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31 Cards in this Set
- Front
- Back
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What is the Dx of Schizophrenia?
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two or more of the following present for a significant portion of time during a 1 month period:
delusions hallucinations disorganized speech grossly disorganized or catatonic behavior negative symptoms (affect flattening, alogia, avolition, apathy) only one criteria if bizarre or hallucinations of two voices talking together/running commentary > 6 mo |
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What is the Dx if symptoms of schizophrenia but < 6 mo?
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schizophreniform
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What are some schizophrenia subtypes?
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paranoid
disorganized catatonic echolalia or echopraxia |
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What % of the population is affected by schizophrenia?
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1-2% of the population
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What is the typical onset of symptoms of schizophrenia?
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17-27 males
17-37 females |
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What % of cases of schizophrenia have onset after 45 years of age?
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10
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Presence of proband with schizophrenia significantly increases the prevalence of ___.
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schizoid
schizotypal personality disorders shizoaffective disorder delusional disorder |
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What % of schizophrenia is genetic? due to environment?
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50/50
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What aberrant neuro-developmental processes are assocaited with schizophrenia?
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increase in the normal age-associated pruning of frontoparietal synapses that occur in adolescence and young adulthood
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What is the proposed pathophysiology for schizophrenia?
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excessive activity in the mesocortical and mesolimbic pathways
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What is more debilitating regarding social and occupational impairment in schizophrenic patients?
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negative symptoms
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What % of patients with schizophrenic patients do not return to pre-illness level of social and vocational functioning?
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>90%
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What % of schizophrenic patients die by suicide?
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10%
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What is the rule of thirds for schizophrenia?
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1/3 have severe symptoms & social/vocational impairment and repeated hospitalizations
1/3 have moderate symptoms and social/vocational impairment and occasional hospitalizations 1/3 have no further hospitalizations but typically have residual symptoms, chronic interpersonal difficulties and most cannot maintain employment |
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Do positive or negative symptoms respond better to treatment?
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positive
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What is the mainstay of treatment of schizophrenic?
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antipsychotics
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What is the rational for using an atypical antipsychotic as first line in treatment of schizophrenia? What are the SE?
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reduced risk of tarditive dyskinesia
weight gain, metabolic syndrome, elevated lipids, type II diabetes |
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What is the risk of tarditive dyskinesia per year? What population displays it the most?
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3-5%
older women with affective disorders |
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In what population is the risk for dystonic reaction after treatment for schizophrenia the highest?
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young males
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What do you need to dx major depressive disorder with psychotic features?
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meets criteria for major depressive episode
also has psychotic symptoms no psychotic symptoms during euthymia |
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What is the treatment for major depressive disorder with psychotic features?
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treat depression
start antipsychotic |
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How do you make the dx for bipolar disorder manic or mixed with psychotic features?
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currently manic or mixed and is exhibiting psychotic features
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How do you treat bipolar disorder manic or mixed with psychotic features?
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treat with mood stabilizer and antipsychotic
if patient is mixed and not responding to meds consider ECT |
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How do you make the dx of schizoaffective disorder?
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an uninterrupted period where there is either a major depressive episode, manic episode or mixed episode while criterion for schizophrenia are met
there also has been periods where there have been delusions or hallucinations for > 2 weeks without prominent mood symptoms symptoms that meet criteria for a mood disorder are present for a substantial portion of the illness |
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What is the lifetime prevalence of schizoaffective disorder?
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0.7%
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What does the treatment of schizoaffective disorder entail?
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antipsychotics are the mainstay
if depressed type use antidepressants as well if bipolar type often need to use mood stabilizer as well |
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How do you make the dx of delusional disorder?
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nonbizarre delusions of at least 1 month duration
criterian A for schizophrenia has never been met apart from the impact of delusions, functioning is not markedly impaired it is not due to a mood or substance |
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What is the lifetime prevalence of delusional disorder?
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0.7%
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What are the subtypes of delusion disorder?
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erotomanic
grandiose persecutory jealous somatic mixed |
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What general medical conditions can cause a psychotic disorder?
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brain tumors
seizure disorder delirium huntington's dx multiple sclerosis cushings vitamin deficiencies electrolyte abnormalities thyroid disorders uremia SLE HIV Wellburtin anabolic steroids corticosteroids antimalarial drugs |
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How do you dx brief psychotic disorder?
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presence of one or more of the following:
delusions hallucinations disorganized speech disorganized or catatonic behavior duration of episode is < 1 month with eventual return to premorbid level of functioning |
