module 6 L4-6 Flashcards
Enumerate: Components of psychosis
- loss of reality testing and impairment in mental functioning
- severe impairment in mental and social functioning
- severe ego regression
Enumerate: Schizophrenia DSM 5 criteria
- Characteristic symptoms
- Social/occupational dysfunction
- 6 months duration of symptoms
- Exclusion of mood and schizo-affective disorder
- Exclusion of substance abuse and other medical conditions as cause
- Relationship with pervasive developmental disorder
Enumerate: Schizophrenia subtypes
- Paranoid
- Disorganised
- Catatonic
- Undifferentiated
- Residual
Positive symptoms are?
Symptoms reflecting an excess or distortion of normal functions
Enumerate: Positive symptoms
- Hallucinations
- Delusions
- Abnormal thought content and process
- Speech disorder
Negative symptoms are?
Symptoms reflecting a diminution or loss of normal functions
Enumerate: Negative symptoms
The 5 A’s:
- Affective flattening
- Alogia
- Avolution-Apathy
- Anhedonia-asociality
- Attention deficits
Examples of cognitive symptoms
- difficulty focusing and attention
- poor executive function
- working memory problems
Identify:False fixed belief not congruent with age, level of education, or culture not readily corrected by logical reasoning
Delusion
Identify: a perceptual disturbance not involving a stimulus
Hallucination
Identify: misinterpretation of a sensory stimulus
Illusion
Identify: the presence of psychotic symptoms lastng more than one day but less than one month
Brief Psychotic Disorder
Identify: the presence of psychotic symptoms for more than one month but less than 6 months
Shizopreniform disorder
Identify: the presence of active phase symptoms of shizophrenia as well as manic or depressive symptoms that are brief relative to the duration of psychosis
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Schizoaffective disorde
Identify: The presence of delusions as the only symptom for at least one month
Delusional disorder
The preoccupation with one or more delusions or auditory hallucinations, usually delusions of persecution or grandeur
Paranoid-subtype schizophrenia
A marked regression to primitive, disinhibited, and unorganised behaviour e.g. disorganised speech and behaviour
Disorganised-subtype schizophrenia
Shizophrenic subtype manifesting as a marked disturbance in motor function, e.g. stupor, negativism, rigidity, excitement, posturing, echolalia, echopraxia, etc.
Catatonic subtype
Undifferentiated subtype: does not fit the criteria for the other subtypes
Residual subtype: an attenuated form without a complete set of active symptoms
Schneiderian delusions are highly indicative of schizphrenia if present. Enumerate.
- Thought withdrawal
- Thought insertion
- Thought broadcasting
- Made impulses
- Made volitional acts
- Somatic passivity
Type of disorganised speech wherein ideas are presented with loosely apparent or completely inapparent logical connections.
Looseness of association
Lack of observance to the main topic of discourse
Tangentiality
Non-linear pattern of getting to the point
Circumstantiality
Grouping of words based on similar sounds even without any logical connection
Clang association
Provision of a similar answer to different questions
Perseveration
Define the Erotomanic type of delusion
The belief that another, usually important or famous person is in love with you
Define the Grandiose type of delusion
An overinflated sense of worth, power, or knowledge
Define the Jealous type of delusion
Belief that a person’s spouse or sexual partner is unfaithful
Define the Persecutory type of delusion
The belief that one is being mistreated, being spied upon, or the target of harm
Define the Somatic type of delusion
The belief that one has a physical defect or medical problem
Enumerate: Characteristic symptoms of schizophrenia
- Delusions
- Hallucinations
- Disorganised speech
- Grossly abnormal psychomotor behaviour e.g. catatonia
- Negative symptoms
Component of social/occupational dysfunction to be monitored for at least 2 months in schizophrenia
- School performance
- Socialisation
- Self-care
Schneiderian auditory hallucinations
- Voices speaking thoughts out loud
- Voices arguing
- Voices commenting on the subject’s action
Differential diagnoses for schizophrenia
- Autism
- Neurological conditions
- Other medical conditions
- Substance-induced psychosis
A medical condition characterised by a trance or seizure with loss of sensation and consciousness accompanied with muscular rigidity and fixity of posture
Catalepsy
Decreased response to stimuli and a tendency to remain in an immobile posture
Waxy flexibility
A time period wherein symptom criteria are fulfilled
Acute episode
A time period wherein there is improvement after a previous episode and the criteria are only partialy fulfilled
Partial remission
A period wherein no disorder-specific symptoms
Full remission
- Oldest known substance of abuse
ethanol
Most frequently used alcohol
Beer
Standard drink for women
2 standard drink of alcohol per day but not more than 7 in a week
Standard drink for men
4 standard drinks per day and not more than 10 drinks in a week
Average age of first alcohol consumption
- 34 years old
Has the highest Influence for Alcohol Consumption
Neighborhood friends or neighbors
Psychodynamic theory refers to the use of alcohol to reduce tension, increase feelings of power and decrease effects of psychological pain
False. The definition stated refers to Psychological theories. Psychodynamic theory is the use of alcohol to deal with self – punitive harsh superegos and decrease unconscious stress levels.
