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NRNP 6635 FINAL EXAM – SCHIZOPHRENIA QUESTIONS WITH 100% ACCURATE ANSWERS
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a psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished inappropriate emotional expression. - Accurate answers Schizophrenia The signs and symptoms of schizophrenia are traditionally separated into 2 groups: positive (delusions, hallucinations, and disorganized speech or behavior) and negative (flat affect, avolition, anhedonia, poor attention, and alogia). - Accurate answers signs and symptoms of schizophrenia a decline in both cognitive and social functioning that often precedes the development of florid psychosis. - Accurate answers Schizophrenia is associated with The exact etiology of schizophrenia is unknown, although it is thought to be linked to an increase in dopaminergic activity. No single etiological factor is responsible for schizophrenia. - Accurate answers Etiology of Schizophrenia Treatment includes antipsychotics in conjunction with behavioral therapy. - Accurate answers Treatment of Schizophrenia Schizophrenia is a chronic serious mental disorder characterized by loss of contact with reality and manifested by two main symptoms: hallucinations and delusions. - Accurate answers Schizophrenia definition Men and women are equally affected, but with a slight difference in the age of onsetMen: average age of onset = 23 years Women: average age of onset = 26 years - Accurate answers onset of schizophrenia The disorder manifests when a person with a genetic predisposition is exposed to one of many environmental stressors.
-Advanced paternal age at conception - Accurate answers Environmental Stressors of Schizophrenia Genetic and environmental risk factors appear to act via a common pathway of disrupting the function of 1 or more neurotransmitter components. Dopaminergic theory: Almost all drugs with antipsychotic properties block the dopaminergic D receptor. However, antipsychotics are only 70% effective and clozapine, the most effective antipsychotic for treating schizophrenia, is a weak D2 antagonist. Hyperactivity of dopamine D2 receptor neurotransmission in subcortical, and limbic brain regions contribute to the positive symptoms of schizophrenia. Hypo functionality of dopamine D1 receptor neurotransmission in the prefrontal cortex contributes to both negative and cognitive symptoms. - Accurate answers Pathophysiology of schizophrenia part 1 Other theories: Hypofunction of the N-methyl-D-aspartate (NMDA) glutamate receptor. Dysfunctional gamma-amino- butyric acid (GABA) interneurons. Dysfunctional nicotinic acetylcholine receptors. - Accurate answers Pathophysiology of schizophrenia part 2 Patients with schizophrenia also have physical abnormalities of the brain tissue, which can be seen in neuroimaging studies. Loss of cortical tissue volume, including the limbic system, prefrontal cortex, thalamus, hippocampus, and amygdala. Ventricular enlargement (third and lateral). Decreased symmetry. Hypoactivity of the frontal lobes and hyperactivity of the basal ganglia. - Accurate answers Physical abnormalities of the brain in schizophrenia Impairment of thoughts and affect, characterized by a distorted perception of reality. The impairments are severe enough to affect the patient's ability to participate in social events or to form relationships. Patients with schizophrenia often lack awareness about their illness (insight). Co-existing substance use disorder and dependence is common ("dual diagnosis"). Symptoms can be classified into premorbid, positive, negative, and cognitive. - Accurate answers Clinical Presentation of schizophrenia Easy to recognize. Delusions:
older medications before 1989. dopamine receptor antagonist Common side effects include EPS (which may become irreversible), hyperprolactinemia, neuroleptic malignant syndrome, QT prolongation, sudden death, and an increased risk of mortality in older adult patients with dementia. Examples include haloperidol, fluphenazine, and chlorpromazine. - Accurate answers 1st- generation antipsychotics Newer medications, starting with clozapine (approved in 1989). Associated with a lower risk for EPS compared with FGAs and therefore the 1st-line drugs to use (although the risk of metabolic syndrome is increased with SGAs). The decreased risk for EPS is the most important distinction from FGAs, as the pharmacologic properties, therapeutic effects, and adverse effects are not distinct between the 2 groups. Serotonin and dopamine antagonists. Common side effects include metabolic syndrome, hypotension, sedation, anticholinergic symptoms, hyperprolactinemia, EPS, cardiac effects, cardiomyopathies, cataracts, and sexual dysfunction. Examples are risperidone, aripiprazole, quetiapine, olanzapine, ziprasidone, clozapine. - Accurate answers 2nd-generation (atypical) antipsychotics Requires immediate attention. Use oral antipsychotic and benzodiazepine (may require intramuscular due to noncompliance or for more rapid effect). Usually lasts 4-6 weeks. - Accurate answers treatment of acute psychosis in schizophrenia