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Psychiatry > Psychosis & Schizophrenia > Flashcards

Psychosis & Schizophrenia Flashcards

1
Q

Name 7 causes of psychosis

A 
Organic Cause
Space Occupying Lesion
Infection
Drug Induced
Schizophrenia
Depression with Psychoses
Mania
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2
Q

What are Scheidners 1st rank symptoms of Schizophrenia?

A
  • 3rd person auditory hallucinations
  • Thought insertion, withdrawal or broadcast (alienation)
  • Delusional Perceptions
  • Delusions of control
  • Somatic Passivity
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3
Q

What is needed for an ICD 10 diagnosis of schizophrenia?

A

1 clear cut symptom or 2-3 less clear cut symptoms for 1 month.

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4
Q

What are some less clear cut symptoms of Schizophrenia?

A 
Overvalued idea
Catatonia
Incongruity of affect or emotional response
Apathy
Blunting affect
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5
Q

What are risk factors for Schizophrenia?

A 
GENETICS
Neurodevelopmental hypothesis
Winter births and influenza
Cannabis in adolescence
Severe child abuse or bullying
Socioeconomic deprivation
Urbanity
Life events immediately before
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6
Q

What are the neurochemical changes in Psychosis?

A

Dopamine excess and overactivity in mesolimbic pathways.

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7
Q

Why does amphetamine cause psychosis?

A

Causes dopamine release

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8
Q

What is Hebephrenic Schizophrenia?

A 
Fluctuating affect
Early Onset
Irresponsible behaviour
Fleeting hallucinations and delusions
Incongruous mood and affect
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9
Q

What is Catatonic Schizophrenia?

A 
Rigidity
Echolalia
Posturing
Echopraxia (copy behaviours)
Psychomotor disturbances
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10
Q

What is redisual schizophrenia?

A

History of full schizophrenia, but only negative and cognitive symptoms remaining

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11
Q

What is Simple Schizophrenia?

A

RARE

Negative symptoms only with no psychosis

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12
Q

What are the negative symptoms in Schizophrenia?

A

Apathy
Lack of emotion
Poor social functioning
Poverty of speech

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13
Q

What are the positive symptoms of schizophrenia?

A

Delusions
Hallucinations
Racing thoughts

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14
Q

What is psychosis?

A

Severe mental disorder such that thoughts and emotions are so impaired that they have lost contact with external reality

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15
Q

When does puerpural psychosis hit?

A

Suddenly, 2 weeks after delivery

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16
Q

What is Paranoid schizophrenia?

A

Delusions and Auditory Hallucinations

17
Q

What is schizoaffective disorder?

A

Affective and Schizophrenia in equal prominence so must be treated for both.

18
Q

Name 5 atypical antipsychotics

A 
Clozapine
Risperidone
Quetiapine
Olanzapine
Aripiprazole
19
Q

What is the mechanism of action of atypicals?

A

5HT2A and D2 antagonists (Dopamine and Serotonin antagonist) meaning they treat positive AND negative symptoms of schizophrenia.

20
Q

What are indications for poor prognosis in schizophrenia?

A

Gradual onset

21
Q

What are indicators for good prognosis in schizophrenia?

A

Rapid Onset
No FH
Education
Stressful life event trigger

22
Q

Which is the most effective Atypical?

A

Clozapine

23
Q

Which atypicals cause the most weight gain and metabolic SEs

A

Olanzapine

Clozapine

24
Q

Which atypical causes fewest SEs and is available as a depot?

A

Risperidone

25
Q

What are the specific SEs of atypicals?

A

T2DM
Dyslipidaemia
Myocarditis
Cardiomyopathy

26
Q

When is clozapine prescribed?

A

When 2 other antipsychotics have failed to control symptoms

27
Q

What additional side effects does Clozapine have?

A 
Agranulocytosis (low WCC)
Seizure risk
Hypersalivation
Constipation
Hypo/hypertension
Nocturnal Enuresis
Nausea 
Constipation
28
Q

What is needed to monitor Clozapine?

A

Regular FBC to check WCC
Weekly for 18 weeks
Fortnightly for 1 year
Monthly

29
Q

What are the side effects caused by ALL antipsychotics?

A
  • Anticholinergic: dry mouth, urinary retention, constipation, confusion
  • Cardiac- Long QT, doubled risk of sudden cardiac risk
  • Neuroleptic Malignant Sydrome- Hyperpyrexia, Confusion, Increased CK and muscle tone
  • Antihistaminergic- drowsiness
  • Antiadrenergic- Postural hypotension
30
Q

Name some typical antipsychotics

A

Phenothiazides (Chlorpromazine, Fluphenazide)

Haloperidol

31
Q

What is the mechanism of action of typicals?

A

Just D2 receptor agonists and increased potency

32
Q

What causes EPSEs?

A

Dopamine blockade at the nigrostriatal pathways

33
Q

What are EPSEs?

A

PArkinsonism
Akathisia (treat with benzos or BBs)
Torticollis
Increased muscle tone

34
Q

What causes Tardive Dykinesia?

A

Long term antipsychotic use due to oversensitivity in dopamine receptors

35
Q

What does TD look like?

A

Chronic Buccolingual Masticatory movements

36
Q

What can be used to treat TD?

A

Clozapine, but irreversible in 50% cases

37
Q

What are the other risks of typicals?

A 
Hyperprolactinaemia
Amenorrhoea
Galactorrhea
Sexual dysfunction
Breast Cancer
38
Q

What are the most abundant dopamine receptors?

A

D2

Psychiatry (13 decks)

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