First Aid Psychotic disorders I Flashcards
delusion vs hallucination vs illusion
delusion is fixed false belief cannot be changed by rational argument
hallucination is a sensory perception without actual external stimulus
illusion is perception in the absence of external stimulus
nonbizarre vs bizarre delusion
non bizarre is a belief that could be true but isnt
bizarre is a false belief that is also impossible
which hallucination is most common in schizophrenics
auditory
what medical illnesses can present with psychosis
CNS disease
Endocrinopathies
Nutritional and Vit deficiency states
other
work up for suspected schizophrenia
TSH, RPR and brain imaging
positive Sx of schizophrenia
halluinations, delusions, bizarre behavior, disorganized speech
negative Sx of schizophrenia
blunted affect anhedonia, apathy, alogia and lack of interest in socialization
cognitive Sx of schizophrenia
impairments in attention, executive function, and working memory
phases of schizophrenia
prodromal- decline in functioning that precedes the 1st psychotic episode, socially withdrawn
psychotic- perceptual disturbances, delusions and disordered thought process/content
residual- between episodes of psychosis, marked by flat affect, social withdrawal, odd thinking or behavior
Dx of Schizophrenia
2+ for at least 1 mo: delusions hallucinations disorganized speech grossly disorganized or catatonic behavior neg Sx
must cause significant social or occupational functional deterioration
duration for at least 6 mo
Sx not medical, neurological or substance induced disorder
types of schizophrenia
paranoid disorganized-- speech and behavior, flat or inappropriate affect catatonic type- rare undifferentiated- mix or none of types residual- prominent negative Sx
schizophreniform
lasts between 1-6 mo
akathisia
unpleasant subjective sense of restlessness often manifested by inability to sit still
which NT is thought to be responsible for schizophrenia
increased dopamine
what drugs can cause schizophrenic like Sx
cocaine and amphetamines
neurotransmitter and receptor abnormalities in schizophrenia
inc dopamine inc serotonin inc NE dec GABA dec glutamate R
CT of schizophrenia
enlargement of ventricles and diffuse cortical atrophy
predisposing factor to paranoid psychosis
deafness
neologism
use of words that have meaning only to the person who uses them and is different than the orthodox meaning of the word
first-generation antipsychotic medications aka “typical”
chlorpromazine
thioridazine
trifluoperazine
haloperidol
D2 antatgonsist for the + Sx
second generation anti psychotic medications
risperidone, clozapine, olanzapine, quetiapine, aripiprazole, ziprosidone
serotonin 5HT2 antagonists at R
inc risk metabolic syndrome
fewer extrapyramidal Sx than typicals
behavioral therapy
improve function in society
side effects of antipsychotic medications
extrapyramidal Sx anticholinergic Sx metabolic Syndrome tardive dyskinesia neuroleptic malignant syndrome
what do you use to Tx the extrapyramidal Sx of antipsychotics
benztropine, diphenhydramine
benzos
beta blockers.
