needed for a schizo diagnosis, and what do they need to be

A

need 2 or more of the criteria, but at least one of them needs to be delusion, hallucination, or diorganized speech

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12
Q

how long does the acute phase of schizo last

A

at least 6 months, with 1 month of symptoms

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13
Q

what do you have to rule out before schizo diagnosis

A

schizoaffectove mood, substances, meds, conditions, ASD

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14
Q

describe positive schizo sx

A

add things that the rest of us dont have

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15
Q

examples of positive symptoms

A

hallucinations adn delusions

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16
Q

describe negative symptoms

A

miss things typical people have

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17
Q

examples of negative symptoms

A

lack of pleasure, cant keep goals for themselves

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18
Q

describe cognitive schizo sx

A

affect ability to think/function

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19
Q

describe affective schizo sx

A

can’t express emotion well

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20
Q

what kind of sx is a persecutory delusion

A

positive

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21
Q

what is a persecutory delusion

A

believe a person is out to get you, constantly scared

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22
Q

what kind of sx is a grandiose delusion

A

positive

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23
Q

describe grandiose delusion

A

exaggerated importance, think they are president, jesus, famous

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24
Q

what kind of sx is a referantial delusion

A

positive

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25
Q

describe referential delusion

A

everything pertains to you, “newspaper articles are all about me”

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26
Q

describe control or influence delusions

A

believe someone else has control over you

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27
Q

describe soamtic delusions

A

body based, patient soaked body in bleach to “get rid of alien eggs”

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28
Q

describe nihilistic delusions

A

end of the world

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29
Q

describe religiosity delusions

A

everything is religiously influenced, obsessive

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30
Q

describe erotomantic delusion

A

think someone loves you, might not even know them

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31
Q

what kind of sx are speech alterations

A

positive

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32
Q

describe associative looseness

A

talking all over the place

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33
Q

describe word salad “schizophasia”

A

real words are jumbled up and person doesn’t realize

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34
Q

describe clang associations

A

use words based on sound and rhyme

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35
Q

describe neologisms

A

made up words

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36
Q

describe echolalia

A

like a parrot, echoes what others say

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37
Q

describe circumstantiality

A

give lots of details but eventually gets to the point

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38
Q

describe tangentiality

A

goes on a tangent, never answers questions

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39
Q

describe pressured speech

A

really fast talking, can’t get a word in, too excited

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40
Q

describe flight of ideas

A

absolutely does not make sense

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41
Q

describe symbolic speech

A

think of blood draws as “evil demons doing their mission to suck blood”

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42
Q

what kind of symptom is disorganized thinking

A

positive

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43
Q

describe cognitive retardation

A

slowing of thoughts

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44
Q

describe thought blocking

A

forget what you’re saying int he middle of a sentence

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45
Q

describe thought insertion

A

believe other people put thoughts into their head (controlled delusion)

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46
Q

describe thought deletion

A

believe someone took thougts from them

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47
Q

describe magical thinking

A

they think their thoughts affect others
ex. get mad, wish someine harm, they actually get hurt, believe you caused it

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48
Q

describe depersonalization vs. derealization

A

depersonalization: something about yourself feels strange, out of body
derealization: reality seems odd

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49
Q

what are the most common hallucinations

A

auditory

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50
Q

what are command hallucinations?

A

tells someone to do something or shows them something, DANGEROUS

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51
Q

what are illusions

A

has a real basis in reality, but is perceived different
(sees a picture, thinks its talking)

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52
Q

what is derealization?

A

reality seems weird/altered

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53
Q

what is a pronounced increase or severe decrease in movement

A

catatonia

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54
Q

what is the term for when muscles go rigid in decreased catatonia?

A

catalepsy

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55
Q

describe waxy flexibility

A

limbs stay where they are put

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56
Q

what kind of movement is less severe than catatonia - slowed movement

A

motor retardation

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57
Q

which movement is less severe than catatonic excitement - mild - a tension relieving activity - fidgety - just can’t relax

A

motor agitation

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58
Q

what are stereotypes behaviors?

