Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
26 Cards in this Set
- Front
- Back
|
Which of the following brain regions appears abnormal in schizophrenia?
A) Medulla oblongata B)Optic chiasm C)Prefrontal cortex D)Reticular activating system E)Third ventricle |
C) prefrontal cortex
|
|
|
A 34 year old woman complains that she is gaining weight since she started taking chlorpromazine for chronic undifferentiated schizophrenia. A complete review of systems and history shows evidence of breast enlargement and lactation. However, a serum pregnancy test is negative. Which of the following neuroleptics would be a good choice for a treatment change?
A)Fluphenazine B)Haloperidol C)Risperidone D)Thioridazine E)Ziprasidone |
E)Ziprasidone
doesnt cause hyperrolactinemia (which all the others do) |
|
|
A 21 year old man is brought to the emergency department by his family. They report that he has been acting strangely for the past 2 weeks since coming home abruptly from college in the middle of the semester. In addition, they mention his rapid speech. The man states that he has been hearing voices and seeing small creatures out the corner of his eye. He presents with an agitated and restless manner. Which of the following is the next appropriate treatment step?
A) Send the patient to the nearest state hospital for treatment B) Order psychological testing C) interview the family to complete a genogram D) Perform a complete physical exam and consider laboratory tests E) Start a depot neuroleptic agent |
D) Perform a complete physical exam and consider laboratory tests
gotta do it to rule out medical causes |
|
|
A 40 yo man presents to a mental health center complaining that his neighbors have been spying on him. He reports a complicated delusion: the Internal Revenue Service is conspiring to take away his home. He denies any hallucinations or mood changes, and he has been able to work as a truck mechanic without loss of function. Which of the following diagnoses is most appropriate?
A) Delusional disorder B) Major depression with psychotic features C)Schizoaffective disorder D) Schizophrenia E) Schizophreniform disorder |
A) Delusional disorder
lacks the global functional detrioration seen in pts with SZ or shizophreniform schizoaffective or psychotic depression requires substantial mood changes |
|
|
A 29 yo man who lives in a group home and takes fluphenazine on a daily basis develops a high fever and muscle rigidity. The man undergoes examination and testing at the local emergency department, where a creatine phosphokinase value comes back as 10,000. Which of the following therapeutic steps should be taken next?
A)Send the pt home with instructions to take acetaminophen every 4 hrs B)Send the pt home on an atypical antipsychotic C) Admit the pt to an ICU D)Admit the pt to a state hospital E)Send the pt home on benztropine (1 mg tid) |
C) Admit the pt to an ICU
pt has neuroleptic malignant syndrome |
|
|
A 29 yo man who lives in a group home and takes fluphenazine on a daily basis develops a high fever and muscle rigidity. The man undergoes examination and testing at the local emergency department, where a creatine phosphokinase value comes back as 10,000. The pt has been hospitalized but plans to return to the community. The treating psychiatrist recommends which of the following changes in the medication regimen?
A) Changing to fluphenazine decanoate B) Changing to haloperidol C) changing to olanzapine D) Adding benztropine E) adding lithium |
C) changing to olanzapine
switching to an atypical neuroleptic would reduce the risk of another episode |
|
|
Which of the following neurotransmitters is believed to play the most critical role in the development of and treatment of schizophrenia?
A)acetylcholine B)norepinephrine C)phospholipid D)protein G E) serotonin |
E) serotonin
|
|
|
A disheveled 27 yo man presents with bizarre movements, agitated behavior, and rapid and unintelligible speech. The patient has had signs of psychosis for much of the past few months, and the family reports that the patient twice spent a month in state psychiatric hospitals. Which of the following schizophrenic subtypes can most appropriately be applied to this pt?
A) Catatonic B) Chronic undifferentiated C) Paranoid D) Residual |
A) Catatonic
catatonia is distinguished by either dramatic increase or decrease in motor activity. the others don't involve significant changes in movements |
|
|
A 45 yo woman with no psychiatric history presents with discheveled appearance, almost mute speech, and thought blocking of several months' duration. She also fears that her internal organs have been stolen by a transplant surgeon to be used in a military robot. Which of the following diagnoses is most appropriate?
A)Bipolar disorder B)Borderline personality disorder C)delusional disorder D)Schizoaffective disorder E)Schizophrenia |
E)Schizophrenia
SZ onset is later in women. Bipolar or szaffective would have had prior episodes. Pt deteriorated too much to have delusional disorder; psychotic too long to have psychosis in a personality disorder |
|
|
A 24 yo man is discharged from the psychiatric ward with a diagnosis of paranoid schizophrenia. Four weeks after discharge, he tells his psychiatrist that he stopped taking his meds 2 days ago. Which of the following interventions is most appropriate?
A) Hospitalize the Pt in a psych ward B) switch to a depot antipsychotic C) refer for psychotherapy D) inquire about side effects from the medication E) discharge the pt from the clinic |
D) inquire about side effects from the medication
side effects are a common cause of nonadherence to tx |
|
|
A 24 yo man is discharged from the psychiatric ward with a diagnosis of paranoid schizophrenia. Four weeks after discharge, he tells his psychiatrist that he stopped taking his meds 2 days ago. He reports that although he receives Social Security Disability Income (SSDI) he has not been able to afford all of his medication. Which of the following interventions is most appropriate?
