psychotic d/o, meds, delusional d/o

Question 1

Patient exhibits abnormal behavior and is unable to differentiate real from imaginary.
Chronic and debilitating
Disruption of the usual balance of emotions and thinking
M>F

Answer 1

schizophrenia

Question 2

Positive symptoms – Extra feelings or behaviors which are usually not present

Answer 2

Delusions and paranoia
Hallucinations
Irrational, bizarre or odd statements or beliefs
Hostility
Disorganized speech
Inappropriate laughter
Hyperactivity

Question 3

Negative symptoms – A lack of behaviors or feelings which are usually present

Answer 3

Social isolation and withdrawal
Becoming more emotionless
Lack of motivation
Deterioration in their personal appearance and hygiene
Catatonic behavior

Question 4

Delusions

Answer 4

False beliefs held in spite of contradictory evidence.

Question 5

Hallucinations

Answer 5

A false perception in any SENSORY modality

Question 6

Auditory hallucinations or delusions of grandiose persecution. Patient does not have poor thought order or disorganized behavior.

Answer 6

Paranoid Schizophrenia – Most common.

Question 7

Flattened affect and thought disorder

Answer 7

Disorganized Schizophrenia

Question 8

Either immobile and mute with waxy flexibility or agitated purposeless movements and echolalia (mimicking sound)

Answer 8

Catatonic Schizophrenia

Question 9

patient has psychotic symptoms but does not fit into the other categories.

Answer 9

Undifferentiated schizophrenia

Question 10

Residual Type schizophrenia subtype

Answer 10

Where positive symptoms are present at a low intensity only

Question 11

A depressive episode arising in the aftermath of a schizophrenic illness where some low-level schizophrenic symptoms may still be present.

Answer 11

Post-schizophrenic depression

Question 12

Insidious and progressive development of prominent negative symptoms with no history of psychotic episodes.

Answer 12

Simple schizophrenia

Question 13

EPS and occur with what

Answer 13

typical antipsychotics
Tardive dyskinesia – irregular jerky motion
Dystonia – Continuous muscle spasms
Parkinsonian movement – tremor, bradykinesia, rigidity

Question 14

Tardive dyskinesia
Dystonia
Parkinsonian movement

Answer 14

Tardive dyskinesia – irregular jerky motion
Dystonia – Continuous muscle spasms
Parkinsonian movement – tremor, bradykinesia, rigidity

Question 15

tx goals typical antipsychotics (3)

Answer 15

psychomotor slowing, emotional quieting, and affective indifference

Question 16

haldol, fluphenazine, chlorpromazine, thioridazine, AZINE

Answer 16

typical antipsychotics

Question 17

haldol and fluphenazine SE

Answer 17

EPS> anticholinergic

QT prolongation, torsades(with IV haldol)

Question 18

chlorpromazine and thioridazine SE

Answer 18

anticholinergic < EPS

Question 19

risperone, abilify, clozapine(clozaril)

Answer 19

atypical antipsychotics

Question 20

atypical antipsychotics SE

Answer 20

wt gain, somnolence, DM2, QTc prolongation

Question 21

clozapine(clozaril)

Answer 21

2nd line for schizophrenia due to propensity for aggranulocytosis and reserved for severe tx resistance and severe tardive dyskinesia
- require weekly CBC monitoring during the 1st 6 months

Question 22

schizophrenia gender and age

Answer 22

males usually; early adulthood

Question 23

schizophrenia phases

Answer 23

prodromal, psychotic, residual

Question 24

delusions
hallucinations
disorganized speech
grossly disorganized behavior, catatonic behavior
negative sx
thought broadcasting

Answer 24

schizophrenia- must have 2 of these during a 1 month period and continuous for at least 6 months

Question 25

name 6 signs for schizo...

Answer 25

``` delusions hallucinations disorganized speech grossly disorganized behavior, catatonic behavior negative sx thought broadcasting ```

Question 26

precedes 1st psychotic break by months or years - subtle behavior changes, functional decline, social withdrawal, irritability - onset men (18-25 y.o) and women (25-35 y.o)

Answer 26

prodromal phase

Question 27

delusions, hallucinations, disorganized speech, bizarre behavior, thought process and content

Answer 27

psychotic phase

Question 28

occurs between psychotic episodes; blunted affect, odd thinking or behavior, and other negative symptoms

Answer 28

residual phase

Question 29

schizophrenia 1st choice and 2nd line tx

Answer 29

1st: atypical antipsychotics 2nd: clozapine or conventional antipsychotics(haldol)

Question 30

typical neuroleptic and antipsychotics with dopamine antagonist does what

Answer 30

lower positive symptoms

Question 31

atypical neuroleptic and antipsychotics for what

Answer 31

management of negative symptoms and less SE

Question 32

tx for resistant cases of schizophrenia

Answer 32

antipsychotic combined with (carbamazepine, valproate, lithium, or benzo)

Question 33

``` brief psychotic d/o schizophreniform d/o schizophrenia schizoaffective schizotypal schizoid ```

Answer 33

brief psychotic d/o: > 1 day and < 1 month schizophreniform d/o: > 1 month and < 6 months schizophrenia-must have 2 of these during a 1 month period and continuous for at least 6 months schizoaffective: schizophrenia plus a major affective d/o(bipolar affective d/o or major depressive d/o) schizotypal: magical thinking schizoid: loners

Question 34

Delusions which are logically constructed and internally consistent May not generally seem odd or bizarre Chronic but treatable

Answer 34

delusional disorder

Question 35

delusions that another person, usually of higher status, is in love with the individual. The person might attempt to contact the object of the delusion, and stalking behavior is common.

Answer 35

Erotomanic

Question 36

delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person

Answer 36

Grandiose

Question 37

believes that his or her spouse or sexual partner is unfaithful.

Answer 37

Jealous

Question 38

believes that they, or someone close to them, are being mistreated, or that someone is spying on them or planning to harm them. Common for people with this type of delusional disorder to make repeated complaints to legal authorities.

Answer 38

Persecutory

Question 39

believes that he or she has a physical defect or medical problem.

Answer 39

Somatic

Question 40

An irritable, angry, or low mood Hallucinations related to the delusion Expresses an idea or belief with unusual persistence or force. Secretive and suspicious Humorless and oversensitive Emotionally over-invested in the idea and it overwhelms other elements of his psyche

Answer 40

delusion d/o

Question 41

``` delusional disorder: Delusions lasting for at least ___ duration. Patient (does or does not) meet criteria for schizophrenia Apart from the impact of the delusions, functioning (is or is not) markedly impaired and behavior (is/ is not) obviously odd or bizarre. The disturbance (is or is not) due to the direct physiological effects of a substance, like drug abuse, a medication, or a general medical condition. ```

Answer 41

``` 1 month does not is is not is not ```

Question 42

delusional disorder: Psychotherapy

Answer 42

- Individual psychotherapy- helps the person recognize and correct the underlying thinking that has become distorted. - Cognitive-behavioral therapy (CBT) helps the person learn to recognize and change thought patterns and behaviors that lead to troublesome feelings. - Family therapy