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PSYCHIATRY II > Psychotic Disorders > Flashcards

Psychotic Disorders Flashcards

1
Q

T/F: Schizophrenia is the same as split personality

A

F

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2
Q

T/F: Schizophrenic patients are unable to differentiate reality from fantasy

A

T

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3
Q

Diagnosis of schizophrenia is based entirely on:

A

Psychiatric history and mental status examination

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4
Q

T/F: CT scan or Pet scan can be used to differentiate a normal bran and a brain with schizophrenia

A

T

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5
Q

Males usually present (negative/positive) symptoms of schizophrenia

A

Negative

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6
Q

Females usually present (negative/positive) symptoms of schizophrenia

A

Positive

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7
Q

First degree biological relatives of schizophrenics are ____ times as likely to develop the disorder as members of the general population

A

10x

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8
Q

There is a ___% chance of getting schizophrenia if both of your parents have it, while ___% chance if one of the parents has it

A

47%; 13%

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9
Q

There is a ___% chance of getting schizophrenia if your identical twin has it, while ___% chance if your non-identical twin has it

A

50%; 18%

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10
Q

There is a ___% chance of getting schizophrenia if one of your siblings has it, while ___% chance if one of your paternal cousins has it

A

9%; 2%

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11
Q

T/F: the age of the mother has a direct correlation with the development of schizophrenia, where mothers older than 60 yo were vulnerable to developing the disorder

A

F
it’s the father

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12
Q

Nine linkage sites associated with schizophrenia:

A

1q, 5q, 6p, 6q, 8p, 10p, 13q, 15q, 22q

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13
Q

Specific genes associated with schizophrenia:

A

Alpha-7 nicotinic receptor, DISC 1, GRM 3, COMT, NRG1, RGS 4, G 72

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14
Q

Mutation (negative symptoms) associated with schizophrenia:

A

dystrobrevin (DTNBP1), neureglin 1

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15
Q

The yellowish fingers of patients with schizophrenia associates the disease with abnormal levels of ____

A

nicotine (among smokers)

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16
Q

Neural changes in a schizophrenic brain include:

(Increased/Decreased) lateral and third ventricle size
(Increased/Decreased) cortical and thalamic volume
(Increased/Decreased) symmetry in temporal, frontal, parietal lobes
(Increased/Decreased) size of amygdala, hippocampus, parahippocampal gyrus
(Increased/Decreased) volume of globus pallidus and substantia nigra
(Increased/Decreased) number of D2 receptors in the caudate, putamen, and nucleus accumbens

A

Increased
Decreased
Decreased
Decreased
Decreased
Increased

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17
Q

Dysfunction in anterior cingulate basal ganglia thalamocortical circuit causes (negative/positive) psychotic symptoms

A

Positive

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18
Q

Dysfunction in dorsolateral prefrontal circuit causes (negative/positive) psychotic symptoms

A

Negative

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19
Q

DSMV Criteria for schizophrenia includes 2 or more of the following being present for 6 months or more:

A

Happy Days, Sad Nights, Dark Days

H = Hallucinations
D = Delusions
S = Speech (Disorganized)
N = Negative symptoms
D = Disorganized or catatonic behavior

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20
Q

T/F: Males have more frequent relapses, more severe disease course and worse outcomes

A

T

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21
Q

Brief psychotic disorder is the presence of one or more following symptoms:

A

Happy Days, Sad and Dark Days

Hallucinations
Delusions
Speech (disorganized)
Disorganized or catatonic behavior

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22
Q

T/F: The duration of Brief psychotic disorder is at least 1 month but less than 6 months, with eventual full return to premorbid level of functioning

A

F
at least one day but less than 1 month

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23
Q

T/F: In schizophrenia, patient declines

A

T

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24
Q

Criteria of schizophreniform disorder include having ___ or more ff symptoms:

Happy Days, Sad Days, Dark days
Hallucinations
Delusions
Speech (disorganized)
Disorganized or catatonic behavior

A

1 or more

recall: in schizophrenia, it’s 2 or more of the same set of symptoms

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25
Q

Duration of schizophreniform disorder

A

at least 1 month but less than 6 months, with eventual full return to premorbid level of functioning

recall:
Schizophrenia: at least 6 months and progressively declines
Brief psychotic disorder: at least 1 day to 1 month with eventual full return to premorbid level of functioning

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26
Q

considered as a basket case diagnosis

A

Schizoaffective Disorder

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27
Q

Mood symptoms + schizophrenia symptoms = what disorder?