A

seen in ASD, reperitive behavior

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59
Q

what is negativism behavior

A

very resistant to advice or wishes

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59
Q

what is echopraxia

A

repeated movement

60
Q

describe gesturing / posturing

A

stands or hold body in a weird way

61
Q

what kind of sx is anhedonia

A

negative

62
Q

describe anhedonia

A

inability to experience pleasure

63
Q

describe avolition

A

hard time with motivation, hard to do tasks

64
Q

what kind of sx is avolition

A

negative

65
Q

what kind of sx is alogia

A

negative

66
Q

describe alogia

A

does not use a lot of words

67
Q

what kind of sx is asociality

A

negative

68
Q

descirbe asociality

A

do not seek out people and connections

69
Q

what kind of sx is apathy

A

negative

70
Q

describe apathy

A

does not care about anything

71
Q

describe affective blunting in schizo

A

a minimal response
-flat affect
-constricted (sad/anger only)
-inappropriate emotional response for situation
-bizarre

72
Q

is affective blunting positive or negative

A

negative

73
Q

is anosognosia a positive or negative symptom

A

negative

74
Q

describe anosognosia

A

do not believe they are sick

75
Q

describe symptoms of the maintenance phase of schizo compared to the symptoms of the acute and prodromal phase

A

symptoms of the acute phase are gone, but symptoms of the prodromal phase are the new baseline

76
Q

how is impairment affected between schizo episodes

A

impairment increases between each episode

77
Q

describe affect and impairment in the maintenance phase

A

flatt affect and role functioning impairment

78
Q

which neurochemical is strongly linked to schizo

A

dopamine

79
Q

which environmental toxins can be linked to schizo

A

tetracholoroethylene (used to be used in laundry/pipes)

80
Q

which drug is often a trigger of schizo

A

marijuana

81
Q

what prenatal stressors can cause schizo

A

poor nutrition, hypoxia, infections, substance use / nicotine & marijuana too

82
Q

describe ventricles in schizo

A

enlarged lateral cerebral ventricles, 3rd ventricle dilation

83
Q

which part of the brain will atrophy in schizo

A

cerebellum

84
Q

what happens to the fissures in schizo

A

increase in size

85
Q

what happens to connectivity of brain region in schizo

A

reduced connectivity

86
Q

what are osychological rish factors for schizo?

A

stress, childhood trauma, ACE events, downward shift hypothesis

87
Q

describe the downward shift hypothesis

A

decreased socioeconomic status, exposed to more bacteria/viruses, worse nutrition, decreased prenatal care, etc.

88
Q

substance/nicotine use related to antipsychotics

A

will decrease effectiveness

89
Q

what are some comorbiditeis with schizo

A

substance use, anxiety, depression, suicide, physical illness, POLYDIPSIA

90
Q

what can polydipsia lead to in schizo

A

water toxicity, hyponatremia, confusuin

91
Q

what makes up schizoaffective disorder

A

bipolar + schizophrenia

92
Q

what is worse, schizophrenia or schizoaffective disorder?

A

schizophrenia

93
Q

what disorder is where you have one delusion but no other symptoms of schizo

A

delusional disorder

94
Q

which disorder is where you develop a disorder from another person close to you

A

shared psychotic disorder (folie a deux)

95
Q

increased levels of which chemical can cause psychotic disprder (related to hepatic system)

A

ammonia

96
Q

describe individual psychotherapy for schizo

A

REALITY ORIENTED, improve compliance, enhance functioning,

97
Q

discuss group therapy for schizo

A

discuss real life plans, problems, relationships, decreases social isolation and improves reality testing

98
Q

what does behavior therapy focus on for schizo

A

reduce bizarre, disturbing, deviating behavior

99
Q

what is milieu therapy

A

therapeutic environment

100
Q

what kind of meds are used for schizo

A

antipsychotics (neuroleptics)

101
Q

what is the main 1st gen antipsychotic given

A

haloperidol (haldol)

102
Q

what is the ling acting injectible form of haldol

A

haloperidol deconate

103
Q

what are 1st gen antipsychotics good at doing?

A

removing positive sx

104
Q

what kind of antipsychotics can help remove negative sx

A

atypical 2nd gen

105
Q

what gen antipsychotic is used for bipolar mania

A

atypical 2nd gen

106
Q

what is the most important atypical 2nd gen antipsychotic

A

paliperidone (invega)

107
Q

which organ are antipsychotics very hard on

A

liver

108
Q

which lab shows impaired liver function

A

LFTs

109
Q

what med can not be given for myloproliferative disorders if a patient is on antipsychotics?

