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Psych Test 2 > Schizophrenia And SCH Spectrum Disorders > Flashcards

Schizophrenia And SCH Spectrum Disorders Flashcards

1
Q

What are the DSM-5 criteria for schizophrenia diagnosis?

A

There has to be a continuous sign of disturbances that exists for at least six months.

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2
Q

What percentage of the global population is diagnosed with SCH?

A

1%

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3
Q

Define schizophrenia.

A

A psychotic disorder where behavior, thinking, feeling and perceiving are disorganized. There is an inability to distinguish reality from fantasy

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4
Q

Are there any differences in incidence of SCH related to race social status or culture.

A

No

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5
Q

What is the onset for SCH?

A

Most often occurs in late teens or early 20s males often have an earlier onset.

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6
Q

Why do SCH Patients more physical illness than the normal population?

A

Because they do not take care of themselves.

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7
Q

What is the life expectancy of an SCH patient compared to the general population?

A

SCH patients die on average 28 years premature.

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8
Q

Comorbidity - What is the percentage of substance-abuse disorders in SCH patients?

A

50%

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9
Q

What is the percentage of nicotine use in SCH patients?

A

70 - 90%

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10
Q

What is the percentage of polydipsia in SCH patients?

A

20%

Polydipsia

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11
Q

What percentage of SCH patients have a genetic correlation?

A

65% - 80%

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12
Q

What is the most accepted Etiology for neurobiological ideology of SCH?

A

Excessive dopamine Theory

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13
Q

What are the three etiologies of schizophrenia?

A

Genetics, neurobiological, brain structure abnormalities.

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14
Q

What percentage of SCH patient’s commit suicide? How does this relate to the general population?

A

10%, it is 8.5 times higher than the general population.

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15
Q

What percentage does a risk of getting schizophrenia increase if you have a 1st° relative with the disease.

A

10%

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16
Q

What percentage does the risk of getting schizophrenia increase if you have the identical twin with the disease? Fraternal twin?

A

50%, 15%

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17
Q

What are the three psychosocial and environmental factors that may relate to schizophrenia.

A

Prenatal stressors ( hypoxia, poor nutrition), psychological stressors ( stress increases cortisol which impedes hypothalamus development), environmental stressors (toxins).

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18
Q

What are the four positive groups of symptoms of schizophrenia?

A

Alterations and thinking, alterations in speech/thought, alterations and perception, movement disorders.

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19
Q

What is a positive symptoms of schizophrenia?

A

Presence of something that is not normally present.

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20
Q

What category of positive symptoms do delusions fall under in schizophrenia?

A

Alterations in thinking

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21
Q

Define a delusion.

A

False, fixed believes that are not corrected by reasoning

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22
Q

What percentage of individuals with a SCH experience a delusion at some point?

A

75%

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23
Q

Define what an alterations in concrete thinking would be in a patient with schizophrenia.

A

Inability to think abstractly. “People in glass houses should not throw stones”

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24
Q

What are the eight alterations in speech or thoughts associated with the positive symptoms of SCH?

A

Clang associations, Word salad, Neologisms, Echolalia, Flight of ideas, Thought blocking, Thought insertion, Thought deletion.

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25
Q

Give an example of what a Clang association is for a positive symptom of schizophrenia.

A

Clock, dock, dirt, flirt.

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26
Q

Define what a word salad is as a positive symptom of schizophrenia.

A

A jumble of meaningless words.

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27
Q

Define what a Neologisms are as a positive symptoms of schizophrenia.

A

Made up words.

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28
Q

Define what Echolalia are, as a positive symptom of schizophrenia.

A

Continuous repeating of another’s words.

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29
Q

Name the five alterations in perception that are associated with positive symptoms of schizophrenia.

A

Depersonalization, derealization, illusions, ideas of reference, hallucinations.

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30
Q

Define depersonalization as a positive symptom of schizophrenia.

A

Patient feels as though their body parts do not belong to them.

31
Q

Define derealization as a positive symptoms of schizophrenia.

A

The false perception that surroundings have been changed.

32
Q

What are the three types of hallucinations.

A

Auditory, command, and visual.

33
Q

What is the most common type of hallucination in schizophrenia?

A

Auditory

34
Q

Define an auditory hallucination in schizophrenia.

A

Hearing voices or sounds.

35
Q

What percentage of schizophrenic patients have auditory hallucinations?

A

60%

36
Q

Define movement disorders as a positive symptoms of schizophrenia.

A

The patient may appear as agitated (restless disconnected) body movements. Patient with a movement disorder may repeat certain motions over and over. In the other extreme a person may become catatonic, this is rare.

37
Q

Defined negative symptoms as related to schizophrenia.

A

Absence of something that should be present.

38
Q

Does a schizophrenic patient have a better or worse prognosis with negative symptoms?

A

Worse.

39
Q

Do negative symptoms develop slowly or quickly?

A

Slowly and most impede the ability to cope.

40
Q

What contributes to poor social functioning, grooming, and withdrawal in the schizophrenic patient?

A

Negative symptoms.

41
Q

Define alogia.

A

Poverty of thought and content of speech.

42
Q

What are five negative symptoms of the schizophrenic patient?

