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Psych Shelf Exam > psychotic disorders > Flashcards

psychotic disorders Flashcards

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1
Q

What is the effect of schizophrenia on dopamine?

A

It increases dopamine

  • Increase in mesolimbic cortex causes POSITIVE
  • Decrease in prefrontal cortex causes NEGATIVE
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2
Q

Are the levels of the following neurotransmitters increased or decreased in schizophrenia?

  1. serotonin
  2. NE
  3. GABA
  4. Glutamate
A
  1. increased
  2. long term antipsychotics decrease NE
  3. decreased
  4. decreased
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3
Q

What antipsychotics antagonize serotonin and weakly antagonize dopamine?

A 
Atypicals-
respiridone
clozapine
olanzapine
quetiapine
aripiprazole
ziprasidone
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4
Q

What are the 4 first-generation antipsychotics?
Which are high/low potency?
What neurotransmitter do they affect?

A
  1. Chlorpromazine - low
  2. haliperidol- high
  3. thioridazine-low
  4. trifluoperazine -mid/high

They are all D2 antagonists

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5
Q

What are the most common side effects of first generation antipsychotics?

A
  1. EPS
  2. TD
  3. NMS
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6
Q

How does the side effect profile differ for atypical and typical antipsychotics?

A

atypicals have less EPS, but more metabolic syndrome

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7
Q

You started a patient on an atypical antipsychotic. What labs do you need to check?

A
  1. glucose
  2. waist circumference, BMI
  3. lipids
  4. BP
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8
Q

What are possible treatments for EPS?

A

Dystonia, Parkinsonism
- benztropine, diphenhydramine

Akathesia
-beta blocker

Both- benzos

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9
Q

What are the “weight neutral” second generation antipsychotics?

A

ziprasidone and aripiprazole

*also encourage exercise, diet, smoking cessation

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10
Q

A patient starts trifluoperazine and now is disoriented, has a high fever, elevated BP and tachycardia. They become rigid and are sweating with elevated CPK leukocytosis and metabolic acidosis. Whats the problem? Whats the treatment?

A

Neuroleptic malignant syndrome
Treatment:
1. withdrawal of all antipsychotic meds
2. cool patient off, dark room, etc to damp down sympathetics

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11
Q

What is the major side effect of clozapine?

A

agranulocytosis requiring weekly blood draws

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12
Q

What is the major side effect of thioridazine?

A

Irreversible retinal pigmentation

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13
Q

What is treatment for schizophreniform disordeR?

A
  1. hospitalization
  2. antipsychotics for 3-6 months
  3. supportive psychotherapy
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14
Q

What is the criteria for schizoaffective?

A
  1. MDD, bipolar 1 or bipolar 2
  2. delusions or hallucinations for 2 wks in the absence of mood symptoms
  3. mood symptoms for a substantial part of the psychotic illness
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15
Q

What 3 groups of people are most likely to experience delusional disorder?

A
  1. over 40
  2. immigrants
  3. hearing impaired
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16
Q

How do the delusions of delusional disorder differ from those of schizophrenia?

A

Schizo- delusions are often bizarre, last 6 months

Delusional disorder- NEVER bizarre, last 1 month

17
Q

What is treatment for delusional disorder?

A
  1. psychotherapy

2. antipsychotics are usually ineffective, but try a course anyway

18
Q

What is treatment for folie a deux?

A
  1. separate the patient from the person with the shared delusion
  2. psychotherapy
  3. antipsychotics if not improved 1-2wks after separation

Psych Shelf Exam (8 decks)

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