Clinical Presentation and Diagnosis
This early period before the first psychotic episode is marked by "dropped out" social functioning and peculiar, but not yet delusional, behavior.
What is the prodromal phase?
What are environmental risk factors for schizophrenia
What is urban upbringing or social adversity?
Primary receptor blocked by all antipsychotics.
What is D2 receptor?
This type of psychosocial intervention helps patients navigate interpersonal relationships and improve their ability to live independently.
Social Skills Training
Major advantage of long-acting injectable antipsychotics.
Increased Adherence
These are fixed, false beliefs that are not amenable to change in light of conflicting evidence.
What are delusions?
What is a primary genetic risk indicator
family hx
i.e first degree relative
5-HT2A blockade reduces EPS by increasing dopamine in which pathway?
What is the nigrostriatal pathway?
On a CT or MRI scan of a patient with chronic schizophrenia, this specific structural change in the brain's fluid-filled cavities is one of the most consistent findings.
What is ventricular enlargement (specifically the lateral ventricles)?
Drug class that blocks serotonin and dopamine receptors.
Atypicals
According to the DSM-5-TR, a patient must exhibit at least two of these five symptoms for a significant portion of a one-month period
What are delusions, hallucinations, disorganized speech, disorganized behavior, and negative symptoms?
Hallucinations and delusions are classified as what symptom type?
What are positive symptoms?
This brain circuit is thought to be underactive in schizophrenia, leading to the negative and cognitive symptoms
What is the mesocortical pathway
Reducing "Expressed Emotion" (EE) within this specific support system is a key goal to help prevent patient relapse.
Family Therapy
Give me one example of an typical psychotic and two notable AES
Haloperidol Fluphenazine Trifluoperazine
dystonia, tardive dyskinesia, akathesia, pseudoparkinsonism
Drug strongly associated with triggering psychosis in vulnerable individuals?
Marijuana
Flat affect, avolition, and anhedonia are what symptom type?
What are negative symptoms?
While typicals carry a higher risk of movement disorders, atypicals are more frequently associated with this cluster of side effects, including weight gain and dyslipidemia.
What is Metabolic Syndrome?
Brain region for executive function impaired in schizophrenia
prefrontal cortex
Which medications cause hyperprolactinemia
What are risperidone, paliperidone
This phase is known as having few or no prominent positive symptoms, ongoing negative symptoms, Persistent functional impairment
What is residual phase?
Cognitive symptom most predictive of long-term disability.
What is executive dysfunction or impaired working memory?
This phenomenon, characterized by an excessive "pruning" of these neuronal structures during adolescence, is a leading theory for why schizophrenia often manifests in early adulthood.
What is excessive synaptic pruning?
When medications block D2 receptors here, the "brake" is removed. Prolactin levels rise (hyperprolactinemia), leading to side effects like gynecomastia or galactorrhea.
What pathway is involved?
Tuberoinfundibular Pathway
A schizophrenia patient has persistent psychosis despite two adequate trials of different antipsychotics, each at therapeutic dose and duration. Best next medication step?
what needs be monitored
What is clozapine?
Absolute neutrophil count