Brainscape's Knowledge GenomeTM

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


See full index

CP2 Psychiatry > Psychosis > Flashcards

Psychosis Flashcards

1
Q

Psychosis

A 
A state in which there is a loss of contact with reality 
Includes: 
Delusions 
Hallucinations 
Formal thought disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Prevlance psychosis

A

1/100

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

When is the peak incidence of psychosis in males?

A

23 y/o

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

When is the peak incidence of psychosis in females?

A

26

2nd peak 30-40

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

Biological aetiology schizophrenia (2)

A

FHx
Idenitcal twins - 46%
Obstetric complication

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

Psychological aetiology schizophrenia

A

Congitive errors

Premorbid personality - schizotypal disorder

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

Social aetiology schizophrenia (4)

A

Urban living
Migration
Life events incl physical + sexual abuse
Ethnicity - Afro-Caribbean

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

Prodrome

A

Period of time when the individual = gradually developing Sx but has not yet met criteria for diagnosis

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

What is the average DUP?

A

> 1

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

Good prognostic factors psychosis (8)

A 
Female 
Married 
FHx affective disorder 
Acute onset 
Good premorbid personality 
Early Tx
prominent mood Sx 
good response to Tx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Poor prognostic factors psychosis (6)

A 
FHx schizophrenia 
High expressed emotion 
Substance misuse 
Prominent negative Sx 
Early onset 
Lack of insight/non-compliance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 3 groups of schizophrenia symptoms?

A

Positive
Negative
Motor/catatonic

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

E.g.s of positive schizophrenia Sx (3)

A

Formal thought disorder
Hallucination
Delusion

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

E.g.s of negative schizophrenia sx (7)

A 
Anhedonia 
Blunting of affect 
Apathy 
Lack of volition - under control 
Poverty of thought 
Poor self-care
Cognitive deficits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

E.g.s of motor/catatonic schziophrenia Sx (7)

A 
Rigidity 
Posturing 
Mutism 
Waxy flexibility 
Negativism 
Stereotypies 
Tics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is rigidity

A

Maintaining a fixed position and rigidly resisting all attempts to be moved

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

What is posturing

A

Adopting an unusual position that is then maintained for some time

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

What is waxy flexibility

A

patients can be moulded like wax into a position that is then maintained

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

What is negativisim

A

A seemingly motiveless resistance to all instructions/attempts to be moved

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

What is stereotypies

A

A complex movement that does not appear to be goal-directed e.g. rocking

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

Perception

A

The process of making sense of the physical information we receive from our 5 sensory modalities

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

Illusions

A

Misperceptions of real external stimuli

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

Delusion

A

A fixed, usually false unshakable belief which is out of keeping with patients educational, cultural and background + held despite all evidence to contrary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Persecutory delusion

A

Delusional belief that one’s life is being interfered with in a harmful way

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Delusion of reference

A

Delusional belief that external events have been arranged so that a messaged is conveyed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Grandiose delusions

A

Delusional belief that the patient has special powers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Primary delusions

A

Do not occur in response to any previous psychopathologies state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Mood congruent delusions

A

Contents are appropriate to patients mood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

De-Clerambault’s syndrome

A

Delusion where the patient believes another individual is in love with them and they are destined to be together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Capgras syndrome

A

Patient is replaced by an identical double’ who is not the real person

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Cotard syndrome

A

Psychotic depressive presentation with nihilistic delusions and hypochondriacal disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Fergoli syndrome

A

Strangers have been replaced by one familiar person who changes appearance or takes on disguises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Nihilistic delusion

A

Patient believes they have died or no longer exists or the world has ended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Delusion perception

A

A real percept that leads immediately to a delusional belief - the traffic lights turned red and I knew I was the King of England’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Overvalued ideas

A

Ideas that are understandable and reasonable in themselves come to dominate the patients life

36
Q

Typical disorders that feature overvalued ideas (5)

A 
Anorexia nervosa
Hypochondriacal disorder 
Dysmorphophobia 
Paranoid personality disorder 
Morbid jealous
37
Q

The more simple the auditory hallucination…

A

The more likely the cause is to be organic

38
Q

When does a Hypnopomic hallucination occur?

A

Upon waking

39
Q

When does a hypnagogic hallucination occur?

A

Upon falling asleep

40
Q

Conditions where visual hallucinations are more common (5)

A 
Dx withdrawal 
Some dementias 
Encephalitis 
Epilepsies 
Occipital lobe tumours
41
Q

What is a visceral tactile delusion

A

False perception of inner organns

42
Q

What is Ekbom’s syndrome

A

False belief that one = infested with small but visible organisms

43
Q

Auditory pseudohallucinations

A

A perceptual experience which differs from hallucination in that it appears to arise in the subjective inner space of the mind

44
Q

How can auditory pseudohallucinations be explained?

A

Internalisation of past aggressor/abuser

E.g. in EUPD

45
Q

Features of formal thought disorder (5)

A 
Loosening of association 
Flight of ideas 
Circumstantial thoughts 
Tangential thoughts 
Thought block
46
Q

What is Knight’s move thinking

A

Patients train of thought shifts suddenly from 1 v loosely unrelated idea –> next

–> ‘word salad’

47
Q

Thought block

A

Pt experience a sudden cessation to their flow of thought, often mid sentance.
Pt - no recall of what they were saying + continue to talk about different topic

48
Q

Neoglisms

A

New word created by the patient

49
Q

Idiosyncratic word use

A

Using recognised words by attributing them with non-recognised meaning

50
Q

Perseveration

A

When an initially correct response is inappropriately repeated

51
Q

Echolalia

A

Patients senselessly repeat words or phrases spoken around them by others = parrot