This refers to the pattern of alcohol consumption that increases the risk of harmful consequences for the user or others
Hazardous Drinking
This refers to alcohol consumption which results to physical, mental and even social consequences
Harmful Drinking
Symptoms of alcohol withdrawal can be relieved by the use of benzodiazepines and alcohol
True
Most common manifestation of alcohol withdrawal
Increased hand tremor
Alcohol is primarily metabolized in this organ
Liver
lcohol is primarily absorbed in this part of intestine
Duodenum
Drug that inhibits aldehyde dehydrogenase causing an intoxicated person to feel headache, nausea and dizziness after drinking
Disulfiram or Metronidazole
Alcohol Elimination Rate
7 – 10g/hr or 1 standard drink/hr
When Alcohol acts on this receptor it gives the relieving sensation to the person
u Receptor sites in the VTA (ventral tegmental area)
Causes the pleasure/ rewarding feeling
Increase release of dopamine in the nucleus accumbens
Causes the emotional uplifting and lessens sensitivity to pain
Stimulation of 5 – HT receptors (serotonin)
The effect of alcohol on these receptors causes the downer effect that dulls the brain, dulls the senses and decreases the inhibitions
GABA receptors, NMDA receptors
Alcohol is both depressant and reinforcer
True
Gain pressure, altered consciousness, conform to behavior of peers and relief of stress and negative emotions are positive reinforcing effects of alcohol
False. Relief of stress and negative emotions is considered negative reinforcing effects of alcohol. All other mentioned are positive effects.
1 standard drink contains how many grams of alcohol
10 g alcohol
12 oz. of beer contains how many percentage of alcohol
5% alcohol
Incoordination, mood lability, and deterioration in cognition is expected in person with what level of blood alcohol
80 – 200 mg/dl
At a level of 250 mg/dl alcohol will cause nystagmus, marked slurring of speech and blackouts.
True. Between 200 – 300 mg/dl a person could manifest with the mentioned symptoms of alcohol intoxication.
blood ethanol concentration of 300 mg/ml would likely to cause damage in this area of the brain
Parietal Lobe
Which marker is good as an initial laboratory test to determine whether a person is heavily drinking. It is also elevated in obstructive liver problems. Returns to normal limits within 2 -3 weeks of abstinence
Gamma Glutamyltransferase (GGT)
Nausea, Vomiting, Tremors, Paroxysmal Sweating, Anxiety, Agitation, Tactile, Auditory and Visual Disturbances and Clouding of sensorium are all part of the parameters used in CIWA
True
A person with slurred speech, incoordination, visual impairment, slow reaction time and blood ethanol level of 100 mg/ml is considered to have what level of intoxication
Mild Intoxication
Resting membrane potential
-70-80mV
When the impulse reaches the synapse this releases the neurotransmitter
Presynaptic neuron
What are the 4 fates of the neurotransmitter when the impulse reaches the synapse
- It is received by its receptor on the postsynaptic neuron
- It returns to presynaptic neuron at the reuptake receptor
- It is destroyed by enzymes
- It returns to the presynaptic neuron and blocks further release of the transmitter
Term used to describe ion channels whose
opening and closing is sensitive to membrane
potential.
Voltage gated
erm for a large group
of neurotransmitter receptors that
combine receptor and ion channel functions into
a single molecule.
Ligand gated
What are metabotropic receptors?
These are 7 transmembrane G protein coupled receptors
T or F: the ligand gated channels respond to changes in the membrane potential of the cell
F: it’s the voltage gated channels
These channels are responsible for fast synaptic transmission typical of hierarchical pathways in the CNS
Ligand gated channels
Acetylcholine is generally excitatory or inhibitory?
Excitatory
Agonist receptor of acetylcholine
Muscarine
Antagonist receptor of acetylcholine
Nicotine
M1 muscarinic receptors acts on
Salivary and peptic secretions
M2 muscarinic receptors acts on
Intestinal muscles and heart
Cholinergic pathways appear to play an important role in
Cognitive functions esp memory
What does OARS mean? This will help you develop a more patient centered relationship
Open-ended questions
Affirming
Reflections
Summarizing
Psychopharmacology alone will not cure a patient. It goes hand in hand with
Psychotherapy
This NT is involved in emotions, feeling of well being, lessens impact of pain
Serotonin
This NT is involved in the fight or flight reaction
Norepinephrine
T or F: Alpha is generally inhibitory and Beta is generally excitatory
F: Alpha- excitatory Beta – inhibitory
NT involved in allergic reactions
Histamine
T or F: GABA and Benzodiazepines are both inhibitory and they work on the same receptor
T
What does tolerance mean?
It’s when a person becomes less responsive to a drug as it is administered over time
Define dependence
It’s when a person can’t function normally without a drug
Relative measure of toxicity or safety of a drug
Therapeutic index
Main way to metabolize medications
Main way to metabolize medications
Oxidation
Relative dose required to achieve certain effects
Potency
Time it takes to reduce a particular concentration in half
Half life
What is the aim in acute phase of drug therapy
Control of current episode
What is the aim in the maintenance phase?
Prevention of relapse, maintain control
What is the aim in the prophylactic phase?
Prevention of future episodes or recurrences
Gabapentin can also be used for
Mood stability, pain control and phantom limb
How does electorconvulsive therapy works? How is it monitored?
It uses controlled seizures for the treatment of mental disorders. It is monitored with Hamilton Depression Scale