First Aid - Psychosis

Question 0

Schizophrenia criteria?

Answer 0

Over six months of 2 positive and/or negative symptoms that result in occupational dysfunction

Question 1

Dopamine pathways?

Answer 1

#Mesolimbic - associated with positive symptoms
#Mesocortical - associated with negative symptoms (Cortical for Catatonia)
#Nigrostriatal – associated with extrapyramidal symptoms and tardive dyskinesia
#Tuberoinfundibular - associated with hyperprolactinemia

Question 2

Psychiatric differential for schizophrenia?

Answer 2

#Schizoaffective, schizophreniform
#Bipolar, melancholia, mood disorder with psychotic features
#Delusional disorder
#Cluster A personality type disorders

Question 3

Differential for organic chords causes of schizophrenia-like illness?

Answer 3

#Early Huntington's disease
#Early Wilson's disease
#Temporal lobe epilepsy
#Early multiple sclerosis
#Acute intermittent porphyria
#hepatic/HIV/viral and cephalopathy/encephalitis
#Endocrine – Cushing's, calcium imbalance, thyroid dysfunction, hyperglycemia

Question 4

Criteria for brief psychotic disorder?

Answer 4

#1 of: delusions, hallucinations, disorganized speech, catatonic or disorganized behavior
#symptoms persist for longer than one day but shorter than one month

Question 5

High potency antipsychotics? Side effect profile consists primarily of?

Answer 5

#Haloperidol/droperidol 
#Fluphenazine
#Thiothixene

Extrapyramidal symptoms

Question 6

Low potency antipsychotics? Side effect profile consists primarily of?

Answer 6

#Chlorpromazine
#Thioridizine

Anticholinergic, sedative, orthostatic effects

Question 7

Mechanism of action of antipsychotics?

Answer 7

Block them in receptors (primarily D2 and D4)

Question 8

Acute dystonia – scene when? In who? Treatment?

Answer 8

After 10-14 days of treatment in males

Benztropine, diphenhydramine, or trihexyphenidyl

Question 9

Parkinsonism secondary to antipsychotics – treatment?

Answer 9

Oral anti-cholinergics and amantadine

Question 10

Drugs to treat neuroleptic malignant syndrome?

Drugs to treat serotonin syndrome?

Answer 10

Dantrolene, bromocriptine, amantadine

Supportive and Cyproheptadine

Question 11

Most likely atypical antipsychotic to cause extrapyramidal symptoms? Other side effects?

Answer 11

Risperidone; anticholinergic, orthostatic hypertension, weight gain

Question 12

Atypical antipsychotic that is particularly effective in treating negative symptoms and agitated patients?

Will not affect this organ?

Answer 12

Olanzapine

Liver

Question 13

One of the more sedating atypical antipsychotics?

Answer 13

Seroquel

Question 14

Atypical antipsychotic that has partial agonist and antagonist effects at these receptors?

Answer 14

Aripiprazole; serotonin 1A partial agonist and 2A antagonist

Question 15

Side effects of atypical antipsychotics?

Answer 15

Weight gain, type two diabetes, QT prolongation

Question 16

Schizoaffective disorder versus mood disorder with psychotic features?

Answer 16

Acute psychotic symptoms must be present for at least two weeks in the absence of mood symptoms in schizoaffective

Question 17

Delusional disorder – criteria?

Answer 17

Non-bizarre delusions must be present for one month without hallucinations, disorganized speech, disorganized behavior, or negative symptoms

Question 18

Erotomanic delusions?

Jealous delusion?

Answer 18

Delusions that another person is in love with the individual

Delusion that the individuals partner is unfaithful

Question 19

Somatic delusion?

Answer 19

Delusions that the individual has a physical defect or medical condition