52
Q

What are Schnider’s 1st rank symptoms (ABCD)

A

Auditory hallucinations
Broadcasting of thought
Controlled thought - delusions of control
Delusional perception

53
Q

Diagnostic criteria schizophrenia - ICD-10

A 
>28 days 
No organic cause 
1st rank symptoms present 
1 or > of: thought sx, delusion control/passivity, delusional perception, hallucinatory voices running commentary, bizarre delusions 
May also have -ve and cognitive
54
Q

Organic causes psychosis (6)

A 
Delirium 
Medication induced 
Endocrine - Cushings, HypoT/hyperT 
Neuro 
Systemic - porphyria/SLE 
Substances
55
Q

Medications that can induce psychosis (3)

A

Corticosteroids
Stimulants
Dopamine agonists

56
Q

DDx psychotic patient (6)

A 
Schizoaffective disorder 
Delusional disorder 
Schizotypal disorder 
Acute + transient psychotic disorder 
Mood disorder 
Substance misuse
57
Q

Ix psychosis (7)

A 
Neurological exam
BMI
Bloods 
Urine - Dx screen
Syphillis screen 
ECG
Collateral Hx
58
Q

Common co-morbidity psychosis

A

Substance misuse

59
Q

Reasons for non-compliance with antipsychotics (5)

A 
Lack of insight 
SE of medication 
Delusions about medication/prescriber 
Patient feels 'better' when ill 
Pt gains remission + thinks meds no longer required
60
Q

Physical health monitoring for psychosis patients (6)

A 
Smoking/drinking status 
P/FHx of DM/Coronary heart disease 
BP
BMI
Bloods 
ECG
61
Q

Define treatment resistance schizophrenia

A

Lack of response to adequate doses of 2 different antipsychotics

62
Q

What should you double check if you are about to diagnose someone with TRS (Tx-resistant schizophrenia)

A

Review diagnosis
Rule out co-morbid substance misuse
Ensure dose/duration + compliance prev Tx

63
Q

Med used for TRS

A

Clozapine

64
Q

SE clozapine (7)

A 
Neutropenia 
Fatal agranulocytosis 
Hypersalivation 
Cardiomyopathy
Myocarditis 
DM
Seizures
65
Q

Monitoring clozapine

A

FBC weekly for 1st 18w
Then every 2w for 1year
Then every 4 weeks

66
Q

Psychological Tx schizophrenia

A

CBT ***
FIT (Family intervention therapy)
Psychoeducation
Coping stratergies

67
Q

What is involved in psychoeducation for schizophrenics (4)

A

Relapse signs
Crisis plans
Relapse prevention
WRAP - Wellness, recovery + Action Plans

68
Q

Conditions antipsychotics can be used for (10)

A 
Psychosis 
Delirium 
Behavioural disturbance - dementia 
Mood disorders 
Severe agitation, anxiety + violent/impulsive behaviour
Insomnia 
Rapid tranquillisation 
N+V
Hiccups
Tics incl Tourette's
69
Q

What are the 3 main aims of Tx in the use of antipsychotics in psychosis

A

Alleviate +ve Sx
Alleviate -ve Sx
minimise SE

70
Q

1st gen antipsychotics (5)

A 
Chlorpromazine 
Haloperidol 
Sulpiride
Flupentixol
Zuclopenthixol
71
Q

2nd gen antipsychotics (5)

A 
Clozapine 
Olanzapine 
Quetiapine
Risperidone
Amisulpride
72
Q

SE 1st gen antipsychotics (12)

A 
NMS
Seizure threshold lowered 
Sedation 
EPSE
BP/Temp changes 
Hypersensitivity reactions - liver, bone marrow, skin 
Raised prolactin
Apathy
Confusion 
Depression 
Arrhythmia 
Metabolic syndrome
73
Q

What is Akathisia

A

Subjective feelings of restlessness

74
Q

Parkinsonism

A

Tremor, rigidity, bradykinesia

75
Q

What is Acute dystonia

A

Involuntary mm spasms which prod briefly sustained abnormal postures.
Within 48hrs initiation

76
Q

What is Tardive Dyskinesia

A

Abnormal involuntary hyperkinetic chewing, head nodding, grimacing, rocking movements

77
Q

Features of metabolic syndrome (6)

A 
Central obesity 
Insulin resistance 
Impaired glucose regulation 
HTN
Raised plasma TG
Raised LDL cholesterol level
78
Q

Mortality rate NMS

A

5-20%

79
Q

Sx NMS (7)

A 
Hyperthermia 
Confusion 
TachyC
Hyper/HoTN 
Tremor 
Raised CK
Low pH - metabolic acidosis
80
Q

SE olanzapine

A 
Sedation + 
W gain ++++
Raised TG 
Dizziness
AntiC SE
81
Q

SE risperidone

A

W gain +
EPSE ++
Sexual dysfunction +
Sedation +

82
Q

Quetiapine SE

A

Sedation ++
Weight gain ++
Possible QT prolongation
Lowest risk EPSE

83
Q

SE Aripiprazole

A

Nausea
Restlessness
Insomnia
Exacerbates psychosis initially

84
Q

What’s great about Aripiprazole

A

Least W gain

Minimal metabolic effect

85
Q

Depot Antipsychotics (7)

A 
Haloperidol 
Flupentixol
Zuclopenthixol
Fluphenazine
Risperidone
Olanzapine
Aripiprazole
86
Q

How long should schizophrenics continue their meds after recovering from an acute episode?

A

1-2 years at least

87
Q

What psychosocial interventions should not be offered to schizophrenics (2)

A

Adherence therapy

Social skills training

CP2 Psychiatry (15 decks)

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