First Aid Psychotic disorders I

Question 1

delusion vs hallucination vs illusion

Answer 1

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

Question 2

nonbizarre vs bizarre delusion

Answer 2

non bizarre is a belief that could be true but isnt

bizarre is a false belief that is also impossible

Question 3

which hallucination is most common in schizophrenics

Answer 3

auditory

Question 4

what medical illnesses can present with psychosis

Answer 4

CNS disease
Endocrinopathies
Nutritional and Vit deficiency states
other

Question 5

work up for suspected schizophrenia

Answer 5

TSH, RPR and brain imaging

Question 6

positive Sx of schizophrenia

Answer 6

halluinations, delusions, bizarre behavior, disorganized speech

Question 7

negative Sx of schizophrenia

Answer 7

blunted affect anhedonia, apathy, alogia and lack of interest in socialization

Question 8

cognitive Sx of schizophrenia

Answer 8

impairments in attention, executive function, and working memory

Question 9

phases of schizophrenia

Answer 9

prodromal- decline in functioning that precedes the 1st psychotic episode, socially withdrawn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

Question 10

Dx of Schizophrenia

Answer 10

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

Question 11

types of schizophrenia

Answer 11

paranoid
disorganized-- speech and behavior, flat or inappropriate affect
catatonic type- rare
undifferentiated- mix or none of types
residual- prominent negative Sx

Question 12

schizophreniform

Answer 12

lasts between 1-6 mo

Question 13

akathisia

Answer 13

unpleasant subjective sense of restlessness often manifested by inability to sit still

Question 14

which NT is thought to be responsible for schizophrenia

Answer 14

increased dopamine

Question 15

what drugs can cause schizophrenic like Sx

Answer 15

cocaine and amphetamines

Question 16

neurotransmitter and receptor abnormalities in schizophrenia

Answer 16

inc dopamine
inc serotonin
inc NE
dec GABA
dec glutamate R

Question 17

CT of schizophrenia

Answer 17

enlargement of ventricles and diffuse cortical atrophy

Question 18

predisposing factor to paranoid psychosis

Answer 18

deafness

Question 19

neologism

Answer 19

use of words that have meaning only to the person who uses them and is different than the orthodox meaning of the word

Question 20

first-generation antipsychotic medications aka “typical”

Answer 20

chlorpromazine
thioridazine
trifluoperazine
haloperidol

D2 antatgonsist for the + Sx

Question 21

second generation anti psychotic medications

Answer 21

risperidone, clozapine, olanzapine, quetiapine, aripiprazole, ziprosidone

serotonin 5HT2 antagonists at R
inc risk metabolic syndrome
fewer extrapyramidal Sx than typicals

Question 22

behavioral therapy

Answer 22

improve function in society

Question 23

side effects of antipsychotic medications

Answer 23

extrapyramidal Sx
anticholinergic Sx
metabolic Syndrome
tardive dyskinesia
neuroleptic malignant syndrome

Question 24

what do you use to Tx the extrapyramidal Sx of antipsychotics

Answer 24

benztropine, diphenhydramine
benzos
beta blockers.

Question 25

tardive dyskinesia is seen more with use of what antipsychotics

Answer 25

the high potency ( haloperidal and trifluoperazine)

switch to atypical neuroleptic maybe

Question 26

signs of neuroleptic malignant syndrome

Answer 26

change in mental status, autonomic changes, lead pipe rigidity, sweating, elevated CPK levels, leukocytosis and metabolic acidosis

Question 27

schizoaffective disorder Dx

Answer 27

meet criteria for major depressive episode, manic episode or mixed
have had delusions or hallucinations for 2 weeks without the mood Sx
have mood Sx for substantial portion time

Question 28

Tx for schizoaffective

Answer 28

hospitalization and supportive psychotherapy

antipsychotics and mood stabilizers; antidepressants or ECT

Question 29

Dx delusional disorder

Answer 29

nonbizarre fixed delusions for at least 1 mo
does not meet criteria for schizophrenia
functioning in life not significantly impaired

Question 30

shared psychotic disorder or folie a deux

Answer 30

patient develops same delusional Sx at someone in close relationship with

Question 31

Tx shared psychotic disorder

Answer 31

separate the people

Question 32

koro

Answer 32

patient believes penis is shrinking and will disappear causing death

Question 33

amok

Answer 33

sudden unprovoked outbursts of violence of which the person has no recollection

Question 34

brain fag

Answer 34

headache fatigue and visual disturbances in male students

Question 35

brief psychotic disorder duration

Question 36

schizotypal

Answer 36

personality disorder

paranoid, odd or magical beliefs, eccentric, lack of friends, social anxiety

Question 37

schizoid

Answer 37

personality
withdrawn, lack of enjoyment from social interactions
emotionally restrained