Schizophrenia

Question 1

What are the three groups of symptoms seen in schizophrenia?

Answer 1

Positive
Negative
Cognitive

Question 2

Give some positive symptoms that may be seen in schizophrenia

Answer 2

Delusions
Hallucinations
Disorganised speech
Disorganised behaviour
Catatonic behaviour

Question 3

Give some negative features that may be seen in schizophrenia

Answer 3

Loss of interest
Flat affect
Alogia (poverty of speech)
Avolition (decreased motivation)

Question 4

Give some cognitive features that may be seen in schizophrenia

Answer 4

Decreased memory
Decreased learning ability
Decreased understanding

Question 5

What are the three phases of schizophrenia?

Answer 5

Prodromal
Active
Residual

Question 6

How will a patient commonly present in the prodromal phase?

Answer 6

Very withdrawn

Question 7

What sort of symptoms may be seen in the active phase?

Answer 7

Positive - delusions; hallucinations; disorganised speech/behaviour and catatonic behaviour

Question 8

What type of symptoms may be seen in the residual phase?

Answer 8

Cognitive

Question 9

Give some risk factors for schizophrenia

Answer 9

Genetics (22q11 mutation)
Birth complications
Drug use (cannabis)
Urban dwelling
Neurodevelopmental changes (enlarged ventricles)

Question 10

The diagnosis of schizophrenia requires the presence of how many first rank symptoms?

Answer 10

At least one

Question 11

Give examples of first-rank symptoms seen in schizophrenia

Answer 11

Thought echo; thought insertion/withdrawal; thought broadcasting
Delusions of control/influence/passivity
Auditory hallucinations

Question 12

The presence of two of which symptoms can also confer a diagnosis of schizophrenia?

Answer 12

Persistent hallucinations
Neologisms or breaks in train of thought causing incoherent speech
Catatonic behaviour
Blunted affect
Marked affect

Question 13

How long must symptoms of schizophrenia be present to diagnose it?

Answer 13

One month

Question 14

What class of drug is used to treat schizophrenia?

Answer 14

Antipsychotics

Question 15

How do antipsychotics generally work?

Answer 15

Block D2 receptors

Question 16

What are the main typical antipsychotics?

Answer 16

Thioridazine
Chlorpromazine
Haloperidol

Question 17

What are the two main side effects of typical antipsychotics?

Answer 17

Extrapyramidal side effects

Hyperprolactinaemia

Question 18

Give some extrapyramidal side effects caused by typical antipsychotics

Answer 18

Acute dystonic reaction
Parkinsonism
Akathisia
Tardive dyskinesia

Question 19

What are the main features of Parkinsonism?

Answer 19

Tremor
Rigidity
Postural instability
Bradykinesia

Question 20

Give some effects of hyperprolactinaemia due to typical antipsychotics

Answer 20

Galactorrhoea
Gynaecomastia
Erectile dysfunction

Question 21

What are the main atypical antipsychotics?

Answer 21

Aripiprazole
Risperidone
Quetiapine
Olanzipine
Clozapine

Question 22

What receptor is partially blocked by clozapine?

Answer 22

D4

Question 23

Give some general effects of atypical antipsychotics

Answer 23

Histamine blockade
Metabolic syndrome
Alpha 1 - adrenergic blockade
Muscarinic blockade

Question 24

Give some side effects due to histamine blockade

Answer 24

Sedation

Increased appetite

Question 25

What can be caused by metabolic syndrome?

Answer 25

Increased weight

Diabetes

Question 26

Alpha-adrenergic blockade can lead to what physiological state?

Answer 26

Hypotension

Question 27

What are the four main effects of muscarinic blockade?

Answer 27

Dry mouth
Blurred vision
Constipation
Urinary retention

Question 28

Clozapine must be closely monitored as it can cause what side effects?

Answer 28

Agranulocytosis

Myocarditis