schizophrenia (1) Flashcards
(148 cards)
1
Q
is schizo a split personality disorder?
A
no
2
Q
is schizo a source of violence or danger
A
no
3
Q
what is the hallmark of schizophrenia
A
psychosis
4
Q
what is altered cognition, disorganized thoughts, and altered perception, impaired reality
A
psychosis
5
Q
what is the age onset of schizo
A
late adolesence or early adult (15-25)
6
Q
what classifies a schizo diagnosis as a childhood onset
A
before 15
7
Q
what classifies a schizo diagnosis as a late onset
A
after 40
8
Q
what is the prodromal phase of schizo
A
a “forewarning” phase
9
Q
which phase of schizo has deteriorating function, social withdraw, functional impairment, sleep disturbance, anxiety, irritability, depression, poor concentration, and fatigue
A
prodromal
10
Q
what are the DSM 5 criteria for schizophrenia
A
1) delusion
2) hallucination
3) disorganized speech
4) grossly disorganized or catatonic behavior
5) negative symptoms
11
Q
how many of the DSM 5 criteria is needed for a schizo diagnosis, and what do they need to be
A
need 2 or more of the criteria, but at least one of them needs to be delusion, hallucination, or diorganized speech
12
Q
how long does the acute phase of schizo last
A
at least 6 months, with 1 month of symptoms
13
Q
what do you have to rule out before schizo diagnosis
A
schizoaffectove mood, substances, meds, conditions, ASD
14
Q
describe positive schizo sx
A
add things that the rest of us dont have
15
Q
examples of positive symptoms
A
hallucinations adn delusions
16
Q
describe negative symptoms
A
miss things typical people have
17
Q
examples of negative symptoms
A
lack of pleasure, cant keep goals for themselves
18
Q
describe cognitive schizo sx
A
affect ability to think/function
19
Q
describe affective schizo sx
A
can’t express emotion well
20
Q
what kind of sx is a persecutory delusion
A
positive
21
Q
what is a persecutory delusion
A
believe a person is out to get you, constantly scared
22
Q
what kind of sx is a grandiose delusion
A
positive
23
Q
describe grandiose delusion
A
exaggerated importance, think they are president, jesus, famous
24
Q
what kind of sx is a referantial delusion
A
positive
25
describe referential delusion
everything pertains to you, "newspaper articles are all about me"
26
describe control or influence delusions
believe someone else has control over you
27
describe soamtic delusions
body based, patient soaked body in bleach to "get rid of alien eggs"
28
describe nihilistic delusions
end of the world
29
describe religiosity delusions
everything is religiously influenced, obsessive
30
describe erotomantic delusion
think someone loves you, might not even know them
31
what kind of sx are speech alterations
positive
32
describe associative looseness
talking all over the place
33
describe word salad "schizophasia"
real words are jumbled up and person doesn't realize
34
describe clang associations
use words based on sound and rhyme
35
describe neologisms
made up words
36
describe echolalia
like a parrot, echoes what others say
37
describe circumstantiality
give lots of details but eventually gets to the point
38
describe tangentiality
goes on a tangent, never answers questions
39
describe pressured speech
really fast talking, can't get a word in, too excited
40
describe flight of ideas
absolutely does not make sense
41
describe symbolic speech
think of blood draws as "evil demons doing their mission to suck blood"
42
what kind of symptom is disorganized thinking
positive
43
describe cognitive retardation
slowing of thoughts
44
describe thought blocking
forget what you're saying int he middle of a sentence
45
describe thought insertion
believe other people put thoughts into their head (controlled delusion)
46
describe thought deletion
believe someone took thougts from them
47
describe magical thinking
they think their thoughts affect others
ex. get mad, wish someine harm, they actually get hurt, believe you caused it
48
describe depersonalization vs. derealization
depersonalization: something about yourself feels strange, out of body
derealization: reality seems odd
49
what are the most common hallucinations
auditory
50
what are command hallucinations?
tells someone to do something or shows them something, DANGEROUS
51
what are illusions
has a real basis in reality, but is perceived different
(sees a picture, thinks its talking)
52
what is derealization?
