K&S & All the Info Flashcards
What is Catatonia characterized by and what are the three sorta classifications
characterized by abnormal movements, behaviours, and withdrawal
classifications = excited, retarded, or malignant.
What are the DSM-V 12 categories for catatonia symptoms
- stupor - extreme hyperactivity, immobility, minimally responsive to stimuli
- cataplexy - spotaneous maintenance of posture’s
- waxy flexibility - when positioning patient initial resistance then allowing to be moved
- mutism
- negativism - apparently motiveless resistance to instruction or attempts to move (doing opposite of instruction)
- posturing
- mannerisms
- stereotypy - repetitive, non-goal directed motor activity
- agitation not influenced by external stimuli
- grimacing - maintenance of odd facial expressions
- echolalia - mimicking speech
- echopraxia - mimicking movement
What are the 23 categories on the Bush Francis Catatonia Rating Scale
- Immobility/Stupor
- Mutism
- Staring
- Posturing/Cataplexy
- Grimacing
- Echopraxia/echolalia
- Stereotypy
- Mannerisms
- Stereotyped and meaningless repetition of words and pharses
- Rigidity
- Negativism
- Waxy Flexibility
- Withdrawal
- Excitement
- Impulsivity
- Automatic Obedience
- Passive Obedience
- Muscle Resistance
- Motorically such - stuck in indecisive hesitant motor movement s
- Grasp reflex
- Perseveration - return to same topic or persists with same movements
- Combativeness - without explanation
- Autonomic abnormality - fever, BP, pulse, inappropriate sweating, flushing.
What medical things can mimic catatonia
Neurologic insults = strokes, neoplasms, Parkinson’s
Autoimmune
Paraneoplastic
drug exposures/poisoning
What is the ___ step treatment algorithm for Catatonia
- Stop all catatonia potentially causing agents (neuroleptics, steroids, stimulants, anticonvulsants, dopamine depletes)
- Lorazepam challenge - with true catatonia you will see improvement in symptoms within 15 - 20 min
- If patient responds to challenge then schedule interval doses (about three times per day) - titrate until catatonia symptoms resolve.
- Patients should not become sedated on the Benzos!
- Then taper the dose as tolerated. (can take weeks to months) - if patient becomes sedated instead of active then usually you can decrease dose
- worst case scenario if Benzo’s don’t work you can try ECT
what is the key difference between ASD and schizoid personality disorder
Social capacity and social motivation. ASD do not have social capacity whereas schizoid PD do not have social motivation
Contrast the
Repetitive behaviours/speech
inflexibility/strict routines
special fixed interests
of ASD with the comparative Schizoid PD symptoms
odd or eccentric speech
concrete/obsessional thinking
unusual preoccupations.
50% of individuals with ASD meet criteria for what category of psychiatric disorders, but it is difficult to distinguish what is ASD and what is this other disorder
Personality Disorders.
which of the big five personality traits are people with ASD more likely to be higher or lower in
higher in neuroticism
lower in extraversion, agreeableness, openness, and conscientiousness.
What new-ish antipsychotic has shown some promise for being more successful in treating negative symptoms of psychosis
Cariprazine (Vraylar)
What makes cariprazine different than other anti-psychotic and is the hypothesis for why it works for negative symptoms better
D2 partial agonism in the prefrontal cortex in addition to D3 partial agonism
Cariprazine is indicated for what disorders currently
schizophrenia
acute mania
mixed episodes of Bipolar I
cariprazine apart from its D2 partial agonism is unique from other anti-psychotics in what way
3 equipotent contributors to its efficacy (cariprazine and 2 active metabolites)
What are the six areas/types of socratic questioning
- Conceptual clarification questions - get them to think more about what exactly they are asking or thinking about
- Probing assumptions - probing their assumptions makes them think about the presuppositions and unquestioned beliefs on which they are founding their argument.
- Probing rationale, reasons and evidence - when they give a rationale for their arguments, dig into that reasoning rather than assuming it is a given.
- Questioning viewpoints and perspectives - most arguments are given from a particular position, show that there are other, equally valid, viewpoints.
- Probe implications and consequences - the argument that they give may have logical implications that can be forecast
- Questions about the question - you can also get reflexive about the whole thing, turning the question in on itself, use their attack against themselves.
American statistic but up to 80% of people in the USA will experience a tramatic event with an average of 3.5 different events but what percentage of people develop PTSD?
7%
