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Psychiatry > Psychotic Disorders > Flashcards

Psychotic Disorders Flashcards

1
Q

Positive sx;s

A

= are an excess or distortion of normal fxns: things that are there that shouldn’t be

  • Delusions
  • Hallucinations
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2
Q

Negative sx’s

A

=things that should be there but are not

  • blunted affect
  • anhedonia
  • apathy
  • inattentiveness
  • less dramatic then positive sx’s
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3
Q

Delusions =

A

fixed false beliefs that cannot be altered by rational arguments and can’t be accounted for by the cultural background of the pt
-referential, somatic, religious, grandiose, bizarre, paranoid, erotomania, jealousy

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4
Q

Types of delusions

A
  • Paranoid
  • ideas of reference (ideas that some event is uniquely related to the individual)
  • thought broadcasting (belief that one’s thoughts can be heard by other
  • delusions of grandeur
  • delusions of guilt
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5
Q

Hallucinations can be:

A
  • auditory (most common)
  • visual
  • tactile
  • olfactory
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6
Q

Delirium features

A
  • short term confusion and changes in cognition
  • is associated with fluctuating sensorium, sudden onset, brief fluctuating course and rapid improvement with tx of underlying disorder
  • can be treated usually
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7
Q

Etiologies of Delirium

A
  • general medical cndtn
  • substance induced
  • multiple etiologies
  • NOS
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8
Q

schizophrenia =

A

clinical syndrome of variable but profoundly disruptive psychopathology that involves cognition, emotion, perception and other aspects of behavior

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9
Q

Clinical Dx of Schizophrenia

A
  • at least 2 ax’s present for at least 1 mnth:
  • delusions
  • hallucinations
  • disorganized speech
  • disorganized or catatonic behavior
  • negative sx’s
  • social/occupational dysfxn for at least 6 mnths
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10
Q

Dx exception of schizophrenia

A
  • only 1 sx needed if:

- delusions are bizarre, 2 or more voices converse or voices are commentary

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11
Q

Risk Factors for Schizophrenia

A
  • Medical illness
  • Birth season: born in winter or spring
  • gestational birth complications
  • exposure to flu epidemics
  • maternal starvation during pregnancy
  • substance abuse
  • genetic factors
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12
Q

Schizophrenia Epidemiology

A
  • males = females
  • equal worldwide but higher incidence in =urban areas of industrialized nations
  • males: age of onset is 18-25
  • females: age of onset is bimodal: 25-35 and another peak after 40
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13
Q

Subtypes of Schizophrenia:

A
  • Disorganized
  • Catatonic
  • Residual
  • Undifferentiated
  • Paranoid
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14
Q

Disorganized schizo

A
  • disorganized speech/behavior, flat/inappropriate affect
  • early onset
  • poor prognosis
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15
Q

Residual schizo

A
  • No hallucinations, delusions or disorganized speech

- Negative sx’s are prominent

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16
Q

Catatonic schizo

A
  • rare
  • stupor, rigidity
  • negativism: motiveless resistance to all instructions or maintenance of rigid posture against attempts to be moved
  • waxy flexibility: motoric immobility
  • echolalia, echopraxia
17
Q

Paranoid schizo

A
  • best prognosis
  • least severe
  • preoccupation with 1 or more delusions or frequent auditory hallucinations
18
Q

Undifferentiated schizo

A

does not meet criteria for other types

19
Q

Diagnostic approach to schizophrenia:

A
  • full set of labs: CBC, BMP, LFTs, B12, folate, TSH, free T4
  • urine fox screen and BAC
  • neuro exam to r/o seizure disorder
20
Q

Schizophrenia on PE

A
  • disheveled appearance
  • flattened affect
  • disorganized thought process
  • intact memory and orientation
  • auditory halluciantions
  • ideas of reference
21
Q

Management

A
  • typical anti psychs

- atypical antipsychs

22
Q

Typical Antipsychs

A
  • Dopamine receptor antagonists
  • haloperidol, fluphenazine, perhpenazine, thiothixene, chlorpromazine, thioridazine
  • tx positive sx’s
  • side effects EPS, neuroleptic malignant syndrome and tar dive dyskinesia
23
Q

Atypical antipsychs

A
  • dopamine and serotonin receptor antagonists
  • Clozapine, risperidone, ziprasidone, quetipine, olanzapine, aripiprazole
  • More effective against negative sx’s
  • side effects: metabolic syndrome, wt gain, hyperlipidemia, some sedation
24
Q

Schizoaffective disorder =

A

-Basically have manic and depressive episodes like that of bipolar but they have psychotic sx’s in btwn those episodes

25
Q

Schizoaffective disorder criteria

A
  • must have an episode of major depression, mania or mixed episode concurrent with schizophrenia sx’s (delusions, hallucinations,)
  • must have these psychotic sx’s without mood sx;s for 2 weeks
26
Q

Management of schizoaffective disorder

A
  • need both mood stabilizer and an antipsychotic because they have both mood disorder and psychotic disorder
  • antidepressants or ECT
27
Q

Dementia=

A
  • severe impairment in memory, judgement, orientation or cognition
  • no alteration in LOC
28
Q

Dementia types:

A
  • Alzheimer’s
  • Vascular
  • Other medical cndtns: Parkinson’s, Lewy Body, Huntington
  • Substance induced
  • multiple etiologies
  • NOS

Psychiatry (9 decks)

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