First Aid Psychiatry: Psychotic Disorders Flashcards

(87 cards)

1
Q

Delusion

A

fixed, false beliefs that remain despite evidence to the contrary

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2
Q

bizarre vs. nonbizarre delusion

A

bizarre: impossible
nonbizarrie: possible

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3
Q

Delusions of persecution/paranoid delusions

A

Irrational belief that one is being persecuted

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4
Q

Ideas of reference

A

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

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5
Q

Delusions of control: 2 types

A
  1. thought broadcasting

2. thought insertion

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6
Q

thought broadcasting

A

belief that one’s thoughts can be heard by others

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7
Q

thought insertion

A

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

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8
Q

Delusions of grandeur

A

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

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9
Q

Delusions of guilt

A

belief that one is guilty or responsible for something

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10
Q

Somatic delusions

A

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

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11
Q

” I am responsible for all world’s war”

A

Delusion of guilt

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12
Q

“The TV characters are speaking directly to me”

A

Ideas of reference

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13
Q

“The CIA is after me and tapped my phone”

A

Delusions of persecution/paranoid delusions

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14
Q

command hallucinations

A

auditory hallucinations that directly tell the patient to perform certain acts

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15
Q

auditory hallucinations are seen in

A

schizophrenic patients

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16
Q

visual hallucinations are seen in

A

drug intoxication, drug and alcohol withdrawal or delirium

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17
Q

olfactory hallucination seen in

A

epilepsy

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18
Q

tactile hallucination seen in

A

drug use or alcohol withdrawal

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19
Q

difference between illusion and hallucination

A

illusion: existing sensory stimulus
hallucination: no external stimulus

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20
Q

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

A
  • prominent hallucinations or delusions

- symptoms do not occur only during an episode of delirium

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21
Q

medical causes of psychosis

A
  • CNS disease
  • Endocrinopathies ( cushing, addison)
  • Nutritional/Vitamin deficiency (B12/folate)
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22
Q

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

A

delirium

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23
Q

what are the three categories for schizophrenia symptoms

A

Positive
negative
cognitive

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24
Q

three phases of schizophrenia

A
  1. Prodromal
  2. Psychotic
  3. Residual
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25
prodromal phase
decline in functioning that precedes the 1st psychotic episode -withdrawn, decline school performance
26
psychotic phase
- perceptual disturbances - delusions - disordered thought
27
Residual phase
following an episode of active psychosis | - mild hallucinations or delusions, social withdrawal and negative symptoms
28
what drug is considered when a patient fails both typical or other atypical antipsychotic? Potential adverse effects
Clozapine: agranulocytosis
29
Name 5 negative symptoms of schizophrenia
``` Anhedonia affect (flat) Alogia ( poverty of speech) Avolition (apathy) Attention (poor) ```
30
DSM 5 criteria for schizophrenia
``` 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 ```
31
when do men present with schizophrenia
mid 20s
32
when do women present with schizophrenia
late 20s
33
most commonly comorbid abused substance for schizophrenia
1. nicotine 2. alcohol 3. cannabis 4. cocaine
34
downward drift hypothesis
lower socioeconomic groups have higher rate of schizophrenia
35
a phenomenon of schizophrenic patients develop what after resolution of their psychotic symptoms
post-psychotic depression
36
children born when have higher incidence of schizophrenia
late winter or early spring
37
akathesis
restlessness
38
what is the main neurotransmitter that causes schizophrenia? pathways?
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
39
blocking nigrostriatal pathway causes what symptoms
parkinsonism, tremor, slurred speech
40
blocking tuberoinfundibular pathway causes what symptoms
gynecomastia
41
other neurtransmitter abnormalities in Schizophrenia
1. elevated serotonin 2. elevated NE 3. decrease GABA 4. Decrease glutamate
42
CT and MRI for schizophrenia shows
- enlarged ventricles - diffuse cortical atrophy - reduced brain volume
43
neologisms
newly coined term or expression that has meaning only to the person who uses it
44
Prognosis for schizophrenia: late onset
good
45
Prognosis for schizophrenia: early onset
bad
46
Prognosis for schizophrenia: good social support
good
47
Prognosis for schizophrenia: positive symptoms
good
48
Prognosis for schizophrenia: negative symptoms
bad
49
Prognosis for schizophrenia: family history
bad
50
Prognosis for schizophrenia: mood symptoms
good
51
Prognosis for schizophrenia: gradual onset
bad
52
Prognosis for schizophrenia: acute onset
good
53
Prognosis for schizophrenia: female
good
54
Prognosis for schizophrenia: male
bad
55
MOA for second generation antipsychotics
antagonize serotonin and dopamine
56
what type of therapy is good for schizophrenia
behavioral, family and group
57
Treatment for extrapyramidal symptoms
Benztropine, diphenhydramine, | - Benzodiazepine, beta blockers (akathesia)
58
Treatment for tardive dyskinesia
Benzodiazepine, Botox and vitamin E
59
what medication usually causes neuroleptic malignant syndrome
high-potency first-generation antipsychotics
60
how to diagnose Schizoaffective
- 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
61
who usually gets delusional disorder
middle-aged or older patients after age 40
62
Erotomanic type
delusion that another person is in love with the individual
63
grandiose type
delusions of having great talent
64
somatic type
physical delusions
65
persecutorytype
delusions of being persecuted
66
Jealous type
delusions of unfaithfulness
67
mixed type
more than one type of delusion
68
Difference between Schizophrenia and Delusional disorder
Delusional disorder: nonbizarre delusions - daily functioning not significantly impaired - does not meet criteria for schizophrenia
69
Koro
Southeast Asia | - intense anxiety that the penis will recede into the body, possibly death
70
Amok
Malaysia | - Sudden unprovoked outbursts of violence, often followed by suicide
71
Brain fag
Africa | Headache, fatigue, eye pain, cognitive difficulties in make students
72
Schizoid
Solitary activities, lack of enjoyment from social interactions - NO psychosis
73
Schizotypal
odd or magical beliefs | - criteria for overt psychosis are not met
74
Echolalia
repeat words or phrases
75
echopraxia
mimic behavior | PRAxia: Practice behavior
76
what drugs create schizophrenic like symtpoms
cocaine and amphetamines
77
What disorder usually has has neologism
Schizophrenia
78
how long should second generation antipsychotics be tried before quitting
4weeks
79
what causes extrapyramidal symptoms
high-potency first generation antipsychotics
80
treatment for extrapyramidal symptoms
Benztropine Diphenhydramine Benzodiazepines/Beta blocker for akathisia
81
what are the extrapyramidal symptoms
ADAPT
82
what causes anticholinergic symtpoms
Low-potency first generation antipsychotics
83
what causes metabolic symptoms
second-generation antipsychotics
84
what causes neuroleptic malignant syndrome
high-potency first-generation antipsychotics
85
how is schizoaffective and mood disorder with psychotic features distinguished
schizoaffective: delusions or hallucinations for 2 weeks in absence of mood disorder
86
Can you diagnosed brief psychotic disorder with someone with borderline personality
no, psychotic features are part of personality
87
criteria for delusional disorder
one or more delusions for at least 1 month