Psychiatry End Of Year Exams: Week 2: Drugs, Schizophrenia And Psychotic Disorders

Front 1

An attempt to modify behaviors, thoughts or moods by
chemical means.

Back 1

Psychopharmacology

Front 2

DSM IV criteria for schizophrenia

Back 2

Two (or more) of the following, each present for a significant portion of
time during a 1 month period:
• (1) delusions
• (2) hallucinations
• (3) disorganized speech
• (4) grossly disorganized or catatonic behavior
• (5) negative symptoms (affective flattening, alogia, or avolition)

Social and occupational dysfunction
• Duration: At least 6 months

Front 3

1. 6th leading cause of worldwide disability (WHO)

Back 3

Schizophrenia

Front 4

In schizophrenia_____% attempt suicide, ______% complete

Back 4

2. 50% attempt suicide, 15% complete

Front 5

In schizophrenia, Average life expectancy approx. _____years less

Back 5

20

Front 6

Schizophrenia is responsible for _____% of all hospital bed days

Back 6

Responsible for 20% of all hospital bed days

Front 7

Schizophrenia is in ____% of the general population

Back 7

1%

Front 8

Prevelance of schizophrenia amongst males and females

Back 8

=

Front 9

Schizophrenia: Peak Age of Onset
– Males (_____-____ years)
– Females (____-_____ years)

Back 9

Peak Age of Onset
– Males (15-25 years)
– Females (25-35 years)

Front 10

Schizophrenia: Concordance ______% MZ Twins
______% DZ Twins

Back 10

Concordance 50% MZ Twins
12% DZ Twins

Front 11

An attempt to modify behaviors, thoughts or moods by
chemical means.

Back 11

Psychopharmacology

Front 12

DSM IV criteria for schizophrenia

Back 12

Two (or more) of the following, each present for a significant portion of
time during a 1 month period:
• (1) delusions
• (2) hallucinations
• (3) disorganized speech
• (4) grossly disorganized or catatonic behavior
• (5) negative symptoms (affective flattening, alogia, or avolition)

Social and occupational dysfunction
• Duration: At least 6 months

Front 13

1. 6th leading cause of worldwide disability (WHO)

Back 13

Schizophrenia

Front 14

In schizophrenia_____% attempt suicide, ______% complete

Back 14

2. 50% attempt suicide, 15% complete

Front 15

In schizophrenia, Average life expectancy approx. _____years less

Back 15

20

Front 16

Schizophrenia is responsible for _____% of all hospital bed days

Back 16

Responsible for 20% of all hospital bed days

Front 17

An attempt to modify behaviors, thoughts or moods by
chemical means.

Back 17

Psychopharmacology

Front 18

Schizophrenia is in ____% of the general population

Back 18

1%

Front 19

DSM IV criteria for schizophrenia

Back 19

Two (or more) of the following, each present for a significant portion of
time during a 1 month period:
• (1) delusions
• (2) hallucinations
• (3) disorganized speech
• (4) grossly disorganized or catatonic behavior
• (5) negative symptoms (affective flattening, alogia, or avolition)

Social and occupational dysfunction
• Duration: At least 6 months

Front 20

Prevelance of schizophrenia amongst males and females

Back 20

=

Front 21

An attempt to modify behaviors, thoughts or moods by
chemical means.

Back 21

Psychopharmacology

Front 22

1. 6th leading cause of worldwide disability (WHO)

Back 22

Schizophrenia

Front 23

Schizophrenia: Peak Age of Onset
– Males (_____-____ years)
– Females (____-_____ years)

Back 23

Peak Age of Onset
– Males (15-25 years)
– Females (25-35 years)

Front 24

DSM IV criteria for schizophrenia

Back 24

Two (or more) of the following, each present for a significant portion of
time during a 1 month period:
• (1) delusions
• (2) hallucinations
• (3) disorganized speech
• (4) grossly disorganized or catatonic behavior
• (5) negative symptoms (affective flattening, alogia, or avolition)