reality seems weird/altered
53
what is a pronounced increase or severe decrease in movement
catatonia
54
what is the term for when muscles go rigid in decreased catatonia?
catalepsy
55
describe waxy flexibility
limbs stay where they are put
56
what kind of movement is less severe than catatonia - slowed movement
motor retardation
57
which movement is less severe than catatonic excitement - mild - a tension relieving activity - fidgety - just can't relax
motor agitation
58
what are stereotypes behaviors?
seen in ASD, reperitive behavior
59
what is negativism behavior
very resistant to advice or wishes
59
what is echopraxia
repeated movement
60
describe gesturing / posturing
stands or hold body in a weird way
61
what kind of sx is anhedonia
negative
62
describe anhedonia
inability to experience pleasure
63
describe avolition
hard time with motivation, hard to do tasks
64
what kind of sx is avolition
negative
65
what kind of sx is alogia
negative
66
describe alogia
does not use a lot of words
67
what kind of sx is asociality
negative
68
descirbe asociality
do not seek out people and connections
69
what kind of sx is apathy
negative
70
describe apathy
does not care about anything
71
describe affective blunting in schizo
a minimal response
-flat affect
-constricted (sad/anger only)
-inappropriate emotional response for situation
-bizarre
72
is affective blunting positive or negative
negative
73
is anosognosia a positive or negative symptom
negative
74
describe anosognosia
do not believe they are sick
75
describe symptoms of the maintenance phase of schizo compared to the symptoms of the acute and prodromal phase
symptoms of the acute phase are gone, but symptoms of the prodromal phase are the new baseline
76
how is impairment affected between schizo episodes
impairment increases between each episode
77
describe affect and impairment in the maintenance phase
flatt affect and role functioning impairment
78
which neurochemical is strongly linked to schizo
dopamine
79
which environmental toxins can be linked to schizo
tetracholoroethylene (used to be used in laundry/pipes)
80
which drug is often a trigger of schizo
marijuana
81
what prenatal stressors can cause schizo
poor nutrition, hypoxia, infections, substance use / nicotine & marijuana too
82
describe ventricles in schizo
enlarged lateral cerebral ventricles, 3rd ventricle dilation
83
which part of the brain will atrophy in schizo
cerebellum
84
what happens to the fissures in schizo
increase in size
85
what happens to connectivity of brain region in schizo
reduced connectivity
86
what are osychological rish factors for schizo?
stress, childhood trauma, ACE events, downward shift hypothesis
87
describe the downward shift hypothesis
decreased socioeconomic status, exposed to more bacteria/viruses, worse nutrition, decreased prenatal care, etc.
88
substance/nicotine use related to antipsychotics
will decrease effectiveness
89
what are some comorbiditeis with schizo
substance use, anxiety, depression, suicide, physical illness, POLYDIPSIA
90
what can polydipsia lead to in schizo
water toxicity, hyponatremia, confusuin
91
what makes up schizoaffective disorder
bipolar + schizophrenia
92
what is worse, schizophrenia or schizoaffective disorder?
schizophrenia
93
what disorder is where you have one delusion but no other symptoms of schizo
delusional disorder
94
which disorder is where you develop a disorder from another person close to you
shared psychotic disorder (folie a deux)
95
increased levels of which chemical can cause psychotic disprder (related to hepatic system)
ammonia
96
describe individual psychotherapy for schizo
REALITY ORIENTED, improve compliance, enhance functioning,
97
discuss group therapy for schizo
discuss real life plans, problems, relationships, decreases social isolation and improves reality testing
98
what does behavior therapy focus on for schizo
reduce bizarre, disturbing, deviating behavior
99
what is milieu therapy
therapeutic environment
100
what kind of meds are used for schizo
antipsychotics (neuroleptics)
101
what is the main 1st gen antipsychotic given
haloperidol (haldol)
102
what is the ling acting injectible form of haldol
haloperidol deconate
103
what are 1st gen antipsychotics good at doing?
