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Psychiatry > Psychosis > Flashcards

Psychosis Flashcards

1
Q

What is psychosis?

A

The inability to differentiate between subjective experience and objective reality.

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2
Q

What are the characteristic features of psychosis?

A

Hallucinations
Delusions
Thought formation disorders

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3
Q

What is schizoaffective disorder?

A

An overlap between bipolar disorder and schizophrenia.

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4
Q

Can psychosis be of organic aetiology?

A

Yes

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5
Q

What are halucinations?

A

A disconnect between perception of a stimulus and memory - a perception without an external stimulus.

It can affect any sensory modality.

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6
Q

What sensory modalities are most commonly affected by hallucinations?

A

Visual

Auditory

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7
Q

What are ideas of reference?

A

When innocuous/coincidental events are ascribed a significant meaning by the patient.

Associated with aberrant dopamine signalling.

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8
Q

What is paranoia?

A

A sense that external events are related to oneself in some way.

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9
Q

What are delusions?

A

Fixed, falsely held beliefs.

Held with unshakeable conviction.

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10
Q

What is passivity?

A

The disconnect between an action/urge.

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11
Q

What are the 4 forms of thought interference?

A

Insertion
Withdrawal
Broadcasting
Blocking

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12
Q

What is insight?

A

The capacity to realise their mental experience is not real.

If retained, a good prognostic factor.

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13
Q

What are possible causes for psychosis?

A

Organic cause
Substance misuse
Paranoid psychoses
Mood disorders

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14
Q

What form of hallucinations are highly suggestive of schizophrenia?

A

Third person auditory hallucinations.

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15
Q

What are the 2 stages of diagnosing a psychiatric disorder?

A

History

Mental state examination

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16
Q

What is delirium?

A

An acute, transient disturbance from normal cognitive function. It is due to an insult to the brain (e.g. infection).

17
Q

What are features of delirium?

A 
Worse at night
Impaired concentration
Hallucinations (usually visual)
Agitation
Psychomotor retardation
Insomnia
18
Q

What drugs are commonly associated with drug-induced psychosis?

A

Legal highs

19
Q

What are the ‘positive’ symptoms of schizophrenia?

A

Hallucinations
Delusions
Passivity phenomena
Thought formation disorder

20
Q

What are ‘negative’ symptoms of schizophrenia?

A 
Reduced speech
Reduced motivation
Reduced interest
Reduced social interaction
Blunted affect
21
Q

Is psychosis a symptom or condition?

A

It is a symptom - appears in many conditions.

22
Q

What are the 5 dopamine pathways within the brain?

A 
Mesolimbic pathway
Mesocortical pathway
Nigrostriatal pathway
Tuberoinfundibular pathway
Hypothalamospinal pathway
23
Q

What are the receptors targeted in schizophrenic patients?

A

D2 receptors of the mesolimbic pathway.

24
Q

What are potential side-effects of dopamine therapy?

A

Extra-pyramidal symptoms
Hyperprolactinaemia
Akathesia/restless leg syndrome
Neuroleptic malignant syndrome

25
Q

What is neuroleptic malignant syndrome?

A

A slowly evolving dystonia with hyperpyrexia and autonomic instability.

Has a CK>1000 and swinging BP too.

Transfer to ITU - highly fatal.

26
Q

What is affected if dopamine is blocked in the tuberoinfundibular pathway?

A

Prolactin

Can produce osteopenia.

27
Q

What are common side-effects of anticholinergics?

A

Dry mouth
Blurred vision
Constipation

28
Q

What is thought to be the best anti-psychotic?

A

Clozapine

Risk of agranulocytosis, therefore last-line treatment.

29
Q

Does schizophrenia affect life expectancy?

A

Yes, associated with 10-20 years less.

30
Q

What is the gold standard assessment for delirium?

A

4AT

31
Q

How is delirium treated?

A

Treat underlying cause.

32
Q

When is schizophrenia most commonly diagnosed?

A

Adulthood

33
Q

How long do the symptoms of delirium typically last?

A

Hours to weeks.

34
Q

Is there any physiological differences seen in those with schizophrenia?

A

Ventricles are enlarged in the brain - this is non-progressive.

35
Q

What is schizophrenia?

A

A disease of dopamine pathway overactivity.

36
Q

Organic cause hallucinations are typically of what sense?

A

Visual

37
Q

How is delirium diagnosed?

A

Physical examination - trying to find the underlying cause.

Psychiatry (12 decks)

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