Social and occupational dysfunction
• Duration: At least 6 months

Front 25

Schizophrenia: Concordance ______% MZ Twins
______% DZ Twins

Back 25

Concordance 50% MZ Twins
12% DZ Twins

Front 26

In schizophrenia_____% attempt suicide, ______% complete

Back 26

2. 50% attempt suicide, 15% complete

Front 27

1. 6th leading cause of worldwide disability (WHO)

Back 27

Schizophrenia

Front 28

In schizophrenia_____% attempt suicide, ______% complete

Back 28

2. 50% attempt suicide, 15% complete

Front 29

An attempt to modify behaviors, thoughts or moods by
chemical means.

Back 29

Psychopharmacology

Front 30

In schizophrenia, Average life expectancy approx. _____years less

Back 30

20

Front 31

In schizophrenia, Average life expectancy approx. _____years less

Back 31

20

Front 32

Schizophrenia is responsible for _____% of all hospital bed days

Back 32

Responsible for 20% of all hospital bed days

Front 33

DSM IV criteria for schizophrenia

Back 33

Two (or more) of the following, each present for a significant portion of
time during a 1 month period:
• (1) delusions
• (2) hallucinations
• (3) disorganized speech
• (4) grossly disorganized or catatonic behavior
• (5) negative symptoms (affective flattening, alogia, or avolition)

Social and occupational dysfunction
• Duration: At least 6 months

Front 34

Schizophrenia is in ____% of the general population

Back 34

1%

Front 35

Schizophrenia is responsible for _____% of all hospital bed days

Back 35

Responsible for 20% of all hospital bed days

Front 36

1. 6th leading cause of worldwide disability (WHO)

Back 36

Schizophrenia

Front 37

Schizophrenia is in ____% of the general population

Back 37

1%

Front 38

Prevelance of schizophrenia amongst males and females

Back 38

=

Front 39

Prevelance of schizophrenia amongst males and females

Back 39

=

Front 40

In schizophrenia_____% attempt suicide, ______% complete

Back 40

2. 50% attempt suicide, 15% complete

Front 41

Schizophrenia: Peak Age of Onset
– Males (_____-____ years)
– Females (____-_____ years)

Back 41

Peak Age of Onset
– Males (15-25 years)
– Females (25-35 years)

Front 42

In schizophrenia, Average life expectancy approx. _____years less

Back 42

20

Front 43

Schizophrenia: Peak Age of Onset
– Males (_____-____ years)
– Females (____-_____ years)

Back 43

Peak Age of Onset
– Males (15-25 years)
– Females (25-35 years)

Front 44

Schizophrenia: Concordance ______% MZ Twins
______% DZ Twins

Back 44

Concordance 50% MZ Twins
12% DZ Twins

Front 45

Schizophrenia is responsible for _____% of all hospital bed days

Back 45

Responsible for 20% of all hospital bed days

Front 46

Schizophrenia: Concordance ______% MZ Twins
______% DZ Twins

Back 46

Concordance 50% MZ Twins
12% DZ Twins

Front 47

Schizophrenia is in ____% of the general population

Back 47

1%

Front 48

Prevelance of schizophrenia amongst males and females

Back 48

=

Front 49

Schizophrenia: Peak Age of Onset
– Males (_____-____ years)
– Females (____-_____ years)

Back 49

Peak Age of Onset
– Males (15-25 years)
– Females (25-35 years)

Front 50

Schizophrenia: Concordance ______% MZ Twins
______% DZ Twins

Back 50

Concordance 50% MZ Twins
12% DZ Twins

Front 51

Name 4 Causes of Psychosis

Back 51

• Dopamine Hypothesis
• Neurotransmitter Interaction
• Structural Abnormalities
• Prenatal or Perinatal Trauma

