Term
| What is the prevalence of schizophrenia in the US? |
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Definition
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Term
| What is the peak age of onset of schizophrenia? |
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Definition
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Term
| what percent of schizophrenics have a significant concurrent medical illnes? |
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Definition
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Term
| Are schizophrenics at risk for suicide? |
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Definition
| about 50% attempt at least once in their lifetime; 10-15% die of suicide |
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Term
| Is there a relationship between substance use/abuse and schizophrenia? |
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Definition
| 75% smoke; 30-50% alcohol abuse; 15-25% cannabis; 5-10% cocaine |
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Term
| How do you diagnose schizophrenia with criteron A? |
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Definition
| two ro more of the following each present for a significant portion of time during a 1 month period (or less if treatment is used): delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms |
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Term
| What are the negative symptoms of schizophrenia? |
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Definition
| affective flattening, alogia, or avolition |
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Term
| Only one criterion A symptoms is required to dx schizophrenia if... |
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Definition
| delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other |
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Term
| What is criteron B for schizophrenia diagnosis? |
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Definition
| social/occupational dysfunction |
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Term
| What is the criterion C for dx of schizophrenia? |
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Definition
| duration (at least six months with 1 month of symptoms or less if successfully treated) |
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Term
| Schizoaffective disorder and mood disorder with psychotic features can be ruled out in a dx of schizophrenia by... |
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Definition
| mood symptoms don't occur with active phase symptoms or their duration has been breif relative to duration of active and residual periods |
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Term
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Definition
| substance/general medical condition exclusion |
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Term
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Definition
| no relationship to a pervasive developmental disorder |
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Term
| What is a formal thought disorder? |
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Definition
| a process affecting the relationship and associations among the words used to express thought |
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Term
| What symptoms reflective of disturbance in process are suggestive of schizophrenia? |
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Definition
| intrusive thoughts, flight of ideas, though blocking, circumstantial thought, tangential thought, looseness of association, clanging |
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Term
| What are the different types of schizophrenic delusions? |
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Definition
| paranoid or persecutory, grandiose, somatic or bizarre |
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Term
| What are the disturbances in thought content experienced by schizophrenics? |
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Definition
| delusions, ideas of reference, thought broadcasting, thought insertion, thought withdrawal |
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Term
| What do you call a false interpretation of a real perception? |
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Definition
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Term
| What are the emotional disturbances of schizophrenia? |
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Definition
| blunting or flattening of affect, inappropriate affect, hostile affect |
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Term
| what are the behavioral disturbances of schizophrenia? |
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Definition
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Term
| List the subtypes of schizophrenia. |
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Definition
| paranoid, disorganized, catatonic, undifferentiated, residual |
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Term
| What is paranoid schizophrenia? |
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Definition
| systematized delusions or hallucinations that involve a single theme, without prominent symptoms of disorganization or a flattened or inappropriate affect |
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Term
| What is disorganized schizophrenia? |
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Definition
| patients present with disorganized speech and behavior and a flat or inappropriate affect |
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Term
| What is catatonic schizophrenia? |
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Definition
| disturbed psychomotor behavior such as rigidity, bizarre posturing, mutism, extreme excitment, or negativism |
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Term
| What is residual schizophrenia? |
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Definition
| presistent residual symptoms such as emotional blunting, avolition, or odd beliefs, in the absence of gross psychotic symptoms or behaviors |
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Term
| What is schizophreniform disorder? |
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Definition
| symptoms the same as schizophrenia except more than one month and less than six months |
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Term
| What is schizoaffective disorder? |
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Definition
| major depressive, manic or mixed episode occurring simultaneously with the characteristic criterion A symptoms of schizophrenia |
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Term
| What is delusional disorder? |
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Definition
| essential feature is a nonbizarre delusion of at least one months duration that is not accompanied by hallucinations, disorganized speech, catatonic behavior, negative symptoms, markedly impaired functioning, or bizarre behavior |
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Term
| what is a brief psychotic disorder? |
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Definition
| delusions, hallucinations or disorganized speech or behavior present for at least one day but for less than one month. After this brief period, pts return to full premorbid functioning |
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Term
| Chance of being schizophrenic if one of your parents is? both? |
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Definition
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Term
| Chance of being schizophrenic if your monozygotic twin is? |
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Definition
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Term
| Chance of being schizophrenic if your aunt/uncle is? |
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Definition
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Term
| Model that explains what causes schizophrenia? |
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Definition
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Term
| What is the neuropathology of schizophrenia? |
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Definition