A

clozapine

110
Q

what is the BBW for antipsychotics?

A

there is an increased incidence of death in elderly with neurocognitive disorders (stroke)

111
Q

hownwill antipsychotics interact with the heart (EKG effects)

A

prolonged QT

112
Q

what kind of cardiac meds should not be given with antipsychs?

A

other meds that prolong QT

113
Q

is a patients QTc is greater than 500, what med can they not give?

A

ziprasidone

114
Q

why is a high QTc bad?

A

increased risk of VT / Vfib

115
Q

what effects come from anticholinergics, and what should you do to prevent them?

A

they dry everything up, ice chips, fluids, increase fiber

116
Q

what can anticholinergic toxicity cause?

A

altered mental status

117
Q

what are side effects of blocking alpha adrenergic receptors

A

ortho hypotension, refelx tachycardia, tremors

118
Q

what side effects do histamine blockades cause

A

weight gain/sedation

119
Q

what med should probably not be given to an overweight person

A

olanzapine (histamine blocker)

120
Q

whay is important to know for women who take antipsychotics?

A

they need contraceptives, these meds are teratogenic

121
Q

what will antipsychotics do to blood counts?

A

decrease them

122
Q

what med in specific do we need to watch out for agranulocytosis

A

clozapine

123
Q

which gen antipsychotics are antipsychotic side effects worse with?

A

typicals

124
Q

what is pseudoparkinsonism

A

tremors, shuffling, drooling, rigidity

125
Q

tx of pseudoparkinsonism

A

antiparkinsons, BENZTROPINE MESYLATE

126
Q

what is the tx for akinesia (muslce weakness)

A

carbidopa/levodopa

127
Q

what is akathisia

A

countinuous restlessness

128
Q

What is the sudden sustained contraction of muscles, spasm of face, arms, legs, neck; often in men less than 25 years old

A

acute dystonesia

129
Q

What is the anti-semitic rolling back of the eyes and can occur as part of dystonesia

A

oculogyric crisis

130
Q

is acute dystonesia an emergency

A

yes

131
Q

Is oculogyric crisis and emergency?

A

yes

132
Q

what is the treatment of acute dystonia and oculogyric crisis

A

stop the psych meds, monitor airway, suction ready

133
Q

What symptoms characterized by bizarre facial and tongue movements, stiff neck, lip smacking or licking, difficulties swallowing

A

tardive dyskinesia

134
Q

Is tardive dyskinesia an emergency?

A

yes

135
Q

Which rating scale is used for tardive dyskinesia?

A

AIMS scale

136
Q

Treatment of tardive dyskinesia

A

Monitor airway, benadryl, cogentin

137
Q

What medication is used to prevent extrapyramidal symptoms such as acute dystonia, oculogyric crisis, and tardive dyskinesia

A

anticholinergics

138
Q

Which antipsychotic side effect is characterized by:
- severe Parkinsonian Muscle Rigidity
- Hyper pyrexia, high fever
- Tachycardia, tachypnea, blood pressure fluctuations
- Diaphoresis
- Rapid deterioration of mental status
Occurs within hours of starting meds

A

Neuroleptic malignant syndrome (NMS)

139
Q

Which meds need to be given for neuroleptic malignant syndrome

A

Parlodel and dantrium

140
Q

Which syndrome comes as a side effect from second generation antipsychotics

A

Metabolic syndrome

141
Q

Which is important to consider if you are going outside while on antipsychotics

A

use sunscreen / protect

142
Q

Which mental health problem is a high risk for people with schizophrenia

A

suicide

143
Q

What is the only consistent protective factor fornsuicide woth schizophrenia

A

Delivery of and adherence to effective treatment

144
Q

How do you tell if a client is hallucinating?

A

-listening pose
-laughing/talking to self
-stops mid sentence
-tracks unknown speaker
watches vacant area of room

145
Q

What should you say to a client if you think they are hallucinating

A

Are you hearing voices or seeing something

146
Q

What are ways that schizophrenia can possibly be prevented?

A

-No malnutrition, substances
-promote resiliency
-Supplemental essential fatty acids
-Early treatment with antipsychotics

147
Q
A

Psych (19 decks)

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