Front 52

Name 3 comorbid conditions of schizophrenia

Back 52

• Diabetes Mellitus
– 2-4x greater risk than population1-4
• Substance Abuse
– Alcohol: 30-50%
– Cannibis: 15-25%
– Cocaine/Amphetamine: 5-10%
• Nicotine Dependence: >75%
– Improve attention?
– Increase Metabolism

Front 53

Name 4 Positive Symptoms of schizophrenia

Back 53

Delusions
Hallucinations
Disorganized speech
Catatonia

Front 54

Name 5 Negative Symptoms of schizophrenia

Back 54

Affective flattening
Alogia
Avolition
Anhedonia
Asociality

Front 55

NAme 6 Mood Symptoms of schizophrenia

Back 55

Depression
Hopelessness
Suicidality
Anxiety
Agitation
Hostility

Front 56

Name 3 cognitive deficits of schizophrenia

Back 56

Memory
Executive functions
(e.g., abstraction)

Front 57

Name the 4 classes of conventional antipsychoics

Back 57

I. Phenothiazines
II. Butyrophenones e.g. haloperidol, droperidol
III. Diphenylbutylpiperidines e.g. pimozide
IV. Benzamide derivatives e.g. sulpiride

Front 58

Name the 3 derivatives of phenothiazine

Back 58

1) Aliphatic derivatives e.g. chlorpromazine
2) Piperidine derivatives e.g. thioridazine
3) Piperazine derivatives e.g. trifluoperazine, fluphenazine

Front 59

Name 3 adverse effects of blocking D2 receptors schizophrenia.

Back 59

1. Mesocortical - ↑ negative symptoms
2. Nigrostriatal - EPS/ Tardive Dyskinesia
3. Tuberoinfundibular - ↑ prolactin
- galactorrhea

Front 60

Name 3 adverse effects of blocking alpha 1 receptor.

Back 60

orthostatic hypotension
dizziness
sedation

Front 61

What are 6 adverse effects of blocking muscarinic receptors?

Back 61

Sedation
• Memory difficulties
• Dry mouth
• Blurred vision
• Constipation
• Urinary retention

Front 62

What are 2 adverse effects of blocking histamine receptors?

Back 62

• weight gain
• sedation

Front 63

- High potency, Low EPS.
- Superior efficacy for positive, disorganisation and
cognitive symptoms.
- Evidence to suggest clozapine, olanzapine,
amisulpiride & risperidone better than others.

Back 63

Atypical Antipsychotics

Front 64

Name the atypical antipsychotics

Back 64

Olanzapine, clozapine, quietapine, risperidone, aripiprazole and ziprasidone.
and amisulpiride
It's Atypical for O-ld c-losets to q-uietly r-isper from A to Z.

Front 65

WRT to psychopharmacology________ _______ reduce
psychotic symptoms

Back 65

Dopamine antagonists

Front 66

Wrt to psychopharmacology ________ _________ may
affect mood, violence,
suicide

Back 66

5-HT modulations

Front 67

wrt psychopharmacology ________ may reduce mania and improve cognition

Back 67

Cholinomimetics

Front 68

Indirectly enhancing ______ release, Reduces
anxiety,irritability and
agitation

Back 68

GABA

Front 69

Enhancing and stabilizing ________ transmission Reduces extremes of
CNS hyperexcitability,
agitation and sensory
overload

Back 69

Glutamate

Front 70

List 2 examples of Loose Relative Binding of Antipsychotic Medications to
Dopamine D2 Receptors

Back 70

Quetiapine, clozapine

Front 71

Intermediate Relative Binding of Antipsychotic Medications to
Dopamine D2 Receptors

Back 71

Olanzapine

Front 72

Tight Relative Binding of Antipsychotic Medications to
Dopamine D2 Receptors

Back 72

Ziprasidone, risperidone, chlorpromazine and haloperidol

Front 73

Haloperidol and all the azine's

Back 73

Typical antipsychotics

Front 74

WRT to _______ D2 binding:
Good Acute Efficacy.
Higher doses not necessarily
more effective.
Greater risk of EPS/TD.
Long-term Efficacy may be
impaired.

