Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 > Psychosis > Flashcards

Psychosis Flashcards

1
Q

What is psychosis?

A

Loss of connection with reality, with a disorder of perception, thought form and personality which is a core feature of schizophrenia and conditions like mania, severe depression, acute delirium, dementia and from drug use.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the features of psychosis?

A

Hallucinations, which may be auditory, visual, olfactory or somatic.

Disorder of flow of thoughts for flow and amount of thoughts, and in psychosis this is typically pressure of speech.
Disorder of form of thoughts which can lead to flight of ideas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the pathophysiology of psychosis?

A

Excess of dopamine in the mesolimbic pathway, involved in reward and under active in the prefrontal cortex and dysregulated in the amygdala which is involved in emotional processing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the clinical features of psychosis?

A

Hallucinations
Delusions
Disorganised thought
Disorganise behaviour
Negative symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a delusion?

A

False unshakeable belief about reality based on an incorrect inference that is intensely sustained.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a delusion of reference?

A

False belief that unrelated events or coincidences are of significance to the individual and directed towards them, such as a television programme.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a delusional perception?

A

The false belief where a patient links a normal perception with a false conclusion a

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is schizophrenia?

A

Schizophrenia is a condition characterised by the prescence of positive and negative symptoms lasting at least one month classified based on the presence of at least one of the following core symptoms :
-> Thought echo/insertion/withdrawal or broadcasting
-> Speech disorder
_> Catatonia
-> Apathy and blunting of speech
-> Hallucinations, which may be auditory, olfactory or visual
-> Delusions
-> Signficisnt change in social behaviour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the aetiology of schizophrenia?

A

->Genetic association which is multi factorial
->Winter birth
->Viral infections
->Life events such as social exclusion, adverse childhood experiences, urban environment, negative attitude
->Peri-natal trauma such as hypoxia and maternal stress

->Substance misuse with amphetamines or cannabis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are first rank symptoms for schizophrenia?

A

Positive symptoms of schizophrenia which are given high priority for consideration:
->Auditory hallucinations
->Thought withdrawal/broadcasting/insertion
->Delusional perception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are second rank symptoms of schizophrenia?

A

Common manifestations of schizophrenia that are present in other disorders:
-> Delusions of reference
-> Paranoid/persecutory delusions
-> Second person auditory hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is paranoid schizophrenia?

A

Characterised by both delusions and hallucinations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is hebephrenic schizophrenia?

A

Disorganised behaviour and speech, with shallow emotional responses and a flat affect, alongside delusions and hallucinations. They can exhibit behaviour emotionally inappropriate to the situation such as laughing in times of distress.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is catatonic schizophrenia?

A

Psychomotor disturbance, where they cycle between complete inactivity and agitation and hyperactivity. This can cause waxy flexibility where they have low resistance to manipulation in contorted positions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is undifferentiated schizophrenia?

A

Individual meets the general criteria for schizophrenia but does not fit a specific subtype.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is residual schizophrenia?

A

Syndrome of depressed mood fitting the criteria for a major depressive disorder following a psychotic episode where positive symptoms are less pronounced.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is simple schizophrenia?

A

There is an absence of delusions and hallucinations and negative symptoms are most prominent, with avolition, anhedonia, and a flat affect, which arises in the absence of an acute episode.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the positive symptoms of schizophrenia?

A

Hallucinations and delusions
Disorganised speech
Thought disorders such as loose associations and thought blocking
Disorganised behaviour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the epidemiology of schizophrenia?

A

Men are affected around age 20-28, women around age 26-32
Symptoms last 6 months
Strong genetic links
Associated with environmental damage in early development such as winter birth and urbanisation
Increased risk of suicide, which is highest in the first year after presentation, predominantly in men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the features of the brain in those with schizophrenia?

A

Decreased cortical volume
Enlarged ventricles
Reduced size of prefrontal cortex, associated with negative symptoms and autism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the negative symptoms of schizophrenia?

