psychosis

Question 1

4 things seen in psychosis?

Answer 1

hallucinations, delusions, passivity, formal thought disorder

Question 2

what is passivity?

Answer 2

(passive movements) feeling as if the mind or body is under the control of some external agency or force

Question 3

formal thought disorder?

Answer 3

umbrella term for disorders such as neologism, thought blocking, poverty of speech, tangenitally, circumstantiality, flight of ideas

Question 4

what is flight of ideas?

Answer 4

words are associated inappropriately, but there is a logical link i.e. rhyming/connection

Question 5

how is a formal thought disorder evidenced?

Answer 5

disorganised thinking causes disorganised speech

Question 6

“He went to the ballpark and bought Frank’s beer belly home in a bag of grass seed.”

What kind of thought disorder?

Answer 6

knights move thinking/loosening of associations

Question 7

4 areas in brain associated with fear?

Answer 7

SHHAT - sensory cortex, hippocampus, hypothalamus, amygdala, thalamus

Question 8

differential diagnosis od psychosis?

Answer 8

Schizophrenia
Psychoactive Substance Use
Mania
Depression
Schizoaffective Disorder
Delirium
Dementia
Other organic cause

Question 9

what is schizo—-affective disorder?

Answer 9

pyschotic symptoms and mood symptoms

Question 10

typical auditory hallucination in severe depression?

Answer 10

2nd person derogatory - you are shit

Question 11

depressive psychosis typified by what psychotic symptoms?

Answer 11

mood congruent…worthlesness, guilt, hypochondriasis, guilt

Question 12

why do you have to be careful in drug induced psychosis? what could be underlying?

Answer 12

underlying schizophrenia/biplolar disorder. they are more likely to use illicit drugs

Question 13

psychosis is a marker of severity in depression. typified by ______ congruent content of psychotic symptoms

Answer 13

mood

Question 14

what kind of delusions do you get in depressive psychosis?

Answer 14

guilt/worthlesness/poverty (nihilistic delusions)

Question 15

mania with psychosis. typically what kind of delusions?

Answer 15

delusions of grandeur, religious and paranoid/suspicious

Question 16

man bought new porsche. new girlfriends. big stakes business transactions. hears gods voice. thinks he is madonnas son and is going to inherit large sums of money?

Answer 16

mania with psychosis

Question 17

septicaemia, organ failure (cardiac, renal, hepatic), hypoglycaemia, post-op hypoxia, post-ictal, encephalitis, space occupying lesion, drug intoxication (e.g. steroids, digoxin, diuretics, anticholinergics), drug withdrawal (e.g. benzodiazepines.
what kind of psychosis?

Answer 17

delirium

Question 18

man having hallucinations (worse at night) in hospital after surgery for MI. seeing people running around and hearing 2nd person auditory threatening hallucinations?

Answer 18

delirium

Question 19

when is delirium worst?

Answer 19

at night

Question 20

orientation in delirium?

Answer 20

loss of orientation in time, place and person

Question 21

what is the course of delirium like?

Answer 21

fluctuating with lucid intervals

Question 22

auditory hallucinations in delirium are often?

Answer 22

threatening

Question 23

delusions are ?

Answer 23

persecutory (jesus cross)

Question 24

uncle d, delirious patients are irritable and insomnic

Answer 24

yes

Question 25

3rd person auditory hallucinations suggests?

Answer 25

schizophrenia

Question 26

79 year old man retired bank manager admitted for elective fem-pop bypass graft (28/10/10)
PMH: aortic stenosis, LVH. No PPH
? post-op MI (31/10/10)
referred to psychiatrist on-call 2:00am 2/11/10
increasingly difficult to manage,
? hallucinated, disorientated in time & place,
trying to leave the ward
WORSE AT NIGHT

Answer 26

DELIRIUM POST MI (hypoxic)

Question 27

55 year old farmer brought by his wife to GP
He believes he has brought financial ruin to his whole family and deserves to die
He admits to very poor sleep, has no energy or appetite and has lost 1st weight in the past 2 months
His thoughts are generally pessimistic and negative towards himself & the future

Answer 27

DEPRESSIVE EPISODE WITH PSYCHOTIC FEATURES
i.e. delusions of guilt / poverty
farm difficulties a possible precipitating factor

Question 28

23 year old unemployed graduate presents to his GP
he has been involved in a number of new business ventures over recent weeks involving a proposed sum of £150 000. He has also tried to buy a Porsche on credit.
He has been involved with a number of new girlfriends and was caught speeding on the A90 at 110mph
He admits to poor sleep over the last 3 weeks but does not feel tired.
He feels full of energy and new ideas and can’t see that he has done anything wrong.
He says he just found out that he is Madonna’s secret son and stands to inherit
£5 000 000 next month.
He knows this because she has broadcast messages to him over the radio & TV

Answer 28

manic

Question 29

what is psychosis characterised by?

Answer 29

hallucinations, delusions, thought disorder and lack of insight

Question 30

olfactory and gustatory hallucinations suggest?

Answer 30

seizure

Question 31

what diagnosis is made when psychosis and mood symptoms are present in equal measure?

Answer 31

schizoaffective disorder