Schizophrenia Flashcards
schizophrenia spectrum
a group of psychotic disorderes by severe disturbances of thought and associative looseness, impaired reality testing and limited socialization
psychosis
total inability to recognize ability reality, not a diagnosis by a symptom
schizophreniform
duration of symptoms is < 6 months
schizoaffective
symptoms are concurrent with major depressive, manic or mixed episode
delusional
non-bizarre delusions without other symptoms of psychosis
brief psychotic
acute onset of symptoms lasting < 1 month
substance-induced psychotic
psychosis within one month of substance intoxication or withdrawal
substance use and tobacco use disorders occur in how many schizo patients
50% of schizo patients
what is the leading cause of pre-mature death in schizo
suicide
what is the schizo gene
C-4
dopamine hypothesis
+ symptoms are associated with excessive dopamine transmission
- symptoms are associated with too little dopamine
non-genetic prenatal complications
viral infections
poor nutrition
hypoxia
exposure to toxins
psychological stressors
childhood sexual abuse
chronic poverty
high crime
stress increases cortisol levels which can cause other issues
environmental stressors for schizophrenia
street drugs before age 21
DSM-5 schizo diagnosis
2+ of the following for 1 month:
delusions hallucinations disorganized speech disorganized/catatonic behavior negative symptoms
positive symptoms
hallucinations
delusions
disorganized speech
bizarre behavior
acute onset - respond to antipsychotic
hallucination types
auditory visual tactile olfactory gustatory
command hallucinations
if they hear it in a familiar voice they are more likely to do it
ask what the voices are telling them to do
personal boundary difficulties
depersonalization
derealization
delusions
ideas of:
reference persecution grandeur somatic jealousy control thought broadcasting thought insertion thought withdrawal
associative looseness
flight of ideas
clanging
rhyming or sound alike words
neologisms
made-up words
echolalia
repeated words
word salad
mix of meaningless words
negative symptoms
affect blunt
alogia
poverty of speech and content
avolition
no motivatoin
anergia
no energy
anhedonia
no pleasure
poverty of speech
answers briefly
thought blocking
interruption in thoughts
FGA antagonizes
DA
FGA has a greater risk of
EPS
SGA antagonizes
serotonin and dopamine
SGA has a greater risk of
metabolic syndrome
why is SGA harder to get
more costly
black box warning for FGA
not approved for dementia-related psychosis
which FGA causes QT prolongation
thioridazine
common anti-psychotic X10
sedation hypotension anticholinergic weight gain photosensitivity sexual dysfunction increased prolactin levels seizures metabolic syndrome EPS
EPS
akathisia
pseudoparkinsonism
acute dystonia
antiparkinson drugs X4
trihexyphenidyl
benztropine
dipenhydramine
biperiden
tardive dyskinesia
serious and irreversible EPS side effect after prolonged treatment
symptoms may subside after meds are discontinued or may be permanent
AIMS
abnormal involuntary movement scale
metabolic syndrome
cluster of conditions that increase risk for heart dz, DM, stroke
how is metabolic syndrome diagnosed
3+ of the following obesity HTN hyperglycemia high cholesterol
Neuroleptic malignant syndrome
rare but potentially fatal SE of antipsychotic
symptoms of NMS X9
decreased consciousness muscular rigidity increased muscle enzymes hyperpyrexia HTN tachycardia tachypnea diaphoresis drooling
how to treat NMS
bromocriptine
dantrolene
IVF
