Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psych Exam 2 > Schizophrenia > Flashcards

Schizophrenia Flashcards

You may prefer our related Brainscape-certified flashcards:
Psychology 101 flashcards GRE® Psychology flashcards
1
Q

what is schizophrenia?

A

psychosis characterized by abnormalities in perception, content of thought, and thought processes and extensive withdraw of interest from people and the outside world
“splitting of thoughts from emotions and people”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

psychosis

A

loosing touch with reality
individual experiencing hallucinations, delusions, disorganized thoughts, speech, or behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the hallmark sign of schizophrenia

A

delusions, hallucinations, and disorganized speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

schizophrenia interferes with a persons ability to

A

think clearly
manage emotions
make decisions
relate to others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

epidemiology of schizophrenia

A

leading cause of disability if diagnosed
most frequently diagnosed in males in urban areas
peek age of onset 15-35
men 15-25
women 25-35
children is uncommon
new cases are rare before age 10 and after 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

etiology of schizophrenia

A

genetics - heredity plays strong role
environmental- malnutrition in 2nd and 3rd trimester can play a part
brain chemistry
substance abuse- mind altering drugs during teen and early adult years can play a part.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

comorbidities with schizophrenia

A

substance use disorders
nicotine dependence
anxiety, depression, and suicide
diabetes
cardiovascular disease
obesity
malignant neoplasm
HIV/AIDS
osteoporosis
Hep C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

positive symptoms of schizophrenia

A

symptoms that exist but shouldn’t be there
hallucinations
delusions
disorganized behavior
disorganized speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

hallucinations

A

can include the 5 senses
auditory and visual are the most common
auditory- obscene, accusatory, or insulting
visual- usually sees something threatening
tactile
olfactory
gustatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

command hallucinations

A

telling them to do something
auditory hallucination
commands to harm themselves or others
must be carefully monitored
ask: Are you hearing a voice that is telling you to do something?
Do you plan to follow the command?
Do you believe the voices are real?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

treating hallucinations

A

-observe for tracking eyes, mutterings, talking to self, distraction, talking and suddenly stopping as if interrupted, intently watching a vacant part of the room
ask about the content of hallucination
*do not refer to hallucinations as if they are real ( do not ask: what are the voices saying to you, instead say What are you hearing?)
-watch for signs of anxiety, these may indicate the hallucinations are intensifying
-do not negotiate with clients hallucinations (I don’t hear the voices that you hear, but it must be frightening for you)
-focus on reality, here and now activities (the voices you are hearing are part of your illness, they cannot hurt you)
-address underlying emotion- fear and guilt (remind them they are safe)
-promote and guide reality testing- ask client to look around and observe if anyone else appears frightened.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

teaching for clients with schizophrenia

A

manage stress
use other sounds to compete with hallucinations (radio, tv, reading, etc.)
check with others to find out what is real and not
engage in activities to take your mind off hallucinations
talk (tell self voices are not real, tell voices to go away, tell yourself no matter what you hear you will be safe)
develop a plan to cope with hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

delusions

A

erroneous fix beliefs that cannot be changed by reasonable arguments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

grandiose delusions

A

belief that one has exceptional powers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

nihilistic deluison

A

belief that one is dead or a disaster is impending

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

persecutor delusion

A

belief that one is being watched, plotted against, and ridiculed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

somatic delusions

A

belief about abnormalities in the body function or structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

religious delsions

A

believe that they have a special relationship with God,, or on a mission from God, or they are sinners

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

referential delusion

A

believes that newspaper articles, TV shows or song lyrics are directed specifically at them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treating delusions

