Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ART_MRCPSYCH_B_MENTOR > catatonia - 1 > Flashcards

catatonia - 1 Flashcards

1
Q

Complications of catatonia?

A

Pulmonary embolism
DVT
Pneumonia
Dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

1st line Rx in catatonia

A

Benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

name a protocol that is used to treat catatonia

A

The lorazepam-diazepam protocol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when the lorazepam-diazepam protocol is commonly used?

A

general medical disorders or substance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

catatonia sub-types,

A

1-A stuporous form with decreased psychomotor behaviour
2- An excited form characterized by agitation, impulsivity, and purposeless overactivity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

key features of stuporous catatonia

A

Mutism
Rigidity
Psychomotor Retardation
Negativism
Posturing
Waxy flexibility
Catalepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

psychiatric causes of stuporous catatonia

A

Schizophrenia ( historically)
Depression
Mania (less common)
Alcohol or Benzo withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

systemic and toxic causes of stuporous catatonia

A

subarachnoid haemorrhages

basal ganglia disorders

non-convulsive status epilepticus
locked-in and akinetic mutism states

endocrine and metabolic disorders, e.g. Wilson’s

Prader–Willi syndrome

antiphospholipid syndrome
autoimmune encephalitis
systemic lupus erythematosus

infections (especially CNS infections)

dementia

drug withdrawal and toxic drug states

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Drug of choice for stupor catatonia occuring in context of affective and conduct disorder?

A

Benzodiazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how does benzodiazepine works (postulations)?

A

Increase GABAnergic transmissions
or
Reduce BDNFs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which benzo has been clinically experimented most in treatment of catatonia?

A

Lorazepam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

at what dose do patients seem to response to lorazepam

A

some at 4mg /day

but repeated and higher doses may be needed [upt to 24 mg/day] (Maudsley 14th edition)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how we can predict response to benzos in catatonia

A

1- a test dose of zolpidem 10 mg
2-IV lorazepam

(Maudsley 14th edition)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Response rate of catatonia in schizophrenian to benzodiazepine?

A

40-50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are lethal catatonia and malignant catatonia?

A

Coined terms for catatonia, which is accompanied by

  • Autonomic instability or hyperthermia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

challenges with lethal catatonia /malignant catatonia?

A

cannot be distinguished from neuroleptic malignant syndrome

17
Q

how can one probably be able to rule out NMS in cases of malignant catatonia?

A

in the absence of prior or recent administration of dopamine antagonists

18
Q

MOST successful Rx for catatonia?

A

ECT

19
Q

Where ECT seem to work well with catatonia?

A

In context of

NMS
Delirious Mania
Self-Injurious behaviours in autism
Limbic encephalitis

20
Q

Where ECT might not work for catatonia despite remaing to be a 2nd choice after benzos failed?

A

schizophrenia

21
Q

best evidence based antipsychotic treatments available for catatonic schizophrenia?

A

Clozapine and Olanzapine ( Use with careful considerations)

Also (aripiprazole, Risperion and Ziprasidone have been reported to be effective)

22
Q

what should you consider before treating catatonia with antipsychotics?

A

Compliance
History of response to antipsychotics
Previous diagnosis

23
Q

what can history of antipsychotic treatment tell us in catatonia?

A

if a patient develops catatonia while on antipsychotics, we should not give more antipsychotics

24
Q

when antipsychotics should be avoided complete regardless of history?

A

when there malignant catatonia (rigidity + autonomic instability which might be NMS)

25
Q

ALgorithm for treating catatonia —starts with?

A

Ruling out underlying physical illness (systemic ones and toxic ones)

26
Q

2nd leg in algorith for treating catatonia?

A

see if catatonia is in psychotic context or affective/conversion disorder

27
Q

what if catatonia is in context of psychotic?

A

Rule out NMS

28
Q

What if catatonia is due to psychosis and NMS is ruled out?

A

consider Clozapine or Olanzapine

Some suggest to cotherapy benzodiazepine (Mausdley 14th ediction, page 133-134)

29
Q

what if treating psychosis induced catatonia did not respond to antipsychotics in 1-2 days?

A

follow the Benzodiazepine/ECT protocol

30
Q

going back up in algorithm of treating catatonia, what if catatonia is in psychosis context and NMS is not ruled out?

A

go to other side of the algorithm: catatonia in context of affective/conversion disorder!

31
Q

On the affective/conversion catatonia side of algorithm what do we do?

A

Lorazepam up to 4 mg / day

32
Q

how is lorazepam in given in affective/conversion catatonia ( or NMS +)

A

start with 2 mg (sublingual in non-compliant patients)

add another 2 mg if no response is achieved in 3 hours

Then, switch to the IV route subsequently.

ART_MRCPSYCH_B_MENTOR (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions