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USMLE STEP 3 PSYCHIATRY > Psychotic Disorders > Flashcards

Psychotic Disorders Flashcards

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USMLE® Step 1 flashcards
1
Q

How do I differentiate various psychotic disorders on exam day?

A

Duration of symptoms

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2
Q

positive symptoms in psychotic disorders is associated with which receptors?

A

Dopamine receptors

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3
Q

Negative symptoms in psychotic disorders are associated with which receptors?

A

Muscarinic receptors

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4
Q

Bizarre Delusions, Disorganized speech/behavior and hallucinations are what type of symptoms? Negative for positive?

A

Positive

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5
Q

Flattened affect, social withdrawal, anhedonia, apathy, poverty of thought are what type of symptoms?

A

Negative symptoms

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6
Q

Psychotic symptoms have been present for at least 1 month, there has been a significant impact on social or occupational functioning for at east 6 months. Pt has delusions, hallucinations & disorganized speech. Dx?

A

Shizophrenia

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7
Q

Psychotic symptoms: delusions, hallucinations and disorganized speech for less than 6 months but over 1 month. Dx?

A

Schizophreniform

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8
Q

Most effective antipsychotic to treat negative symptoms? (Neg symptoms are associated with muscarinic receptors)

A

Atypical Antipsychotics

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9
Q

Meaning of phrenia

A

> 6 months

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10
Q

Meaning of phreniform

A

> 1 month but <6 months

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11
Q

A stressful life event that precipitates psychotic disorder and symptoms occur for < 1 month and patient returns to basleine. Dx

A

Brief psychotic disorder

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12
Q

When a patient has had symptoms for years with no impairment of baseline functioning, what 2 dx should i be thinking of on test day?

A

non-bizzare delusional disorder, personality disorders

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13
Q

Perform these tests for patients with psychosis that are not schizophrenia.

A

Drug screen first!!!!!

TSH, basic electrolytes, calcium, HIV, VDRL, EEG (temporal lobe epilepsy)

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14
Q

The greatest risk of factor for progression to schizophrenia?

A

Schizophreniform disorder

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15
Q

The time when schizophreniform patients are at greatest risk of depression and suicide?

A

After episode of psychosis resolves

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16
Q

What to do with a patient with bizarre or paranoid symptoms?

A

Hospitalize

17
Q

Treatment of patients psychotic patient with agitation?

A

Benzodiazepines & Antipsychotics x 6 months unless history of repeat episodes then plan ofr long-term antipsychotics. Must initiate long-term psychotheraphy

18
Q

2 disorders that you can treat with antipsychotics

A

Huntington and Tourette syndrome

19
Q

What to do when a patient on a low potency antipsychotic causes orthostatic hypotension, acute urinary retention, dry mouth, blurry vision and delirium?

A

Change to an Atypical antipsychotic

20
Q

AntIpsychotic associated with prolonged QT, arrhythmias, chest pain, dyspnea, palpitations etc

A

Thioridazine

21
Q

Patients on this antipsychotic need routine eye exam while on the medication because it causes abnormal retinal pigmentation.

A

Thioridazine

22
Q

side effects that cause noncompliance in females on antipsychotics.

A

Weight gain due to hyperprolactinemia. May also have galactorrhea and amenorrhea.

23
Q

Antipschotic associated with agranulocytosis which requires CBC with diff before start of therapy and weekly after that?

A

Clozapine/Clozaril/versacloz

24
Q

Side effects that cause noncompliance in males on antipsyhotics?

A

Impotence and inhibition of ejaculation (alpha blocker effect).

25
Q

Antipsychotic with the greatest weight gain?

A

Olanzepine

26
Q

High potency antipsychotics like Haloperidol and Fluphenazine have the disadvantage of being associated with ?

A

EPS (Extrapyramidal systems)

27
Q

This Atypical antipsychotic is reserved for treatment- resistant patients because of Agranulocytosis?

A

Clozapine

28
Q

These drugs have little or no risk of EPS so they are the drug of choice for initial therapy in psychosis:

A

Atypical antipsychotics: Quetiapine ( Seroquel ), Risperidone ( Risperdal ), Olanzepine ( Zyprexa ), Clozapine ( clozaril)

29
Q

Atypical antipsychotics end with what word? except for which one?

A

Pine

Except for Risperidone

30
Q

First choice antipsychotics when insomnia is a problem?

A

Olanzepine, quetiapine, ziprazidone and aripiprazole

31
Q

First choice for schizophrenia when sedation is a problem?

A

Risperidone

32
Q

6 receptors affected by Risperidone?

A

5HT, D1, D2, alpha 1, alpha 2 and H1

USMLE STEP 3 PSYCHIATRY (2 decks)

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