Chapter 3 pt 1

Question 1

what is psychosis

Answer 1

general term used to describe distorted perception of reality

delusions, perceptual disturbances (illusions or hallucinations), and/or disorganized thinking/behavior

Question 2

what can cause psychosis

Answer 2

can be a symptom of: schizophrenia, mania, depression, delirium, and dementia

can be substance or medication- induced

Question 3

what is a delusion

Answer 3

fixed false beliefs that remain despite evidence to the contrary and cannot be accounted for by the cultural background of the individual

Question 4

what are two categorized of delusions

Answer 4

bizarre: false belief that is impossible

non-bizzare: false belief that is plausible but is not true

Question 5

what is a delusion of persecution/paranoid delusions

Answer 5

irrational belief that one is being persecuted

Question 6

what is a delusion of ideas of reference

Answer 6

belief that cues in the external environment are uniquely related to the individual

Question 7

delusions of control

Answer 7

thought broadcasting: belief that one’s thoughts can be heard by others

thought insertion: belief that others thoughts care being placed in one’s head

Question 8

what are delusions of grandeur

Answer 8

bell that one has special powers beyond those of a normal person

Question 9

what are delusions of guilt

Answer 9

bell that on is guilty or responsible for something

Question 10

what are somatic delusions

Answer 10

belief that one is infected with a disease or has a certain illness

Question 11

what are perceptual disturbances

Answer 11

illusions

hallucinations

Question 12

what is an illusion

Answer 12

misinterpretation of an existing sensory stimulus (such as a shadow for a cat)

Question 13

what is a hallucination and what types are there

Answer 13

sensory perception without an actual external stimulus
auditory (most common)
visual
olfactory
tactile

Question 14

when does one usually see olfactory hallucinations

Answer 14

epilepsy

Question 15

when does one usually see auditory hallucinations

Answer 15

schizophrenia

Question 16

when does one usually see visual hallucinations

Answer 16

schizophrenia (less common than auditory)
drug intoxication
drug and alcohol withdrawal
delirium

Question 17

when does one usually see tactile hallucinations

Answer 17

drug or alcohol withdrawal

Question 18

what is the differential diagnosis for psychosis

Answer 18

psychotic disorder due to another medical condition
substance/medication-induced psychotic disorder
delirium/ dementia
bipolar disorder, manic/mixed episode
major depression with psychotic features
brief psychotic disorder
schizophrenia, schizophreniform, schizoaffective disorders
delusional disorder

Question 19

what are some medical causes of psychosis

Answer 19

CNS disease (MS, CVD, neoplasm, Alzheimers, Parkinson's, Huntingtons, syphilis, temporal lobe epilepsy, encephalitis, prion disease, AIDS, neurosarcodiosis)
endocrinopathies (addisons/cushings, hyper/hypothyroid, hyper/hypocalcemia, hypopituitarism)
nutritional/vitamin deficient states (B12, folate, niacin)

Question 20

what is the DSM 5 criteria of psychotic disorder due to another medical condition

Answer 20

prominent hallucinations or delusions
symptoms do not occur only during an episode of delirium
evidence from history, physical, or lab data to support other medical cause

Question 21

what is a command hallucination

Answer 21

auditory hallucinations that tell people what to do

Question 22

what are the positive symptoms of schizophrenia

Answer 22

hallucinations
delusions
bizarre behavior
disorganized speech
-respond robustly to antipsychotic medications

Question 23

what are the negative symptoms of schizophrenia

Answer 23

flat or blunted affect
anhedonia
apathy
alogia
lack of interest in socialization
-more often treatment resistant

Question 24

what re the cognitive symptoms of schizophrenia

Answer 24

impairments in attention, executive function, and working memory

Question 25

what re the three phases of schizophrenia

Answer 25

prodromal
psychotic
residual

Question 26

what is the prodromal phase of schizophrenia

Answer 26

decline in functioning that precedes the first psychotic episode
pt may become socially withdrawn and irritable
may have physical complaints, decline in work/school performance and/or new found interest in religion or cult

Question 27

what is the psychotic phase of schizophrenia

Answer 27

perceptual disturbances, delusions, and disordered thought process/content

Question 28

what is the residual phase of schizophrenia

Answer 28

occurs following an episode of active psychosis

marked by mild hallucinations or delusions, social withdrawal, and negative symptoms

Question 29

what important lab workup should one do if pt complains of delusions and hearing voices

Answer 29

TSH
Rapid plasma reagin (RPR) for syphilis
brain imaging (tumor)

Question 30

what is the DSM-5 criteria for schizophrenia disorder

Answer 30

-two or more of the following for at least one month:
1. delusions
2. hallucinations
3. disorganized speech
4. grossly disorganized or catatonic behavior
5. negative symptoms
* at least one must be # 1, 2, or 3
-must cause significant social, occupational, or self-care functional deterioration
duration of illness for at least 6 months (including prodromal or residual periods)
-symptoms not due to other medical condition or substances