Schizophrenia

Question 1

what symptom is most likely during the prodrome phase?

Answer 1

attenuated positive sx

Question 2

which type of city is a risk factor for scz?

Answer 2

densely populated, large urban ones

Question 3

what is a major risk factor for suicide in scz?

Answer 3

hopelessness

Question 4

which PD is the relative of someone with scz going to have

Answer 4

schizotypal

Question 5

maximum amount of time one can have psychotic sx during prodrome?

Answer 5

less than 7 days

Question 6

Name the three syndromal subgroups:

Answer 6

1. attenuated positive symptom syndrome (most common) 2. brief intermittent psychotic 3. genetic risk and deterioration

Question 7

Treatment of serotonin syndrome

Answer 7

atypical AP or benzos, cyproheptadine

Question 8

Treatment of NMS

Answer 8

bromocriptine (Da agonist), dantrolene (muscle relaxant)

Question 9

Top four lab findings in NMS (all increased)

Answer 9

1. WBC 2. CK 3. myoglobin 4. liver enzymes

Question 10

two tx for neuroleptic induced akathesia

Answer 10

1. benzo. 2. propranolol

Question 11

Is violence more or less likely in FEP

Answer 11

more– greatest risk of violence and self harm

Question 12

What are the ABCD of first rank sx

Answer 12

AH (audible thoughts), Broadcasting/TI/TW, Control (passivity delusions), Delusions

Question 13

Which genetic syndrome is most linked to scz

Answer 13

22q11

Question 14

Does psychoeducation help in scz?

Answer 14

No effect on tx outcomes

Question 15

Prevalence of SUD in scz

Answer 15

47%

Question 16

How many years earlier do cannabis users develop psychosis than controls?

Answer 16

2.7 yr

Question 17

Which CYP enzyme does cigarette smoking work on?

Answer 17

1A2 inducer (increases metabolism)

Question 18

The metabolism of which two AP are susceptible to cig smoking?

Answer 18

clz and olz

Question 19

What is the risk of someone with a Clinical High Risk of developing psychosis?

Answer 19

25-35%

Question 20

Health Canada suggested QTc cut-off

Answer 20

500ms

Question 21

Which psychosocial intervention has the strongest evidence to prevent relapse in scz?

Answer 21

family intervention (which involved 1. communication skills 2. psychoed 3. problem solving)

Question 22

Name two medical conditions to rule out in post partum psychosis

Answer 22

1. hypothyroidism 2. cushing’s

Question 23

Key difference bw NMS and SS?

Answer 23

SS has hyperreflexia and myoclonus, NMS has hyporeflexia

Question 24

Two most common delusions

Answer 24

1. persecutory 2. jealousy

Question 25

Which age is considered late onset scz

Answer 25

45

Question 26

Neuroimaging findings in scz

Answer 26

basically most structures are atrophies except the caudate which are enlarged (may be secondary to AP effect in basal ganglia)

Question 27

Which is a RF for scz, advanced maternal or paternal age?

Answer 27

paternal age, over 60

Question 28

Which mental illness is being in an oneiroid state associated with?

Answer 28

scz (perplexed, dream like state where one is so enmeshed in their hallucinations)

Question 29

Which gender does schizoaffective predominantly affect?

Answer 29

bipolar type M=F, dep F>M (overall F>M)

Question 30

In scza how long is the period of just psychotic sx?

Answer 30

2 weeks

Question 31

what is a kinesthetic hallucination

Answer 31

feeling your body move

Question 32

If both parents have scz, what is the risk of the child getting it?

Answer 32

40%

Question 33

Risk of getting scz if one non-twin sibling is affected?

Answer 33

8%

Question 34

Neuroanatomic regions affected by scz? (3)

Answer 34

1. cerebral cortex (prefrontal). 2. limbic system. 3. basal ganglia

Question 35

Two cognitive impairments in scz

Answer 35

1. working memory (impaired digit backwards) 2. temporal-limbic

Question 36

Which gender's fertility is more affected by scz?

Answer 36

M

Question 37

What are Bleuler's 4 As

Answer 37

1. associations 2. ambivalence 3. autism. 4. affect

Question 38

Most efficacious tx of akathesia?

Answer 38

BB

Question 39

What is a cenethestic hallucination

Answer 39

unfounded bodily sensation (brain on fire)

Question 40

therapeutic range for clozapine?

Answer 40

1050- 1650 nmol/L

Question 41

first line intervention for clinically high risk folks

Answer 41

CBT +/- family

Question 42

What ECG changes do you see with myocarditis

Answer 42

sinus tachycardia with non-specific ST and T wave changes (inversion common)

Question 43

Which AP associated movement d/o is the only one more likely to happen in M than F

Answer 43

Dystonia

Question 44

Which class of AP is better for scz with co-morbid SUD?

Answer 44

atypicals (esp clozapin)

Question 45

What do you tell patient's about their footwear before starting AIMS

Answer 45

Remove shoes and socks

Question 46

Three blood tests to order for suspected myocarditis?

Answer 46

1. CRP 2. Trop 3. eosinophil (CBC)

Question 47

What is the relationship bw depression and delusional d/o?

Answer 47

It is co-morbid but NOT a risk factor

Question 48

How long does BIPS last?

Answer 48

LESS than 7 days

Question 49

Best imaging study to dx myocarditis?

Answer 49

echo