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Psychiatry > Psychotic Disorders > Flashcards

Psychotic Disorders Flashcards

1
Q

a false, fixed belief

A

delusion

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2
Q

Positive symptoms in schizophrenia are due to ?

A

increased dopamine levels

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3
Q

Negative symptoms in schizophrenia are due to?

A

increased levels of serotonin

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4
Q

What are some positive symptoms of schizophrenia?

A
  • delusions (persecution or grandiosity or both)
  • hallucinations
  • disorganized speech
  • disorganized behavior
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5
Q

what are some negative symptoms of schizophrenia?

A
  • flat affect
  • cognitive delay of speech or movement
  • poverty of speech
  • anhedonia
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6
Q

A psychotic break in a schizophrenic patient can occur after?

A

A major stressor

-ex: seen in young adults living on their own for the first time may induce a psychotic break

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7
Q

What are the criteria to diagnose schizophrenia?

A
  • Symptoms must be going on for at least 6 months
  • must have either delusions, hallucinations, or disorganized speech as one of the symptoms
  • Must have two or more of the positive and/or negative symptoms
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8
Q

Always rule out ___ in possible schizophrenia patients.

A

Drug use via urine tox

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9
Q

Tx for schizophrenia

A

antipsychotics–> depending on positive and or negative symptoms which one to use

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10
Q

If a patient is experiencing delusions or hallucinations, what is the time line to diagnose brief psychotic disorder?

A
  • the symptoms must be going on for at least one day but less than one month
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11
Q

If a patient is experiencing delusions or hallucinations, what is the time line to diagnose schizophreniform disorder?

A
  • Symptoms must be going on for at least 3 months but less than 6 months.
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12
Q

What is the difference between schizoaffective disorder and schizophrenia?

A

Patients with schizoaffective disorder will have a mood component. They will be experiencing the same symptoms as a schizophrenic patient, like the positive and negative symptoms, but they will also have episodes of mood changes, like depression or mania.

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13
Q

When treating schizoaffective disorder, what should be your first concern in treating?

A

their mood symptoms

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14
Q

When treating mood disorder with psychotic features, what should be your first concern in treating?

A

their mood symptoms

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15
Q

A compliant schizophrenic patient or a patient that needs an antipsychotic, what are your first line options?

A
  • The atypical antipsychotics, such as olanzapine, quetiapine, risperidone
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16
Q

A combative schizophrenic patient first line antipsychotic is?

A

haloperidol

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17
Q

In the ED if the patient is combative and is a schizophrenic, first line?

A

haloperidol or olanzapine (can see both be given)

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18
Q

A noncompliant schizophrenic patient would best be treated with what kind of antipsychotic?

A
  • A depot injection, Haldol IM
  • Invega Sustaina IM

*they last longer and do not need to be taken every day–> helps increase compliance

19
Q

A case of refractive schizophrenia should be treated with?

A

clozapine

20
Q

What should be closely monitored when a patient is on clozapine?

A

blood counts, look for neutropenia/leukopenia

21
Q

A patient on an antipsychotic may present with increased heart rate, blood pressure, and temp with rigidity, like a lead pipe. What is the diagnosis and how should you treat them?

A
  • neuroleptic malignant syndrome
  • First, remove the offending agent.
  • Second, prescribe dantrolene
22
Q

Patient with NMS will have an elevated ___ on labs.

A
  • creatine kinase
23
Q

define delusional disorder

A
  • patient has a fixed, false belief that is non-bizarre but they have no impairment in every day functioning
24
Q

Positive symptoms of schizophrenia are driven by?

A
  • dopamine due to the D2 receptors in the mesolimbic system
25
Q

Negative symptoms of schizophrenia are driven by?

A
  • serotonin due to 5-HT receptors
26
Q

Name some typical antipsychotic medication

A
  • haloperidol
  • fluphenazine
  • thioridazine
  • chlorpromazine
27
Q

Typical antipsychotics are associated with?

A
  • extrapyramidal side effects
28
Q

Typical antipsychotics will treat which symptoms?

A
    • symptoms because they act on D2 receptors to antagonize them in the mesolimbic system
29
Q

Blocking dopamine in the nigrostriatal system of the brain will lead to ?

A
  • extrapyramidal side effects
30
Q
  • blocking dopamine in the tubuloinfundibular system of the brain will lead to ?
A
  • gynecomastia in men

- amenorrhea and galactorrhea in women

31
Q

Name some second generation antipsychotics

A
  • quetiapine
  • olanzapine
  • risperidone
  • aripiprazole
  • ziprasidone
  • clozapine
32
Q

ADR associated with olanzapine?

A
  • metabolic syndrome –> diabetes and weight gain
33
Q

ADR associated with risperidone

A
  • EPS out of the second gen antipsychotics
34
Q

What are some examples of EPS?

A
  • akasthesia
  • acute dystonia
  • dyskinesia
  • tardive dyskinesia
35
Q

restlessness, moving around/figeting, like ants in their pants

A
  • akasthesia
36
Q

ocular gyro crisis, torticollis, and handwringing are examples of ___ EPS.

A

acute dystonia

37
Q

____ will show as parkinsonian features due to taking antipsychotics

A

dyskinesia

38
Q

A permanent condition caused by antipsychotics that features jaw moving, grimacing.

A

tardive dyskinesia

39
Q

EPS can be treated with ?

A
  • diphenhydramine

- benztropine

40
Q

benztropine mechanism of action ?

A
  • Ach antagonist
41
Q

Ziprasidone is known for prolonging ?

A

QT interval

42
Q

____ antipsychotic is the last line of medication and is only used when the patient has failed 2 or more other antipsychotics

A
  • clozapine
43
Q

ADR of clozapine

A
  • agranulocytosis

Psychiatry (15 decks)

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