SCHIZOPHRENIA

Question 1

17 yo w/ dx of schizophrenia for 2 yrs believes people can read his thoughts
and has AH, currently on risperidone 6
mg, hx of high dose olanzapine and
haldol. What is next line? (2x)

Answer 1

Discontinue Risperidone and start

Clozapine

Question 2

Most participants on anti psychotics
drop out of the Treatment of Early Onset
Schizophrenia Spectrum study (TEOSS)
due to lack of efficacy and? (2x)

Answer 2

Weight gain

Question 3

Why should anticholinergic medications
given to prevent EPS be gradually
tapered after stabilization? (2x)

Answer 3

Decrease cognitive burden of

anticholinergics

Question 4

What differentiates primary psychosis
from psychotic symptoms related to
trauma? (2x)

Answer 4

Disorganized thought and behavior

Question 5

Youth develops tardive dyskinesia with
long term risperidone, even with reducing
dose and trials of nearly every other
atypical? Next step?

Answer 5

Switch to Clozapine

Question 6

Why should you administer clozapine twice a day?

Answer 6

Lower daily peak concentration

Question 7

Efforts focused on developing selective

interventions to prevent onset of psychosis have focused on?

Answer 7

Screening children whose parents have schizophrenia

Question 8

Early onset (less than 18 yo) schizophrenia
have what genetic finding as compared to
adult onset schizophrenia?

Answer 8

Higher rates of rare genomic deletion or duplication mutations

Question 9

What describes the relationship between prodromal state in later development of psychotic disorder?

Answer 9

Less than half of prodromal patients will go

on to develop a psychotic disorder

Question 10

Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS) clinical trial showed what impact on cognitive functioning at one year?

Answer 10

Minimal neurocognitive improvement

Question 11

Characteristic of childhood-onset

schizophrenia that differs from adult-onset?

Answer 11

Presents with greater illness severity

Question 12

16 yo w/ schizophrenia has gained
excessive weight w/treatment of
olanzapine. Histamine rebound would most likely occur with which cross taper?

Answer 12

Aripiprazole

Question 13

Primary treatment medication for

catatonia?

Answer 13

Benzodiazepine

Question 14

16 yo with psychosis, on risperidone,
gained 20 pounds since 2 months. Unable to lower dose because symptoms worsen.
Next step?

Answer 14

Cross taper to aripiprazole or ziprasidone

Question 15

Medication with most evidence for treating inappropriate weight gain in pediatric patients on second-gen antipsychotics

Answer 15

Metformin

Question 16

Kindergarten child on quetiapine for 6
months reports seeing a hero-like figure
that talks to the patient. Only upsetting
when hero gives him incorrect answers in
school. Family agrees to start
psychotherapy. What should be done about
medication?

Answer 16

Observe them off of Quetiapine

Question 17

Higher levels of aggressive/antisocial behavior is an indicator of poorer outcomes in which disorders?

Answer 17

Psychotic and substance use disorders

Question 18

Most appropriate ECT indication in

adolescents?

Answer 18

Refractory Catatonia

Question 19

ECT is appropriate in adolescents w/

refractory MDD, bipolar, and _____?

Answer 19

Refractory Schizophrenia

Question 20

16 yo with stable schizophrenia on

medication. Therapeutic approach?

Answer 20

Supportive

Question 21

Which antipsychotic should be avoided for

early onset schizophrenia?

Answer 21

Ziprasidone

Question 22

Greatest risk factor for schizophrenia?

Answer 22

Identical twin with schizophrenia

Question 23

Response After an Initial Schizophrenia
Episode (RAISE) study showed that a
shorter duration of untreated psychosis provides?

Answer 23

Greater improvement in quality of life

Question 24

High dose of what supplement shows
preliminary evidence in preventing
progression of schizophrenia in youth?

Answer 24

Omega-3 Fatty Acids