Schizophrenia And Psychosis

Question 1

What is psychosis?

Answer 1

Mental disorder in which thoughts, affective response or ability to recognise reality and ability to communicated related to other impaired.
Hallucinations, delusions and disorder of the form of thought
Lack of insight

Question 2

List psychotic experiences

Answer 2

Hallucinations
Passivity phenomenas
Delusions
Formal thought disorder

Question 3

What is a hallucination ?

Answer 3

A perception which occurs in absence of an external stimulus
Can occur in any sensory modality

Question 4

Types of auditory hallucinations?

Answer 4

2nd person - voices which directly address the patient
3rd person - voices which discuss the patient
Thought echo - experiences own thought being spoken or repeated out loud

Question 5

Types of hallucinations?

Answer 5

Auditory 
Visual 
Olfactory 
Gustatory
Somatic

Question 6

What is passivity phenomena?

Answer 6

Behaviour is experienced as being controlled by and external agency

Question 7

What are self-referential experiences?

Answer 7

The belief that external events are related to oneself

Question 8

List some differential diagnoses of psychotic symptoms

Answer 8

Schizophrenia 
Psychoactive substance use 
Mania 
Depression 
Delirium 
Dementia

Question 9

List the positive symptoms of schizophrenia

Answer 9

Hallucinations
Delusions
Passivity phenomena
Disorder of the form of thought

Question 10

List the negative symptoms of schizophrenia

Answer 10

Reduced amount of speech 
Reduced motivation and drive 
Reduced interest and pleasure 
Reduced social interaction 
Restricted range of effect

Question 11

Usual onset of schizophrenia?

Answer 11

Young adults
Female - 25-35yrs
Male - 15-25 yrs

Question 12

What are bad prognostic indicators of schizophrenia?

Answer 12

Poor pre-morbid adjustment 
Insidious onset
Early onset 
Cognitive impairment 
Enlarged ventricles

Question 13

What are some good prognostic indicators of schizophrenia?

Answer 13

Older age of onset
Female
Marked mood disturbance
Family history of mood disorder

Question 14

What is biggest risk factor for schizophrenia?

Answer 14

+ve family history

Question 15

People with schizophrenia have ___________ lateral verticals

Answer 15

Enlarged

Question 16

People with schizophrenia have ________ frontotemporal volume

Answer 16

Reduced

Question 17

What affect does dopamine have in schizophrenia?

Answer 17

Induces psychotic state

Question 18

Amphetamine worsens/ betters symptoms of schizophrenia

Answer 18

Worsens

Question 19

It is assumed that schizophrenia is related to over/ under activity of dopamine pathways in the brain

Answer 19

Over activity

Question 20

What is the Mode of action of typical antipsychotics?

Answer 20

D2 inhibition

Block the post synaptic receptor

Question 21

List examples of typical antipsychotics

Answer 21

Chlorpromazine
Thioridazine
Fluphenazine
Haloperidol

Question 22

What is the mode of action of atypical antipsychotics?

Answer 22

High 5-HT2a to D2 ratio

Question 23

Atypical antipsychotics have a better efficacy agains positive or negative symptoms?

Answer 23

Negative

Question 24

List examples of atypical antipsychotics

Answer 24

Olanzapine
Risperidone
Clozapine
Aripiprazole

Question 25

What is the major side effect of clozapine?

Answer 25

AGRANULOCYTOSIS

Question 26

What monitoring do patients need when on clozapine?

Answer 26

FBC
weekly for first 6 months 
Fortnightly for next 6 months 
Every 4 weeks there after 
For 1 month after cessation of the drug