removing positive sx
104
what kind of antipsychotics can help remove negative sx
atypical 2nd gen
105
what gen antipsychotic is used for bipolar mania
atypical 2nd gen
106
what is the most important atypical 2nd gen antipsychotic
paliperidone (invega)
107
which organ are antipsychotics very hard on
liver
108
which lab shows impaired liver function
LFTs
109
what med can not be given for myloproliferative disorders if a patient is on antipsychotics?
clozapine
110
what is the BBW for antipsychotics?
there is an increased incidence of death in elderly with neurocognitive disorders (stroke)
111
hownwill antipsychotics interact with the heart (EKG effects)
prolonged QT
112
what kind of cardiac meds should not be given with antipsychs?
other meds that prolong QT
113
is a patients QTc is greater than 500, what med can they not give?
ziprasidone
114
why is a high QTc bad?
increased risk of VT / Vfib
115
what effects come from anticholinergics, and what should you do to prevent them?
they dry everything up, ice chips, fluids, increase fiber
116
what can anticholinergic toxicity cause?
altered mental status
117
what are side effects of blocking alpha adrenergic receptors
ortho hypotension, refelx tachycardia, tremors
118
what side effects do histamine blockades cause
weight gain/sedation
119
what med should probably not be given to an overweight person
olanzapine (histamine blocker)
120
whay is important to know for women who take antipsychotics?
they need contraceptives, these meds are teratogenic
121
what will antipsychotics do to blood counts?
decrease them
122
what med in specific do we need to watch out for agranulocytosis
clozapine
123
which gen antipsychotics are antipsychotic side effects worse with?
typicals
124
what is pseudoparkinsonism
tremors, shuffling, drooling, rigidity
125
tx of pseudoparkinsonism
antiparkinsons, BENZTROPINE MESYLATE
126
what is the tx for akinesia (muslce weakness)
carbidopa/levodopa
127
what is akathisia
countinuous restlessness
128
What is the sudden sustained contraction of muscles, spasm of face, arms, legs, neck; often in men less than 25 years old
acute dystonesia
129
What is the anti-semitic rolling back of the eyes and can occur as part of dystonesia
oculogyric crisis
130
is acute dystonesia an emergency
yes
131
Is oculogyric crisis and emergency?
yes
132
what is the treatment of acute dystonia and oculogyric crisis
stop the psych meds, monitor airway, suction ready
133
What symptoms characterized by bizarre facial and tongue movements, stiff neck, lip smacking or licking, difficulties swallowing
tardive dyskinesia
134
Is tardive dyskinesia an emergency?
yes
135
Which rating scale is used for tardive dyskinesia?
AIMS scale
136
Treatment of tardive dyskinesia
Monitor airway, benadryl, cogentin
137
What medication is used to prevent extrapyramidal symptoms such as acute dystonia, oculogyric crisis, and tardive dyskinesia
anticholinergics
138
Which antipsychotic side effect is characterized by:
- severe Parkinsonian Muscle Rigidity
- Hyper pyrexia, high fever
- Tachycardia, tachypnea, blood pressure fluctuations
- Diaphoresis
- Rapid deterioration of mental status
Occurs within hours of starting meds
Neuroleptic malignant syndrome (NMS)
139
Which meds need to be given for neuroleptic malignant syndrome
Parlodel and dantrium
140
Which syndrome comes as a side effect from second generation antipsychotics
Metabolic syndrome
141
Which is important to consider if you are going outside while on antipsychotics
use sunscreen / protect
142
Which mental health problem is a high risk for people with schizophrenia
suicide
143
What is the only consistent protective factor fornsuicide woth schizophrenia
Delivery of and adherence to effective treatment
144
How do you tell if a client is hallucinating?
-listening pose
-laughing/talking to self
-stops mid sentence
-tracks unknown speaker
watches vacant area of room
145
What should you say to a client if you think they are hallucinating
Are you hearing voices or seeing something
146
What are ways that schizophrenia can possibly be prevented?
-No malnutrition, substances
-promote resiliency
-Supplemental essential fatty acids
-Early treatment with antipsychotics
147