| lateral and 3rd ventricle enlargement with some decrease in cortical volume, hippocampus, amygdala and parahippocampal gyrus are reduced, hypoactivity of frontal lobe, nonspecific abnormalities in EEG |
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Term
| Where do the original antipyschotic come from? |
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Definition
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Term
| What were the original antipsychotics? |
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Definition
| chlorpromazine (thorazine) class of phenothiazines |
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Term
| How does chlorpromazine (thorazine) work? |
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Definition
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Term
| What are dopaminergic cell bodies located? |
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Definition
| ventral tegmental area, substantia nigra, and hypothalamus |
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Term
| Which dopamine receptors are D1 like? |
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Definition
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Term
| Which dopamine receptors are D2 like? |
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Definition
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Term
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Definition
| deficits in spatial learning and consume less alcohol |
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Term
| What's the difference between D1 and D5? |
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Definition
| D5 has 10 fold higher affinity for dopamine than D1 |
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Term
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Definition
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Term
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Definition
| only in limbic areas--cognitive and emotional control |
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Term
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Definition
| locomotor supersensitivity to EtOH, cocaine, amphetamine |
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Term
| What dopaminergic pathway is associated with which symptoms/side effects? |
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Definition
| mesolimbic (pos symptoms), mesocortical (neg symptoms), nigrostriatl (EPS), tuberoinfundibular (increased prolactin) |
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Term
| Name some typical antipsychotics? |
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Definition
| thorazine, stelazine, Navane, Haldol |
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Term
| What is the generic name for stelazine? |
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Definition
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Term
| What is the generic name for navane? |
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Definition
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Term
| Name some atypical antipsychotics? |
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Definition
| clozapine, Risperidone, Olanzapine, quitiapine, Ziprasidone, Aripiprazole, paliperidone, asenapine, Iloperidone |
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Term
| What is the generic name for risperidal? |
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Definition
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Term
| What is the generic name for zyprexa? |
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Definition
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Term
| What is the generic name for seroquel? |
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Definition
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Term
| What is the generic name for geodon? |
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Definition
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Term
| What is the generic name for abilify? |
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Definition
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Term
| What are the side effects of antipsychotics by receptor? |
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Definition
| antihistaminic (sleep; weight), antiadrenergic (dizzy; orthostasis); anticholinergic (dry mouth, constipation, blurred vision), anti dopaminergic (efficacy) |
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Term
| How do atypical antipsychotics work? |
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Definition
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Term
| How do atypicals have lower side effects? |
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Definition
| block serotonin which inhibits dopamine in the nitrostriatl tract |
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Term
| How does aripiprazole work? |
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Definition
| unique emchanism of action being a partial agonist at D2 (also an antagonist at 5 HT2 and partial agonist at 5HT1A) |
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Term
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Definition
| low affinity for D2; binds preferentially to D1 and D4. Acts selectively on mesocortical and mesolimbic tracts |
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Term
| What antipsychotic is used in treatment refractory cases? |
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Definition
| clozapine (however, there are numerous side effects) |
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Term
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Definition
| extrapyramidal symptoms (akathisia, dystonia, parkinsonian symptoms, tardive dyskinesia) |
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Term
| How do you treat akathisia caused by antipsychotics? |
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Definition
| lower dose, add beta-blocker, or add benzodiazepine |
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Term
| How do you treat dystonia? |
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Definition
| anticholinergic agents (give IM emergently) |
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Term
| How do you treat antipsychotic side effect of parkinsonian symptoms? |
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Definition
| lower dose or maintenence anticholinergic agent |
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Term
| What causes neuroleptic malignant syndrome? |
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Definition
| acute disturbance of thermoregulation and neuromotor control |
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Term
| What is the clinical presentation of neuroleptic malignant syndrome? |
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Definition
| fever, lead pipe rigidity, autonomic dysfunction, altered mental status, inc CPK, inc WBC, inc LFTs, myoglobinurea |
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Term
| How do you treat neuroleptic malignant syndrome? |
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Definition
| supportive care, dantrolene, bromocriptine |
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Term
| What is the prognosis of neuroleptic malignant syndrome? |
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Definition
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Term
| Which side effects are specific for clozapine? |
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Definition
| seizures, hypersalivation, hypotension, agranulocytosis |
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Term
| What are side effects of antipsychotics? |
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Definition
| seizures, sedation, cognitive dulling, anticholinergic effects, hypersalivation, hypotension, risk of arrhythmia, skina nd eye changes, elevated prolactin, weight gain, agranulocytosis |
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Term
| Besides schizophrenia, what else can you use antipsychotics for? |
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Definition
| bipolar disorder, treatment resistant depression, treatment resistant OCD, PTSD, impuse control disorders, MR, personality d/os, dementia, delirium |
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