A

-establish therapeutic relationship
-respond to suspicion in matter of fact, empathic, supportive and calm manner
-ask client to describe his beliefs (tell me more about someone trying to hurt you)
-never debate the delusional content (although it is frightening to you, it seems that it would be hard for a small girl to hurt you)
-validate if part of the delusion is real (yes there was a man at then nurses station but he was asking for water)
focus on feelings or themes
-use reality based interventions to help meet clients underlying needs (if client believes he is powerful he may really feel powerless)
-acknowledge that while belief seems very real to client, illnesses can make things seem true even though they aren’t
-don’t dwell excessively on the delusion, instead focus on reality-based topics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

thought blocking

A

client is talking, and abruptly pauses and cannot remember what they were saying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

thought broadcasting

A

“people can read their minds”
clients think people can hear their thoughts or know what they are thinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

thought withdraw

A

people are taking thoughts out of their brains
blames poor memory on government agents who steal their thoughts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

thought insertion

A

repeatedly complains of having disturbingly violent thoughts, which she clans are being sent by satan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

paranoia

A

irrational fear, ranging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

circumstantiality

A

extremely detailed and lengthy talk about a topic but eventually gets to point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

tangentiality

A

extremely detailed and lengthy talk but never gets to the point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

loose associations

A

absence of normal connected thoughts, ideas and topics ( i was home when drum beating began, i flew too low)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Flight of Ideas

A

conversation topic changes repeatedly and rapidly with only superficial associative connections ( a man begins talking about his business, but quickly shifts to talking about the economy, government, and other countries)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

echolalia

A

repetition of another’s words, pathological repetition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

clang associations

A

repetition of works with a similar sound but in no other way ( i heard a bell. well, hell then i fell)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

stilted language

A

overly and artificially formal language

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

pressured speech

A

words are being forced out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

word salad

A

string of words totally unconnected, jumbled, meaningless to a listener
(because is makes a twirl in life, my box is broken, help me blue elephant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

neologism

A

made up words meaning for the patient only ( I got to do angry, I picked up a dish and threw it at the geshinker)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

paranoid disorganized speech

A

suspiciousness that is unrealistic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

illogicaliy

A

conclusions are reached that do not follow logic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

aggression

A

behaviors or attitudes that reflect rage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

agitation

A

inability to sit still or attend to others, pacing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

catatonic excitement

A

hyperactivity characterized by purposeless activity and abnormal movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

catatonia

A

waxy, hold same position for hours, not just specific to schizophrenia, can be immobile, non-responsive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

echopraxia

A

involuntary imitations of another’s movements and gestures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

regressive behavior

A

childlike/immature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

stereotype

A

repetitive purposeless movements that are peculiar to the person

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

hypervigilance

A

sustained attention to external stimuli

46
Q

waxy flexiblity

A

posture held in a flexible position, patient can be posed

47
Q

negative symptoms

A

symptoms that should be there aren’t
affective flattening or blunting
ambivalence- presence of two opposing forces, leading to inaction, cant decide, stuck
alogia- poverty of speech
avolition- inability to complete projects, assignments, work, loss of motivation
anhedonia- loss of pleasure, hijacks joy
asociality- decreased desire for social interactions, isolation

48
Q

cognitive symptoms

A

concrete thinking- inability to think abstractly
impaired memory- impacts short term memory and ability to learn
impaired information processing- delayed responses, misperceptions or difficulty understanding others
impaired executive functioning- difficulty with reasoning, setting priorities, comparing options, planning

49
Q

prodromal phase of schizophrenia

A

mild changes in thinking
insufficient to meet DSM 5 criteria for schizophrenia
symptoms appear 1 month to more than 1 year before full blown episode
speech and thought may be odd or eccentric
anxiety, obsessive thoughts, and compulsive behaviors
deterioration in concentration
distressing thoughts, suspiciousness, memory impairment, significant disorganization in speech

50
Q

Acute phase of schizophrenia

A

later symptoms from few and mild to many and disabling
symptoms include hallucinations, delusions, apathy, social withdraw, diminished affect, anhedonia, disorganized behavior, impaired judgement, and cognitive regression
difficulty coping as symptoms worsen
symptoms that were once concealed become apparent
hospitalization required
men late adolescents 15-25, women 25-35