Back 74

Tight

Front 75

WRT to _______ D2 binding:
For Acute Efficacy, higher doses
may be required.
Lower risk of EPS/TD.
Better maintenance of response.

Back 75

Loose

Front 76

Dose-Related SideEffects of clozapine

Back 76

seizures and orthostasis

Front 77

Dose-Related SideEffects risperidone

Back 77

EPS and orthostasis

Front 78

Dose-Related SideEffects of olanzapine

Back 78

Sedation
(Wt gain not dose related)

Front 79

Dose-Related SideEffects of quetiapine

Back 79

Sedation, Weight gain,
Orthostasis

Front 80

Dose-Related SideEffects of aripipazole

Back 80

Nausea, worsening of psychosis

Front 81

Dose-Related SideEffects of ziprasidone

Back 81

QTc prolongation, Dystonia

Front 82

The following are major side effects of____________:
• Extrapyramidal Symptoms (EPS)
• Tardive Dyskinesia (TD)
• Neuroleptic Malignant Syndrome (NMS)
• Prolactin Elevation
• Weight Gain
• Hyperglycemia
• QTc Prolongation
• Lipid Changes

Back 82

Antipsychotics

Front 83

8 Major Side Effects of
Antipsychotic Medications

Back 83

• Extrapyramidal Symptoms (EPS)
• Tardive Dyskinesia (TD)
• Neuroleptic Malignant Syndrome (NMS)
• Prolactin Elevation
• Weight Gain
• Hyperglycemia
• QTc Prolongation
• Lipid Changes

Front 84

Most efficacious antipsychotic – indicated for treatment resistant or
negative symptoms

Back 84

Clozapine

Front 85

Rare but important SE of clozapine

Back 85

• Agranulocytosis (0.5-2%/year)

Front 86

Name 4 first line antipsychotics

Back 86

Olanzapine, risperidone, quetiapine and ziprasidone

Front 87

First line agent Indicated for Positive, Negative symptoms and Treatment Resistant
Schizophrenia

Back 87

Olanzapine

Front 88

First line antipsychotic that treats Positive and Negative symptoms with Less weight gain than other atypicals

Back 88

risperidone

Front 89

First line antipsychotic used to treat positive symptoms but causes weight gain and may cause cataracts

Back 89

Quetiapine

Front 90

First line agent used to treat positive and negative symptoms with
• Less weight gain and metabolic disturbance than other atypicals
but
can cause
• QTc prolongation

Back 90

Ziprasidone

Front 91

An antipsychotic Not associated with symptomatic hyperprolactinaemia, QTc
prolongation, impaired glucose tolerance, weight gain

Back 91

Aripripazole

Front 92

Acute treatment of schizophrenia

Back 92

Oral haloperidol +/- lorazepam

Front 93

In maintenance trx of schizophrenia
____% unresponsive
____% intolerant of SE
______% non-compliant (adverse effects/ poor insight)

Back 93

5-25% unresponsive
5-10% intolerant of side effects
40-60% non-compliance (adverse effects/ poor insight)

Front 94

Maintenance treatment of schizophrenia:
__- ___% relapse within 1 year,
___% within 2 years
vs.
___% on active medication

Back 94

60-70% relapse within 1 year,
85% within 2 years
vs.
20% on active medication

Front 95

Name 3 Steps to implement to achieve
better compliance

Back 95

Medication choice
♦ Appropriate dose
♦ Therapeutic Alliance between clinician and patient,
family

Front 96

4 methods to avoid relapse

Back 96

1. Provide info about medication
• Acknowledge side effects
• Enquire about adherence
2. Discuss treatment goals with patient
3. Develop Relapse-preventing contract
• What should family / cargivers do if patient becomes
non-compliant
4. Have family become familiar with support services,
suicide prevention line

