for the

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Jeopardy

• for the
• Psychiatry Clerkship

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And Now Here Is The Host . . .
is proud to present
Insert Name Here
3

• The categories for todays Jeopardy on
  Schizophrenia will be

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Diagnosis
5
Course of Illness
6
Treatment
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FGAs
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SGAs
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Diagnosis
SGAs
Course of Illness
Treatment
FGAs
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10
What are negative symptoms? (alogia, affective
flattening, avolution, anhedonia)
Males are more likely than females to have these
A Criteria symptoms of schizophrenia

• Row 1, Col 1

11
What are hallucinations?
Positive symptoms of schizophrenia are delusions,
disorganized thinking, and this

• 1,2

12
What is schizophreniform disorder?
If the A criteria for Schizophrenia have been met
for between 1 6 months, the diagnosis is this

• 1,3

13
What are mood disorders?
Other psychotic disorders, childhood
developmental disorders, medical or neurological
illness, substance abuse or medication induced,
personality disorders, this must be ruled out
before diagnosing schizophrenia

• 1,4

14
What is tact (social cognition)?
Regarding the cognitive symptoms of
schizophrenia, the mnemonic SMART refers to
speed, memory, attention, reasoning, and this

• 1,5

15
What is anhedonia?
This A criteria negative symptom of schizophrenia
is also a symptom of major depression

• 1,6

16
What is a bizarre delusion? (In DSM5, for A
criteria need 2 of 5 signs/symptoms. Bizarre vs
non-bizarre delusions not a consideration.
In DSM4, this type of delusion will, by itself,
meet the A criteria of Schizophrenia

• 1,7

17
What is females? M-negative symptoms F-positive
symptoms
Delusions are more likely to be experienced by
females than males and hallucinations are more
likely to be experienced by this sex.

• 1,8

18
What are hypnopompic hallucinations?
Voices that are only heard when a patient is just
waking up from sleeping are called this

• 1,9

19
What are negative symptoms (or cognitive
symptoms)?
These symptoms of schizophrenia present early
in the illness, worsen during the active periods,
do not respond well to anti-psychotic
medications

• 2,1

20
What is get married?
It is proposed that because most patients with
schizophrenia have limited social contacts, only
30-40 do this

• 2,2

21
What is 10? (30 intermittent course, 60
chronic course)
10, 30, 60 the percentage of patients with
schizophrenia who experience a single active
episode is this

• 2,3

22
What is a prodrome?
Seen in 85 of patients, this negative
prognostic sign lasts several months to years

• 2,4

23
What is a 2nd smaller peak age of onset peak for
females after age 40?
For ? ? with schizophrenia, the peak age of
onset (the mode) is the same but the average age
of onset is different because of this

• 2,5

24
What is cardiovascular disease?
Patients with schizophrenia have a life
expectancy that is about 25 years less than the
general population primarily due to this

• 2,6

25
What is the prodrome?
The functional decline for a patient with
schizophrenia begins during this phase of the
illness

• 2,7

26
What is live independently?
Due to their many problems as outlined in the B
criteria, only 33 of those with schizophrenia
are able to do this on July 4th

• 2,8

27
What is males generally develop the illness
earlier?
The average course of schizophrenia tends to be
more severe in males than females because of this

• 2,9

28
What is prevent relapse into the active phase?
For patients with schizophrenia, the main goal of
continuous treatment with antipsychotics is this

• 3,1

29
What is increased risk of relapse?
Decreasing the antipsychotic medication in an
attempt to use the lowest effective dose is
associated with this

• 3,2

30
What is psychosis/active phase of illness?

• The most common reason patients with
  schizophrenia are
• hospitalized is this

• 3,3

31
What is 2 weeks?
Except for clozapine (clozaril), all
anti-psychotic medications are unlikely to work
by 4 weeks if a patient does not show a response
within this number of week(s)

