schizophrenia Flashcards
schizophrenia presentation
psychosis
delusions
hallucinations
thought disorder -abnormal speech and behaviour
lack of insight
prodromal schizophrenia
subtle symptoms eg poor memory
reduced concentration
loss of appetite
poor sleep
social withdrawal
less motivation
schizoaffective disorder
bipolar + schizophrenia
Differentials for schizophrenia
mania
psychotic depression
drug induced
stroke
brain tumours
huntingtons
positive symptoms of schizophrenia
auditory hallucinations usually 3rd person
somatic passivity
thought insertion and thought withdrawal
thought broadcasting
persecutory delusions
ideas of reference
negative symptoms of schizophrenia
affective flattening
alogia
anhedonia - lack on interest
avolition - lack of motivation
reduced level of functioning - social, care, productivity
diagnosis of schizophrenia
symptoms for at least 6 months
active phase for at least 1 month
management of schizophrenia
antipsychotic - typical eg chlorpromazine
haloperidol
atypical - quetiapine, aripiprazole, olanzapine, risperidone
depot - aripiprazole, risperidone
Clozapine
Clozapine complications
agranulocytosis
myocarditis or cardiomyopathy
constipation
seizures
salivation
monitoring for antipsychotic
weight and waist circumference
bp and pulse
bloods - hba1c, lipids, prolactin
ECG
side effects of antipsychotics
weight gain
diabetes
prolonged QT
raised prolactin
extrapyramidal
Neuroleptic malignant syndrome
extrapyramidal side effects
akathisia - cant stay still
dystonia
pseudo-parkinsonism
tardive dyskinesia - abnormal movements eg face
neuroleptic malignant syndrome
muscle rigidity
hyperthermia
altered consciousness
autonomic dysfunction - tachycardia and fluctuating BP
management of neuroleptic malignant syndrome
stop antipsychotic
supportive care - iv fluid, benzo,
severe - bromocriptine
