Brainscape's Knowledge GenomeTM

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


See full index

Year 4- Psychiatry > Schizophrenia > Flashcards

Schizophrenia Flashcards

You may prefer our related Brainscape-certified flashcards:
WSET ® Level 4 D2 Business of Wine flashcards
1
Q

What is Schizophrenia?

A

Chronic relapsing condition, form of psychosis with distortion to thinking and perception and inappropriate or blunted affect

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

When does schizophrenia present?

A

15-30

Earlier in men than women

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

How long must symptoms be present for schizophrenia to be diagnosed?

A

1 month

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

What is Schizoaffective disorder?

A

Symptoms of schizophrenia with bipolar disorder

Patients have psychosis and symptoms of depression and mania

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

What is Schizophreniform disorder?

A

Same features as schizophrenia but less than 6 months

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

How would you explain schizophrenia to a patient?

A

Condition that affects how the brain processes information

Brain struggles to understand the world and makes mistakes deciding what information is important and organises thoughts in a confused way

This causes strong beliefs that do not fit with reality called delusions and experience voices that are not there called hallucinations

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

What is the psychosis?

A

Individual is experiencing a reality different to everyone else
Lack of insight

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

How long does it take for a psychotic episode to happen?

A

Can begin suddenly or gradually

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

How long do psychotic episodes last?

A

Days, weeks or months

Longer the psychosis, more damaging effects

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

What is a hallucination?

A

Perception in the absence of an external stimulus

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

Are voices in the head psychosis?

A

No, pseudohallucination

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

What is formal thought disorder?

A

Problem of speech, which means each sentence does not follow on from the next

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

What can a psychotic episode cause?

A

Personality change

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

What can cause psychosis?

A

Psychotic depression
Stroke
Cushing’s syndrome
Huntington’s
Hyperthyroidism
Brain tumours
Drugs
Mania

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

What causes schizophrenia?

A

Genetic and environmental factors

Family member affected is a large risk factor

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

What is the chance of schizophrenia in identical twins if one twin is affected?

A

50%

Environmental factors also contribute to risk of development

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

How does schizophrenia first present?

A

Prodrome phase
Precedes full symptoms of psychosis

Patient experiences subtle symptoms

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

What is the central feature of schizophrenia?

A

Delusions
Hallucinations
Thought disorder (disorganised thoughts causing abnormal speech and behaviour)

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

What is lack of insight?

A

Important feature of psychosis

Lack awareness that delusions and hallucinations are not based in reality

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

What are the key positive symptoms typical in schizophrenia?

A
  • Auditory hallucinations
  • Persecutory delusions (someone is going to harm them)
  • Somatic passivity (external entity is controlling their sensations and actions)
  • Thought insertion or withdrawal
  • Thought broadcasting
  • Ideas of reference (events or details relate to them)
  • Delusional perceptions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the key negative symptoms of schizophrenia?

A

5 As

Affective flattening (minimal emotional reaction to emotive subjects or events)
Alogia (reduced speech)
Anhedonia
Avolition (lack of motivation towards goals)
Asociality (no desire for social interaction)

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

What is a delusional perception?

A

Delusion formed in response to external stimulus without any logical sense

e.g. watching TV and believing you were chosen to meet the president

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

What does a reduced level of functioning involve in schizophrenia?

A

Social engagement
Productivity and achievement at work or school
Self-care

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

What are the patterns of schizophrenia?

A

Continuous
Episodic
Single episode only

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

What is diagnosis of schizophrenia based on?

A

ICD-11 criteria only

Below is what DSM5 uses

Symptoms present for at least 6 months

Symptoms of active phase must be present for at least 1 month

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

How is schizophrenia managed?

A

Early intervention in psychosis
For first episodes of psychosis

Crisis resolution and home treatment teams
Urgent support for patients in a crisis

Acute hospital admission

Community mental health team
Ongoing monitoring and management

27
Q

What are Schneider’s first rank symptoms of schizophrenia?

A

ABCD

Auditory hallucination, about the person in the 3rd person, a voice or voices giving running commentary on the patient’s actions or thoughts in 3rd person

Broadcasting of thought

Controlled phenomenon - feelings, actions or impulses controlled by something or someone else

Delusional perception

28
Q

How is schizophrenia treated?

A

Antipsychotics
CBT

29
Q

What are antipsychotics also called?

A

Neuroleptics

30
Q

How do antipsychotic medications work?

A

Inhibiting dopamine receptors

D2 receptors

31
Q

What pathways are targeted?

A

Mesocortical
Mesolimbic

32
Q

Where do unwanted side effects of antipsychotic use come from?

A

Nigrostriatal
Tuberoinfundibular

33
Q

What are some examples of oral antipsychotics?

A

Chlorpromazine
Haloperidol
Quetiapine
Olanzapine
Risperidone

34
Q

What are depot antipsychotics and when are they used?