• 3,4

32
What is greater sensitivity to medication side
effects?
Lower doses of antipsychotics are used to treat
the first active phase of schizophrenia because
of this

• 3,5

33
What is decreases risk of suicide?
Treating schizophrenic patients with clozapine
(clozaril) and treating bipolar patients with
lithium both have this same unique benefit

• 3,6

34
What is recurrent suicidality/violence?
Common indications for a clozapine (clozaril)
trial include persistence of positive symptoms,
failure of gt 2 antipsychotic trials, co-morbid
substance abuse, and this

• 3,7

35
What is 75-80
In treating patients with FGAs, often titrating
the dose up until side effects emerge corresponds
to blocking this percentage of dopamine
receptors

• 3,8

36
What is mesolimbic tract?
In order to have the desired antipsychotic
effect, medications need to block at least 65
of dopamine receptors in this pathway

• 3,9

37
What is anti-cholinergic activity (cholinergic
blockade)?
Low potency antipsychotics have common side
effects of dry mouth, constipation, blurred
vision, urinary hesitancy due to this

• 4,1

38
What is dystonia?
Young males may be at higher risk than the rest
of the population for this EPS side effect of
muscle spasms

• 4,2

39
What is remain static/unchanged (ongoing
symptoms)?
Improve, worsen, or remain unchanged Once a
patient develops tardive dyskinesia, the most
common course of the symptoms is this

• 4,3

40
What is propranolol (indural)
While amantadine (symmetrel), lorazepam
(ativan), clonidine (catapres), even mirtazepine
(remeron), can be used for treating akathisia,
the first choice of medication for treatment is
this

• 4,4

41
What is antihistiminic?
Adjunctive medications that are anticholinergic,
dopaminergic, and/or this are commonly used to
treat EPS side effects

• 4,5

42
What is low potency FGAs?
chlorpromazine (thorazine) .
While there is still a significant risk of EPS,
patients are less likely to complain of EPS
symptoms from this type of FGA

• 4,6

43
What is clozapine (clozaril)?
About half of the patients with tardive
dyskinesia show a 50 symptom reduction from
treatment with this medication

• 4,7

44
What is older adults/geriatric (gt70 y/o)?
The risk of tardive dyskinesia in patients who
take FGAs for 24 months is 50 in this age
group

• 4,8

45
What is akathisia?
An EPS side effect often described as a
subjective sense of restlessness (the person
cant sit still) is this

• 4,9

46
What is clozapine (clozaril) and quetiapine
(seroquel)?
These two SGAs are least likely to have EPS side
effects

• 5,1

47
What is aripiprazole (abilify)?
This SGA has a particularly long half life and a
low risk of metabolic syndrome, but is the SGA
most likely to cause akathisia

• 5,2

48
What are risperidone (risperdal) palliperidone
(invega)?
These 2 SGAs are available in depot form but
can cause dose dependent EPS prolactin
elevation

• 5,3

49
What is ziprasidone (geodone)?
This SGA has a low risk of metabolic syndrome,
needs to be taken with food, and is the most
likely SGA to cause qTc prolongation

• 5,4

50
What are olanzapine (zyprexa)?
This SGA has the highest risk of metabolic
syndrome, is very sedating, and the CATIE study
showed patients are highly likely to be
compliant

• 5,5

51
What is paliperidone (invega)?
This SGA does not require hepatic metabolism
because it is an active metabolite of risperidone
(risperdal)

• 5,6

52
What are quetiapine (seroquel)?
This SGA has almost zero risk of EPS or
agranulocytosis, is often sedating has a
moderate risk of metabolic syndrome

• 5,7

53
What is aripiprazole (abilify)?
This SGA is unique since it is a partial agonist

• 5,8

54
What is clozapine (clozaril)?
This SGA may cause side effects of sialorrhea,
weight gain, sedation, anticholinergic effects,
myocarditis, and a lower seizure threshold

• 5,9