Schizophrenia Jeopardy

Question 1

Negative Symptoms

Answer 1

M>F 
Alogia
Affective fattening
Evolution
Anhedonia (sx of MDD)

Question 2

Positive Symptoms

Answer 2

delusions
disorganized thinking
hallucinations

1 of this to meet DSM5 A criteria of Schizophrenia

Question 3

schizophreniform disorder

Answer 3

sx bw 1 - 6 months of criteria A schizophrenia

Question 4

Rule out diagnosis

before schizophrenia

Answer 4

Other psychotic disorder
Childhood developmental disorders
Medical or neuro illness
Substance/medication abuse
Personality disorders
Mood disorders

Question 5

Cognitive Symptoms

SMART

Answer 5

Speed
Memory
Attention
Reasoning
Tact (social)

Question 6

Catatonia

Answer 6

stupor
waxy flexibility
mutism
negativism
stereotypy
echolalia

Question 7

Hypnopompic hallucination

Answer 7

heard when waking up

Question 8

Negative or Cognitive sx

Answer 8

Early in dx
Worsen during active periods
Do not respond to anti-psychotic

Question 9

only __ pts with schizophrenia get married

Answer 9

30-40%

limited social contact

Question 10

schizophrenia with 1 single episode

Answer 10

10%

intermittent course 30%

chronic course 60%

Question 11

Prodrome

Answer 11

seen in 85% prior to 1st psychotic episode

negative prognostic sign

months-years

beginning of functional decline

Question 12

different average age of onset bw M and F

Answer 12

2nd smaller peak age of onset peak for females after age 40

peak age of onset is same

Question 13

Dec life expectancy bc

Answer 13

cardiovascular disease

Question 14

% of pts with schizophrenia that live independently

Answer 14

33%

Question 15

course of dz in Males more severe than Females

Answer 15

bc MALES develop illness earlier

Question 16

continous tx goal

Answer 16

prevent relapse into the active phase

Question 17

“lowest effective dose” can cause

Answer 17

INC risk of relapse

but used bc greater sensitivity to medication AE during first episode

Question 18

common reason pt with schizophrenia are psychiatric hospitalized

Answer 18

psychosis/active phase of illness

Question 19

response time of anti-psychotic rx

Answer 19

2 weeks
except for clozapine

if no good effect seen, less likely it will work by 4 weeks

Question 20

Clozapine

Lithium

Answer 20

DEC risk of suicide

Question 21

Clozapine

Answer 21

persistence of + sx
failure of >2 antipsychotic trial
co-morbid substance abuse
recurrent suicidality/violence

AE: sialorrhea 
weight gain
sedation
myocarditis
lower seizure threshold

Question 22

FGAs goal %

Answer 22

> 60% in mesolimbic tract

but 80% AE

Question 23

Low potency anti-psychotic AE

Answer 23

anti-cholinergic sx
dry mouth
constipation
BV
urinary hesitance

Question 24

Dystonia

Answer 24

EPS side effect

INC risk in young males

Question 25

Tardive dyskinesia

Answer 25

once developed, remains static/unchanged
(ongoing sx)

TX: clozapine

50% chance in pts >70yo

Question 26

Akathisia

Answer 26

EPS side effect - subjective sense of restlessness (person can’t sit still)

TX: #1 propranolol
also: amantadine, lorazepam, clinidine, mirtazepine

Question 27

EPS

Answer 27

TX: Diphenhydramine (Benadryl) - anticholinergic

lowest risk with low potency FGAs (chlorpromazine)

Question 28

Clozapine (clozaril)

Quetiapine (seroquel)

Answer 28

least likely to have EPS

Question 29

Aripiprazole

abilify

Answer 29

SGAs
partial agonist

long half life
low risk of metabolic syndrome
INC risk of akathisia

Question 30

Risperidone

Palliperidone

Answer 30

SGAs
Long acting injectable form
Dose dependent EPS
prolactin elevation

Question 31

Ziprasidone

Answer 31

SGA
Low risk of metabolic syndrome
Taken with food

QTC prolongation

Question 32

Olanzapine

Answer 32

SGA
INC risk of metabolic syndrome
Sedating
compliance (CATIE study)

Question 33

Paliiperidone

Answer 33

SGA
active metabolite of risperidone
does NOT need HEPATIC metabolism

Question 34

Quetiapine

Seroquel

Answer 34

SGA
NO EPS, NO agranulocytosis
YES: sedation
Moderate risk of metabolic syndrome