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Nervous system > Psychosis > Flashcards

Psychosis Flashcards

1
Q

what is definition of psychosis

A

The presence of hallucinations or delusions

Describes symptoms, not a diagnosis in itself

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2
Q

what is definition of hallucinations ?

A

Perception without a stimulus
Can be in any sensory modality
Visual hallucinations are usually organic
(caused by problem with brain or eyes)

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3
Q

what are Hypnogogic hallucinations ?

Hypnopompic ?

A

hallucinations before going to sleep
waking up
these are normal

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4
Q

what are delusions ?

A

abnormal belief,
outside of cultural norms,
unshakeable

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5
Q

what is organic psychosis ?

causes >

A

abnormal brain function with known physical abnormalities

Steroids
L-dopa
Hyperthyroidism
Encephalitis
Drugs/alcohol 
Hypercalcaemia
cerebral lupus
delirium - infections , tremens
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6
Q

what are first rank symptoms of schizophrenia ?

A 
Auditory hallucinations 
passivity experiences 
thought withdrawal , broadcast or insertion 
delusional perceptions 
somatic hallucinations
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7
Q

what kind of auditory hallucinations are seen in schizophrenia?

A

thought echo - hearing thoughts aloud

Running commentary - third person and multiple voices

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8
Q

what is passivity experiences ?

A

patients believes actions or feeling is caused by external force

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9
Q

what is Thought withdrawal, broadcast and insertion?

A 
Thought withdrawal – thoughts are being
taken out of the mind
Thought broadcast - thoughts are being
made known to others e.g. via radio
Thought insertion – thoughts implanted
by others
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10
Q

what is Delusional perception?

A

attribution of new meaning,
usually in the sense of self-reference,
to a normally perceived object.
e.g traffic lights were red = aliens will come

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11
Q

what are somatic hallucinations ?

A

Mimics feeling from inside the body

- ‘there is snake in my stomach ‘

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12
Q

what are positive symptoms in schizophrenia ?

A

Delusions, hallucinations, thought disorder, lack of
insight
Added symptoms

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13
Q

what are negative symptoms in schizophrenia ?

A

Underactivity, low motivation, social withdrawal,
emotional flattening, self neglect
Symptoms that take away from the patient

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14
Q

what is the ICD 10 diagnosis of schizophrenia ?

A

At least one of the following
a) Thought echo, insertion, withdrawal, broadcast
b) Delusions of control, influence or passivity, clearly referred to
body/limb movements or specific thoughts actions or sensations,
delusional perception
c) Hallucinatory voices giving a running commentary on the patient’s
behaviour, or discussing them between themselves, or other types
of hallucinatory voices coming from some part of the body
d) Persistent delusions of other kinds that are culturally inappropriate
and completely impossible

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15
Q

what are the types of schizophrenia ?

A 
Paranoid schizophrenia
Simple
Hebephrenic
Undifferentiated
Catatonic
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16
Q

define paranoid schizophrenia

A

delusions or hallucinations

prominent

17
Q

define simple schizophrenia

A 
loss of drive and
interest, aimlessness, idleness, self
absorbed attitude and social withdrawal.
Marked decline in social, academic or
work performance. No
hallucinations/delusions
18
Q

define hebephrenic schizophrenia

A

definite and
sustained flattening or shallowness of affect
or incongruity/inappropriateness of affect,
aimless and disjointed behaviour or thought
disorder affecting speech
Hallucinations/delusions must not dominate

19
Q

what pathways are affected in Schizophrenia ?

A

dopamine pathways -

Mesocortical and mesolimbic

20
Q

where does the mesolimbic pathway start/ finish?

A 
From
Ventral tegmental area
To
Limbic structures
(amygdala, septal area,
hippocampal formation)
and
Nucleus accumbens
(large cell group in basal
forebrain)
21
Q

what is the ventral tegemtal area ?

A

midbrain collection of dopaminergic neurones

22
Q

what does the mesolimbic pathway do? how active in schizophrenia ?

A

Motivation, reward, pleasure

overactive

23
Q

where does the mesocortical pathway start/ finish?

A 
From
Ventral tegmental area
To
Frontal cortex
and
Cingulate cortex
24
Q

what does the mesocortical pathway do? how active in schizophrenia ?

A

Cognition, motivation, emotional response

under active

25
Q

what are brain changes in schizophrenia ?

A

Enlarged ventricles

reduced hippocampus, amygdala , prefrontal cortex

26
Q

what type of Encephalitis is seen in schizophrenia ? where is it seen mostly ?
why does it occur ?
treatment

A 
Anti-NDMA- sudden onset  (1-3wks)
seen in women with ovarian teratoma
 antibodies bind to NMDA= hypofucntion
corticosteroids and IV immunoglobulin 
can lead ot coma
27
Q

what do typical antipscychotics do ?

A

Block D2 receptors in all CNS

dopaminergic pathways- mesolimibic/ cortical

28
Q

what do atypical antipsychotics do ?

A

Low affinity for D2 receptors
Milder side effects as dissociate rapidly
from D2 receptor

29
Q

where are D2 receptors found in the brain ?

A

Striatum
Substantia nigra
Pituitary gland

30
Q

what side effects are seen in Anti-psychotics ?

A

parkinosonian symptoms e.g. acute dystonia

31
Q

what is catatonia ?

A

more than 2 wks of 1 or more:

stupor / mutism , excitement , posturing, negativism, rigidity, waxy flexibility , command automatism

32
Q

what causes catatonia ? how is it treated ?

A

less GABA binding = loss of inhibitory effect

Lorazapam = benzo

33
Q

what is the ICD 10 criteria of drug indued psychosis ?

A

Onset of psychotic symptoms during or within two weeks of substance use
Persistence of the psychotic symptoms for more than 48 hours
Duration of the disorder not exceeding six months

34
Q

what is affective psychosis ?

A

experiences are congruent with mood

E.g manic patients = hear voice of God

35
Q

What is PP psychosis ?

A 
very severe 
Can present in patients with no
previous psychiatric history
More common if previous
bipolar disorder or psychotic illness,
or mother or sister suffered
Onset within days to weeks of delivery
Can develop over hours to days

Nervous system (20 decks)

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