Schizophrenia Jeopardy Flashcards
Males are more likely than females to have these A Criteria symptoms of schizophrenia:
Negative symptoms (alogia, affective flattening, avolution, anhedonia)
Positive sx of schizophrenia are delusions, disorganized behavior, disorganized thinking, and this:
Hallucinations
If the A criteria for schizophrenia have been met for between 1 and 6 months, the diagnosis is this:
Schizophreniform d/o
Before diagnosing schizophrenia, exclusionary diagnoses that must be ruled out include: other psychotic disorders, childhood developmental disorders, medical or neurological illness, substance abuse or medication-induced, personality disorders, and this:
Mood disorders
Regarding the cognitive symptoms of schizophrenia, the mnemonic SMART refers to:
Speed, memory, attention, reasoning, and tact (social cognition)
This A criteria negative symptom of schizophrenia is also a symptom of major depression.
Anhedonia
To meet DSM5’s A criteria of Schizophrenia, of the 2 symptoms, 1 needs to be a delusion, a hallucination, or this
Disorganized speech/behavior
Seen in schizophrenia (and other d/o’s)-stupor, waxy flexibility, mutism, negativism, stereotypy, and echolalia are motor activities that are part of a clinical picture of this.
Catatonia
Voices that are only heard when a patient is just waking up from sleeping are called this.
Hypnopompic hallucinations
These symptoms of schizophrenia present early in the illness, worsen during the active periods, and do not respond well to anti-psychotic medications.
Negative symptoms (or cognitive symptoms)
It is “proposed” that because most patients with schizophrenia have limited social contacts, only 30-40% do this.
Get married
the percentage of patients with schizophrenia who experience a single active episode is this:
10%
~30% intermittent course; ~60% chronic course
Seen in ~85% of patients prior to the 1st psychotic episode, this negative prognostic sign lasts several months to years,
Prodrome
For M and F with schizophrenia, the peak age of onset (the mode) is the same but the average age of onset is different because of this:
a 2nd smaller peak age of onset peak for females after age 40
Patients with schizophrenia have a life expectancy that is about 25 years less than the general population, primarily due to this:
CV disease
The functional decline for a patient with schizophrenia begins during this phase of the illness:
Prodrome
Due to their many problems as outlined in the B criteria, only 33% of those with schizophrenia are able to do this on July 4th.
Live independently
The average course of schizophrenia tends to be more severe in males than females because of this.
Males generally develop the illness earlier
For patients with schizophrenia, the main goal of continuous pharmacologic treatment with antipsychotics is this:
Prevent relapse into active phase
Decreasing the antipsychotic medication in an attempt to use the “lowest effective dose” is associated with this:
Increased risk of relapse
The most common reason patients with schizophrenia are psychiatrically hospitalized is this:
Psychosis/active phase of illness
Except for clozapine (Clozaril), all anti-psychotic medications are unlikely to work by 4 weeks if a patient does not show a response within this number of week(s).
2 weeks
Lower doses of antipsychotics are used to treat patients with the first active phase of schizophrenia because of this:
Greater sensitivity to medication side effects
Clozapine (Clozaril) for patients with schizophrenia and lithium for patients with bipolar disorder both have this same unique benefit:
Decreases risk of suicide
Common indications for a clozapine (Clozaril) trial include: persistence of positive sx, failure of > 2 antipsychotic trials, co-morbid substance abuse, and this:
Recurrent suicidality/violence
In treating patients with FGA’s, often titrating the dose up until side effects emerge corresponds to blocking
this % of dopamine receptors.
75-80%
In order to have the desired antipsychotic effect, meds need to block at least 65% of dopamine receptors in this pathway.
Mesolimbic tract
Low potency antipsychotics have common side effects of dry mouth, constipation, blurred vision, and urinary hesitancy due to this:
Anti-cholinergic activity (anti-cholinergic blockade)
Young males may be at higher risk than the rest of the population for this EPS side effect of muscle spasms.
Dystonia
Once a patient develops tardive dyskinesia, the most common course of the symptoms is this:
Remain static/unchanged (ongoing symptoms)
While amantadine (Symmetrel), lorazepam (Ativan), clonidine (Catapres), even mirtazepine (Remeron), can be used for treating akathisia, the first choice of medication for treatment is this:
Propranolol (Indural)
Antihistaminic
Anticholinergic
Dopaminergic
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Diphenhydramine (Benadryl) is used to treat EPS because of this:
Anticholinergic
can also use benztropine or trihexyphenidyl
While there is still a significant risk of EPS, patients are less likely to complain of EPS symptoms from this type of FGA.
Low potency FGAs: chlorpromazine (Thorazine)
About half of the patients with tardive dyskinesia show a 50% symptom reduction from treatment with this medication.
Clozapine (Clozaril)
The risk of tardive dyskinesia in patients who take FGA’s for 24 months is 50% in this age group.
Older adults/geriatric (>70 y/o)
An EPS side effect often described as a subjective sense of restlessness (the person can’t sit still) is this:
Akathisia
These two SGA’s are least likely to have EPS side effects.
- Clozapine (Clozaril)
- Quetiapine (Seroquel)
This SGA has a particularly long half life and a low risk of metabolic syndrome, but is the SGA most likely to cause akathisia.
Aripiprazole (Abilify)
These 2 SGA’s are available in long acting injectable form but can cause dose-dependent EPS and prolactin elevation.
- Risperidone (Risperdal)
- Palliperidone (Invega)
This SGA has a low risk of metabolic syndrome, needs to be taken with food, and is the most likely SGA to cause qTc prolongation.
Ziprasidone (Geodon)
This SGA has the highest risk of metabolic syndrome, is very sedating, and the CATIE study showed patients are highly likely to be compliant.
Olanzapine (Zyprexa)
This SGA does not require hepatic metabolism because it is an active metabolite of risperidone (Risperdal).
Paliperidone (Invega)
This SGA has almost zero risk of EPS or agranulocytosis, is often sedating, and has a moderate risk of metabolic syndrome.
Quetiapine (Seroquel)
This SGA is unique since it is a partial agonist.
Aripiprazole (Abilify)
This SGA may cause side effects of sialorrhea, weight gain, sedation, anticholinergic effects, myocarditis, and a lower seizure threshold.
Clozapine (Clozaril)