A

Schizoaffective Disorder

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28
Q

T/F: Schizoaffective disorder is a better prognosis than schizophrenia and worse than mood disorder

A

T

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29
Q

T/F: Delusions are bizarre only

A

F
they can be bizarre or non-bizarre

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30
Q

T/F Delusional disorders are nonbizarre delusions of at least ___ month/s in duration, with slight preponderance of (male/female) patients

A

1 month; female

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31
Q

This type of delusional disorder refers to delusions that another person, usually of higher status, is in love with the individual (women predominant)

A

Erotomaniac/ De Clerambault/ Psychose Passionelle

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32
Q

3 subtypes of Monosymptomatic Hypochondriacal Psychosis

A

Infestation
Dysmorphophobia
Olfactory

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33
Q

This unspecified type of delusional disorder refers to delusions where a familiar person has been replaced by an impostor

A

Capgras (Illusion of Doubles)

34
Q

This unspecified type of delusional disorder refers to delusions where a familiar person can assume the guise of strangers

A

Fergoli’s

35
Q

This unspecified type of delusional disorder refers to delusions where a familiar person can change into another person at will

A

Intermetamorphosis

36
Q

T/F Vocational and psychosocial rehabilitation of patients with psychotic disorders cannot be done outpatient

A

F
it can be done outpatient

37
Q

T/F: It is necessary that a patient experiencing exacerbation of psychotic symptoms be hospitalized

A

F
not necessarily, if there are adequate community alternatives that are available like support from the family

38
Q

T/F First episodes of psychosis and unusual presentations of psychotic conditions are indications of hospitalization

A

T

39
Q

T/F: Patients experiencing extreme fear and significant confusion require long term hospital care

A

F
short term only

40
Q

T/F: Patients with suicidal risk and command hallucinations require long term hospital care

A

F
short term only

41
Q

T/F Treatment of significant comorbidity from med illness, substance abuse, and med complications require long term hospital care

A

T

42
Q

T/F: Protection from self-inflicted harm or danger to others require short-term hospital care

A

F
long term

43
Q

First generation antipsychotics

A

Dopamine Receptor Antagonist

44
Q

T/F: First generation antipsychotics are effective in positive symptoms

A

T

44
Q

T/F: First generation antipsychotics include chlorpromazine

A

T

45
Q

T/F: Typical neuroleptics are completely absorbed after oral administration, with low protein binding, volume of distribution, and lipid solubilities

A

F
they are INCOMPLETELY ABSORBED; with HIGH protein binding, etc

46
Q

Typical neuroleptics

Peak plasma concentration : ____ hours
Half life: _____ hours
Metabolized in the liver with steady state in ____ days

A

Peak plasma concentration : 1-4 hours
Half life: 10-20 hours
Metabolized in the liver with steady state in 5-10 days

47
Q

T/F: Typical neuroleptic aliphatics such as Chlorpromazine and Levomepromazine are already phased out

A

T

48
Q

This drug comes in handy especially when there is an agitated patient in the ER, due to its fast sedation and de-escalation of violence or aggression

A

Haloperidol
Class Butyrophenone

49
Q

This very good antipsychotic but behaves like an atypical psychotic is used at low doses as adjunct for negative thoughts if a person is depressed

A

Amisulpride
Class Benzamide

50
Q

These three medications are injectables good for 1 month. Ideal for patients who are noncompliant and find it hassle to take medicine everyday

A

Fluphenazine
Flupenthixol
Haloperidol

51
Q

T/F: Oral forms of therapy are necessary for patients who are too agitated or incapacitated to comply with treatment

A

F
Parenteral forms

52
Q

This adverse effect results from the blockade of dopamine receptors in the basal ganglia, and occurs upon intake of high-potency neuroleptics like ____________

A

Extrapyramidal Syndromes; haloperidol

53
Q

This EPS syndrome occurs immediately after intake of neuroleptic, and involve sudden tonic contractions of the muscles of the tongue, neck, ,back, mouth and eyes

Usual affected population:
Drug to alleviate this EPS:_______________

A

Acute dystonia
Young males
Diphenhydramine

54
Q

This EPS syndrome occurs after 1 week o f intake of medication causing motor restlessness, inability to keep legs and feet still

Commonly affected population:
Common in patients taking this atypical antipsychotic:

A

Akathisia
Middle-aged Women
Aripiprazole

55
Q

T/F: Parkinsonism as an EPS may occur in the first months of treatment

A

F
first weeks

56
Q

Some of the manifestations of this EPS is drooling, mask-like facies, loss of postural reflexes

A

Parkinsonism
Other manifestations: cogwheel rigidity, bradykinesia, tremor

57
Q

What happens in patients with Tardive dyskinesia as EPS?

