Schizophrenia

Question 1

Which region of the brain is associated with depersonalization episodes?

Answer 1

Parietal and Occipital

Question 2

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)

Answer 2

D/C Risperdal and start Clozaril

Question 3

Most participants on anti psychotics drop out of the Treatment of Early Onset Schizophrenia Spectrum study (TEOSS) due to lack of efficacy and? (2x)

Answer 3

Weight gain

Question 4

Why should anticholinergic medications given to prevent EPS be gradually tapered after stabilization? (2x)

Answer 4

Decrease cognitive burden of anticholinergics

Question 5

What differentiates primary psychosis from psychotic symptoms related to trauma? (2x)

Answer 5

Disorganized behavior and thought

Question 6

Youth develops tardive dyskinesia with long term risperidone, even with reducing dose and trials of nearly every other atypical? Next step?

Answer 6

Switch to Clozapine

Question 7

Why should you administer clozapine twice a day?

Answer 7

Lower daily peak concentration

Question 8

Efforts focused on developing selective interventions to prevent onset of psychosis have focused on?

Answer 8

Screening children whose parents have schizophrenia

Question 9

Early onset (less than 18 yo) schizophrenia have what genetic finding as compared to adult onset schizophrenia?

Answer 9

Higher rates of rare genomic deletion or duplication mutations

Question 10

What describes the relationship between prodromal state in later development of psychotic disorder?

Answer 10

Less than half of prodromal patients will go on to develop a psychotic disorder

Question 11

Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS) clinical trial showed what impact on cognitive functioning at one year?

Answer 11

Minimal neurocognitive improvement

Question 12

Characteristic of childhood-onset schizophrenia that differs from adult-onset?

Answer 12

Presents with greater illness severity

Question 13

16 yo w/ schizophrenia has gained excessive weight w/treatment of olanzapine. Histamine rebound would most likely occur with which cross taper?

Answer 13

Abilify

Question 14

Primary treatment medication for catatonia?

Answer 14

Benzo

Question 15

16 yo with psychosis, on risperidone, gained 20 pounds since 2 months. Unable to lower dose because symptoms worsen. Next step?

Answer 15

Cross taper with Abilify

Question 16

Medication with most evidence for treating inappropriate weight gain in pediatric patients on second-gen antipsychotics

Answer 16

Metformin

Question 17

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?

Answer 17

Observe the pt off the Seroquel

Question 18

Higher levels of aggressive/antisocial behavior is an indicator of poorer outcomes in which disorders?

Answer 18

psychotic and substance use disorders

Question 19

Most appropriate ECT indication in adolescents?

Answer 19

Refractory Catatonia

Question 20

ECT is appropriate in adolescents w/ refractory MDD, bipolar, and _____?

Answer 20

Refractory Schizophrenia

Question 21

16 yo with stable schizophrenia on medication. Therapeutic approach?

Answer 21

Supportive

Question 22

Which antipsychotic should be avoided for early onset schizophrenia?

Answer 22

Geodon

Question 23

Greatest risk factor for schizophrenia?

Answer 23

Identical Twin w/ schizophrenia

Question 24

Response After an Initial Schizophrenia Episode (RAISE) study showed that a shorter duration of untreated psychosis provides?

Answer 24

Greater Improvement in quality of life

Question 25

High dose of what supplement shows preliminary evidence in preventing progression of schizophrenia in youth?

Answer 25

Omega 3 Fatty acids