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MS4 - Psychiatry > Schizophrenia and Psychoses > Flashcards

Schizophrenia and Psychoses Flashcards

1
Q

Schneider’s first rank Sx of Schizophrenia

A

1) Auditory Hallucinations
2) Thought Disturbances
3) Somatic Hallucinations
4) Delusional Perception

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2
Q

Auditory hallucinations

A

Thought echo
Voices arguing
Voices commenting on one’s actions

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3
Q

Thought disturbances

A

Thought withdrawal
Thought broadcasting
Thought insertion

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4
Q

Thought broadcasting

A

Often accompanied by delusional explanation

Eg. telepathy, radio transmitters

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5
Q

Schizophrenia aetiology hypothesis

A

Several susceptible genes + Early environmental events
=>
Increased vulnerability
=> Psychoses (with drug misuse or social factors)

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6
Q

Peri-natal risk factors for schizophrenia

A

Winter births - maternal infection + lower vit D
Low birth weight
Premature babies

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7
Q

Brain abnormalities in schizophrenia

A

Not diagnostic
Reduced brain volume
Increased ventricular size
Reduced hippocampus and amygdala volume

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8
Q

Amygdala

A

Fear and emotion

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9
Q

Hippocampus

A

Memory

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10
Q

Nucleus accumbens

A

Reward centre

Dopamine

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11
Q

Prefrontal cortex

A

Logic
Reason
Personality

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12
Q

Social RFs for schizophrenia

A 
Lower socio-economic class
Urban areas
Recent immigrants
Drug misuse
Adverse life events
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13
Q

VTA

A

Ventricle Tegmental Area

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14
Q

Pathophysiological theory of schizophrenia

A

Hyperactive mesolimbic pathways

Hypoactive mesocortical pathways

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15
Q

Mesolimbic pathway

A

VTA to nucleus accumbens

Hyperactivity leads to positive Sx

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16
Q

Mesocortical pathway

A

VTA to prefrontal cortex

Hypoactivity leads to negative Sx

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17
Q

Schizophrenia Sx categories

A

Premorbid stage
Prodromal stage
Positive Sx
Negative Sx - usually after 5 yrs

18
Q

Premorbid Sx of schizophrenia

A

Subtle motor, linguistic and social dysfunction

19
Q

Prodromal Sx of schizophrenia

A 
Functional decline
Odd ideas
Changes in mood/affect
Unusual speech
Bizarre perceptual experiences
20
Q

Positive Sx

A

Delusions
Hallucinations
Thought disorder
Behavior abnormalities

21
Q

Negative Sx

A

Flattening of affect
Amotivation
Anhedonia
Attention impairment

22
Q

Anhedonia

A

Loss of joy from previously positive activities

23
Q

Definition of schizophrenia

A

Sx lasting at least one month
With at least one of Schneider’s frist rank Sx
OR at least two Second rank Sx

24
Q

Second rank Sx

A

Persistent hallucinations
Catatonic behavior
Negative Sx
Neologisms

25
Q

Neologisms

A

Breaks in train of thought

Results in incoherence

26
Q

Differential Diagnoses of schizophrenia

A

Manic or depressive episodes
Organic brain disease
Alcohol or drug related

27
Q

Side effect of Ritilin

A

Psychotic Sx

28
Q

Schizophrenia subtypes

A

Paranoid schizophrenia - most common
Catatonic schizophrenia
Simple schizophrenia

29
Q

Prognosis options for schizophrenia

A

Complete remission - one episode only
Episodic remittent
Stable deficit - impaired after first episode
Impairment increasing after each episode

30
Q

Medical Mx of schizophrenia

A

Dopamine D2 receptor antagonist
Muscarinic ACh receptor antagonist
Alpha 1 adrenergic receptor antagonist
Histamine receptor antagonist

31
Q

Side effects of D2 antagonists

A

Extra pyramidal side effects

32
Q

Side effects of Muscarinic ACh receptor antagonists

A

Constipation
Drowsiness
Dry mouth
Blurred vision

33
Q

Side effects Alpha 1 adrenergic receptor antagonists

A

Hypotension

Dizziness

34
Q

Side effects of Histaminic receptor antagonists

A

Weight gain

Drowsiness

35
Q

Adjunctive medications for schizophrenia

A

Anti-depressants
Mood stabilisers
Tranquilizers

36
Q

Typical antipsychotics

A

Haloperidol
Fluphenazine
Zoopclopedixol (depo)

37
Q

Side effects of typical antipsychotics

A

Extra pyramidal side effects
Weight gain
Sexual side effects

38
Q

Atypical new generation antipsychotics

A 
Risperidone
Olanzapine
Amisulpride
Quetiapine
Aripiprazole (prolactin)
39
Q

Side effects of atypical antipsychotics

A

Less extra pyramidal
More weight gain
Metabolic syndrome

40
Q

Treatment resistant antipsychotics

A

Clozapine - last resort

Only used if unsuccessful with 2 other antipsychotics

41
Q

Life threatening management

A

ECT

42
Q

NICE guidelines for trial period for antipsychotics

A

4-6 wks

MS4 - Psychiatry (15 decks)

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