Psychiatry 20q Test Trial

Avolition is not a positive symptom of schizophrenia. Positive symptoms refer to the presence of abnormal behaviors or experiences that are not typically seen in healthy individuals. Delusions, disorganized speech, hallucinations, and disorganized behavior are all examples of positive symptoms commonly associated with schizophrenia. Avolition, on the other hand, is a negative symptom, which refers to the absence or reduction of normal behaviors or experiences. It is characterized by a lack of motivation, decreased ability to initiate and persist in goal-directed activities, and a general loss of interest or pleasure in activities.

Clozapine is the correct answer because it is an atypical antipsychotic medication that is effective in treating both the positive symptoms (such as hallucinations and delusions) and negative symptoms (such as social withdrawal and lack of motivation) of schizophrenia. Unlike other typical antipsychotics, clozapine has a lower risk of causing movement disorders and has been shown to be more effective in reducing symptoms and improving overall functioning in individuals with schizophrenia.

Second generation antipsychotics antagonize D2 and 5HT2 receptors. D2 receptors are dopamine receptors, and antagonizing them helps to reduce the symptoms of psychosis. 5HT2 receptors are serotonin receptors, and antagonizing them helps to improve mood and reduce anxiety. By blocking both of these receptors, second generation antipsychotics can effectively treat a range of psychiatric disorders.

The correct answer is Clozapine because.....

The most reasonable statement about the disease course of schizophrenia is that it starts with negative symptoms early on, then transitions to positive symptoms during the active phase of the disease, and finally, there is a prominence of negative symptoms later on in the disease. This pattern suggests that the disease may progress and change over time, with different symptom presentations at different stages.

The correct answer is Cataleptic Type. Cataleptic Type is not a recognized subtype of schizophrenia. The subtypes of schizophrenia include Paranoid Type, Residual Type, Undifferentiated Type, and Disorganized Type. Cataleptic Type is not included in the list of recognized subtypes of schizophrenia.

The initial response to medication is considered the best prognostic sign in schizophrenia because it indicates that the individual is more likely to respond positively to treatment and have a better long-term outcome. This suggests that their symptoms may be more manageable and that they may experience greater symptom reduction and functional improvement with medication. It is an important indicator as it can help guide treatment decisions and provide hope for individuals with schizophrenia and their families.

Clozapine and Olanzapine are the antipsychotic pair associated with the greatest weight gain. Weight gain is a common side effect of antipsychotic medications, but studies have shown that Clozapine and Olanzapine have a higher propensity for causing weight gain compared to other antipsychotics. This can be attributed to their effects on appetite and metabolism. These medications can increase appetite and lead to metabolic changes that promote weight gain. Therefore, patients taking Clozapine and Olanzapine should be closely monitored for weight gain and appropriate interventions should be implemented to manage this side effect.

The prevalence of schizophrenia in the general population is estimated to be between 0.5 to 1.5%. This means that approximately 0.5 to 1.5 out of every 100 people in the general population are diagnosed with schizophrenia. Schizophrenia is a relatively rare mental disorder, affecting a small percentage of the population.

The mesocortical pathway is responsible for the negative symptoms of schizophrenia. This pathway connects the ventral tegmental area (VTA) in the midbrain to the prefrontal cortex. Dysfunction in this pathway can lead to a decrease in dopamine transmission in the prefrontal cortex, which is associated with negative symptoms such as social withdrawal, apathy, and decreased motivation.

The minimum length of time for the active phase of schizophrenia is 1 month. This means that for a diagnosis of schizophrenia, the individual must experience symptoms such as hallucinations, delusions, disorganized speech or behavior, or negative symptoms for at least 1 month. It is important to note that this is the minimum duration and in most cases, the active phase of schizophrenia lasts longer than 1 month.

Neuroleptic Malignant Syndrome (NMS) is a potentially life-threatening condition caused by adverse reactions to antipsychotic medications. It is characterized by symptoms such as lead pipe rigidity, autonomic instability, high fever, and dysphagia. However, leukopenia, which refers to a decrease in white blood cell count, is not typically seen in NMS. This is because NMS primarily affects the neuromuscular and autonomic systems, rather than the hematological system.

The most reasonable diagnosis at this time is Schizophreniform Disorder. Jon is experiencing symptoms such as depressed mood, sleep disturbances, delusions of surveillance, and auditory hallucinations. These symptoms have been present for at least one month but less than six months, which aligns with the diagnostic criteria for Schizophreniform Disorder. This diagnosis is more appropriate than Schizophrenia because the duration of symptoms is less than six months. Schizoaffective Disorder is not the most reasonable diagnosis because Jon does not meet the criteria for a major mood episode. Brief Psychotic Disorder is not the most reasonable diagnosis because the duration of symptoms is longer than one day but less than one month. Delusion Disorder is not the most reasonable diagnosis because Jon is experiencing both delusions and hallucinations.

Chlorpromazine is the correct answer because it is known to be associated with deposits in the cornea and lens. This side effect, known as corneal and lens deposits, is a result of the drug's anticholinergic properties. Thioridazine is also associated with corneal and lens deposits, but it is already mentioned in the options and cannot be the correct answer twice. Fluphenazine and trifluoperazine do not typically cause corneal and lens deposits.

Clozapine is the correct answer because it has the lowest associated risk of inducing extrapyramidal symptoms (EPS) among the given antipsychotics. EPS are movement disorders commonly associated with antipsychotic medications, and they can include symptoms like tremors, stiffness, and abnormal muscle movements. Clozapine is known for having a lower risk of causing EPS compared to other second-generation antipsychotics.

Thioridazine is associated with retinal pigmentation. Retinal pigmentation refers to the darkening or discoloration of the retina, which is the light-sensitive tissue at the back of the eye. Thioridazine is a first-generation antipsychotic medication that has been linked to this side effect. The pigmentation can cause visual disturbances and potentially lead to vision loss. It is important for patients taking thioridazine to have regular eye examinations to monitor for any signs of retinal pigmentation.

Lorazepam 1mg SL is not a medication used in the management of an acute dystonic reaction. The other options, such as Benztropine, Diphenhydramine, and Lorazepam 1mg IM, are commonly used to treat acute dystonic reactions. SL stands for sublingual, which means the medication is placed under the tongue and absorbed into the bloodstream. In the case of acute dystonic reactions, medications are typically administered intramuscularly (IM) or intravenously (IV) for faster and more immediate effects.

If both of the patient's parents have schizophrenia, the concordance rate is 40%. This means that there is a 40% chance that the patient will also develop schizophrenia. The concordance rate is a measure of the likelihood that a trait or disorder will be present in both members of a pair of individuals, such as twins or in this case, the patient and their parents.

The correct answer is 20%. Neuroleptic Malignant Syndrome (NMS) is a rare but potentially life-threatening condition that can occur as a side effect of antipsychotic medications. If left untreated, NMS can lead to severe complications such as organ failure and death. The mortality risk of untreated NMS is estimated to be around 20%, highlighting the importance of early recognition and intervention to improve outcomes.

66% of patients with schizophreniform disorder go on to develop schizophrenia or schizoaffective disorder. This means that the majority of individuals with schizophreniform disorder eventually progress to a more chronic and severe form of psychosis. It is important to note that schizophreniform disorder itself is characterized by symptoms similar to schizophrenia, but the duration of symptoms is shorter (between 1 to 6 months). However, if symptoms persist beyond 6 months, the diagnosis may be changed to schizophrenia or schizoaffective disorder.