Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry - First Aid > Psychotic Disorders > Flashcards

Psychotic Disorders Flashcards

1
Q

In general, what is psychosis?

A

a distorted perception of reality - a general term for delusions, perceptual disturbances (hallucinations or illusions) and/or disorganized thinking

note - it’s a symptom of something bigger! Not a diagnosis!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a delusion?

A

a fixed, false belief that cannot be altered by rational arguments and cannot be accounted for by the cultural background of the individual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What’s the difference between a nonbizarre delusion and a bizarre delusion

A

a nonbizarre is a false belief that could conceivably be true.

a bizarre delusion is impossible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does “ideas of reference” mean?

A

it’s a belief that cues in the external environment are uniquely directed to the individual - like if someone believes the radio is sending him/her secret messages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the two types of delusions of control?

A

thought broadcasting (belief that one’s thoughts can be heard by others)

thought insertion (belief that other people are placing their thoughts in one’s head)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Auditory hallucinations are usually associated with what disease?

A

schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

VIsual hallucinations are less commonly associated with schizophrenia and are more common with what?

A

drug intoxication, withdrawal (especially alcoholic hallucinosis), or delerium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Olfactory hallucinations are usually associated with what?

A

an aura associated with elipepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tactile hallucinations are usually secondary to what?

A

drug intoxication or alcohol withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What’s the differential diagnosis for psychosis?

A 
psychosis 2/2 a medical conditions
substance-induced
delerium/dementia
bipolar disorder, manic/mixed episode
major depression with psychotic features
brief psychotic disorder
schizophrenia
schizophreniform disorder
schizoaffective disorder
delusional disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some general medical causes of psychosis?

A

CNS disease (CVA, MS, neoplasm, Alzheimer, Parkinson, Huntington, tertiary syphilis, temporal lobe epilspey, encephalitis, prion disease, neurosarcoidosis, AIDs)

Endocrinopathies (Addisons/Cushings, hyper/hypothyroid, hyper/hypocalcemia, hypopituitarism)

Nutritional/Vitamin deficiencies (B12, folate, niacin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What classes of medications are commonly associated with psychosis?

A 
corticosteroids
antiparkinsonian agents
anticonvulsants
antihistamines
anticholinergics
some antihypertensives - beta blockers and digitalis
methylphenidate
fluoroquinolones
barbiturates
benzodiazepines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How long does a person need to have symptoms before they get a diagnosis of schizophrenia?

A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the positive symptoms of schizophrenia?

A

hallucinations, delusions, bizarre behavior, disorganized speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the negative symptoms of schizophrenia?

A

blunted affect, anhedonia, apathy, alogia, lack of interest in socialization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some of the cognitive symptoms of schizophrenia>

A

impairment in attention, executive function and working memory, often lead to poor school and work performance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the three phases of symptoms in schizophrenia?

A

prodromal - decline in fucntion preceding the first psychotic episode (withdrawn, irritable, newfound religiosity, etc)

psychotic

residual - occurs between episodes of psychosis (flat affect, withdrawal, odd thinking or behavior)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If the symptoms of schizophrenia are present for less than 1 month, what’s the diagnosis?

A

brief psychotic disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If the symptoms of schizophrenia are present between 1-6 months, what’s the diagnosis?

A

schizophreniform disorder

20
Q

What percentage of people will be diagnosed with schizophrenia over their lifetime?

A

1%

21
Q

How do men and women present differently with schizophrenia?

A

men tend to present around age 20, women around 30

men tend to have more negative symptoms and more social impairment than women

22
Q

Substance abuse is highly comorbid with schizophrenia. What is the most commonly abused substance?

A

alcohol (in 30-50%)

23
Q

What neurotransmitter is most involved in the pathogenesis of schizophrenia?

A

dopamine

24
Q

What are the two main dopaminergic pathways that are affected in schizophrenia? Which one is associated with the negative and which one is associated with the positive symptoms?

A 
Prefrontal cortical (inadequate DA = negative symptoms)
Mesolimbic (excessive DA = positive symptoms)
25
Q

What dopaminergic pathway is affected by neuroleptics, contributing to the side effects of gynecomastia, galactorrhea, and menstrual irregularieis?

A

tuberoinfundibular (causes hyperprolactinemia)

26
Q

What dopaminergic pathway is affected by neuroleptics, contributing to the extrapyramidal side effects like tremor, slurred speech, akathisia, dystonia and other abnormal movements?

A

nigrostriatal

27
Q

What are some other neurotransmitters implicated in schizophrenia?

A

elevated serotonin
elevated norepinephrine
decreased GABA
decreased glutamate receptors

28
Q

What might a CT of the brain show in schizophrenia?

A

enlarged ventricles and diffuse cortical atrophy

29
Q

SIgnificant impirovement is noted in what percentage of schizophrenic patients who take antispychotic meds? BUt what percentage will be able to function fairly well in society with medication?

A

70% improve significantly, but only 20-30% will be able to function well in society

30
Q

What percentage of patients with schizophrenia will attempt suicide?

A

50%

31
Q

What are the main side effects of the first generation anti=psychotics?

A

extrapyramidal symptoms, neuroleptic malignant syndome and tardive dyskinesia

32
Q

What are the main side effects of the second generation antipsychotics?

A

metabolic syndrome

less likely to cause extrapyramidal side effects

33
Q

What medication is reserved for patients who have failed multiple antipsychotic trials? Why?

A

Clozapine - risk for agranulocytosis

34
Q

What are some examples of extrapyramidal side effects?

A

dystonia, parkinsonism, akathisia

35
Q

If someone develops metabolic syndrome, what are the medication options?

A

you can switch to a first generation antipsychotic, or use a more wight-neutral second generation like aripiprazole or ziprasidone

36
Q

Describe how neuroleptic malignant syndrome presents.

A

altered mental status and autonomic changes (high fever, hypertension, tachycardia), lead pipe rigidity, sweating

labs show elevated creatine phosphokinase levels, leukocytosis and metabolic acidosis

37
Q

What percentage of patients treated with long-term antispychotics will experience tardive dyskinesia?

A

20%

38
Q

What percentage of patients wil experience spontaneous remission of TD after stopping the offending agent?

A

50%

39
Q

What percentage of patients with schizophreniform disorder will progress to schizophrenia?

A

63%

40
Q

If someone meets criteria for either a major depressive episode, manic episode or mixed episode during which the criteria for schizophrenia are also met, what additional criteria must they have to receive the diagnosis of schizoaffective disorder? Why?

A

must have had delusions or hallucinations for 2 weeks in the absence of mood disorder symptoms

this is to differentiate schizoaffective disorder from mood disorder with psychotic features

41
Q

What percentage of those with schizoaffective disorder will progress to schizophrenia?

A

60-80%

42
Q

What’s the recovery rate with brief psychotic disorder?

A

50-80%

43
Q

What are the criteria for a diagnosis of delusional disorder?

A
  1. nonbizarre, fixed delusions for at leat 1 month
  2. not meeting criteria for schizophrenia
  3. functioning not significantly impaired
44
Q

What percentage of those with delusional disorder will experience a full recovery?

A

50%

20% will have a decrease in symptoms

30% will have no change

45
Q

True or false: antipsychotic medications are often effective for delusional disorder

A

false - usually ineffective, but should be tried

46
Q

What is the prognosis for the psychotic disorders from best to worst?

A

mood disorder with psychotic features > brief psychotic disorder > schizoaffective disorder > schizophreniform > schizophrenia

Psychiatry - First Aid (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions