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Exam Questions > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

What is schizophrenia

A
  • A chronic relapsing condition
  • Often presenting in early adulthood
  • With psychotic, disorganisation, negative symptoms
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2
Q

Psychotic and disorganisation symptoms

A
  • Psychotic = Hallucinations and Delusions

- Disorganisation = Incongruous mood, abnormal speech + thought

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3
Q

Negative symptoms (W.A.R.B.S.)

A
  • Withdrawal
  • Apathy
  • Reduced motivation
  • Blunted mood
  • Self neglect
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4
Q

3 common symptoms of schizophrenia

A
  • Psychosis
  • Distorted thinking (delusions)
  • Distorted perception (hallucinations)
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5
Q

4 types of psychosis

A
  • Affective psychoses
  • Transient psychotic disorders
  • Psychosis due to medical disorder
  • Schizophrenia-like non-affective disorders
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6
Q

2 examples of affective psychoses

A
  • Depression

- Bi-polar disorder

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7
Q

Cause of transient psychotic disorders

A

Usually drug abuse

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8
Q

Cause of psychosis due to medical disorder

A

Brain tumour

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9
Q

8 things you should look for when diagnosing schizophrenia

A

1-Thought insertion, broadcasting, withdrawal
2-Delusions that external forces influence/control feelings/actions/impulses
3-Auditory hallucinations (voices)
4-Persistent delusions (culturally inappropriate or impossible)

5-Persistent hallucinations of any modality (somatic, visual, tactile)
6-Breaks in train of thought
7-Catatonic behaviour
8-Negative symptoms

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10
Q

What about the persistent hallucinations makes it diagnostic

A

They occur every day for weeks on end

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11
Q

What do breaks in train of thought cause

A
  • Incoherence
  • Irrelevant speech
  • Tangents
  • Neologisms
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12
Q

What is catatonic behaviour

A
  • “Strange, purposeless, behaviour”
  • Sudden excitement
  • Negativism
  • Mutism
  • Waxy flexibility
  • Echopraxia (involuntary imitation of another’s actions)
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13
Q

What are negative symptoms

A
  • Apathy
  • Paucity of speech
  • Blunting or incongruity of affect (laughing at bad news)
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14
Q

Main diagnostic criteria for schizophrenia

A
  • At least 1, clear cut, symptoms from 1-4 (2/> if less clear cut)
  • 2 symptoms from 5-8

MUST BE FOR 6/> MONTHS

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15
Q

What should be done before diagnosing schizophrenia

A

Rule out other causes:

  • Bi-polar
  • Drugs/alcohol
  • CNS tumour
  • Head injury
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16
Q

3 sub-types of schizophrenia

A
  • Paranoid
  • Hebephrenic
  • Catatonic
17
Q

Describe paranoid schizophrenia

A
  • Comments

- Hallucinations + delusions are prominent

18
Q

Describe hebephrenic schizophrenia

A
  • 15-25 yrs onset
  • Poor prognosis
  • Fluctuating affect prominent
  • Fleeting, fragmented, delusions + hallucinations
19
Q

Describe catatonic schizophrenia

A
  • Stupor
  • Posturing
  • Waxy flexibility
  • Negativism
20
Q

Frequent symptoms of schizophrenia

A
  • Lack of insight (97%)
  • Auditory hallucinations (74%)
  • Ideas of reference (70%)
  • Paranoia
  • Flat affect
  • Persecutory delusions
21
Q

Frequent behaviours in schizophrenia

A
  • Social withdrawal
  • Anhedonia
  • Apathy
  • Psychomotor retardation
22
Q

If concordance with a medication is an issue what is a possible solution

A

IM depots (long lasting injection)

23
Q

Broad Rx for schizophrenia

A
  • Antipsychotics

- Psychological interventions (CBT)

24
Q

Pharmacological Rx of schizophrenia

A
  • Risperidone (Second generation antipsychotic) (1st line)
  • Haloperidol (first generation antipsychotic)
  • Aripiprazole (third generation antipsychotic)
25
Q

Rx of treatment-resistant schizophrenia

A

Clozapine

26
Q

What should be checked before commence antipsychotic medication

A

-Hx/FHx of diabetes, hypertension, CVS disease
-Check:
BP
FBC
Weight
Fasting blood glucose
Lipid profile
ECG (if on clozapine)

27
Q

What should be done after 6 months of antipsychotic medication

A
  • LFTs
  • U&Es
  • Weight
  • Hba1c
  • Prolactin
28
Q

SEs of antipsychotic medication

A
  • Hunger
  • Thirst
  • Sexual dysfunction
  • DM
  • Weight gain
  • Seizure threshold reduced
29
Q

What should be stopped when taking antipsychotic medication

A
  • Smoking, induces metabolism thus requiring higher doses

- Breast-feeding

Exam Questions (21 decks)

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