Schizophrenia Flashcards
Which region of the brain is associated with depersonalization episodes?
Parietal and Occipital
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)
D/C Risperdal and start Clozaril
Most participants on anti psychotics drop out of the Treatment of Early Onset Schizophrenia Spectrum study (TEOSS) due to lack of efficacy and? (2x)
Weight gain
Why should anticholinergic medications given to prevent EPS be gradually tapered after stabilization? (2x)
Decrease cognitive burden of anticholinergics
What differentiates primary psychosis from psychotic symptoms related to trauma? (2x)
Disorganized behavior and thought
Youth develops tardive dyskinesia with long term risperidone, even with reducing dose and trials of nearly every other atypical? Next step?
Switch to Clozapine
Why should you administer clozapine twice a day?
Lower daily peak concentration
Efforts focused on developing selective interventions to prevent onset of psychosis have focused on?
Screening children whose parents have schizophrenia
Early onset (less than 18 yo) schizophrenia have what genetic finding as compared to adult onset schizophrenia?
Higher rates of rare genomic deletion or duplication mutations
What describes the relationship between prodromal state in later development of psychotic disorder?
Less than half of prodromal patients will go on to develop a psychotic disorder
Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS) clinical trial showed what impact on cognitive functioning at one year?
Minimal neurocognitive improvement
Characteristic of childhood-onset schizophrenia that differs from adult-onset?
Presents with greater illness severity
16 yo w/ schizophrenia has gained excessive weight w/treatment of olanzapine. Histamine rebound would most likely occur with which cross taper?
Abilify
Primary treatment medication for catatonia?
Benzo
16 yo with psychosis, on risperidone, gained 20 pounds since 2 months. Unable to lower dose because symptoms worsen. Next step?
Cross taper with Abilify
Medication with most evidence for treating inappropriate weight gain in pediatric patients on second-gen antipsychotics
Metformin
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?
Observe the pt off the Seroquel
Higher levels of aggressive/antisocial behavior is an indicator of poorer outcomes in which disorders?
psychotic and substance use disorders
Most appropriate ECT indication in adolescents?
Refractory Catatonia
ECT is appropriate in adolescents w/ refractory MDD, bipolar, and _____?
Refractory Schizophrenia
16 yo with stable schizophrenia on medication. Therapeutic approach?
Supportive
Which antipsychotic should be avoided for early onset schizophrenia?
Geodon
Greatest risk factor for schizophrenia?
Identical Twin w/ schizophrenia
Response After an Initial Schizophrenia Episode (RAISE) study showed that a shorter duration of untreated psychosis provides?
Greater Improvement in quality of life
High dose of what supplement shows preliminary evidence in preventing progression of schizophrenia in youth?
Omega 3 Fatty acids
