Term
| The structural changes involved in schizophrenia include _______ |
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Definition
| Increased ventricle size, decrease in brain size, decrease in hippocampal volume, reduction in the medial temporal lobe size. |
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Term
| In schizophrenia, there is a _______ of glutamatergic activity that has similar symptoms as _________ |
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Definition
| deficiency, hyperactivity |
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Term
| Patients with abnormal brain scans have _________ of 5HT, which corresponds with ________. Present on the DA axons, stimulation of these receptors __________ in the striatum. |
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Definition
| higher concentrations, larger ventricles. Decreases DA release. |
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Term
| The 5 symptoms of schizophrenia. Each must be present over a period of _____ |
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Definition
| Delusions, hallucinations, disorganized speech, grossly disorganized/catatonic behavior, negative symptoms. 1 month. |
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Term
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Definition
| Paranoid, disorganized, catatonic, undifferentiated, residual. |
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Term
| The positive symptom clusters |
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Definition
| Suspciousness, unusual thought content (delusions), hallucinations, conceptual disorganization |
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Term
| the negative symptom clusters |
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Definition
| Affective flattening, alogia, anhendonia, avoltion |
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Term
| The cognitive symptom clusters |
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Definition
| impaired attention, working memory, and executive funxion |
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Term
| The 3 most responsive target symptoms to treatment are_____. The 3 least responsive are____. |
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Definition
| combatitiveness, tension and hyperactivity, hallucinations; realistic planning, judgement, insight. |
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Term
| Severe muscle spasms, that are painful and acute in onset and potentially life threatening are _______. They occur within _____ of initiating or increasing dose. |
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Definition
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Term
| Treatment for Dystonias are _______. They may be repeated after _______ |
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Definition
| Benztropine (2mg IM), Diphenhydramine (50mg IM/IV), Lorazepam (1-2 mg IM). 15 mins. |
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Term
| Pseudoparkinsonism can be characterized by_______. Onset is _____ after increase or initiation of dose. |
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Definition
| pill rolling tremor, bradykinesia, cog-wheel rigidity, postural instability. 1-2 weeks. |
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Term
| Pseudoparkinsonism can be treated with: |
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Definition
| diphenhydramine (25mg to 50 mg TID), biperiden (2 mg TID) and amantadine (controversial) |
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Term
| The inability to sit still; inner restlessness is______ |
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Definition
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Term
| Akathisia can be treated by: |
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Definition
| propranolol (up to 160mg/d), BZDs (controversial in substance abuse), changing meds. Anticholinergic agents are INEFFECTIVE. |
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Term
| Abnormal involuntary movements, including the orofacial movements of lip smacking, lateral jaw movements, as well as quick jerky extremity movements is ________. Onset typically occurs _____ |
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Definition
| tardive dyskinesia; late in therapy (>6 mos) |
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Term
| _________ are used to treat tardive dyskinesia |
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Definition
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Term
| There are metabolic complications that may arise in the case of schizo tx. The parameters that should be monitored are________, and measurements for them should be taken______. |
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Definition
| Personal history & waist circumference (baseline & annual), BMI (basline, 4, 8, 12 wks and quarterly), BP, fasting plasma glucose (baseline, 12 wks, and anually), and fasting lipids (baseline and every 12 wks) |
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Term
| NMS is a potentially fatal reaction whose symptoms occurwithin ______. Cardinal symptoms include________ |
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Definition
| 24-72h; >100.4 temp, altered mental status, autonomic dysfxn (diaphoresis, labile BP, tach), muscle rigidity, non-specific labs. |
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Term
| Tx for NMS include_____. In the future, use a ______ in the event of psychosis. |
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Definition
| stopping meds, supportive care w/ IV fluids, bromocriptine (reverse DA blockate) and dantrolene (skel muscle relaxant). Atypical. |
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Term
| ECG changes may be seen in______. Discontinue if QTc ____ |
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Definition
| ziprasidone, thioridazine (BBW) & mesoridazine (BBW) >500msec |
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