Schizophrenia CBL

Question 1

What are the Schneider first rank symptoms of schizophrenia?

Answer 1

ABCD
Auditory Hallucinations
Broadcasting of thought
Controlled Thought (Insertion or withdrawal)
Delusional Perception

Question 2

Which gender gets more schizophrenia?

Answer 2

Its equal

But men tend to get it earlier (23 vs 26) and worse

Question 3

Is schizophrenia associated with any perinatal complications?

Answer 3

Hypoxia & infection particularly

Question 4

What time of year births are associated with schizophrenia?

Answer 4

Late winter/early Spring births

Possibly due to in-utero viral exposure

Question 5

Can cannabis cause schizophrenia?

Answer 5

No although it is associated with a higher risk and it can alter the course of existing schizophrenia

Question 6

What CT sign is associated with schizophrenia?

Answer 6

Enlarged Ventricles

Question 7

What dopaminergic pathway in the brain are associated with the symptoms of schizophrenia?

Answer 7

Meso-limbic dopamine pathway –> Overactivity –> +ve symptoms

Meso-cortical dopamine pathway –> Underactivity –> -ve symptoms

Question 8

What dopaminergic pathways are associated with the side effects of anti-psychotics?

Answer 8

D2 blockade of the Nigrostriatal Dopamine pathway –> Parkinsonian side effects

D2 blockade of the Tuberoinfundibular dopamine pathway –> Hyperprolactinaemia

Question 9

Which anti-psychotic doesn’t cause tardive dyskinesia?

Answer 9

Clozapine

Question 10

Other than schizophrenia what are Atypical antipsychotics licensed for?

Answer 10

Mania

Question 11

Which of these 4 factors increases schizophrenia relapse risk?
- Non compliance
- Substance misuse
- High expressed emotion at home
- Major life events

Answer 11

All of them

Question 12

What are the major side effects of clozapine?

Answer 12

• Metabolic syndrome
• Idiopathic hyperthermia
• Hypersalivation
• Seizure
• Neutropenia

Question 13

How do we manage weight gain as a side effect of anti-psychotics?

Answer 13

Educate patient in advance
Record Baseline BMI
Record BMI every 6 months
Encourage healthy diet & exercise

Question 14

What are the parts of metabolic syndrome?

Answer 14

Obesity
Dyslipidaemia
Abnormal Glucose Metabolism
Hypertension

Question 15

What do we need to diagnose metabolic syndrome?

Answer 15

3 or more of:
- BP > 130/85
- Serum HDL >1.04(M) or >1,29 (F)
- Serum Triglyceride >1.69
- Fasting Glc >6.1
- Waist circumference >102cm(M) or >88cm(F)

Question 16

What anti-psychotics are most likely to cause hyperprolactinaemia?

Answer 16

Typicals
Risperidone
Amisulpride

Question 17

How do we manage QT prolongation as a side effect of anti-psychotics?

Answer 17

record any cardiac symptoms before prescribing
Check Fh
Baseline ECG

Question 18

What are the aims of psychosocial treatments for schizophrenia?

Answer 18

• Provide Psychoeducation
• Improve personal illness management
• Increase coping skills
• Reduce risk of co-morbidities
• Enhance interpersonal/social functional
• Promote independent living

Question 19

Which psychosocial interventions are good for schizophrenia?

Answer 19

CBT
Family Therapy
Supported Employment
Compliance Therapy
Social Skills Training

Question 20

What factors are associated with a better outcome in schizophrenia?

Answer 20

Marriage/stable relationship
Acute onset
Prominent Affective Symptoms
Older onset

Question 21

What schizophrenic populations have the highest mortality?

Answer 21

Younger
Women