A

Flat affect
Avolition (loss of motivation)
Catatonia
Reduced social interaction
Alogia (speaking less)
Poor attention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the course of schizophrenia?

A

Prodromal phase: precedes the acute episode of schizophrenia, characterised by non specific negative symptoms

Active phase: psychotic symptoms, with hallucinations

Residual phase: resolution of psychosis however new behaviour emerged of emotional blunting, social withdrawal and illogical thinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a good prognosis for schizophrenia?

A

Onset in mid-life
Identifiable life stressors
Acute onset
Absence of prodromal disturbances
Early treatment

24
Q

Which dopaminergic pathways are involved in schizophrenia?

A

Schizophrenia is associated with an excess of dopamine that leads to:

->Increasing the activity via D2 receptors of the mesolimbic pathway involved in reward and inhibiting the tuberoinfundibular pathway for the release of prolactin

-> hypofunction of the mesocortical pathway for affect and cognition and the nigrostriatal pathway for movement, that is responsible for the negative symptoms

25
Q

What is the dopamine hypothesis?

A

Dopamine hyperactivity is responsible for the positive and negative symptoms of schizophrenia, supported by:
->All effective antipsychotics are dopamine receptor antagonists
->Correlation between levels of the dopamine metabolite homovanillic acid, severity of psychotic symptoms and treatment response to antipsychotics
->Amphetamine drugs in schizophrenia patients never exposed to treatment causes a greater displacement of ligands bound to dopamine receptors

26
Q

What is the serotoniergic hypothesis for schizophrenia?

A

Hallucinogens such as LSD have a mode of action as a partial agonist on 5-HT receptors that causes sensory distortions

Clozapine has both dopaminergic and serotonergic antagonism on 5-HT2 receptors, which is prescribed for treatment-resistant schizophrenia

27
Q

What is the glutaminergic hypothesis for schizophrenia?

A

REDUCTION of the levels of glutamate is hypothesised to be a contributing factor for the development of schizophrenia
->Drugs such as ketamine that act as antagonists of NMDA receptors induce both positive and
negative symptoms of schizophrenia in healthy volunteers
-> phenycyclidine can cause psychosis by acting on NMDA receptors

28
Q

What s the neurodevelopmental hypothesis of schizophrenia?

A

Schizophrenia is a disorder of neurodevelopment where:
-> Obstetric complications occur
-> Schizophrenic patients have motor and cognitive issues prior to illness onset and abnormalities of cerebral structures
-> Increased risk of schizophrenia with synaptic pruning

29
Q

What is the investigation for a patient with suspected schizophrenia?

A

Detailed psychological history including mental state examination
Assess the risk of the patient to themselves and others
Establishing community or inpatient treatment
Physical examination, especially focused on neurological for cranial nerves and co-ordination
-> Bood test, drug urine test, CT scan, ECG
Current social support

30
Q

What is the initial management of a patient with schizophrenia?

A

Defusing situation and providing reassurance
Initial assessment of mental state
Managing agitation with benzodiazepines
Evaluating psychiatric symptoms
Checking vital signs and obs to rule out delirium
Provide rapid tranquillisation if necessary
Providing behavioural management through blankets to increase patient comfort

31
Q

What is rapid tranquilisation?

A

Last resort medication for patients at risk of harming themselves to avoid prolonged physical intervention. These include haloperidol, lorazepam and olanzapine
-> This is contraindicated in Parkinson’s disease

32
Q

What is associated with a schizophrenia diagnosis?

A

Co-morbidity with substance abuse, particularly cannabis, nicotine and stomulsntd
Co-morbidity with coeliac disease and metachromic leukodystrophy
Reduced fertility in men and women
Greater risk of STI’s and ischaemic heart disease and diabetes

33
Q

Which social factors affect the diagnosis of psychosis?

A

Sociocultural exclusion such as being an ethnic minority and linguistic barriers
-> Higher rates in people of African/Carribean descent
-> First episode is generally 18-25
-> Generally affects those aged 15-40 years old

34
Q

How is risk assessed for compulsory admission of psychotic patients?