A

fasciculations of the tongue, choreoathetotic movements of the extremities and trunk

occurs among chronic patients

58
Q

T/F: Tardive dyskinesia is a late-onset movement disorder due to a disturbance in dopamine-acetylcholine balance in the basal ganglia

A

T

59
Q

Best remedy for Tardive dyskinesia

A

Clozapine

60
Q

4 discussed examples of EPS as a side effect of neuroleptics

A

Acute dystonia
Parkinsonism
Akathisia
Tardive Dyskinesia

61
Q

This is the most dreaded adverse effect of neuroleptic therapy, which causes rapid onset of muscular rigidity, fever, autonomic instability and altered levels of consciousness

Can possibly treated with ____ and ___

A

Neuroleptic Malignant Syndrome
Dantrolene and Bromocriptine

62
Q

T/F: CV effects are associated with high potency neuroleptics like Levomepromazine and Chlorpromazine

CV Effects are very common with the atypical antipsychotic _______

A

F
Must be low-potency

  • Quetiapine
63
Q

Hypothalamic effects cause (increased/decreased) libido and (increased/decreased) appetite; hypersecretion of prolactin is also common in drugs ________ and _________

A

Decreased Libido
Increased Appetite
Risperidone and Amisulpride

64
Q

Agranulocytosis is usually associated with this neuroleptic ______

A

Clozapine

65
Q

T/F: Dermatologic effects may be observed in patients with schizophrenia

A

T

66
Q

Aripriprazole is a (typical/atypical) antipsychotic
Dose range: _____
Peak plasma:
Half life:

A

Atypical
5-30 mg
Peak plasma: 3-5 hours
Half life: 75 hours

67
Q

Clozapine is a (typical/atypical) antipsychotic
Lowest and highest doses__
Peak plasma:
Half life:

A

Atypical
Lowest dose: 25 mg
highest: 800 mg
Peak plasma: 2 hours
Half life: 12 hours

68
Q

Risperidone and paliperidone can cause prolactin changes and can cause ______ at high doses

A

Parkinsonism

69
Q

Risperidone is a (typical/atypical) antipsychotic
Dose range: _____
Peak Plasma:
Half life

A

Atypical
0.5-6 mg
Peak plasma: 1 hour
Half life: 20 hours -> once daily

70
Q

Paliperidone is a (typical/atypical) antipsychotic
T/F: Available in oral form

A

Atypical
F- available as long acting injection

71
Q

Olanzapine is a (typical/atypical) antipsychotic
Dose range: _____
Peak Plasma:
Half Life:

A

Atypical
10-20 mg
Peak plasma: 5 hours
Half life:31 hours

72
Q

this atypical neuroleptic is for treatment-resistant schizophrenia

A

Clozapine

73
Q

Risperidone is the first line treatment for: (SAPA)

A

Schizophrenia
Aggression
Psychotic Depression
Acute Mania

same as olanzapine, quetiapine, aripiprazole

74
Q

T/F: risperidone is notorious for weight gain

A

F
Olanzapine

75
Q

Quetiapine Peak plasma:
Half life:

A

peak plasma: 1-2 hours
Half life: 7 hours

76
Q

Quetiapine
25 (low dose) can be used for ________
75-150 (mid dose) mg can be used for ____
300-600 mg can be used for __________
400-800 and above can be used for _________

A

Insomnia
Anxiety
Psychotic Disorders
Bipolar Disorder

77
Q

Cleanest neuroleptic

A

Aripiprazole
but worst effect is akathisia

78
Q

What is electroconvulsive therapy?

A

This is reserved for patients with severe psychotic symptoms, suicidal/homicidal patients, to also treat treatment-resistant schizophrenia
It is done once daily, with 2 more administrations if significant improvement is observed. add 2 more if significant improvement after 4 days

79
Q

what are the other biological therapies for faster recovery of patient who just relapsed?

A

Electroconvulsive Therapy
Vagus Nerve Stimulation
Transcranial MAgnetic Stimulation
Psychosurgery

PSYCHIATRY II (4 decks)

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