Schizophrenia Flashcards

1
Q

What is the most common cause of psychosis

A

Schizophrenia

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2
Q

Which gender is more affected in schizophrenia

A

M=F

Equally

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3
Q

Typical age onset for schizophrenia

A

15-35yrs

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4
Q

What is psychosis

A

Represents an inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality

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5
Q

What is a hallucination

A

Have the full force and clarity of true perception
located in external space
No external stimulus
Not willed or controlled

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6
Q

What is the prevalence of schizophrenia

A

1%

1 in 100 pf population

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7
Q

Positive symptoms of schizophrenia

A

Hallucinations
Delusions
Disordered thinking

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8
Q

What are positive symptoms associated with

A

A better prognosis

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9
Q

What are the negative symptoms

A

Apathy
Lack of interest
Lack of emotions

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10
Q

What are negative symptoms associated with

A

A poorer prognosis

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11
Q

What is the underlying criteria for schizophrenia

A

Symptoms >1month in the absence of organisms or affective disorder

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12
Q

ICD-10 classification of schizophrenia (at least 1 of the following)

A

At least 1 of the following

a) Alienation of thought as thought echo, thought insertion or withdrawal, or thought broadcasting
b) Delusions of control, influence or passivity, clearly referred to body or limb movement actions, or sensations; delusional perception
c) Hallucinatory voices (auditory) giving a running commentary on the patient’s behaviour, or discussing him between themselves, or other types of hallucinatory voices coming from some part of the body.
d) Persistent delusions of other kinds that are culturally inappropriate and completely impossible (e.g. beingable to control the weather)

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13
Q

ICD-10 classification (and OR at least 2 of the following)

A

And OR at least 2 of the following

(e) Persistent hallucinations in any modality (visual, auditory ec..), when occurring every day for at least one month.
f) Neologisms, breaks or interpolations in the train of thought, resulting in incoherence or irrelevant speech.
g) Catatonic behaviour, such as excitement, posturing or waxy flexibility, negativism, mutism and stupor.
h) “Negative” symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses.

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14
Q

What are the biological factors implicated with schizophrenia

A
Winter births 
Maternal influenza 
Substance misuse
Obstetric complications 
Malnutrition and famine
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15
Q

What are the social and psychological factors implicated with schizophrenia

A
Occupation 
Social class
Migration
Social isolation 
Life events as precipitants 
Cultural factors are NOT implicated
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16
Q

Good prognostic factors

A
Absence FH 
Good premorbid function 
Clear precipitant 
Acute onset 
Mood disturbance 
Prompt Rx
17
Q

Poor prognostic factors

A

Slow insidious onset
Prominent negative symptoms
Starts in childhood
Substance misuse

18
Q

What is the Rx for treatment resistant types

A

Clozapine

19
Q

Psychological interventions

A

CBT
Family therapy
Arts therapy

20
Q

What is the 1st line R

A

Atypical anti-psychotics

21
Q

Name some typical anti-psychotics

A
Chlorpromazine
Fluphenazine 
Haloperido 
Perphenzine 
Thioridazine
22
Q

Give drug examples of Atypical anti-psychotics

A
Amisulpride 
Olanzapine 
Quetiapine 
Risperidone 
Aripiprazole
23
Q

What is clozapine associated with

A

Agranulocytosis therefore specialist monitoring is required

24
Q

What psychotic features might you see in a depressive episode with psychosis

A

Delusions of guilt, worthlessness and persecution

Derogatory auditory hallucinations

25
Q

Ddx for psychosis

A

Schizophrenia
Delirium (acute state)
Affective disorders with psychosis (depression and mania)

26
Q

What psychotic features might you see in a manic episode with psychosis

A

Delusions of grandeur; special powers or messianic roles

Gross overactivity, irritability and behavioural disturbance: Manic excitement

27
Q

What psychotic features might you see in delirium

A

Prominent visual experience, hallucinations and illusions
Affect of terror
Delusions are persecutory and evanescent
Fluctuating, worse at night

28
Q

What are the different types of schizophrenia

A
Paranoid 
Hebephrenic 
Catatonic 
Simple 
Residual
29
Q

Which is the most common type of schizophrenia

A

Paranoid

30
Q

Side effects of anti-psychotics

A
Weight gain 
DM 
Postural hypotension 
Long QT 
Daytime drowsiness 
Sexual dysfunction (e.g ED,  libido)
Hyperprolactinaemia