A)Rehospitalize the pt in a psychiatric ward B)Switch to a less expensive antipsychotic C) Refer the pt for psychotherapy D)Inquire into how he has budgeted his money E)Discharge the pt from the clinic |
D)Inquire into how he has budgeted his money
|
|
|
A 24 yo man is discharged from the psychiatric ward with a diagnosis of paranoid schizophrenia. Four weeks after discharge, he tells his psychiatrist that he stopped taking his meds 2 days ago. He reports that he has been giving much of his money away to panhandlers. Which of the following interventions is most appropriate?
A)Rehospitalize the pt in the psychiatric ward B)Refer the patient for case management C) Refer the pt for psychosurgery D) Inquire into how he can get a larger disability check E)Discharge the pt |
B)Refer the patient for case management
|
|
|
Schizophrenia may develop as a result of which of the following factors?
A)schizophrenigenic fathers B)Expressed emotions C)living in rural areas as opposed to cities D) schizophrenigenic mothers E)Polygenic transmission |
E)Polygenic transmission
industrialized areas increase risk |
|
|
What is the most consistent finding in brain structural abnormalities in schizophrenia?
A) enlargement of the third ventricle B)loss of CSF C)enlargement of the lateral ventricles D)increased size of the thalamus E)abnormalities in the cell architecture in the prefrontal cortex |
C)enlargement of the lateral ventricles
|
|
|
The increase in risk of developing schizophrenia for persons born after the Dutch hardship winter (1945-46) is explained by which of the following factors?
A)Poor prenatal malnutrition B) expressed emotions C) living in industrial areas as opposed to rural areas D)good obstetric care E) polygenic transmission |
A)Poor prenatal malnutrition
|
|
|
A) Anticholinergics
B) atypical neuroleptics C)Barbiturates D)Benzos E) Depot haloperidol a pt who is sometimes agitated has been tried on several different typical and atypical antipsychotics with little success |
D)Benzos
the agitation of akathisia can be treated with benzos |
|
|
A) Anticholinergics
B) atypical neuroleptics C)Barbiturates D)Benzos E) Depot haloperidol a pt on thiothixene who develops a pill-rolling tremor and suffling gate |
A) Anticholinergics
anticholinergics are indicated for treating EPS that occur as a result of neuroleptic use. |
|
|
A) Anticholinergics
B) atypical neuroleptics C)Barbiturates D)Benzos E) Depot haloperidol A pt who has a positive response to antipsychotic medication int he hospital but becomes noncompliant shortly after five discharges in 1 year |
E) Depot haloperidol
proven way to better ensure compliance in such a "heavy-dose" pt. |
|
|
A) Anticholinergics
B) atypical neuroleptics C)Barbiturates D)Benzos E) Depot haloperidol A pt whose hallucinations respond to haloperidol but severe negative sx prevent successful discharge from the state hospital |
B) atypical neuroleptics
atypicals are best for tx of negative sx |
|
|
A) Brief psychotic disorder
B)Delusional disorder C)Schizoaffective disorder D)Schizophrenia E)Schizophreniform disorder A pt presents with hallucinations and bizarre delusions lasting 8 weeks |
E)Schizophreniform disorder
schizophreniform disorder involves psychotic sx lasting longer than 2 weeks but less than 6 mo |
|
|
A) Brief psychotic disorder
B)Delusional disorder C)Schizoaffective disorder D)Schizophrenia E)Schizophreniform disorder A pt presents with periods of mood disturbance with psychosis and periods of psychosis with-out mood disturbance over the past 3 years |
C)Schizoaffective disorder
schizoaffective disorder involves both periods of mood disturbance with psychosis and periods of psychosis without mood disturbance |
|
|
A) Brief psychotic disorder
B)Delusional disorder C)Schizoaffective disorder D)Schizophrenia E)Schizophreniform disorder A patient presents with a second lifetime episode of hallucinations and bizarre delusions that again lasts only a few days |
A) Brief psychotic disorder
brief psychoitc disorder involves periods of psychosis lasting less than 1 month. this disorder can recur later in life |
|
|
A) Brief psychotic disorder
B)Delusional disorder C)Schizoaffective disorder D)Schizophrenia E)Schizophreniform disorder A pt who otherwise appears normal presents with a 5-month belief that a champion race car driver has fallen madly in love with her; she believes he demonstrates his love by painting the pts age as the number on his car |
B)Delusional disorder
this is erotomanic type (higher status person falls in love with you) |
|
|
Chose the best neuroleptic for the clinical scenario
A)Aripiprazole B)Chlorpromazine C)Clozapine D)Olanzapine E)Ziprasidone A pt presents with persistent suicide attempts after tx with fluphenazine, risperidone, and quetiapine. |
C)Clozapine
clozapine appears to convey particular benefits in psychotic pts with tendencies to attempt suicidal or aggressive behaviors |
|
|
Chose the best neuroleptic for the clinical scenario
A)Aripiprazole B)Chlorpromazine C)Clozapine D)Olanzapine E)Ziprasidone A severely overweight pt presents with cardiac conduction abnormalities after myocarditis from clozapine |
A)Aripiprazole
aripiprazole and ziprasidone have the lowest weight gain risk, but zuprasidone can cause QTc prolongation |
|
|
Chose the best neuroleptic for the clinical scenario
A)Aripiprazole B)Chlorpromazine C)Clozapine D)Olanzapine E)Ziprasidone a pt reporting an allergy to ziprasidone requires intramuscular administration of a neuroleptic in the ED |
D)Olanzapine
only olanzapine and ziprasidone have currently available IM formulations |
