Psychosis Flashcards

1
Q

A collection of symptoms affecting the mind and impairing one’s ability to determine what is real. Common symptoms include hallucinations, delusions, disorganized thought and/or behavior.

A

Psychosis

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2
Q

Type of Hallucinations

A

Auditory
Visual
Tactile
Olfactory
Gustatory

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3
Q

sensations of touch without any physical stimulus.

Auditory
Visual
Tactile
Olfactory
Gustatory

A

Tactile

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4
Q

Which is common

Auditory
Visual
Tactile
Olfactory
Gustatory

A

Auditory

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5
Q

Which is Rare
Auditory
Visual
Tactile
Olfactory
Gustatory

A

Olfactory
Gustatory

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6
Q

Fixed false belief
Fixed = does not change if presented with evidence to the contrary

A

Delusions

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7
Q

Type of Delusions
P
R
S
R
G
N
E
B

A

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

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8
Q

A false belief that someone is being mistreated or harmed, or that someone close to them is being mistreated or harmed.

The police are following me because they want to torture me

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

A

Persecutory

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9
Q

A false belief that is implausible, not based on normal life experiences, and not part of cultural practices.

Believing that aliens have removed your internal organs and replaced them with someone else’s

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

A

Bizarre

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10
Q

A common psychotic symptom that involves believing that neutral events have special significance and refer to the individual personally.

That a song is about them

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

A

Referential

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11
Q

a person believes that someone else is in love with them, even if that person is a stranger or celebrity

Billie Jean is not my lover, but she says I am the one

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

A

Erotomanic

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12
Q

False beliefs about the body that are a type of delusional disorder

The person believes they are infested with parasites or insects

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

A

Somatic

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13
Q

A type of psychopathological belief that one or more aspects of reality do not exist or have been destroyed

Believing that one’s face and body are non-existent

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

A

Nihilistic

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14
Q

Any delusion associated with religious content

Believing that you are being punished for a sin

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

A

Religious

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15
Q

A false belief that someone has special powers, wealth, or identity

Believing you have extraordinary talents or superpowers

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

A

Grandiose

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16
Q

The repetition of words or phrases spoken by someone else

Echolalia
Echopraxia

A

Echolalia

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17
Q

The copying someone else’s physical movements or facial expressions

Echolalia
Echopraxia

A

Echopraxia

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18
Q

To be diagnosed with Schizophrenia you most have ? symptoms with last ? months

A

2 or more
Greater than 6 months

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19
Q

A disorder that disrupts a person’s awareness of the world around them

A

Catatonia

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20
Q

An effect that is being added to the patient

Positive symptoms vs Negative Symptoms

A

Positive symptoms

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21
Q

An effect that is being taken away or diminished from the patient

Positive symptoms vs Negative Symptoms

A

Negative Symptoms

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22
Q

Delusions

Positive symptoms vs Negative Symptoms

A

Positive symptoms

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23
Q

Avolition (lack of motivation)

Positive symptoms vs Negative Symptoms

A

Negative Symptoms

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24
Q

Hallucinations

Positive symptoms vs Negative Symptoms

A

Positive symptoms

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25
Q

Anhedonia (inability to experience joy or pleasure)

Positive symptoms vs Negative Symptoms

A

Negative Symptoms

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26
Q

Bizarre Behavior

Positive symptoms vs Negative Symptoms

A

Positive symptoms

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27
Q

Alogia (poverty of speech)

Positive symptoms vs Negative Symptoms

A

Negative Symptoms

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28
Q

Disorganization

Positive symptoms vs Negative Symptoms

A

Positive symptoms

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29
Q

Blunted/flat affect( reduction in the outward expression of emotion)

Positive symptoms vs Negative Symptoms

A

Negative Symptoms

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30
Q

Social Withdrawal

Positive symptoms vs Negative Symptoms

A

Negative Symptoms

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31
Q

Attention & *cognitive deficits

Positive symptoms vs Negative Symptoms

A

Negative Symptoms

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32
Q

Schizophrenia Onset

2

A

Late in Adolescence
Earlier in Males

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33
Q

Schizophrenia is the ? leading cause of disability

A

9th

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34
Q

Schizophrenia
Treatment

Primarily life-long pharmacologic treatment Often preference to utilize ? for improved adherence

A

Long Acting Injectables (LAI)

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35
Q

Schizophrenia
Treatment

For uncontrolled symptoms

A

Electroconvulsive Therapy

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36
Q

Schizophrenia
Treatment

The third one ?