Front 97

Treatment of EPS: treat akathesia

Back 97

Reduce dose or change to an atypical

Front 98

Treatment of EPS: Dystonia

Back 98

Use an anticholinergic. Constantly reassess further use of these compounds

Front 99

Characterized by choreiform, athetoid, and rhythmic movements of the
tongue, jaw, trunk, and extremities for at least 4 weeks that begin during
treatment with neuroleptics or within 4 weeks of discontinuing
neuroleptics. Oral and genital pain can also be prominent features.

Back 99

Tardive dyskinesea

Front 100

Treatment of EPS: tardive dyskinesea

Back 100

Switch to atypicals, if on atypicals switch to clozapine

Front 101

Predisposing factors to tardive dyskinesea

Back 101

long term Rx with NLPs, female sex, increasing age
and cognitive disturbance, illness itself

Front 102

Evolution of extra pyrimidal side effects wrt to:
dystonia
akinesia
akathisia
tardive dyskinesea

Back 102

4h- acute dystonia (muscle spasm and stiffness)
4days- akinesia (parkinsonia symptoms)
4 weeks- akathisia (restlessness)
4 months- tardive dyskinesia

Front 103

T/F Bipolar disorder has a social class skew

Back 103

F

Front 104

T/F, inipolar depression has a social class skew

Back 104

T

Front 105

At least five of the following symptoms have been present during the same two
week period and represent a change from previous functioning: at least one of the
symptoms is either depressed mood, or loss of interest or pleasure. + list of symptoms

Back 105

Depression DSM 4 criteria

Front 106

A distinct period of abnormal and persistently elevated, expansive, or
irritable mood, lasting at least 1 week (or any duration if hospitalisation
is necessary).
• During the period of mood disturbance, three (or more) of the following
symptoms have persisted ( four if the mood is only irritable) and have
been present to a significant degree: + list of symptoms

Back 106

Mania DSM 4 criteria

Front 107

Name the 5 aetiology theories of mood disorders

Back 107

• Genetic Hypotheses
• Psychological Hypotheses
• Life Events
• Organic/Secondary
• Monoamine Theory of Depression

Front 108

Depression associated with synaptic and post-synaptic
changes in NA and 5HT.

Back 108

Monoamine theory of depression

Front 109

Name the SSRI's

Back 109

Fluoxetine, paroxetine, sertraline, citalopram

Front 110

Noradrenergic & Specific Serotonin (NaSSA) anti depressant

Back 110

Mirtazapine

Front 111

Serotonin 2A antagonist/reuptake inh (SARI) antidepressant

Back 111

Nefazadone, Trazadone

Front 112

Dual inhibitors (5HT/NA) (SNRI) antidepressants

Back 112

Venlafaxine, Duloxetine

Front 113

Monoamine oxidase inhibitors (MAOI)

Back 113

Phenelzine and moclobemide

Front 114

Irreversible Monoamine oxidase inhibitors (MAOI)

Back 114

Phenelzine

Front 115

Reversible Monoamine oxidase inhibitors (MAOI)

Back 115

Moclobemide

Front 116

WRT Acute Treatment of Depressio: Treatment should be continued for _________months
after the person has made a full recovery

Back 116

Treatment should be continued for 4-6 months
after the person has made a full recovery

Front 117

WRT to acute treatment of depression in patients: An adequate trial of treatment necessitates them receiving at least

Back 117

– 20 mg or 50 mg of an SSRI,
– 30 mg of NaSSA,
– 75 mg of a newer MARI (SNRI) or 150-300 mg of an older MARI,
– 45 mg of an older MAOI or 300 mg of a newer MAOI (RIMA) for 4-6
weeks

Front 118

Efficacy of Antidepressants:
Placebo _______%
Antidepressant meds _________%
Electroconvulsive therapy_________%