51
Q

stabilization phase of schizophrenia

A

symptoms are stabilizing and diminishing
movement toward a previous level of functioning

52
Q

maintenance or residual phases of schizophrenia

A

condition has stabilized
new baseline established
positive symptoms are usually absent or significantly diminished but negative symptoms continue to be a concern

53
Q

relapse with schizophrenia

A

can occur at any time during treatment
detrimental to the successful management
with each relapse takes a longer time to recover
combining meds with psychotherapy diminishes the severity and frequency of relapses
major reason for relapse is nonadherence with meds
stopping meds will certainly lead to relapse

54
Q

is there a cure for schizophrenia?

A

no cure but can recover!

55
Q

schizophrenia and violence

A

violence is a risk for those not medicated and experiencing command hallucinations and/or who have a substance abuse or alcohol abuse problem

56
Q

schizophrenia and suicide

A

suicide attempts are common within 3 yrs of diagnosis
more common upon discharge following first episode

57
Q

risk factors of suicide and schizophrenia

A

depressive symptoms
young age at onset
absence of supportive friends and family

58
Q

schizophrenia and mortality rate

A

higher mortality rate from accidents and medical illnesses (die at younger age because they dont take care of their physical health)
high rates of smoking
wt gain with neuroleptic meds can cause metabolic syndrome, type 2 DM, and cardiac problems

59
Q

late signs and symptoms of schizophrenia

A

hallucinations with auditory
delusions
lack of emotion
emotions are inappropriate
social withdraw
poor school performance
decreased ability to practice self care
strange eating rituals
incoherent speech
illogical thinking
agitation

60
Q

anitpsychotics treat

A

severe thought disorders such as schizophrenia and bipolar
acute and chronic confusion
psychosis, extreme aggression, and dementia

61
Q

target symptoms that antipsychotics treat

A

disorganized thinking, speech, and behavior
flat or inappropriate affect
delusions
hallucinations
catatonia

62
Q

treatment goals of schizophrenia

A

safety in all settings
stabilization on antipsychotic
client and family education
physical care
psychosocial support

63
Q

failure to take prescribed meds can result in

A

risk of relapse
risk of suicide
increased mortality rates
potential for hospital readmission
declined quality of life
social and occupational difficulty

64
Q

antipsychotic meds are essential to treat

A

symptoms during both acute and long term phases of illness

65
Q

what does early intervention with meds do for schizophrenia?

A

decreases some associated long term co-morbid, co-existing conditions

66
Q

typical antipsychotics

A

chlorpromazine (thorazine)
haloperidol (haldol)

67
Q

side effects of typical antipsychotics

A

anticholinergic
sedation
EPS
hypotension
seizure
photosensitivity
skin rash
GI upset
EKG changes
hormonal/endocrine
agranulocytosis
neuromalignant syndrome
tardive dyskinesia
Liver impairment
prolonged QT

68
Q

first generation typical antipsychotics

A

D2 receptor agonist
target positive symptoms of schizophrenia
less expensive than second generation
disadvantages: EPS, Anticholinergic side effects, tardive dyskinesia, WT gain, sexual dysfunction, endocrine disturbances

69
Q

anosognosia

A

inability to realize they are ill
may cause resistance to treatment plan or cessation of treatment
combined with paranoia so that accepting help is impossible

70
Q

anticholinergic side effects

A

hot as a hare
dry as a bone
red as a beet
mad as a hatter

71
Q

Extrapyramidal Symptoms

A

psudoparkinsonism
akathisia
actue dystonia
tardive dyskinesia
usually start within a few weeks of starting antipsyhotics
symptoms may cause discomfort, social stigma, and poor compliance

72
Q

psudoparkinsonism

A

simulates parkinsons disease
is reversible and includes tremors in hands and arms
bradykinesia, akinesia, hypersalivation, masked faces, and shuffling gate

73
Q

treatment of psudoparkinsonism

A

dose reduction or addition of oral anticholinergic med

74
Q

Akathisia

A

inner restlessness manifested by excessive pacing or inability to remain still for any length of time