A

Psychosocial

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37
Q

Schizophrenia
Treatment
Psychosocial
? – for psychosis
? training
Promote ?
Treat ??
? Support

A

CBT
Social skills
coping skills
comorbidities such as SUD, anxiety
Vocational

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38
Q

Indicated for acute and maintenance

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen

A

a. Antipsychotics 1st Gen

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39
Q

MOA: Dopamine antagonism (postsynaptic blockade), Ach and NE activity as well

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen

A

a. Antipsychotics 1st Gen

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40
Q

Antipsychotics 1st Gen
Antipsychotics 2st Gen
Antipsychotics 3nd Gen

Formulations: 3 ?

A

PO, IM, LAI

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41
Q

Antipsychotics 1st Gen

Side Effects/Adverse Effect
Neuroendocrine: g?, m?
S?
W?
E?
N?

A

Side Effects/Adverse Effect
Neuroendocrine: gynecomastia, menstrual irregularities
Sedation
Weight gain
Extrapyramidal Symptoms (EPS)
Neuroleptic Malignant Syndrome (NMS)

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42
Q

Neuroendocrine: gynecomastia, menstrual irregularities

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen

A

a. Antipsychotics 1st Gen

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43
Q

Haldol/haloperidol

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen

A

a. Antipsychotics 1st Gen

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44
Q

Thorazine/chlorpromazine

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen

A

a. Antipsychotics 1st Gen

45
Q

Antipsychotics 1st Gen
Antipsychotics 2nd Gen
Antipsychotics 3nd Gen

BLACK BOX: Not approved for ? related psychosis.? implications

A

dementia
Cardiac

46
Q

Neuroleptic Malignant Syndrome
mnemonic

A

Hot, stiff, out of it

47
Q

Hot, stiff, out of it

A

Neuroleptic Malignant Syndrome
mnemonic

48
Q

Neuroleptic Malignant Syndrome

Etiology not totally clear but likely dopamine blockade in ?

A

hypothalamus

49
Q

Neuroleptic Malignant Syndrome Risk Factors

D
? month of treatment
? Predisposition
? dose or ? antipsychotics

A

Risk Factors
Dehydration
First month of treatment
Genetic Predisposition
Increasing dose or multiple antipsychotics

50
Q

Neuroleptic Malignant Syndrome Symptoms

S? “?”
? Temperature
? Status
Autonomic Instability
HTN, tachycardia, diaphoresis, tachypnea

A

Severe Muscle Rigidity “Lead Pipe”
Elevated Temperature
Altered Mental Status
Autonomic Instability
HTN, tachycardia, diaphoresis, tachypnea

51
Q

Neuroleptic Malignant Syndrome

Nursing Interventions

S?
C?
Monitor ? & ?
Expect orders for ? agonists (?)

and/or

? relaxants (? or ?)

A

Nursing Interventions
Stop Medication
Cool off
Monitor I/O & Vital Signs
Expect orders for dopamine agonists (bromocriptine) and/or muscle relaxants (dantrolene or benzodiazepines)

52
Q

dopamine agonists (bromocriptine)

Neuroleptic Malignant Syndrome
or
Extrapyramidal Symptoms

A

Neuroleptic Malignant Syndrome

53
Q

muscle relaxants (dantrolene or benzodiazepines)

