Step 3 Ch 19 Psychiatry 1-0

Front 1

1. 4 positive symptoms of schizophrenia?

Back 1

1. Delusions (mostly bizarre)
2. disorganized speech/behavior
3. hallucinations
4. education

Front 2

with what chemical are the positive symptoms of schizophrenia associated?

Back 2

a. Dopamine receptors

Front 3

3. with what chemical or the negative symptoms of schizophrenia associated?

Back 3

a. Muscarinic receptors (acetylcholine).

Front 4

4. Negative symptoms of schizophrenia (5)?

Back 4

1. Flattened affect
2. social withdrawal
3. anhedonia
4. apathy
5. poverty of thought.

Front 5

5. What class of medications are the most effective treatment for the negative symptoms of schizophrenia?

Back 5

a. Atypical antipsychotics.

Front 6

6. Diagnosis of schizophrenia?

Back 6

a. Positive psychosis symptoms that affect social and occupational functioning for LONGER THAN SIX MONTHS.
b. Schizophrenia presents at a younger age in males than females (15-24 vs. 25-34).

Front 7

7. when psychotic symptoms are present for <6 months but > 1 month. What is the diagnosis?

Back 7

a. Schizophrenic form disorder

Front 8

8. when the symptoms of psychosis are present for <1 month, and the question states that there is a return to baseline, what is the diagnosis?

Back 8

a. Brief psychotic disorder (look for a stressful life event that precipitates it).

Front 9

9. When there is a history of psychotic symptoms for many years with no impairment of baseline functioning, think of?

Back 9

a. Delusional disorder (the key is that delusions are non-bizarre)
b. and
c. personality disorders (especially schizotypal personality disorder, which presents with peculiar thinking and social isolation, but does not involve psychosis).

Front 10

10. How is the treatment of delusional disorder and personality disorders, such as schizotypal personality disorder different from schizophrenia?

Back 10

a. These patients do not respond to antipsychotics.
b. Psychotherapy is the preferred therapy.

Front 11

11. Management to rule out other forms of psychosis that aren't schizophrenia?

Back 11

a. Order a drug screen to rule out substance abuse.
b. Look for signs or symptoms of seizure. Temporal lobe epilepsy can present with hallucinations (auditory and a factory, distortions), feeling of déjà vu, or disassociation from surroundings.

Front 12

12. Note: watch out for suicidal ideation in schizophrenia and schizophrenia form patients.

Back 12

12. Note: watch out for suicidal ideation in schizophrenia and schizophrenia form patients.

Front 13

13. 50% of schizophrenia patients attempt suicide in their lifetimes, and 10% of these attempts are successful.schizophrenia form patients are at greater risk of depression and suicide after the episode of psychosis results.

Back 13

13. 50% of schizophrenia patients attempt suicide in their lifetimes, and 10% of these attempts are successful.schizophrenia form patients are at greater risk of depression and suicide after the episode of psychosis results.

Front 14

14. What is the first step in the management of a schizophrenia or schizophrenia form with suicidal ideation?

Back 14

a. Always hospitalize the patient If there's any risk of suicide.

Front 15

15. What is the greatest risk factor for progression to schizophrenia?

Back 15

a. Schizophreniform disorder.
b. Two thirds of eventually progressed to schizophrenia.

Front 16

16. Schizophrenia prognosis?

Back 16

a. In general, females have a better prognosis and respond better to treatment than males.
b. Patients with paranoid schizophrenia are more responsive to treatment than those with other kinds

Front 17

17. Treatment of schizophrenia?

Back 17

a. If the case describes bizarre paranoid symptoms, hospitalize the patient.
b. Give benzodiazepines for agitation in start and start antipsychotics.
1. Antipsychotic medications are given for six months and are the most effective therapy to prevent further episodes.
2. Long-term antipsychotics are only given when there is a history of repeat episodes.
c. Initiate long-term psychotherapy.

Front 18

18. What is the first step in the management of any acute psychiatric condition?

Back 18

a. To determine if the patient needs hospitalization.
b. Hospitalize the patient if there is risk of harm to self or others.
c. Hospitalized against the patients will if the patient has suicidal or homicidal ideation.

Front 19

19. What five things portend a poor prognosis with schizophrenia?

Back 19

1. Early age of onset
2. negative symptoms
3. poor premorbid functioning
4. family history of schizophrenia
5. disorganized or deficit subtype.

Front 20

20. Immediate effect of antipsychotics?

Back 20

a. Antipsychotics have an immediate quieting effect in acute psychotic attacks of any cause ( e.g.schizophrenia, depression with psychotic features, mania and bipolar disorder)
b. they also delay relapses.