75
Q

treatment of akathisia

A

dose reduction of antipsychotic or addition of low-dose beta blocker, such as propranolol (inderal)

76
Q

dystonia’s Extrapyramidal side effects

A

dystonic reactions caused by antipsychotics need to be monitored for and acted on emergently
torticollis, oculogyric crisis, opisthotonus, laryngospasm, oral-facial maxillary spasm

77
Q

torticollis

A

spasmodic and painful spasm of muscles (head pulled to one side)

78
Q

ocylogyric crisis

A

eyes roll back, only white visible
emergency situation

79
Q

opisthotonus

A

a type of spasm om which the head and heels arch backward in extreme hyperextension and the body forms a reverse bow

80
Q

laryngospasm

A

spasm of throat impairing breathing and swallowing

81
Q

oral-facial maxillary spasms

A

treat emergently as the may progress (resembles bells palsy)

82
Q

treatment for mild side effects of EPS

A

reduce dosage
d/c med- taper them off
switch to another med in same class- one is tapered down while one is tapered up
add an anticholinergic- benztropine (Cogentin), diphenhydramine (Benadryl), trihexyphenidyl (atrane)
sometimes anticholinergics are given with antipsychotics to reduce likelihood of EPS
add beta blocker- propranolol

83
Q

tardive dyskinesia

A

involuntary movement that can occur with long term antipsychotic treatment and may not be reversible even when med discontinued
usually involves orofacial region, can include myoclonic jerks, tics, chorea, dystonia, symptoms become more evident when patient is aroused, and ease when pt is relaxed or disappear during sleep
attempts to treat TD usually begin with discontinuing the offending agent or switch to one with lower risk

84
Q

risk factors for developing tardive dyskensia

A

long term therapy with FGA’s at higher doses
older age
female
concurrent affective disorders

85
Q

late onset tardive dyskinesia

A

after many years of antipsychotics
often permanent dysfunction of voluntary muscles effects mouth (tongue protrudes, smacking of lips, mouth movements)
routinely evaluate client on AIMS scale
changes may be gradual or mild and slowly progress, providers can miss signs
often irreversible
important to catch early

86
Q

treating tardive dyskinesia

A

depends on severity, med may be discontinued
thorough exam and documentation of symptoms
use AIM scale
close and continued follow up
clozapine (Clozaril) has shown efficacy in symptom reduction

87
Q

new medication for TD

A

avobenzone

88
Q

NMS: neuroleptic malignant syndrome

A

serious and potentially fatal
usually associated with antipsychotics ( or drugs that block dopamine receptors)
dehydration is predisposing factor
more common in warm climates
may have genetic predisposition

89
Q

signs and symptoms of NMS

A

fever 103-105
diaphoresis
muscle rigidity: arm/abdomen board like with corresponding increase in CPK levels
labile BP swings from hypo to HTN
tachycardia >130
Tachypnea >25
agitation r/t respiratory distress
mental status changes; stupor/coma

90
Q

interventions for NMS

A

stop all antipsychotics
symptomatic; supportive treatment
hospitalization required

91
Q

drugs to treat NMS

A

dantrolene (dantrium)
bromocriptone (parlodel)
levodopa
lorazepan (ativan)
10% fatality rate
difficult to diagnose in emergent situation

92
Q

atypical antipsychotics second generation

A

treat both positive and negative symptoms
minimal to no EPS
disadvantages- tendency to cause significant weight gain, risk of metabolic syndrome

93
Q

atypical antipsychotics

A

clozapine (clozaril)
olanzapine (zyprexa)
respiridone (respiradol)
respiradol consta
ziprasidone (geodon)

94
Q

third generation antipsychotic meds

A

subset of second
dopamine system stabilizers
may improve positive and negative symptoms and cognitive function
little risk of EPS or TD
aripiprazole (abilify)
brexpiprazole (rexulti)
caripazine (vraylar)