A
  1. Abolition/Anergia
  2. Affect is flat or facial expression blunted or minimal emotional response.
  3. Anhedonia
  4. Alogia
  5. Ambivalence
43
Q

What are six cognitive symptoms/actions that patients with schizophrenia have difficult with?

A
  1. Attention
  2. Memory
  3. Poor problem-solving
  4. Poor decision-making
  5. Illogical thinking
  6. Impaired judgment
44
Q

What are four desired outcomes for the patient with schizophrenia?

A
  1. Patient safety and medical stabilization
  2. Help patient understand illness and treatment
  3. Stabilize medications
  4. Control or cope with symptoms
45
Q

What are two maintenance desires for the patient with schizophrenia?

A
  1. Prevent relapse

2. Achieve independence, satisfactory quality-of-life

46
Q

What are the psychobiological interventions for the patient with schizophrenia?

A

Antipsychotic medications, either first, second, or third generation.

47
Q

What are the four extraparametal side effects of schizophrenia?

A
  1. Acute dystonia
  2. Akathisia
  3. Pseudoparkinsonism
  4. Tardive dyskinesia
48
Q

What is acute dystonia in the schizophrenic patient?

A

Muscle spasms, usually above the neck and uncontrollable.

49
Q

What is Akathisia and the schizophrenic patient?

A

Restlessness, inability to hold still.

50
Q

What is pseudoparkinsonism in the schizophrenic patient?

A

Stooped posture, tremors, rigidity

51
Q

What is tardive dyskinesia in the schizophrenic patient?

A

Involuntary repetitive movement, most often from Long term use of first generation antipsychotics.

52
Q

What are the conventional antipsychotics a.k.a. first-generation drugs used to treat schizophrenia?

A

Dopamine antagonists. (D2 receptor antagonist)

  • Thorazine
  • Haldol
  • Loxipine
  • Prolixin
53
Q

What generation of medications used to treat schizophrenia targets the positive symptoms?

A

First generation

54
Q

What are the advantages of first-generation antipsychotic drugs used to treat schizophrenia?

A

Less expensive than second-generation, some studies have shown them to be as effective as second-generation.

55
Q

What are the disadvantage of first-generation antipsychotic meds used to treat schizophrenia?

A

They do not treat the negative symptoms, extraparametal side effects are more likely to occur, anticholinergic side effects, weight gain, sexual dysfunction, endocrine disturbances, Tardive dyskinesia more likely to occur.

56
Q

What are anticholinergic side effects and what generation of antipsychotic medications causes them?

A

Dry mouth, dry eyes, constipation. First generation

57
Q

What generation of antipsychotic medications are considered the first line of treatment for schizophrenia?

A

Second generation

58
Q

What are second-generation antipsychotics and what pathways do they work on?

A

Atypical antipsychotics, they work on serotonin receptors in addition to dopamine receptors.

59
Q

What are advantages of second-generation antipsychotics?

A

They treat both positive and negative symptoms, they reduce the incidence of extraparametal side effects.

60
Q

What are the disadvantages of second-generation antipsychotics

A

Tendency to cause significant weight gain, metabolic syndrome may occur more often (this increases the diabetic ricks factors), cost more than typical antipsychotics.

61
Q

Name the six atypical antipsychotics.

A
  1. Clozapine (Clozaril)
  2. Risperidone (Risperdal)
  3. Olanzapine (Zypexia) highest weight gain
  4. Quetiapine (Seroquel)
  5. Ziprasidone (Grodon) low weight gain, pt w/ history abn ekg need ekg before starting and ekg monitoring throughout.
  6. Paliperidone (Invega)
62
Q

Which atypical antipsychotic has the highest weight gain?

A

Olanzapine (Zyprexa)

63
Q

Which atypical antipsychotic has the lowest weight gain?

A

Ziprasidone (Geodon) EKG!!!!!

64
Q

How do you third generation antipsychotics work?

A

They are dopamine system stabilizers

65
Q

What are the advantages of third generation antipsychotics?

A

Improve positive and negative symptoms, as well as cognitive functioning, little risk of extraparametal side effects or tardive dyskinesia, little or no weight gain.

66
Q

What are the three medications used to reduce EPS?

A

Anticholinergics, Antihistamines,

67
Q

What are anticholinergic’ s used for?

A

Parkinsonism, dystonia, may reduce akathisia

68
Q

What meds are used for Akathisia?

A
  • Benztropine - Cogentin
  • Trihexyphenidyl- Artane, Tritane
  • Inderal, Ativan, Valium
69
Q

What are antihistamines used for?

A

Used IM for rapid relief of acute dystonia.

70
Q

Name an antihistamine drug.

A

Diphenhydramine - Benadryl

71
Q

What does NMS stand for?

A

Neuroleptic malignant syndrome

72
Q

What is neuroleptic malignant syndrome caused by, and what are the symptoms?

A

Acute reduction in dopamine is the suspect cause, it causes hyperpyrexia, tachycardia, diaphoresis, incontinence, drooling, labile htn, increased muscle rigidity, and lessened consciousness.

73
Q

What generation of antipsychotic medications cause NMS more often?

A

Conventional first generation antipsychotics

74
Q

What other medication can also be associated with NMS?

A

Antidepressants

Psych Test 2 (6 decks)

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