Back 118

Placebo 40%
Antidepressant 60%
ECT 70%

Front 119

Name 3 indications for Prophylactic Treatment of
Depression

Back 119

• 2 or more episodes of moderate to severe depression
• Dose identical to acute phase
• Continue for 2-5 years

Front 120

Treatment of Depression - Subtypes

Back 120

Resistant
• Atypical
• Psychotic

Front 121

Acute Treatment of Mania

Back 121

• Use either conventional or atypical neuroleptics (olanzapine and
risperidone are licensed)
• Use 30-40 mg of olanzapine initially
• Add in lorazepam - behavioural disturbance only
• 2-4 weeks to work

Front 122

Name 6 mood stabilizers for the prophylactic treatment of mania

Back 122

1. Lithium
2. Carbamazepine
3. Sodium Valproate
4. Olanzapine
5. Quetiapine
6. Risperidone

Front 123

Name 7 acute side effects of lithium

Back 123

1. Nausea
2. Vomitting
3. Diarrhoea
4. Urinary frequency
5. Dry mouth
6. Polyuria
7. Fine tremor

Front 124

Name 7 chronic adverse effects of lithium

Back 124

1. Cadiotoxicity (T wave
inversion & flattening)
2. Hypothyriodism
3. Nephrogenic diabetes
insipidus
4. Irreversible renal damage
5. Tardive dyskinesia
6. Weight gain
7. Glucose intolerance

Front 125

Toxicity dose of lithium

Back 125

>2.0 mmol/L

Front 126

Name 6 adverse effects of lithium overdose toxicity

Back 126

1. Coarse tremor
2. Drowsiness
3. Ataxia
4. Confusion
5. Convulsions
6. Death

Front 127

Adverse effects of carbamezepine

Back 127

Headaches, sedation, dizziness,
erythematous rash (generalised),
leucopenia

Front 128

Adverse effects of sodium valproate

Back 128

GIT symptoms (nausea, anorexia,
vomiting), sedation, tremor,ataxia,
rash.

Front 129

__________ and _____________ are usually used in combination with other mood stabilisers

Back 129

Lamotrigine and Gabapentin are usually
used in combination with other mood stabilisers.

Front 130

TRX of bipolar depression

Back 130

• Use SSRIs
• Lamotrogine

Front 131

Name the 2 classes of anxiolytics

Back 131

Benzodiazepines
Barbiturates

Front 132

Adverse effects of Anxiolytics - Benzodiazepines

Back 132

• No P450 enzyme induction
• Drowsiness, ataxia, dizziness

Front 133

Adverse effects of Anxiolytics - Barbiturates

Back 133

CNS depression
• Physical & psychological dependence
• Induces P450 enzymes - alters metabolism of anticoagulants,
steroids, phenytoin

Front 134

MAOI's adverse effects in pregnancy

Back 134

growth retardation,
hypertension, drug interactions (e.g. narcotics)

Front 135

Avoid TCAs in the ______ trimester

Back 135

1rst

Front 136

Fetal adverse effects of lithium

Back 136

– Goitre (fetus)
– Neurological A/E (flaccidity, inhibition of neonatal reflexes)
– CVS A/E (atrial flutter, heart failure)
– Ebstein’s Anomoly (cardiac malformation)

Front 137

Adverse effects in pregnancy of carbamezepine and valproate

Back 137

(risk of Spina Bifida – use prophylactic folic acid)

Front 138

Schneider’s 1st Rank Symptoms

Back 138

• Thought Insertion
• Thought Broadcast
• Thought Withdrawal
• Thought Echo
– Echo de la pensée
– Gedankenlautwerden
• 3rd Person Auditory Hallucination
– Running Commentary
– Voices discussing patient
• Delusional Perception
• Made Feelings, Impulses and Actions
• Somatic Passivity

