Management: Ethical Care and Provider Self-Care
Covering: diagnostic criteria, neurobiology, pharmacological management,
ethical obligations, and provider self-care.
Diagnostic Criteria & Neurobiology
1. Which dopamine pathway is primarily associated with the positive
symptoms of schizophrenia, such as hallucinations and delusions?
o A) Mesocortical
o B) Mesolimbic
o C) Nigrostriatal
o D) Tuberoinfundibular
o Rationale: The mesolimbic pathway is the primary circuit associated
with positive symptoms.
2. A patient presents with a flattened affect, reduced speech (alogia), and a
lack of initiative (avolition). Which dopamine pathway is likely involved?
o A) Mesolimbic
o B) Mesocortical
o C) Nigrostriatal
o D) Tuberoinfundibular
o Rationale: The mesocortical pathway is associated with the negative
symptoms of schizophrenia.
3. What is the main neurotransmitter (NTM) involved in the pathophysiology
of psychosis?
o A) Serotonin
, o B) GABA
o C) Dopamine
o D) Norepinephrine
o Rationale: Dopamine is the primary NTM identified in the signaling
pathways of psychosis.
4. According to DSM-5 criteria, how long must continuous signs of a
disturbance persist for a diagnosis of Schizophrenia?
o A) 1 month
o B) 3 months
o C) 6 months
o D) 12 months
o Rationale: Diagnostic criteria require symptoms for a 1-month period
with continuous signs of disturbance for at least 6 months.
5. A 22-year-old male experiences acute onset paranoid delusions and visual
hallucinations lasting for 2 weeks before fully resolving. What is the most
likely diagnosis?
o A) Brief psychotic disorder
o B) Schizophreniform disorder
o C) Schizophrenia
o D) Delusional disorder
o Rationale: Brief psychotic disorder is characterized by acute psychosis
often precipitated by stress and lasting less than one month.
6. Which phase of schizophrenia describes the period where symptoms
develop before the first full psychotic episode?
o A) Active phase
, o B) Residual phase
o C) Prodromal phase
o D) Premorbid phase
o Rationale: The prodrome phase describes the period where
symptoms develop prior to the first episode.
7. A patient insists they have a severe physical illness despite a normal
medical evaluation and normal hemoglobin levels. This is an example of a:
o A) Persecutory delusion
o B) Grandiose delusion
o C) Somatic delusion
o D) Jealous delusion
o Rationale: Somatic delusions involve a preoccupation with physical
health or organ function despite evidence to the contrary.
8. Schizophreniform disorder is characterized by symptoms lasting more
than 1 month but less than:
o A) 3 months
o B) 6 months
o C) 9 months
o D) 12 months
o Rationale: Schizophreniform disorder has the same symptoms as
schizophrenia but a shorter duration (1–6 months).
9. Which screening tool is often used specifically in research settings to
differentiate between positive and negative symptoms?
o A) Brief Psychiatric Rating Scale (BPRS)
o B) Positive and Negative Syndrome Scale (PANSS)