Neuroleptic Malignant Syndrome
or
Extrapyramidal Symptoms

A

Neuroleptic Malignant Syndrome

54
Q

Akathisia

Neuroleptic Malignant Syndrome
or
Extrapyramidal Symptoms

A

Extrapyramidal Symptoms

55
Q

Dystonia

Neuroleptic Malignant Syndrome
or
Extrapyramidal Symptoms

A

Extrapyramidal Symptoms

56
Q

Pseudoparkinsonism

Neuroleptic Malignant Syndrome
or
Extrapyramidal Symptoms

A

Extrapyramidal Symptoms

57
Q

inability to sit still

A

Akathisia

58
Q

involuntary muscle spasms, stiffness

A

Dystonia

59
Q

rigidity, tremor, slowed movement

A

Pseudoparkinsonism

60
Q

? can occur due to medications that block dopamine receptors

A

pseudoparkinsonism

61
Q

Treatment
Acute: Benztropine (Cogentin)

Neuroleptic Malignant Syndrome
or
Extrapyramidal Symptoms

A

Extrapyramidal Symptoms

62
Q

Diphenhydramine (Benadryl) IM or IV

Neuroleptic Malignant Syndrome
or
Extrapyramidal Symptoms

A

Extrapyramidal Symptoms

63
Q

Long term: daily oral anticholinergic therapy

Neuroleptic Malignant Syndrome
or
Extrapyramidal Symptoms

A

Extrapyramidal Symptoms

64
Q

Uncontrollable facial movement such as lip smacking

Tardive Dyskinesia
pseudoparkinsonism

A

Tardive Dyskinesia

65
Q

Tardive Dyskinesia: later onset, and harder/impossible to reverse
Uncontrollable facial movement such as lip smacking

Neuroleptic Malignant Syndrome
or
Extrapyramidal Symptoms

A

Extrapyramidal Symptoms

66
Q

Valbenazine (Ingrezza) Treats ?

Tardive Dyskinesia
pseudoparkinsonism

A

Tardive Dyskinesia

67
Q

Deutetrabenazine (Austedo) Treats?

Tardive Dyskinesia
pseudoparkinsonism

A

Tardive Dyskinesia

68
Q

Which is life-threatening

Neuroleptic Malignant Syndrome
or
Extrapyramidal Symptoms

A

Neuroleptic Malignant Syndrome

69
Q

Not typically fatal but can significantly impact a person’s comfort and quality of life if not treated?

Neuroleptic Malignant Syndrome
or
Extrapyramidal Symptoms

A

Extrapyramidal Symptoms

70
Q

AIMS: Abnormal Involuntary movement scale is associated with?

Neuroleptic Malignant Syndrome
or
Extrapyramidal Symptoms

A

Extrapyramidal Symptoms

71
Q

MOA: dopamine and serotonin antagonism

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen

A

b. Antipsychotics 2nd Gen

72
Q

Preferred due to side effects, not efficacy

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c.Antipsychotics 3nd Gen

A

b. Antipsychotics 2nd Gen
c.Antipsychotics 3nd Gen

73
Q

Anticholinergic effects*

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c.Antipsychotics 3nd Gen

A

b. Antipsychotics 2nd Gen
c.Antipsychotics 3nd Gen

74
Q

Hyperprolactinemia

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c.Antipsychotics 3nd Gen

A

b. Antipsychotics 2nd Gen
c.Antipsychotics 3nd Gen

75
Q

Weight gain

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c.Antipsychotics 3nd Gen

A

All

76
Q

metabolic syndrome

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c.Antipsychotics 3nd Gen

A

b. Antipsychotics 2nd Gen
c. Antipsychotics 3nd Gen

77
Q

Agitation, insomnia

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c.Antipsychotics 3nd Gen

A

b. Antipsychotics 2nd Gen
c. Antipsychotics 3nd Gen

78
Q

Weakness, fatigue, sedation

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c.Antipsychotics 3nd Gen

A

all

79
Q

Cardiac Implications

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c. Antipsychotics 3nd Gen

A

All

80
Q

Sexual dysfunction

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c. Antipsychotics 3nd Gen

A

b. Antipsychotics 2nd Gen
c. Antipsychotics 3nd Gen

81
Q

EPS/NMS (but less likely)