Front 139

• A false belief that is unshakeably held
• despite evidence to the contrary
• out of keeping with patients background
– socially
– educationally
– religious

Back 139

Delusion

Front 140

bizarre
delusion in response to a real sensory perception“I saw the neighbour look out his window and then I
knew he was planning to kill me”

Back 140

Delusional perception

Front 141

have no discernable connection with any previous
interactions or experiences

Back 141

Primary delusions (autochthonous)

Front 142

Delusions that arises out of other psychic experiences,
prevailing affect, fears, hallucinations

Back 142

Secondary delusion

Front 143

Name 10 areas of delusional content

Back 143

• Reference
• Persecution
• Religious
• Guilt / Sin
• Jealousy
• Shared
• Infidelity
• Love
• Nihilistic

Front 144

Intense preoccupations with marked associated
emotional investment

Back 144

Over-valued idea

Front 145

Disintegration of boundary between self and surrounding World

Back 145

Passivity phenomena

Front 146

the patient experiences bodily
sensations in the absence of a stimulus
(somatic hallucination) and attributes
them to an external force

Back 146

Somatic passivity

Front 147

• Thought Insertion
• Thought Withdrawal
• Thought Broadcasting
• Made feelings - “they make me hate him”
• Made impulses - “they make me move like a puppet”
• Made actions – “something speaks with my mouth and lips”

Back 147

Passivity phenomena

Front 148

Perceptions arising in the absence of an external
stimulus
• Perceived as having the same quality as normal
perceptions
• Not subject to conscious manipulation – not produced or
dismissed at will
• Not distortions of real perceptions (illusions)
• Located in external World

Back 148

Hallucinations

Front 149

Abnormalities of thought expressed in language
• Logical association between ideas are often loosened
and incomprehensible to listener

Back 149

Formal thought disorder

Front 150

Disordered tempo (fast – mania, slow – depression)
• Omission
• Neologisms, clang associations
• Derailment
• Fusion
• Drivelling
• Thought blocking
• Verbigeration (word salad)

Back 150

Examples of formal thought disorder

Front 151

Automatic obedience, Echopraxia,
Echolalia, Mitmachen (body can be put into any posture,
despite instructions to resist), Mitgehen, Negativism

Back 151

Induced movements

Front 152

Stereotypies, chorea &
athethosis after neuroleptics

Back 152

Spontaneous movements

Front 153

Motor activity of schizophrenia include:

Back 153

Induced and spontaneous movements

Front 154

Name the 5 negative sx. of schizophrenia

Back 154

1. Affect flattening
2. alogia
3. avolition
4. Anhedonia
5. attention deficits

Front 155

– Unchanging facial expression, poor eye contact
– Lack of vocal inflection

Back 155

Affect flattening

Front 156

Poverty of speech

Back 156

Alogia

Front 157

– Poor grooming and hygiene,
– Physical anergia

Back 157

Avolition

Front 158

– Few interests, limited relationships,
reduced libido,

Back 158

Anhedonia

Front 159

Social inattentiveness and on
examination

Back 159

Attention deficits

Front 160

ICD classification of schizophrenia requires sx. present for > ____ month(s)

Back 160

1 month

Front 161

Significant and consistent change in overall
quality of some aspect of personal behaviour
– loss of interest, aimlessness, withdrawal.
Should be present for > 1 year

Back 161

Simple schizophrenia

Front 162

ICD schizophrenia criteria require >/= ____ major symtpoms and >/= ____minor symptoms

Back 162

1 and 2

Front 163

Name 8 indications for a schizophrenic to be admitted into hospital

Back 163

• Suicidal Ideation
• Homicidal Ideation
• Floridly psychotic and agitated
• Significant mood component
• Significant interference with daily life
• Insightless
• Compliance issues
• Poor social network

Front 164

Minimum trial time required fpr schizophrenia treatment

Back 164

6 weeks

Front 165

(≥2 different
agents ineffective), neuroleptic intolerance, type of schizophrenia

Back 165

Refractory Schizophrenia

Front 166

What are the 5 components of neuroleptic malignant syndrome?

Back 166

FEVER

F-fever
E-ncephalopathy
V-itals unstable
E-levated enzymes (LFT's)
R-igidity of muscles

Front 167

Ruel of 1/3's for schizophrenia prognosis

Back 167

⅓ good ⅓ intermediate ⅓ poor

Front 168

Name some of the 16 negative prognositc issues with schizophrenia

Back 168

• Male gender
• Younger age of onset
• Insidious onset
• Longer before tx
• Negative symptoms
• Family hx
• Poor response to tx.
• Poor compliance
• Obstetric complications
• Abnormal PMP
• Low IQ
• Poor educational hx
• Impaired social skills
• Lower SEC
• Single
• Developed country

Front 169

WRT to current concepts of pathobiology of schizophrenia, are the following increased or decreased?
?Ventricular volume
? Cerebral volume [cortical grey matter]
? Temporal lobe volume [medial temporal lobe]
Disturbed temporal lobe cytoarchitecture/function
? Frontal lobe volume [dorsolateral prefrontal cortex]
Disturbed frontal lobe cytoarchitecture/function
? Thalamic volume [mediodorsal nucleus]

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↑ Ventricular volume
↓ Cerebral volume [cortical grey matter]
↓ Temporal lobe volume [medial temporal lobe]
Disturbed temporal lobe cytoarchitecture/function
↓ Frontal lobe volume [dorsolateral prefrontal cortex]
Disturbed frontal lobe cytoarchitecture/function
↓ Thalamic volume [mediodorsal nucleus]

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Is urban or rural birthplace a higher risk for schizophrenia?

Back 170

Urban

Front 171

Peak birth month related to schizophrenia?

Back 171

February (winter) (Though lowest relative risk in comparison to other risk factors)

Front 172

Largest relative risk factor for becoming psychotic?

Back 172

Psychotic first-degree relative (RR 10)

Front 173

A mental disorder characterised by disturbances in
thinking, mood and behaviour

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Schizophrenia

Front 174

Name the 4 main types of schizophrenia

Back 174

Paranoid Schizophrenia

Front 175

Most common schizophrenia subtype, characterised by:
- Delusions of persecution
- Delusions of reference
- Delusions of exalted birth
- Delusions of bodily change
- Delusions of jealousy
- Auditory hallucinations
- Hallucinations of other modalities
- Thought disorder
- Affective abnormalities

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Paranoid schizophrenia

Front 176

Type of schizophrenia characterized by: Negative symptoms and poor prognosis, features :

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Hebephrenic schizophrenia

Front 177

Type of schizophrenia: Not seen commonly anymore, features :

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Catatonic schizophrenia

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Type of schizophrenia: Insidious onset of functional decline

Back 178

Simple schizophrenia

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Incidence of schizophrenia

Back 179

10-20/ 100 000

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Prevelance of schizophrenia

Back 180

1%

Front 181

Male to female ratio schizophrenia

Back 181

=

Front 182

Peak age of onset range schizophrenia:
Male and female

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Male : 15 – 25 years
Female: 25 – 35 years

Front 183

Name 5 risk factors for schizophrenia

Back 183

Seasonality of birth (winter)
Urban area
Prison population
Immigrant
Low social economic group

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Schizophrenia Concordance rates in MZ(____-_______%) : DZ(_________-_______%)

Back 184

Concordance rates in MZ(42-46%) : DZ(9-14%)

Front 185

Name the 4 theories of biochemical aetiology behind schizophrenia

Back 185

Dopamine, seotonin, excitatory and phospholipid membrane hypotheis

Front 186

Schizophrenia structural abnormalities:
↑ Ventricular volume

Back 186

↑ Ventricular volume

Front 187

% of cannabic user that develop schizophrenia

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1%