95
Q

side effects of atypical antipsychotics

A

sedation
n/v- usually stops after 2 weeks
less likely to cause anticholinergic effects, orthostatic hypotension, seizures, EPS
more likely to cause major weight gain, changes in person metabolism leading to DM, hypoprolctinemia
potential for cardiac dysrhythmias/ even sudden cardiac death
rhinitis
sexual dysfuntion
more costly than antipyschotics

96
Q

metabolic syndrome

A

special concern with atypical antipsychotics
heart disease, lipid problems, HTN, type 2 DM, dementia, cancer, PCOS, Non-alcoholic fatty liver disease
monitor wt and girth, initial glucose tolerance test, monitor glucose, provide nutritional support and activity support, consider lifestyle changes

97
Q

clozaril

A

treats refractory schizophrenia or schizophrenia that doesn’t respond to normal tx
pts with refractory are prone to violence and suicide
med results in decreased negative symptoms, increased pulse control, reduced violence to self harm and others, improved quality of life
has potentially fatal side effect of agranulocytosis

98
Q

agranulocytosis

A

low production of granulocytes
body cannot fight off infection
WBC drops dangerously low
monitor WBC weekly for first 6 months, then every other week
discontinue Clozaril if WBC falls below 3000 or granulocytes fall below 1500
reversible if treated early

99
Q

parenteral drugs

A

for patients that are severely disturbed or present serious compliance risk
also available in injectable form
long acting only require administration once every 2 to 4 weeks
fluphenazine decanoate
haloperidol decanoate
risperidone microspheres
paliperidone palmitate
olanzapine long acting injectable
aripiprazole microspheres

100
Q

Long Acting Anti-psychotics meds

A

long lasting 2 weeks
haloperidol (Haldol decanoate)
risperidone (consta)
paliperidone (Invega Sustenna)

101
Q

implications for Long acting anti-psychotic meds

A

schizophrenia
bipolar 1
and those unable to adhere to treatment
be aware of patients travel/transportation, cognitive deficits, lack of social support
* must have transportation to receive injection

102
Q

paliperidone palmitate (Invega Trinza)

A

3 month injection
atypical antipsychotic for schizophrenia after successful treatment with Invega Sustenna (1 month injections) for at least 4 months

103
Q

Dissolvable anti-psychotic meds

A

olanzipine (zydis)
risperidone ( Risperdal M-tab)
asenapine (saphris)

indicated for severe agitation, inability to follow directions on how to take me, or inability to swallow tablets

104
Q

Toxins affecting efficacy of anti-psychoitc meds
CANS

A

Caffeine
alcohol
nicotine
sugar

105
Q

additional schizophrenia treatments

A

ECT
behavior therapy
group therapy
family therapy
social skills training
case management
support groups

106
Q

prognosis of schizophrenia

A

for most symptoms improve with meds and psychosocial interventions
can experience good quality of life, family and occupations
sometimes does not respond fully to tx leaving mild to severe residual symptoms and varying degrees of dysfunction/disability

107
Q

factors that require repeated or lengthy inpatient care

A

slow onset of disease (more than 2-3 yrs)
younger age at onset
longer duration between first symptom and first treatment
longer periods of untreated illness
more negative symptoms

108
Q

dichotomous

A

often seen in borderline personality disorder
tend to perceive and evaluate every thought or situation as black or white, good, or bad, all or nothing.
unable to see grey areas

109
Q

perservation

A

persistent repetition of words or ideas

110
Q

racing

A

does not just mean thinking fast. Thoughts wont be quiet ; they can be in the background of other thoughts or take over a persons consciousness; they can gallop around in the persons head like a carousel gone out of control

111
Q

referential

A

belief that neutral, everyday occurrences carry specific personal meaning to the individual. Varies in intensity. may be seen in someone with schizoaffective disorder

112
Q

Alogia

A

Poverty of speech

Psych Exam 2 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions