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Neuro missing > 12- psychosis > Flashcards

12- psychosis Flashcards

1
Q

Definition of psychosis

A

The presence of hallucinations or delusions. Describes symptoms not a diagnosis

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2
Q

Definition hallucinations

A

Perception without a stimulus. Can be in any sensory modality.

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3
Q

Definition delusions

A

A fixed false belief which is unshakeable. Outside of cultural norms

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4
Q

When are hallucinations normal

A

Hypnogogic- as you fall asleep. Or hypnopomic- as you wake up.

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5
Q

First rank symptoms of schizophrenia

A

Auditory hallucinations, passivity experiences, thought withdrawal, broadcast or insertion, delusional perceptions, somatic hallucinations

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6
Q

Auditory hallucinations

A
  • Thought echo- hearing thoughts aloud
  • running commentary
  • third person voices having a conversation
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7
Q

What is a passivity experience

A

Patient believes an action or feeling is caused by an external force

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8
Q

Thought withdrawal

A

Thoughts are being taken out of the mind

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9
Q

Thought broadcast

A

Everyone knows what the person is thinking

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10
Q

Thought insertion

A

Thoughts implanted by others

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11
Q

Delusional perception

A

“Attribution of new meaning, usually in sense of self reference to a normally perceived object”

Eg. The traffic lights went read and in knew that aliens were going to land soon

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12
Q

Somatic hallucinations

A

Mimics feelings from inside the body

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13
Q

Positive vs negative symptoms

A

+ve- delusions, hallucinations, thought disorder, lack of insight

-ve- under activity, low motivation, social withdrawal, emotional flattening, self neglect

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14
Q

3 things thought to be involved in pathophysiology of schizophrenia

A

Dopamine pathways, brain changes, limbic system

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15
Q

Describe the dopamine (DA) theory of schizophrenia

A

Drugs eg. Amphetamines cause relapse of DA induce psychotic symptoms. Allmedications t that antagonise DA receptors can be used to treat psychosis

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16
Q

What are the 4 DA pathways

A

Mesocortical, Mesolimbic, nigrostriatal, tuberoinfundibular pathway

17
Q

Describe the mesolimbic pathway

A

From ventral tegmantal area to limb in structures and nucleus accumbens.

18
Q

Describe the mesocortical pathway

A

From ventral tegmental area to frontal and cingulate cortex.

19
Q

Which pathways are under/overactive in schizophrenia

A

Mesolimbic- overactive. Mesocortical- under active

20
Q

Brain changes in schizophrenia

A

Enlarged ventricles, reduced grey matter, decreased temporal lobe volume, reduced hippocampal formation, amygdala, parahippocampal gurus and prefrontal cortex

21
Q

Neuropathology of schizophrenia

A

Decreased pre-synaptic markers, decreased oligodendroglia, fewer thalamic neurones.

Theory of aberrant connectivity

22
Q

Other theories of cause of schizophrenia

A

Involvement of limbic structures, basal ganglia involvement

23
Q

Treatment of schizophrenia

A

Antipsychotics- D2 blockers in all CNS dopaminergic pathways, and mesolimbic/mesocortical pathways.

Atypical antipsychotics- lower affinity for D2 receptors, blocking 5HT2 receptors

24
Q

Where are D2 receptors located

A

Striatum, substantia nigra, pituitary gland

25
Q

Describe nigrostriatal pathway

A

From substantia nigra pars compacta to striatum

26
Q

How does dopamine affect activity of cortex

A

Less dopamine, less excitation

27
Q

Difficulties of atypicals

A

Weight gain, loss of motivation

28
Q

What can happen if Parkinson’s patients are prescribed with Levadopa

A

They can become psychotic.

29
Q

What is catatonia

A

Catatonia is a type of schizophrenia that usually involve a lack of movement and communication, and also can include agitation, confusion, and restlessness. Cannot move for a period of time

30
Q

Symptoms catatonia

A

Stupor, excitement, posturing, negativism, rigidity,waxy flexibility

31
Q

What causes catatonia

A

Less gaba binding so loss of inhibitory effect

32
Q

Describe tuberoinfundibular pathway

A

From accurate and periventricular nuclei of hypothalamus to infundibular region of hypothalamus

33
Q

How do antipsychotics cause their side effects and what are they

A
  • amenorrhoea, galactorrhoea, decreased fertility, reduced libido, osteopenia/osteoporosis
  • dopamine normally inhibits prolactin release from pituitary. DA antagonists lead to loss of DA inhibitor, increasing prolactin release.
34
Q

Difficulties treating schizophrenia

A

Lack insight so don’t always take medication.

35
Q

Prognosis schizophrenia

A
  • the earlier treatment the better
  • good prognosis associated with absence of family history, acute onset, mood disuurbance, prompt treatment, maintenance of initiative and motivation
36
Q

Why is prognosis poorer for other conditions with schizophrenia

A

-shorter life expectancy, morre CVS and resp disease, higher suicide risk, higher risk of violent death, substance misuse, cigarette smoking.

Neuro missing (19 decks)

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