A

Risk of violence and agitation based on patient delusions and hallucinations is important and affect
Assessment of past history of violence
Drug or alcohol intoxication
Availability of weapons
Potential victims

35
Q

What is the management plan for psychosis?

A

-> Prescribing benzodiazepines or antipsychotics
-> Using atypical antipsychotic like haloperidol if ineffective

Patient’s oxygen saturation should be monitored during this stage with a pulse oximetry.

36
Q

How are schizophrenia patients rehabilitated into the community to prevent relapse?

A

Treatment is focused on the minimal effective dose and returning the patient to their highest possible level of social functioning.

->Assessing mental state in every appointment due to high risk of post-psychotic depression
->Addressing substance use
->Planning for discharge
->Psychoeducation and family therapy for 3-12 months
->Individual CBT
->Support for return to education and housing involvement from social services

37
Q

How is relapse prevented in the community?

A

Relapse prevention plan to identify triggers and warning signs, and patient should carry phone number of emergency contacts

Care Programme Approach which assesses a patient’s needs and reviews the care plan

38
Q

What is schizoaffective disorder?

A

Disorder with features of both schizophrenia (hallucinations+ delusions) and affective symptoms (mania or depression) for two weeks.

It has a better outcome than schizophrenia and treatment is focused on the manic and depressive symptoms being addressed

39
Q

What is common law?

A

Development of statutes based on court decisions and past trials.

40
Q

What is statute law?

A

Laws passed by parliament.

41
Q

What is De Clerambault’s syndrome?

A

AKA erotomania where patient has the delusion that an important person is in love with them and make efforts t contact that person, which may include assaultive behaviour.

42
Q

What is Capgras syndrome?

A

Delusion that an individual has been replaced by an imposter.

43
Q

What is Fregoli’s syndrome?

A

Delusion that an individual is a shapeshifter.

44
Q

What is Cotard’s syndrome?

A

Delusional belief that the self is dead, or have lost their internal organs or rotting.

45
Q

What is Ekbom’s syndrome?

A

Delusion that the self is infested with living or non-living agents.

46
Q

What is folie a deux?

A

Psychiatric syndrome where symptoms of delusional belief are shared with another. The content of the belief depends on the individual with the primary illness, that can be identified when seaparating the two.

47
Q

How is folie a deux managed?

A

Separation of the two individuals can result in complete remission in some cases
Psychological therapy aimed at giving up the delusional therapy
Pharmacological therapy for the partner experiencing the primary delusion

48
Q

What is brief psychotic disorder?

A

Sudden, brief display of psychotic disorder which includes hallucinations and delusions that occurs following a stressful event which often occurs in people in their 20s to 40s and often returns baseline functioning. A predisposing factor for this condition is personality disorder.

49
Q

What is splitting?

A

Believing that all people are good or bad at different times due to intolerance of ambiguity which is often seen in borderline personality disorder.

50
Q

What is disassociation?

A

Temporary drastic change in personality, memory or motor behaviour to avoid emotional stress

51
Q

What is associated with a poor prognosis of schizophrenia?

A

Strong family history
Gradual onset
Low IQ
Prodromal phase of social withdrawal

52
Q

What is associated with a poor prognosis of schizophrenia?

A

Strong family history
Gradual onset
Low IQ
Prodromal phase of social withdrawal

53
Q

What is flight of ideas?

A

It is a rapid shifting of ideas with only superficial associations between them, such that the speech is difficult to follow

54
Q

What are primary disorders?

A

Primary delusions are those which cannot be described by any previous psychopathological state, such as a mood disorder

55
Q

What is an elementary hallucination?

A

Simple unstructured sounds such as buzzing or whistling.

56
Q

What is an autoscopic hallucination?

A

Visual hallucination.

57
Q

What are reflex hallucinations?

A

Hallucinations are precipitated by a normal sensory stimulus.

Year 3 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions