Schizophrenia and Antipsychotic Drugs Flashcards

1
Q

3 types of schizophrenia symtptoms

A

positive
negative
cognitive

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2
Q

positive Sch symtoms

A

hallucinations
delusions
agitation
disorganised thinking

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3
Q

negative sch symptoms

A

introversion
apathy
low self esteem
personal neglect

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4
Q

cognitive sch symtoms

A

poor memory, esp working memory
attention deficit
executive dysfunction

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5
Q

average age of sch onset in males and females

A

males - 18-25
females - 25-35

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6
Q

the DSM-5 criteria requires a patient to have how many of the following symptoms for sch diagnosis - delusions, hallucinations, disorganised speech, disorganised/catatonic behaviour, negative symtoms

A

2, 1 of which must be delusions, hallucinations, or disorganised speech

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7
Q

how long must sch symptoms occur before DSM5 diagnosis

A

6 months with at least 1 month active symptoms

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8
Q

3 patterns of sch lifetime evolution

A

simple
undulating
atypical

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9
Q

structural changes in sch

A

larger ventricles
smaller medial temporal lobe structures
grey matter loss

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10
Q

which part of the brain is hypoactive in schizophrenia

A

frontal lobe

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11
Q

how is frontal lobe function assessed

A

wisconsin card sorting test

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12
Q

what does the wisconsin card sorting test involve

A

pt asked to match cards withour being told rules for matching, rules for matching are changed throughout the test

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13
Q

do structural brain changes or symptoms occur first in sch

A

structural brain changes

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14
Q

what part of neurones are fewer in the cortices of sch pts and why

A

dendritic spines - excess pruning

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15
Q

how is sch linked to neurodevelopment

A

some forms of sch caused by brain circuit formation and maturation abnormalities

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16
Q

sch risk factors

A

pregnancy/birth complications
older father
immune system activation
cannabis
Repeated infections
Prenatal infection + incr cytokine levels in pregnancy

17
Q

prodromal phase

A

period of sub clinical symptoms in the years prior to first psychosis episode

18
Q

What signs of neuro inflammation are present in the brains of sch pts

A

Incr cytokine level
Incr peripheral inflammatory markers
Immune cell migration to brain
Activated microglia

19
Q

Why is oligodendrocyte density decreased in sch

A

Inflammation and immune activation
Different expression of molecules regulating myelination

20
Q

Is synchronicity in the default brain network increased or decreased in sch pts and their relatives

21
Q

Which neural circuits are effected by sch and how are they effected

A

Mesolimbic - hyperactive
Mesocortical - hypoactive
Incr synchronicity in DMN

22
Q

Which type of dopamine receptors are targeted by sch drug

23
Q

Which type of antipsychotics can help cognitive symtoms

A

Atypical antipsychotics

24
Q

Are chlorpromazine, thioridazine, fluphenazine, haloperidol, and flupenthixol typical or atypical antipsychotics

25
Atypical antipsychotic examples
Risperidone Olanzapine Clozapine Quetiapine Paliperidone Aripiprazole
26
Are atypical or typical antipsychotics used first
Atypical
27
Which drug is used for treatment resistant sch
Clozapine
28
Why are adverse effects common with antipsychotics
Not fully specific for dopamine receptors so affect other targets
29
Antipsychotic drug adverse effects
Extrapyramidal effects Prolactin rise Weight gain Dyslipidaemia Type 2 diabetes Anticholinergic effects Postural hypotension Neuroleptic malignant syndrome
30
Extrapyramidal effects
Acute Dystonia Parkinsonism Tardive dyskinesia
31
Which system is most commonly effected by atypical antipsychotic adverse effects
Metabolic
32
Which system is most commonly effected by typical antipsychotic adverse effects
Extrapyramidal
33
Neuroleptic malignant syndrome symtoms
Hyperpyrexia Muscle rigidity Tremor Confusion Autonomic instability
34
Tardive dyskinesia
Involuntary movements of the lips, jaw, and face, and limbs, grimacing, chewing, and tongue thrusting
35
Major risk of clozapine
Agranulocytosis
36
Non pharmacological sch treatments
CBT cognitive remediation Family therapy