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Schizophrenia Flashcards

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1
Q

positive symptoms

A

delusions- persecutory, passivity, thought interference; auditory hallucinations; formal thought disorder

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2
Q

negative symptoms

A

poverty of speech and thought, flattened mood, anhedonia, loss motivation, blunted affect, social withdrawal

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3
Q

what are the first rank symptoms

A

3rd person auditory hallucinations, thought echo, delusional perception, thought insertion/withdrawal, passivity

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4
Q

how long must you be experiencing symptoms for for diagnosis

A

1 month ICD10, 6 DSM

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5
Q

types of schizophrenia

A

paranoid, catatonic, hebephrenic, residual(chronic), undifferentiated (simple)

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6
Q

what is paranoid schizophrenia

A

most common. delusions and auditory hallucinations

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7
Q

what is catatonic schizophrenia

A

uncommon. psychomotor disturbance, rigidity, posturing, echolalia, echopraxia

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8
Q

differentials

A

substance induced psychosis, psychosis due to general medical condition, mood disorders with psychotic features, sleep related disorder, dementia and delirium, PTSD, OCD, schizoaffective disorder

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9
Q

aetiology

A

neurochemical, genetic, neurodevelopmental, social

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10
Q

what happens to the chemicals in the brain

A

increased dopamine, increased serotonin, decreased glutamate

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11
Q

neurodevelopmental causes

A

obstetric complications, neurodevelopmental delay, cannabis, temporal lobe epilepsy

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12
Q

genetic causes

A

50% those with monozygotic twins have it

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13
Q

social causes

A

socio economic deprivation, excess of life events, living in a family with high expressed emotion- more likely to relapse

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14
Q

what is high expressed emotion

A

family is overinvolved, critical comments, making it hostile

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15
Q

what is schizoaffective disorder

A

mixture of schizophrenic and affective symptos- equal weighting

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16
Q

what is delusional disorder

A

fixed delusion or delusional system with other areas of thinking preserved

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17
Q

what is brief psychotic episodes

A

lasting less time than required for schizophrenia diagnosis

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18
Q

what can be used to treat acute psychotic episode

A

lorazepam and haloperidol (oral first line, IM second line)

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19
Q

what are the main side effects of typical (conventional) antipsychotics

A

EPSEs- dystonia, akithisia, tardive dyskinesia, parkinsonism

20
Q

what is the benefit of atypical antipsychotics

A

less EPSEs as they target D2 less than D1

21
Q

how do antipsychotics work

A

block D1 and D2 receptors so less dopamine

22
Q

examples of typical antipsychcotics

A

chlorpromazine, haloperidol, trifluoperazine

23
Q

examples of atypicals

A

olanzapine, clozapine, quetiapine, amisulpiride, risperidone

24
Q

what are the side effects of risperidone and amisulpiride

A

hyperprolactinaemia

25
Q

side effect olanzapine

A

weight gain, increased risk diabetes

26
Q

side effect clozapine

A

agranulocytosis

27
Q

what is the neuroleptic malignancy syndrome

A

muscle rigidity, fever, autonomic, delirium. increased CK levels and WCC

28
Q

what can you give to treat neuroleptic malignant syndrome

A

bromocriptine

29
Q

what is a neurological emergency from antipsychotics

A

neuroleptic malignant syndrome

30
Q

what is used for treatment resistant

A

clozapine

31
Q

definition of treatment resistant

A

failure to respond to more than 2 drugs for 6 weeks or more

32
Q

how does clozapine work

A

blocks D1 and D4, lower affinity for D2 so lack of EPSEs

33
Q

what are the contraindications of clozapine

A

neutropenia, myocarditis, pericarditis, cardiomyopathy, cardiac or renal disorders, hepatic

34
Q

what is the usual dose clozapine

A

200-450mg

35
Q

what do you measure before initiating clozapine

A

leukocyte count

36
Q

why do you need to do weekly FBCs in clozapine use

A

checking for agranulocytosis

37
Q

anticholinergic side effects antipsychotics

A

dry mouth, blurred vision, urinary retention, constipatiorn

38
Q

anti adrenergic side effects

A

postural hypotension, tachycardia, sexual dysfunction

39
Q

anti histaminic side effects

A

sedation, weight gain

40
Q

what is schizotypal disorder

A

cluster A personality disorder, no delusions or hallucinations. ideas of reference, odd beliefs, odd behaviour or appearance odd speech

41
Q

tests for cognition

A

stroop test- words and colours, trail making executive planning.

42
Q

acute v chronic schizophrenia

A

acute- psychotic, delusions. chronic- negative symptoms

43
Q

psychological and social management

A

psych- CBT, education, family therapy. social- housing and benefits, substance misuse, occupation, lifestyle

44
Q

depot antipsychotics benefits

A

less frequent than tablets, known compliance, predictable bioavailability, contact and monitoring

45
Q

depot antipsychotics risks

A

inflexible administration, longer washout if side effects, getting to steady state, patient acceptability

46
Q

suicide risk is higher in

A

young men, first few years of illness, persistent hallucinations or delusions, hx illicit drug use, prev suicide attempts

Psych (15 decks)

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