Schizophrenia Flashcards
what symptom is most likely during the prodrome phase?
attenuated positive sx
which type of city is a risk factor for scz?
densely populated, large urban ones
what is a major risk factor for suicide in scz?
hopelessness
which PD is the relative of someone with scz going to have
schizotypal
maximum amount of time one can have psychotic sx during prodrome?
less than 7 days
Name the three syndromal subgroups:
- attenuated positive symptom syndrome (most common) 2. brief intermittent psychotic 3. genetic risk and deterioration
Treatment of serotonin syndrome
atypical AP or benzos, cyproheptadine
Treatment of NMS
bromocriptine (Da agonist), dantrolene (muscle relaxant)
Top four lab findings in NMS (all increased)
- WBC 2. CK 3. myoglobin 4. liver enzymes
two tx for neuroleptic induced akathesia
- benzo. 2. propranolol
Is violence more or less likely in FEP
more– greatest risk of violence and self harm
What are the ABCD of first rank sx
AH (audible thoughts), Broadcasting/TI/TW, Control (passivity delusions), Delusions
Which genetic syndrome is most linked to scz
22q11
Does psychoeducation help in scz?
No effect on tx outcomes
Prevalence of SUD in scz
47%
How many years earlier do cannabis users develop psychosis than controls?
2.7 yr
Which CYP enzyme does cigarette smoking work on?
1A2 inducer (increases metabolism)
The metabolism of which two AP are susceptible to cig smoking?
clz and olz
What is the risk of someone with a Clinical High Risk of developing psychosis?
25-35%
Health Canada suggested QTc cut-off
500ms
Which psychosocial intervention has the strongest evidence to prevent relapse in scz?
family intervention (which involved 1. communication skills 2. psychoed 3. problem solving)
Name two medical conditions to rule out in post partum psychosis
- hypothyroidism 2. cushing’s
Key difference bw NMS and SS?
SS has hyperreflexia and myoclonus, NMS has hyporeflexia
Two most common delusions
- persecutory 2. jealousy
Which age is considered late onset scz
45
Neuroimaging findings in scz
basically most structures are atrophies except the caudate which are enlarged (may be secondary to AP effect in basal ganglia)
Which is a RF for scz, advanced maternal or paternal age?
paternal age, over 60
Which mental illness is being in an oneiroid state associated with?
scz (perplexed, dream like state where one is so enmeshed in their hallucinations)
Which gender does schizoaffective predominantly affect?
bipolar type M=F, dep F>M (overall F>M)
In scza how long is the period of just psychotic sx?
2 weeks
what is a kinesthetic hallucination
feeling your body move
If both parents have scz, what is the risk of the child getting it?
40%
Risk of getting scz if one non-twin sibling is affected?
8%
Neuroanatomic regions affected by scz? (3)
- cerebral cortex (prefrontal). 2. limbic system. 3. basal ganglia
Two cognitive impairments in scz
- working memory (impaired digit backwards) 2. temporal-limbic
Which gender’s fertility is more affected by scz?
M
What are Bleuler’s 4 As
- associations 2. ambivalence 3. autism. 4. affect
Most efficacious tx of akathesia?
BB
What is a cenethestic hallucination
unfounded bodily sensation (brain on fire)
therapeutic range for clozapine?
1050- 1650 nmol/L
first line intervention for clinically high risk folks
CBT +/- family
What ECG changes do you see with myocarditis
sinus tachycardia with non-specific ST and T wave changes (inversion common)
Which AP associated movement d/o is the only one more likely to happen in M than F
Dystonia
Which class of AP is better for scz with co-morbid SUD?
atypicals (esp clozapin)
What do you tell patient’s about their footwear before starting AIMS
Remove shoes and socks
Three blood tests to order for suspected myocarditis?
- CRP 2. Trop 3. eosinophil (CBC)
What is the relationship bw depression and delusional d/o?
It is co-morbid but NOT a risk factor
How long does BIPS last?
LESS than 7 days
Best imaging study to dx myocarditis?
echo
