NRNP 6635 COMPREHENSIVE EXAM QUESTIONS AND
ANSWERS RATED A+
✔✔1. EPS
2. Tardive dyskinesia
3. elevated prolactin
4. metabolic
5. neuroleptic malignant syndrome - ✔✔side effects to antipsychotics (both)
✔✔definition/ treatment:
- Movement disorders secondary to drugs that block dopamine receptors.
- Movement phenotypes include: dystonia (involuntary muscle contractions), akathisia
(inner restlessness), parkinsonism.
- Treatment options include decreasing dosage, changing to a drug having a lower risk
of EPS, or adding an antimuscarinic agent such as benztropine or diphenhydramine;
propanolol and benzodiazepines are also used, and botulinum toxin injections are used
for focal dystonia. - ✔✔extrapyramidal symptoms
✔✔- A subset of EPS.
- Associated with long-term treatment with 1st-generation antipsychotics
Movement phenotypes include: torticollis (involuntary contraction of neck muscle,
causing head tilt), dystonia of lips, tongue, oromandibular, or pharynx.
- Treatment includes drugs (valbenazine and deutetrabenazine) that block vesicular
monoamine transporter 2 protein, which then prevents presynaptic dopamine release;
injection of botulinum toxin is also used. - ✔✔tardive dyskinesia
✔✔- Caused by almost all antipsychotics.
- Can result in irregular menses, galactorrhea, and sexual dysfunction.
- Treatment includes dosage reduction/medication changes. - ✔✔Elevated prolactin
✔✔- Weight gain, hyperlipidemia, hyperglycemia, and hypertension → increased
cardiovascular risk.
- Treatment: Change from high-risk drug (e.g., olanzapine, quetiapine, risperidone) to
an antipsychotic with lower metabolic risk (e.g., aripiprazole or ziprasidone) if possible.
- Monitor and treat each cardiovascular risk factor appropriately. - ✔✔Metabolic
✔✔- Idiosyncratic reaction to antipsychotics.
- This is a life-threatening emergency.
- Symptoms include at least 2 of the following cardinal symptoms: fever, altered mental
status, muscle rigidity, and autonomic dysfunction.
- Treatment includes immediate discontinuation of the antipsychotic medication and
aggressive supportive care. - ✔✔Neuroleptic Malignant Syndrome
, ✔✔Nonpharmacological treatments are known to be partially effective in treating the
negative and cognitive symptoms of the disorder and increase patient adherence to
medications.
1. Hospitalization: May be required to ensure the safety of patients.
In certain cases, isolation may be required for a short period of time.
2. Psychosocial therapy:
- Cognitive-behavioral therapy
- Compliance therapy Individual psychotherapy
- Group therapy
3. Electroconvulsive therapy: mostly treatment-resistant cases for augmentation to
pharmacotherapy. - ✔✔Nonpharmacological treatments for schizophrenia
✔✔1. brief psychotic disorder
2. schizophreniform disorder
3. schizoaffective disorder
4. delusional disorder
5. substance induced psychotic disorder
6. psychotic disorder d/t medical condition
7. mood disorder with psychotic features - ✔✔Differential Diagnosis (DDx) for
schizophrenia
✔✔ a psychological disorder characterized by delusions, hallucinations, disorganized
speech, and/or diminished inappropriate emotional expression. - ✔✔Schizophrenia
✔✔The signs and symptoms of schizophrenia are traditionally separated into 2 groups:
positive (delusions, hallucinations, and disorganized speech or behavior) and negative
(flat affect, avolition, anhedonia, poor attention, and alogia). - ✔✔signs and symptoms
of schizophrenia
✔✔a decline in both cognitive and social functioning that often precedes the
development of florid psychosis. - ✔✔Schizophrenia is associated with
✔✔The exact etiology of schizophrenia is unknown, although it is thought to be linked to
an increase in dopaminergic activity.
No single etiological factor is responsible for schizophrenia. - ✔✔Etiology of
Schizophrenia
✔✔Treatment includes antipsychotics in conjunction with behavioral therapy. -
✔✔Treatment of Schizophrenia
✔✔Schizophrenia is a chronic serious mental disorder characterized by loss of contact
with reality and manifested by two main symptoms: hallucinations and delusions. -
✔✔Schizophrenia definition
ANSWERS RATED A+
✔✔1. EPS
2. Tardive dyskinesia
3. elevated prolactin
4. metabolic
5. neuroleptic malignant syndrome - ✔✔side effects to antipsychotics (both)
✔✔definition/ treatment:
- Movement disorders secondary to drugs that block dopamine receptors.
- Movement phenotypes include: dystonia (involuntary muscle contractions), akathisia
(inner restlessness), parkinsonism.
- Treatment options include decreasing dosage, changing to a drug having a lower risk
of EPS, or adding an antimuscarinic agent such as benztropine or diphenhydramine;
propanolol and benzodiazepines are also used, and botulinum toxin injections are used
for focal dystonia. - ✔✔extrapyramidal symptoms
✔✔- A subset of EPS.
- Associated with long-term treatment with 1st-generation antipsychotics
Movement phenotypes include: torticollis (involuntary contraction of neck muscle,
causing head tilt), dystonia of lips, tongue, oromandibular, or pharynx.
- Treatment includes drugs (valbenazine and deutetrabenazine) that block vesicular
monoamine transporter 2 protein, which then prevents presynaptic dopamine release;
injection of botulinum toxin is also used. - ✔✔tardive dyskinesia
✔✔- Caused by almost all antipsychotics.
- Can result in irregular menses, galactorrhea, and sexual dysfunction.
- Treatment includes dosage reduction/medication changes. - ✔✔Elevated prolactin
✔✔- Weight gain, hyperlipidemia, hyperglycemia, and hypertension → increased
cardiovascular risk.
- Treatment: Change from high-risk drug (e.g., olanzapine, quetiapine, risperidone) to
an antipsychotic with lower metabolic risk (e.g., aripiprazole or ziprasidone) if possible.
- Monitor and treat each cardiovascular risk factor appropriately. - ✔✔Metabolic
✔✔- Idiosyncratic reaction to antipsychotics.
- This is a life-threatening emergency.
- Symptoms include at least 2 of the following cardinal symptoms: fever, altered mental
status, muscle rigidity, and autonomic dysfunction.
- Treatment includes immediate discontinuation of the antipsychotic medication and
aggressive supportive care. - ✔✔Neuroleptic Malignant Syndrome
, ✔✔Nonpharmacological treatments are known to be partially effective in treating the
negative and cognitive symptoms of the disorder and increase patient adherence to
medications.
1. Hospitalization: May be required to ensure the safety of patients.
In certain cases, isolation may be required for a short period of time.
2. Psychosocial therapy:
- Cognitive-behavioral therapy
- Compliance therapy Individual psychotherapy
- Group therapy
3. Electroconvulsive therapy: mostly treatment-resistant cases for augmentation to
pharmacotherapy. - ✔✔Nonpharmacological treatments for schizophrenia
✔✔1. brief psychotic disorder
2. schizophreniform disorder
3. schizoaffective disorder
4. delusional disorder
5. substance induced psychotic disorder
6. psychotic disorder d/t medical condition
7. mood disorder with psychotic features - ✔✔Differential Diagnosis (DDx) for
schizophrenia
✔✔ a psychological disorder characterized by delusions, hallucinations, disorganized
speech, and/or diminished inappropriate emotional expression. - ✔✔Schizophrenia
✔✔The signs and symptoms of schizophrenia are traditionally separated into 2 groups:
positive (delusions, hallucinations, and disorganized speech or behavior) and negative
(flat affect, avolition, anhedonia, poor attention, and alogia). - ✔✔signs and symptoms
of schizophrenia
✔✔a decline in both cognitive and social functioning that often precedes the
development of florid psychosis. - ✔✔Schizophrenia is associated with
✔✔The exact etiology of schizophrenia is unknown, although it is thought to be linked to
an increase in dopaminergic activity.
No single etiological factor is responsible for schizophrenia. - ✔✔Etiology of
Schizophrenia
✔✔Treatment includes antipsychotics in conjunction with behavioral therapy. -
✔✔Treatment of Schizophrenia
✔✔Schizophrenia is a chronic serious mental disorder characterized by loss of contact
with reality and manifested by two main symptoms: hallucinations and delusions. -
✔✔Schizophrenia definition