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c. Antipsychotics 3nd Gen

A

b. Antipsychotics 2nd Gen
c. Antipsychotics 3nd Gen

82
Q

EPS/NMS

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen

A

a. Antipsychotics 1st Gen

83
Q

Clozaril/clozapine

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen

A

b. Antipsychotics 2nd Gen

84
Q

High Risk, High Regulation Drug
Risk: Severe Neutropenia

Clozaril/clozapine
Invega/paliperidone

A

Clozaril/clozapine

85
Q

Clozaril/clozapine
Monitoring:

? at initiation
Weekly absolute neutrophil count (ANC) for the first ? months
? for another 6 months
Then ? for duration of therapy

A

Monitoring:
CBC at initiation
Weekly absolute neutrophil count (ANC) for the first 6 months
Biweekly for another 6 months
Then monthly for duration of therapy

86
Q

Which is not used first with b. Antipsychotics 2nd Gen

Clozaril/clozapine
Invega/paliperidone

A

Clozaril/clozapine

87
Q

Often grouped with SGA/atypicals

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c. Antipsychotics 3nd Gen

A

c. Antipsychotics 3nd Gen

88
Q

used as adjunctive or monotherapy in mood disorders

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c. Antipsychotics 3nd Gen

A

c. Antipsychotics 3nd Gen

89
Q

MOA: partial dopamine agonist, serotonin-dopamine activity modulator

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c. Antipsychotics 3nd Gen

A

c. Antipsychotics 3nd Gen

90
Q

Claims of being “weight neutral”

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c. Antipsychotics 3nd Gen

A

c. Antipsychotics 3nd Gen

91
Q

Similar to 2nd Gen

a. Antipsychotics 1st Gen
b. Antipsychotics 2nd Gen
c. Antipsychotics 3nd Gen

A

c. Antipsychotics 3nd Gen

92
Q

What I always have to remember about Anticholinergic Side Effects

A

Body stays in Sympathetic State
But Fluid production is bloked because the body cannot regulate it self in parasympathic is blocked.
Urine rentiontion
Sweat decreases
Dry Mouth

93
Q

Schizophrenia Spectrum

Brief psychotic disorder
Less than ? month

A

1

94
Q

Schizophrenia Spectrum

Schizophreniform
? months

A

1-6

95
Q

Less than 1 month

Brief psychotic disorder
Schizophreniform

A

Brief psychotic disorder

96
Q

1-6 months

Brief psychotic disorder
Schizophreniform

A

Schizophreniform

97
Q

With Schizophrenia you checks signs of

3?

A

NMS
EPS
Anticholinergic Crisis

98
Q

With Schizophrenia you have pt ? Balance

A

Promote Fluid

99
Q

You will AIMS: Abnormal Involuntary movement scale to cheach for movent of al these disorders

A

Yes

100
Q

what are used to diagnosis Schizophrenia

D
H
D
D or C Behavior
N

A

Delusions
Hallucinations
Disorganized speech
Disorganized or catatonic behavior
Negative symptoms

101
Q

Schizoaffective
Criteria

What 3 must pt have

A

Schizophrenia, Major depressive, Mania

102
Q

Schizoaffective

Co-occurring ? and ? episode

A

psychosis ( Schizophrenia symptoms)
Mood d/o (Mania or MDD)

103
Q

Schizoaffective

Delusions or hallucinations for ? weeks in the absence of a major mood episode

A

2 or more

104
Q

Schizoaffective

Mood disorder symptoms must be present for >?% of total duration of illness

A

50

105
Q

Schizoaffective is same treatment as Schizophreniia just atypical no 1st genration.

A
106
Q

Delusional Disorder

Logical, stable, well-systematized delusions that occur in the absence of other psychiatric disorders for >?month

A

1

107
Q

Delusional Disorder

All subtype of psychosis just two more ?

A

jellous
Mixed

108
Q

Delusional Disorder

Goal: ?

A

reduce severity of delusion

109
Q

Delusional Disorder

No ? only ? to treat it.

A

Meds
CBT