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
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• The categories for todays Jeopardy on
  Schizophrenia will be

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Diagnosis
5
Course of Illness
6
Treatment
7
1st GenerationAntipsychotics
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2nd Generation Antipsychotics
9
Diagnosis
2nd Gen APs
Course of Illness
Treatment
1st Gen APs
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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?
Before diagnosing schizophrenia, exclusionary
diagnoses that must be ruled out include other
psychotic disorders, childhood developmental
disorders, medical or neurological illness,
substance abuse or medication induced,
personality disorders, this

• 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 disorganized thinking/speech?
To meet DSM5s A criteria of Schizophrenia, of
the 2 symptoms 1 needs to be a delusion, a
hallucination, or this

• 1,7

17
What is catatonia?
Seen in schizophrenia other disorders, stupor,
waxy flexibility, mutism, negativism, stereotypy,
echolalia, are motor activities that are seen
in a patient with this

• 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 prior to the 1st
psychotic episode, 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 pharmacologic 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
• psychiatrically 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
patients with the first active phase of
schizophrenia because of this

• 3,5

33
What is decreases risk of suicide?
Clozapine (Clozaril) for patients with
schizophrenia and lithium for patients with
bipolar disorder 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?
The most commonly used adjunctive medications to
treat EPS side effects are anticholinergic,
dopaminergic, and/or this

• 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