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Psych 2 > Psychosis > Flashcards

Psychosis Flashcards

1
Q

What are the positive symptoms of psychosis?

A

-Hallucinations
-Delusions

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2
Q

What are the negative symptoms of psychosis?

A

-Alogia= poverty of speech, slow to respond to questioning
-Anhedonia
-Avolition/apathy
-Affective flattening= straight faced, lack of expression and emotion

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3
Q

What are the disorganisation symptoms of psychosis?

A

-Bizarre behaviour
-Formal thought disorder= lack of logical connection between thoughts

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4
Q

What amino acid is dopamine synthesised from?

A

L Tyrosine (via tyrosine hydroxylase and dopamine decarboxylase)

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5
Q

What is the rate limiting step of dopamine synthesis?

A

Tyrosine hydroxylase

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6
Q

How is the RLS bypassed?

A

Increase the dopamine intermediate (L-DOPA)

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7
Q

What is COMT?

A

Metabolises all NTs in same class of dopamine

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8
Q

What are MAO-A and B?

A

Involved in breaking down dopamine

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9
Q

What is schizophrenia?

A

A psychotic disorder which happens in 3 phases

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10
Q

What are the 3 phases of schizophrenia?

A

Prodomal
Active phase
Residual phase

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11
Q

What are the features of the prodomal phase of schizophrenia?

A

Insidious onset over months/years
Subtle behavioural changes
Social withdrawal
Work impairment
Avolition
Improper affect
Strange ideation

NEGATIVE SYMPTOMS

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12
Q

What is avolition?

A

Lack of willpower

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13
Q

What is affect?

A

Expression of emotion

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14
Q

What are core symptoms of active/classic schizophrenia?

A

Hallucinations
Delusions (belief)
Unorganised speech

(Can get a acute exacerbation during the residual phase)

POSITIVE SYMMPTOMS

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15
Q

What are key characteristics of residual phase of schizophrenia?

A

Loss of psychotic symptoms
Loss of positive symptoms

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16
Q

What is psychosis?

A

Difficulty perceiving and understanding reality

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17
Q

What are the 2 main dopaminergic pathways involved in schizophrenia?

A

Mesocortical dopamine pathway
Mesolimbic dopamine pathway

18
Q

What is the mesolimbic dopamine pathway?

A

Pleasure and reward pathway

19
Q

Increase in mesolimbic pathway results in?

A

Positive symptoms

20
Q

What is the mesocortical dopamine pathway?

A

Executive functions and behavioural patterns

21
Q

Decrease in mesocortical pathway results in?

A

Negative symptoms

22
Q

What is the first stage of diagnosing schizophrenia?

A

Eliminating organic causes

CNS infection, tumour, stroke

23
Q

What are the different sections of a mental state exam?

A

Appearance and behaviour
Speech
Mood
Thoughts
Perceptions
Cognition
Insight

24
Q

Main treatment for schizophrenia?

A

Antipsychotics

25
Q

What are the 2 types of antipsychotics?

A

Typical and atypical

26
Q

What are 2 examples of atypical antipsychotics?

A

Chlorpromazine
Haloperidol

27
Q

What is chlorpromazine?

A

Muscarinic and dopamine (D2 receptor) antagonist

Reduces positive symptoms due to inhibition of D2 receptor

28
Q

What are side effects of chlorpromazine?

A

Sedation
Extra-pyramidal side effects (motor control affects)

Parkinsonian-like symptoms

29
Q

What is Haloperidol?

A

Potent dopamine (D2 receptor antagonist)

Reduces positive symptoms due to inhibition of D2 receptor

30
Q

What are side effects of haloperidol?

A

More severe extra-pyramidal side effects (motor control effects)

Parkinsonian-like symptoms

31
Q

What are parkinsonian-like symptoms?

A

Tremors
Muscle stiffness/rigidity
Bradykinesia (slowness of movement)
Acute dystonia (sustained spasm of the muscle)
Akathisia (extreme restlessness)
Tardive dyskinesia (involuntary movements of face and jaw)

32
Q

Very common side effect of dopamine antagonists?

A

Hyperprolactinemia

33
Q

What amino acid is serotonin synthesised from?

A

Tryptophan

34
Q

What are examples of second typical antipsychotics?

A

Clozapine
Risperidone
Quetiapine

35
Q

What is clozapine?

A

Inhibits 5-HT2A receptors (serotonin receptor antagonist)

Treats negative symptoms of schizophrenia

36
Q

What are side effects of clozapine?

A

Fatal agranulocytosis (neutropenia)
Weight gain
Myocarditis

37
Q

What is the condition for the use of clozapine?

A

Only given after 2 different antipsychotic medication has been given where one of which has to be atypical

38
Q

What is risperidone?

A

Antagonises 5-HT2A and D2 receptors (serotonin and dopamine antagonist)

39
Q

What are side effects of risperidone?

A

Extrapyramidal side effects (motor symptoms)

40
Q

What is quetiapine?

A

Antagonist of H1 receptors (histamine antagonist)

41
Q

What are side effects of quetiapine?

A

Fewer extrapyramidal side effects

42
Q

Schizophrenia vs mania/depression?

A

Psychotic symptoms show first

Psych 2 (7 decks)

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