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nmsp exam 3 > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

Neurophysiology in SCHIZOPHRENIA

A

reduced brain volume: enlarged lateral and third ventricles

limbic system decreases in size

prefrontal cortex is dyfunctional

shrinkage of the hypothalamus!

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2
Q

Elevated activity of D2 receptors is associated with _ symptoms in Schizophrenia

A

positive = better prognosis

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3
Q

what neurotransmitter levels have low activity in schizophrenia

A

GABA and NMDA (receptor hypo function)

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4
Q

what neurotransmitters are involved in the neurophysiology of schizophrenia

A

dopamine
serotonin
norepinephrine
GABA
NMDA
glutamate

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5
Q

PCP studies have been found to reduce _ function in schizophrenia

A

glutamate

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6
Q

what is the A category of the DSM-5 criteria for schizophrenia ?

A

two or more of the following for most of 1 month and at least one of the first three symptoms

delusions
hallucinations
disorganized speech
grossly disorganized or catatonic behavior
negative symptoms

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7
Q

what is the B category in the DSM5 criteria for Schizophrenia

A

marked social or occupational dysfunction

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8
Q

what is category C of the DSM 5 criteria of Schizophrenia

A

duration of at least 6 months of persistent symptoms such as attenuated forms of group A above or negative symptoms at least one moth must include a group A symptom

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9
Q

what is category D of the DSM-5 criteria for Schizophrenia

A

symptoms of schizoaffective and mood disorder are ruled out

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10
Q

what is category E of the DSM 5 criteria for Schizophrenia

A

substance abuse and medical conditions are ruled out as etiologic

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11
Q

risk factors for being violent with schizophrenia

A

antisocial/borderline personality disorder
history of violent acts
paranoid beliefs
content of auditory hallucinations
substance abuse
impulsivity
talking about violence

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12
Q

_ is the single leading cause of death in Schizophrenia patients

A

suicide

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13
Q

_ may reduce suicide rates in schizophrenia

A

clozapine

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14
Q

what are the 5 diagnostic criteria for Schizophrenia Catatonic Type (only need 2/5)

A
  1. motor immobility as evidenced by catalepsy or stupor
  2. excessive motor activity
  3. extreme negativism or mutism
  4. weird voluntary movement such as posturing, prominent mannerisms or prominent grimacing
  5. Echolalia or Echopraxia
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15
Q

how can we treat Schizophrenia ?

A

hospitalize them
group therapy
psychotherapy
community treatment
self-help programs
medication
Electroconvulsive therapy
Benzodiazepines for catatonic disorder

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16
Q

how do we treat acute psychosis in schizophrenia ?

A

IM injections of haloperidol, fluphenazine. olanzapine, choropromazine

17
Q

how do you treat the stabilization phase of Schizophrenia ?

A

newer atypical antipsychotics

18
Q

how do you treat the maintenance phase of schizophrenia ?

A

long acting depot injections

keep patients free from symptoms while avoiding incapacitating effects

19
Q

poor responders are _ in patients whose SCHIZOPHRENIA was once under control but no longer responds

A

relapses

there is noncompliance with medication

20
Q

first generation antipsychotics block _ receptors

A

dopamine

21
Q

what are the first generation antipsychotics? (6)

A

Haloperidol
Loxapine
Pimozide
Chlopromazine
Perphenazine
Thiothixene

22
Q

what are the side effects of first generation antipsychotics ?

A

extrapyramidal syndromes (EPSs)

neuroleptic malignant syndrome

23
Q

what is extrapyramidal syndrome?

A

acute dystonic reactions - contractions of the mouth, eyes, and face

drug induced Parkinsonism- cogwheel rigidity, bradykinesia, tremor

antipsychotic induced catatonia- inability to speak

tardive dyskinesia- fasciculation’s of the tongue, lingual-facial hyperkinesis

akathisia- motor restlessness, inability to keep legs and feet still

24
Q

what is neuroleptic malignant syndrome

A

muscular rigidity , fever, autonomic instability, altered level of consiousness

25
Q

second generation antipsychotics. block ?

A

dopamine and serotonin activity

26
Q

what are the side effects of clozapine

A

agranulocytosis and weight gain

27
Q

what is the risk with taking risperidone ?

A

increased prolactin

28
Q

what is the risk of taking olanzapine

A

weight gain, metabolic syndrome

29
Q

what is the side effect of taking ziprasidone?

A

QT prolongation

30
Q

what is brief psychotic disorder?

A

presence of either delusions, hallucinations, disorganized speech , (catatonic behavior) +/-

31
Q

duration of an episode of a brief psychotic disorder is at least _ (duration) but no more than _ (duration)

A

1 day

1 month

32
Q

what is Schizophreniform?

A

when a person meets criteria A,D,and E for schizophrenia
* A. Two (or more) of the following for most of 1 Month; at least one of the first 3 symptoms
* Delusions
* Hallucinations
* Disorganized Speech
* Grossly Disorganized or Catatonic Behavior
* Negative Symptoms
* D. Symptoms of schizoaffective and mood disorder ruled out.
* E. Substance abuse and medical conditions ruled out as etiologic.

duration is ony 1-6 months

33
Q

what are some good prognostic features to schizophreniform (3)

A

onset of psychotic symptoms within 4 weeks of the first noticeable change

confusion or perplexity of height of episode

good premorbid social and occupational functioning

no flat affect

34
Q

what is schizoaffective disorder?

A

uninterrupted period of illness with either a major depressive episode or manic episode along with Schizophrenia symptoms (criteria A)

35
Q

what are the two types of schizoaffective disorder

A

bipolar type and depressive type

36
Q

delusions that are not always non bizarre that could involve real life situations like being followed, poisoned or infected, having a disease, loving from a distance Etc. for at least 1 months duration

have never meet criteria A for Schizophrenia

functioning in intact

A

delusional disorder

37
Q

types of delusional disorders

A

erotomania, grandiose, jealous, persecutor, somatic, mixed, unspecified

38
Q

schizophrenia delusions are usually

A

bizarre

(more impairment in function too than delusional disorder)

nmsp exam 3 (11 decks)

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