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Psychiatry > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

A Criteria Symptoms of Schizophrenia

A

Negative Sx: Alogia, Affective Flattening, Avolution, Anhedonia

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2
Q

Positive Symptoms of Schizophrenia

A

Delusions, Disorganized Thinking, Hallucinations

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3
Q

Which gender is more likely to have A Criteria Sx of Schizophrenia?

A

Males >Females

A Criteria Sx = Negative Sx

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4
Q

A Criteria Sx for Schizophrenia for 1 to 6 months

Dx?

A

Schizophreniform Disorder

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5
Q

What must be done before diagnosing Schizphrenia?

A

Rule out other diagnosis: other psychotic disorders, childhood developmental disorders, medical/neurological disease, substance abuse, medication induced, personality disorder, mood disorders

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6
Q

Cognitive Symptoms of Schizophrenia

A 
SMART:
Speed
Memory
Attention
Reasoning
Tact (Social Cognition)
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7
Q

What A Criteria Negative Sx of Schizphrenia is also a sx of major depression

A

Anhedonia

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8
Q

Criteria to meet DSM-5’s A Criteria of Schizophrenia

A

Of 2 sx, 1 needs to be :

Delusion, Hallucination, Disorganized thinking/speech

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9
Q

What is catatoni

A

Stupor, waxy flexibility, mutism, negativsm, echolalia

Seen in schizophrenia and other disorders

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10
Q

What is hyponopompic hallucinations?

A

Auditory hallucinations heard when patient is waking up from sleeping

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11
Q

Which symptoms of schizophrenia present early in the illness?

A

Negative/Cognitive Sx

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12
Q

Do negative symptoms worsen or improve during hte active periods of schizophrenia?

A

Worsen

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13
Q

Do antipsychotic medications work well for negative symptoms of schizophrenia?

A

No

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14
Q

What % of schizophrenics get married and why?

A

Only 30-40% due to limited social contacts

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15
Q

What % of schizphrenic patients experience only a single active episode?

A

10%

30% intermittent course, 60% chronic course

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16
Q

What sign is seen in 85% of patients prior to first psychotic episode? How long does it last?

A

Prodrome: Lasts several months to years

This is a negative prognostic sign

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17
Q

Why do females and males have the same peak age of onset (mode) but different average age of onset?

A

2nd smaller peak age of onset peak seen in females after age 40

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18
Q

Why do schizophrenics have a life expectancy that is 25 years less than the general population?

A

Cardiovascular Disease

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19
Q

When does the functional decline begin in a patient with schizophrenia

A

Prodrome

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20
Q

Which gender is the average course of schizophrenia more severe in? Why?

A

Males >Females

Males generally develop illness earlier

21
Q

What is the main goal of continuous antipsychotic treatment in patients with schizophrenia

A

Prevent relapse into active phase

22
Q

What happens when decreasing antipsychotic medication dose to use lowest effective dose?

A

Increased risk of relapse

23
Q

Most common reason patients with schizophrenia are hospitalized

A

Psychosis/Active Phase

24
Q

Most antipsychotic medications are unlikely to work by 4 weeks if what? What medication is the exception

A

If a patient does not show a response wtihin 2 weeks

EXCEPTION: Clozapine (Clozaril)

25
Q

Why are lower doses of antipsychotics used to treat patients with first active phase of schizophrenia

A

Greater sensitivity to med SE

26
Q

Which medications have the unique benefit for decreasing risk of suicide?

A

Clozapine (Clozaril) for schizophrenia

Lithium for Bipolar Disorder

27
Q

Indications for Clozapine (Clozaril) Trial

A

Persistence of Positive Sx
Failure of >2 antipsychotic trials
Comorbid Substance Abuse
Recurrent Suicidality/Violence

28
Q

What % of dopamine receptors need to be blocked with FGAs to see SE?

A

75-80%

29
Q

What % of dopamine receptors need to be blocked in what pathway to have the desired antipsychotic effect?

A

At least 65% blocked

Mesolimbic Tract

30
Q

Low Potency Antipsychotics SE

A

Anticholinergic: dry mouth, constipation, blurry eyes, urinary hesitancy

31
Q

What is dystonia and who is at higher risk than general population?

A

EPS Side Effect of muscle spasm

Younger Males are at greater risk

32
Q

Once a patient develops Tardive Dyskinesia, the most common course is:

A

Remain Static/Unchanged

33
Q

What is the first choice medication for treating akathisia?

What other drugs can be used?

A

1st Line: Propranolol
Others:
Amantadine, Lorazepam (Ativan), Clonidine, Mirtazepine (Remeron)

34
Q

Can diphenhydramine (Benadryl) be used to treat EPS? Why or why not?

A

YES

Due to anticholinergic effects

35
Q

Which FGA has less chance of developing EPS symptoms in patients?

A

Low Potency FGA: Chlorpromazine (Thorazine)

36
Q

About half of the patients with tardive dyskinesia show a 50% symptom reduction from treatment with
this medication

A

Clozapine (Clozaril)

37
Q

What age group has 50% of developing tardive dyskinesia after taking FGAs for 2 years

A

Geriatric (>70)

38
Q

What is Akathisia

A

EPS SE: subjective sense of restlessness

39
Q

Which SGA have the least risk of EPS SE

A

Clozapine (Clozaril)

Quetiapine (Seroquel)

40
Q

Which SGA is most likely to cause akathisia?

A

Aripipraole (Abilifty)

41
Q

Which SGA has long half life and low risk of metabolic syndrome?

A

Aripiprazole (Abilify)

42
Q

Which SGA are available in long acting injectable form but with risk of dose dependent EPS and hyperprolactinemia?

A

Risperidone (Risperdal)

Palliperidone (Invega)

43
Q

Name the SGA
Low Risk of Metabolic Syndrome
Needs to be taken with food
Causes QTc prologation

A

Ziprasidone (Geodon)

44
Q

Which SGA was shown by the CATIE study that patients were highly likely to be compliant? What is the downside of this drug?

A

Olanzapine (Zyprexa)

SE: High risk of metabolic syndrome, very sedating

45
Q

Which SGA is an active metabolite of risperidone (Risperdal)

A

Palliperidone (Invega)

46
Q

Properties of Quetiapine (Seroquel)

A

SGA:
No risk of EPS or Agranulocytosis
Sedating
Moderate risk of metabolic syndrome

47
Q

Unique property of Aripiprazole (Abilifty) amongst SGA

A

Partial Agonist

48
Q

SE of Clozapine (Clozaril)

A

SGA

SE: Sialorrhea, Weight Gain, Sedation, Anticholinergic, Myocarditis, Lower Seizure Threshold

Psychiatry (7 decks)

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