psychosis

Question 1

loss of touch with reality

Answer 1

psychosis

Question 2

disorders with psychosis

Answer 2

schizophrenia
bipolar disorder
depression
organic (head injury, ETOH, etc)

Question 3

this meets criteria for schizophrenia but less than 6 months duration

Answer 3

pchizophreniform disorder

Question 4

schizophrenia + mood disorder

Answer 4

schizoaffective disorder (major depression or bipolar d/o)

Question 5

delusional disorder

Answer 5

paranoid disorders, delusions about things that could not happen in real life (being followed, poisoned)

Question 6

diagnosis for shizophrenia

Answer 6

greater than 6 months duration of illness with 1 month of acute sx along with FUNCTIONAL DECLINE & 2 or more symptoms: 1. hallucinations, 2. delusions, 3. disorganized speech, 4. disorganized/catatonic sx, 5. negative symptoms

Question 7

symptoms of schizophrenia

Answer 7

1. paranoid: preoccupied with delusions of persecution or grandeur: usually tense and guarded
2. disorganized: unorganized behavior, disorganized speech, inappropriate affect
3. catatonic: silent, doesn’t respond to external stimuli
4. residual: socially withdrawn

Question 8

pathophysiology of positive sx of schizophrenia

Answer 8

excess dopamine receptors in mesolimbic pathway

hallucinations, delusions, disorganized speech and thinking, movement disorders (catatonic behavior

Question 9

pathophysiology of negative sx of schizophrenia

Answer 9

flat emotional affect, caused by dopamine dysfunction in the mesocortical pathway

(flat emotional affect: social withdrawal, lack of emotional expression, communication and reactivity, silent patients)

Question 10

% of population who is schizophrenic

Answer 10

1% - 10% incidence in pts with 1st degree relative that is schizophrenic

Question 11

management of schizophrenia

Answer 11

1. antipsychotics: dopamine receptor antagonists –> 2nd generation is 1st line treatment!! Ex : clozapine, risperidone, olanzapine
   1st generation: chlorpromazine or haloperidole (increased extrapyramidal sx)