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psychotic disorders Flashcards

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1
Q

delusions of control

A

includes thought broadcasting (belief that one’s thoughts can be heard by others) and thought insertion (belief that other people’s thoughts are being placed in one’s head)

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2
Q

delusions of grandeur

A

belief that one has special powers beyond those of a normal person

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3
Q

somatic delusions

A

false belief that one is infected with a disease or has a certain illness

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4
Q

olfactory hallucination comes usu in what scenario

A

aura assoc with epilepsy

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5
Q

what meds can cause psychosis

A 
corticosteroids
antiparkinsonian agents
anticonvulsants
antihistamines
anticholinergics
some antihypertensives including beta blockers
digitalis
methaylphenidate
fluoroquinolones
illicit drugs
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6
Q

positive symptoms of schizophrenia

A

hallucinations
delusions
bizarre behavior
disorganized speech

tend to respond more robustly to current antipsychotic meds

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7
Q

neg symptoms of schizophrenia

A 
blunted affect
anhedonia
apathy
alogia (poverty of speech)
lack of interest in socialization

these symptoms often tx resistant

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8
Q

cognitive symptoms of schizophrenia

A

impairments in attention, executive fxn, working memory

possibly leading to poor work and school performance

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9
Q

diagnosis of schizophrenia

A

pg 25

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10
Q

catatonic schizophrenic pts-what signs?

A

stereotyped mvmt
bizarre posturing
musc rigidity

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11
Q

higher functioning form of schizophrenia

A

paranoid type

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12
Q

paranoid type of schizophrenia must meet what criteria

A

preoccupation w one or more delusions or freq auditory hallucinations

no predominance of disorganized speech, disorganized or catatonic behavior, or inappropriate affect

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13
Q

disorganized type of schizophrenia must meet what criteria

A

diroganized speech
disorgznied behvior
flat or inappropriate affect

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14
Q

catatonic type of schizophrenia must meet at least two of what critera

A

motor immobility
excessive purposeless motor activity
etreme negativism or mutism
peculair voluntary movements or posturing
ECHOLALIA or ECHOPRAXIA (repetition of mvmts of others)

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15
Q

undifferentiated type of schizophrenia

A

characteristic of more than 1 subtype or none of the subtypes

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16
Q

residual type of schizophrenia

A

prominent negative symptoms (such as flattened affect or oscial withdrawal) with only minimal evidence of positive symptoms

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17
Q

the 5 A’s of schizophrenia

A 
anhedonia
affect (flat)
alogia 
avolition
attention (poor)
18
Q

typical PE findings for schizophrenia pts

A 
disheveled appearance
falttened affect
disorganized thought process
intact memory and orientation
audiotyr hallucinations
paranoid delusions
ideas of reference
concrete understanding of similarities/proverbs
lack insight into their disease
19
Q

if first degree relative has schizophrenia, what is risk of having schizophrenia

A

12 percent

20
Q

what drugs can increase dopamine activity

A

cocaine, amphetamines

21
Q

in schizophrenia, where in the brain is there excessive dopaminergic activity?

A

mesolimbic pathway

22
Q

neurotransmitter abnormalities other than dopamine in schizophrenia

A

elevated serotonin
elevated NE
decreased GABA
decreased glutamate receptors

23
Q

what factors are assoc w better prognosis in schizophrenia

A 
later onset
good social support
positive symptoms
mood symptoms
acute onset
female sex
few relapses
good premorbid functioning
24
Q

what factors are assoc w worse prognosis in schizophrenia

A 
early onset
poor social support
neg symptoms
family hx
gradual onset
male sex
many relapses
poor premorbid functioning (social isolation)
comorbid substance abuse
25
Q

MOA of second gen antipsychotic meds

A

antagonize serotonin receptors as well as dopamine receptors

26
Q

compare first gen and second gen antipsychotics

A

no significant diff btwn the two in treating neg symptoms

second gen has much lower EPS, but increase risk for metabolic syndrome

27
Q

tx for schizophrenia

A

antipsychotics

behavioral therapy

28
Q

EPS are especially prominent in

A

high potency traditional antipsychotics

29
Q

tx for EPS

A

antiparkinsonian agents (benztropine, diphenhydramine), benzos, beta blockers (specifically for akathisia)

30
Q

side effects of antipsychotics

A 
EPS
anticholinergic symptoms (esp low potency trad antipsy and atypical antipsy)

metabolic syndrome (2nd gen antipsy)-increased BP, increased insulin, excess body fat around waist or abnormal cholesterol)

tardive dyskinesia (high potency antipsy)

neuroleptic malignant syndrome (high potency antipsy)

prolonged QT and other ECG changes
hyperprolactinemia
hematologic effects (cloazpine)
opthalmologic conditions (thioridzine, chlorpromazine)
derm conditions (rashes, photosensitivity)
31
Q

what are more weight neutral second gen antipsychotics

A

aripiprazole

ziprasidone

32
Q

prognosis for schizophreniform disorder

A

1/3 recover completely

2/3 progress to schizoaffective or schizophrenia

33
Q

diagnosis of schizoaffective disorder

A

pg 30

34
Q

why is prompt discontinuation of agent causing tardive dyskinesia important?

A

b/c the condition can become permanent

35
Q

beta blockers and digoxin are known to exacerbate psychosis in predisoposed pts: true or false

A

true

36
Q

prognosis fo brief psychotic disorder

A

50-80 percent recovery rate, 20-50 percent may eveutally have schizophrenia or mood disorder

37
Q

diagnosis of delusional disorder

A

see pg 31

38
Q

types of delusions

A 
erotomanic
grandiose
somatic
persecutory type
jealous type
mixed type
39
Q

tx of delusional disorder

A

very difficult to treat. antipsy meds often ineffective

40
Q

shared psychotic disorder

A

also known as folie a deux

pt develops same delusional symptoms as someone he or she is in a close relationship with

41
Q

prognosis of psychotics disorders–compare them

A

from best to worst

mood disorder, brief psychotic disorder, schizoaffective disorder, schizophreniform disorder, schizophrenia

Psych (20 decks)

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