First Aid Psychiatry: Psychotic Disorders

Question 1

Delusion

Answer 1

fixed, false beliefs that remain despite evidence to the contrary

Question 2

bizarre vs. nonbizarre delusion

Answer 2

bizarre: impossible
nonbizarrie: possible

Question 3

Delusions of persecution/paranoid delusions

Answer 3

Irrational belief that one is being persecuted

Question 4

Ideas of reference

Answer 4

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

Question 5

Delusions of control: 2 types

Answer 5

1. thought broadcasting

2. thought insertion

Question 6

thought broadcasting

Answer 6

belief that one’s thoughts can be heard by others

Question 7

thought insertion

Answer 7

belief that others’ thoughts are being placed in one’s head

Question 8

Delusions of grandeur

Answer 8

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

Question 9

Delusions of guilt

Answer 9

belief that one is guilty or responsible for something

Question 10

Somatic delusions

Answer 10

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

Question 11

” I am responsible for all world’s war”

Answer 11

Delusion of guilt

Question 12

“The TV characters are speaking directly to me”

Answer 12

Ideas of reference

Question 13

“The CIA is after me and tapped my phone”

Answer 13

Delusions of persecution/paranoid delusions

Question 14

command hallucinations

Answer 14

auditory hallucinations that directly tell the patient to perform certain acts

Question 15

auditory hallucinations are seen in

Answer 15

schizophrenic patients

Question 16

visual hallucinations are seen in

Answer 16

drug intoxication, drug and alcohol withdrawal or delirium

Question 17

olfactory hallucination seen in

Answer 17

epilepsy

Question 18

tactile hallucination seen in

Answer 18

drug use or alcohol withdrawal

Question 19

difference between illusion and hallucination

Answer 19

illusion: existing sensory stimulus
hallucination: no external stimulus

Question 20

DSM- 5 criteria for psychotic disorder due to another medical condition

Answer 20

• prominent hallucinations or delusions

- symptoms do not occur only during an episode of delirium

Question 21

medical causes of psychosis

Answer 21

• CNS disease
• Endocrinopathies ( cushing, addison)
• Nutritional/Vitamin deficiency (B12/folate)

Question 22

Elderly, medically ill patients who present with psychotic symptoms such as hallucinations, confusion, or paranoia should be carefully evaluated for what

Answer 22

delirium

Question 23

what are the three categories for schizophrenia symptoms

Answer 23

Positive
negative
cognitive

Question 24

three phases of schizophrenia

Answer 24

1. Prodromal
2. Psychotic
3. Residual

Question 25

prodromal phase

Answer 25

decline in functioning that precedes the 1st psychotic episode -withdrawn, decline school performance

Question 26

psychotic phase

Answer 26

- perceptual disturbances - delusions - disordered thought

Question 27

Residual phase

Answer 27

following an episode of active psychosis | - mild hallucinations or delusions, social withdrawal and negative symptoms

Question 28

what drug is considered when a patient fails both typical or other atypical antipsychotic? Potential adverse effects

Answer 28

Clozapine: agranulocytosis

Question 29

Name 5 negative symptoms of schizophrenia

Answer 29

``` Anhedonia affect (flat) Alogia ( poverty of speech) Avolition (apathy) Attention (poor) ```

Question 30

DSM 5 criteria for schizophrenia

Answer 30

``` 2 or more must be present for 1 month 1. delusions 2. hallucinations 3. Disorganized speech 4. disorganied behavior 5. negative symptoms 1 of them must be 1,2,or3 ```

Question 31

when do men present with schizophrenia

Answer 31

mid 20s

Question 32

when do women present with schizophrenia

Answer 32

late 20s

Question 33

most commonly comorbid abused substance for schizophrenia

Answer 33

1. nicotine 2. alcohol 3. cannabis 4. cocaine

Question 34

downward drift hypothesis

Answer 34

lower socioeconomic groups have higher rate of schizophrenia

Question 35

a phenomenon of schizophrenic patients develop what after resolution of their psychotic symptoms

Answer 35

post-psychotic depression

Question 36

children born when have higher incidence of schizophrenia

Answer 36

late winter or early spring

Question 37

akathesis

Answer 37

restlessness

Question 38

what is the main neurotransmitter that causes schizophrenia? pathways?

