Psychotic Disorders

Question 1

Describe the DSM-5 criteria for diagnosis of schizophrenia (2)

Answer 1

• Presence of 2 positive symptoms at least 1 month
• Continuous disturbance for at least 6 months

Question 2

Define anosognosia

Answer 2

Lack of insight about own mental health

Question 3

Describe schizoaffective disorder

Answer 3

Psychosis with mood symptoms (mania / depression)

Question 4

Describe brief psychotic disorder

Answer 4

Psychotic symptoms lasting 1 day - 1 month

Question 5

Assertive-community treatment assists what types of patients? (2)

Answer 5

• Patients with repeated hospitalization
• Patients without housing

Question 6

What drug classes are used for schizophrenia? (2)

Answer 6

• Typical antipsychotics (first generation)
• Atypical antipsychotics (second / third generation)

Question 7

Name some examples of typical antipsychotics (3)

Answer 7

• Haloperidol
• Fluphenazine
• Loxapine

Question 8

Name some examples of atypical antipsychotics (4)

Answer 8

• Aripiprazole
• Risperidone
• Clozapine
• Olanzapine

Question 9

Typical antipsychotics target ______ symptoms

Answer 9

Positive

Question 10

Atypical antipsychotics target ______ symptoms

Answer 10

Positive and negative

Question 11

Describe the MOA of typical antipsychotics

Answer 11

Block dopamine receptors (positive symptoms)

Question 12

Describe the MOA of atypical antipsychotics

Answer 12

• Block dopamine receptors (positive symptoms)
• Inhibit serotonin reuptake (negative symptoms)

Question 13

Which class of antipsychotic has a lower risk of EPS?

Answer 13

Atypical antipsychotics

Question 14

What adverse effects are associated with antipsychotics? (4)

Answer 14

• EPS - typical antipsychotics
• Metabolic syndrome - atypical antipsychotics
• Agranulocytosis - Clozapine
• Neuroleptic malignant syndrome - Haloperidol

Question 15

What laboratory testing is required for patients taking atypical antipsychotics?

Answer 15

Blood glucose / lipid levels - risk of metabolic syndrome

Question 16

What laboratory testing is required for patients taking Clozapine?

Answer 16

Absolute neutrophil / WBC count - risk of agranulocytosis

Question 17

What are the manifestations of neuroleptic malignant syndrome? (5)

Answer 17

• Muscle rigidity
• Hyperthermia
• Tachycardia
• Tremors
• Elevated CK enzymes

Question 18

What medication can be used to reverse the effects of neuroleptic malignant syndrome?

Answer 18

Dantrolene

Question 19

Name the EPS symptom:

• Facial grimacing
• Locked gaze (oculogyric crisis)
• Laryngeal spasms

Answer 19

Acute dystonia

Question 20

Name the EPS symptom:

• Pacing / inability to stand still
• Rocking back and forth

Answer 20

Akathisia

Question 21

Name the EPS symptom:

• Slumped posture
• Drooling
• Pill rolling
• Shuffling gait
• Tremors at rest
• Bradykinesia

Answer 21

Pseudoparkinsonism

Question 22

Name the EPS symptom:

• Tongue protrusion
• Lip smacking
• Chewing motion

Answer 22

Tardive dyskinesia

Question 23

Which type of EPS is irreversible?

Answer 23

Tardive dyskinesia

Question 24

What medication can be used to reverse the effects of EPS?

Answer 24

Benztropine

Question 25

Name the schizophrenia manifestation: Lack of interest in activities that were once important

Answer 25

Apathy

Question 26

Name the schizophrenia manifestation: Lack of pleasure

Answer 26

Anhedonia

Question 27

Name the schizophrenia manifestation: Lack of motivation, slow thought process

Answer 27

Avolition

Question 28

Name the schizophrenia manifestation: Lack of energy

Answer 28

Anergia

Question 29

Name the schizophrenia manifestation: Lack of language skills ("poverty of speech”)

Answer 29

Alogia

Question 30

Name the schizophrenia manifestation: Lack of expression / emotion (blunting)

Answer 30

Flat affect