A

IM injections every 2 weeks-3 months

Useful when adherence is an issue

Aripiprazole
Risperidone
Paliperidone

35
Q

What can happen with chlopromazine use?

A

Oculogyric crisis

Dystonic reaction, causes extrapyramidal effects

36
Q

What do you give for extrapyramidal side effects? e.g. oculogyric crisis

A

Procyclidine

37
Q

When is clozapine used?

A

When other treatments do not control symptoms

Only available orally

Very effective but significant adverse effects

38
Q

What are the adverse effects of clozapine?

A

Agranulocytosis
Myocarditis
Constipation
Seizures
Excessive salivation

39
Q

What are the common side effects of clozapine use?

A

Constipation
Hypersalivation
Weight gain
Sedation
Metabolic disturbances

40
Q

Before starting antipsychotics and during what is monitored?

A
  • Weight and waist circumference
  • BP and HR
  • Bloods
  • ECG
41
Q

What are the side effects of antipsychotics?

A
  • Weight gain
  • Diabetes
  • Prolonged QT interval
  • Raised prolactin
  • Extrapyramidal symptoms
42
Q

What are the extrapyramidal side effects?

A

Akathisia (inability to stay still)
Dystonia
Pseudo-parkinsonism
Tardive dyskinesia (abnormal movements, particularly affecting face)

43
Q

What can be given for tardive dyskinesia?

A

Tetrabenazine

T=Tardive

44
Q

What is the difference in side effects between typical and atypical antipsychotics?

A

Typical
More likely to cause extra-pyramidal side effects
Dizziness
Sexual dysfunction
Binds to more muscarinic and histaminic receptors

Atypical
More serotonergic activity
Weight gain
Dyslipidaemia and diabetes

45
Q

What are some examples of Typical antipsychotics?

A

Haloperidol
Chlopromazine
Flupenthixol
Zuclopenthixol
Sulpiride

46
Q

What are some examples of Atypical antipsychotics?

A

Clozapine
Olanzapine
Quetiapine- used in BPAD, can increase risk of lithium toxicity
Risperidone
Amisulpiride
Aripipzaole

47
Q

How does clozapine work?

A

D2 antagonist
5HT-2 antagonist

48
Q

When is clozapine used?

A

In schizophrenia after two other antipsychotics have not been effective

49
Q

How is clozapine monitored?

A

Agranulocytosis risk
Weekly FBC for first 18 weeks
Biweekly for up to a year
Then monthly

50
Q

What is the highest cause of fatality in clozapine use?

A

Significant hypo-mobility of the bowels
Constipation causing fatal bowel obstruction

51
Q

How is agranulocytosis treated?

A

Stop clozapine
Stop any other bone marrow suppressors e.g. sodium valproate
If antipsychotic needed give aripiprazole
Prophylactic ABx
Lithium to increase WCC and neutrophil count

Consider G-CSF

52
Q

What is neuroleptic malignant syndrome?

A

Life threatening complication of antipsychotics

Typical Triad
Muscle rigidity
Hyperthermia
Altered consciousness
Autonomic dysfunction

53
Q

What causes death in neuroleptic malignant syndrome?

A

Rhabdomyolysis
Renal failure
Seizures

54
Q

What are the risk factors for neuroleptic malignant syndrome?

A

High potency dopamine antagonists (typical antipsychotics)
High doses
Young men

55
Q

What are the key blood findings in neuroleptic malignant syndrome?

A

Raised creatine kinase
Raised white cell count

56
Q

How is neuroleptic malignant syndrome managed?

A

Stop causative medications
Supportive care- cooling blankets, fluids etc

Bromocriptine (dopamine agonist) in severe cases with dantrolene (muscle relaxant)

57
Q

How is rhabdomyolysis treated in neuroleptic malignant syndrome?

A

Fluids and sodium bicarbonate
Alkalises the urine

58
Q

What is part of the mesocortical pathway and what does it do?

A

Ventral tegmental area
Prefrontal cortex

Executive functions

59
Q

What is part of the nigrostriatal pathway and what does it do?

A

Substantia nigra
Caudate nucleus
Putamen

Motor function
Reward-related cognition
Associative learning

60
Q

What is part of the tuberoinfundibular pathway and what does it do?

A

Hypothalamus
Pituitary gland

Prolactic secretion

61
Q

Why can gynaecomastia develop in antipsychotic use?

A

D2 receptor inhibition in the tuberoinfundibular pathway

This causes a rise in prolactin as there is reduced regulation from reduced dopamine

Increase prolactin leads to gynaecomastia, galactorrhoea, reduced libido

62
Q

What antipsychotic has the lowest risk of hyperprolactinaemia?

A

Aripiprazole

63
Q

Why does olanzapine not work as well in patients who smoke?

A

Smoking can induce CYP450 enzymes in the liver

This causes increased breakdown up to 50% of olanzapine, so patients will need an increased dose

Year 4- Psychiatry (22 decks)

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