Answer 38

dopamine increase 1. prefrontal cortical: decrease dopamine causes negative symptoms 2. mesolimbic: increase dopamine causes positive symptoms 3. tuberoinfundibular: blocked my antipsychotic 4. nigrostriatal: blocked by antipsychotics

Question 39

blocking nigrostriatal pathway causes what symptoms

Answer 39

parkinsonism, tremor, slurred speech

Question 40

blocking tuberoinfundibular pathway causes what symptoms

Answer 40

gynecomastia

Question 41

other neurtransmitter abnormalities in Schizophrenia

Answer 41

1. elevated serotonin 2. elevated NE 3. decrease GABA 4. Decrease glutamate

Question 42

CT and MRI for schizophrenia shows

Answer 42

- enlarged ventricles - diffuse cortical atrophy - reduced brain volume

Question 43

neologisms

Answer 43

newly coined term or expression that has meaning only to the person who uses it

Question 44

Prognosis for schizophrenia: late onset

Answer 44

good

Question 45

Prognosis for schizophrenia: early onset

Answer 45

bad

Question 46

Prognosis for schizophrenia: good social support

Answer 46

good

Question 47

Prognosis for schizophrenia: positive symptoms

Answer 47

good

Question 48

Prognosis for schizophrenia: negative symptoms

Answer 48

bad

Question 49

Prognosis for schizophrenia: family history

Answer 49

bad

Question 50

Prognosis for schizophrenia: mood symptoms

Answer 50

good

Question 51

Prognosis for schizophrenia: gradual onset

Answer 51

bad

Question 52

Prognosis for schizophrenia: acute onset

Answer 52

good

Question 53

Prognosis for schizophrenia: female

Answer 53

good

Question 54

Prognosis for schizophrenia: male

Answer 54

bad

Question 55

MOA for second generation antipsychotics

Answer 55

antagonize serotonin and dopamine

Question 56

what type of therapy is good for schizophrenia

Answer 56

behavioral, family and group

Question 57

Treatment for extrapyramidal symptoms

Answer 57

Benztropine, diphenhydramine, | - Benzodiazepine, beta blockers (akathesia)

Question 58

Treatment for tardive dyskinesia

Answer 58

Benzodiazepine, Botox and vitamin E

Question 59

what medication usually causes neuroleptic malignant syndrome

Answer 59

high-potency first-generation antipsychotics

Question 60

how to diagnose Schizoaffective

Answer 60

- meet criteria for either major depressive or manic episode during which psychotic symptoms of schizophrenia are met also - Delusions or hallucinations for 2 weeks in absence of mood disorder

Question 61

who usually gets delusional disorder

Answer 61

middle-aged or older patients after age 40

Question 62

Erotomanic type

Answer 62

delusion that another person is in love with the individual

Question 63

grandiose type

Answer 63

delusions of having great talent

Question 64

somatic type

Answer 64

physical delusions

Question 65

persecutorytype

Answer 65

delusions of being persecuted

Question 66

Jealous type

Answer 66

delusions of unfaithfulness

Question 67

mixed type

Answer 67

more than one type of delusion

Question 68

Difference between Schizophrenia and Delusional disorder

Answer 68

Delusional disorder: nonbizarre delusions - daily functioning not significantly impaired - does not meet criteria for schizophrenia

Question 69

Koro

Answer 69

Southeast Asia | - intense anxiety that the penis will recede into the body, possibly death

Question 70

Amok

Answer 70

Malaysia | - Sudden unprovoked outbursts of violence, often followed by suicide

Question 71

Brain fag

Answer 71

Africa | Headache, fatigue, eye pain, cognitive difficulties in make students

Question 72

Schizoid

Answer 72

Solitary activities, lack of enjoyment from social interactions - NO psychosis

Question 73

Schizotypal

Answer 73

odd or magical beliefs | - criteria for overt psychosis are not met

Question 74

Echolalia

Answer 74

repeat words or phrases

Question 75

echopraxia

Answer 75

mimic behavior | PRAxia: Practice behavior

Question 76

what drugs create schizophrenic like symtpoms

Answer 76

cocaine and amphetamines

Question 77

What disorder usually has has neologism

Answer 77

Schizophrenia

Question 78

how long should second generation antipsychotics be tried before quitting

Answer 78

4weeks

Question 79

what causes extrapyramidal symptoms

Answer 79

high-potency first generation antipsychotics

Question 80

treatment for extrapyramidal symptoms

Answer 80

Benztropine Diphenhydramine Benzodiazepines/Beta blocker for akathisia

Question 81

what are the extrapyramidal symptoms

Answer 81

ADAPT

Question 82

what causes anticholinergic symtpoms

Answer 82

Low-potency first generation antipsychotics

Question 83

what causes metabolic symptoms

Answer 83

second-generation antipsychotics

Question 84

what causes neuroleptic malignant syndrome

Answer 84

high-potency first-generation antipsychotics

Question 85

how is schizoaffective and mood disorder with psychotic features distinguished

Answer 85

schizoaffective: delusions or hallucinations for 2 weeks in absence of mood disorder

Question 86

Can you diagnosed brief psychotic disorder with someone with borderline personality

Answer 86

no, psychotic features are part of personality

Question 87

criteria for delusional disorder

Answer 87

one or more delusions for at least 1 month