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psychiatric principles > Psychotic disorders > Flashcards

Psychotic disorders Flashcards

1
Q

What is psychosis

A
  • loss of contact with reality
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2
Q

fixed, false beliefs, despite disproving evidence

A

delusions

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3
Q

sensory perceptions in the absence of a stimulus

A

hallucinations

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4
Q

paranoid, grandiose, reference, and somatic are examples of

A

delusions

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5
Q

hallucinations can come in what forms

A
  • auditory
  • visual
  • tactile
  • olfactory
  • gustatory
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6
Q

List the 4 signs that point to psychosis

A
  1. delusions
  2. hallucination
  3. disorganized thoughts and speech
  4. disorganized or catatonic behavior
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7
Q

what is disorganized or catatonic behavior

A
  • activity that is not goal-directed
  • inability to complete simple tasks
  • immobility
  • waxy flexibility
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8
Q

Bleuler’s “four As’ of schizophrenia

A
  • loose associations
  • affective flattening
  • autism
  • ambivalence
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9
Q

negative symptoms

A

decrease or absence of function

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10
Q

positive symptoms

A
  • delusion
  • hallucination
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11
Q

Which psychotic disorder is characterized by non-bizarre delusions (plausible but false)

i.e. being followed by police, infestations

A

Delusional disorder

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12
Q

what is the level of psychosocial functioning in Delusional disorder

A
  • NOT markedly impaired
  • normal thought process
  • poor insight
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13
Q

List the diagnostic criteria for Delusional disorder

A
  1. non-bizarre delusions for at least 1 month
  2. criterion A for schizoprenia has never been met (but hallucinations related to delusion ok)
  3. functioning not markedly impaired
  4. mood episodes (if present) are breif relative to delusion
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14
Q

erotomanic Delusional disorder

A
  • another person is in love with the patient
  • usually person of higher status (celebrity stalkers)
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15
Q

grandiose Delusional disorder

A
  • inflated worth, power, knowledge, identity, or special relationship to deity or famous person
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16
Q

jealous Delusional disorder

A
  • spouse, significant other, sexual partner is unfaithful
17
Q

persecutory Delusional disorder

A
  • being treated malevolntly
  • conspired against, cheated, spied on, followed, poisoned
18
Q

what type of Delusional disorder is this: physical defect or medical condition

A

somatic

19
Q

patients with a brief psychotic disorder have a high risk of

A

suicide

20
Q

list diagnostic criteria of brief psychotic disorder

A
  1. presence of 1 or more
    1. ​delusion
    2. hallucination
    3. disorganized speech
    4. disorganized or catatonic behavior
  2. duration 1 day to 1 month with eventual full return to premorbid level of functioning
21
Q

What percentage of patients with schizopreniform disorder progress to schizophrenia or schizoaffective disorder

A
  • 1/3 recover
  • 2/3 progress
22
Q

list diagnostic criteria of schizopreniform disorder

A
  1. presence of 2 or more
    1. ​delusions
    2. hallucination
    3. disorganized speech
    4. grossly disorganized or catatonic behavior
  2. duration 1 month - 6 months
23
Q

which type of symptoms often appear first in schizophrenia

A

negative symptoms

24
Q

list the diagnostic criteria for schizophrenia

A
  1. at least 1 month of 2+ of the following
    1. delusion
    2. hallucination
    3. disorganized speech
    4. disorganized or catatonic behavior
    5. negative symptoms
  2. social/occupation dysfunction
  3. duration 6 months
25
Q

schizophrenia with catatonia is diagnosed via what criteria

A
  • > or = 3 of the following
  1. stupor
  2. catalepsy
  3. waxy flexibility
  4. mutism
  5. negativism
  6. posturing
  7. mannerism
  8. stereotypy
  9. agitation
  10. grimacing
  11. echolalia
  12. echopraxia
26
Q

What is schizoaffective disorder? what are the two types

A
  • schizophrenia + mood disorder
  • types
    1. bipolar
    2. depressed (more common in women)
27
Q

list the diagnostic criteria for schizoaffective disorder

A
  1. meets first criteria for schizophrenia (characteristic symptoms) and concurrently has major depressive, manic, or mixed episode
  2. must have 2+ weeks of delusions or hallucinations without prominant mood sxs
  3. mood symptoms are present for a significant portion of the illness
28
Q

goal of treatment of psychotic disorders (3 things)

A
  1. acute stabilization
  2. indications for hospitalization
  3. maintenance
    • includes pharmacotherapy
29
Q

acute stabilization involves

A
  1. start antipsychotic at low doses and titrate as needed
    • avoid use of 2 antipsychotics
    • may require hospitalization
    • agitation is first to improve
30
Q

list the 4 indications for hospitalization

A
  1. danger to self (DTS)
  2. danger to others (DTO)
  3. command auditory hallucinations
  4. unable to care for self
31
Q

goal of maintenance therapy

A

symptom control and relapse prevention

32
Q

Which two antipsychotics are first generation D2 receptor blockades used acutely to stabilize patient

A
  • chlorpromazine
  • haloperidol
33
Q

List the 2nd generation atypical antipsycotics

A
  • Aripiprazole (abilify)
  • Clozapine (clozaril)
  • Olanzapine (zyprexa)
  • Quetiapine (seroquel)
  • Risperidone (Risperdal)
34
Q

adverse effect of Clozapine (clozaril)

A
  • agranulocytosis
    • requires regular CBC monitoring of WBC
35
Q

side effect of Olanzapine

A

weight gain

36
Q

side effects of Risperidone

A
  • elevates prolactin
  • extrapyramidal symptoms
37
Q

List the extrapyramidal symptoms

A
  • tardive dyskinesia
  • neuroleptic malignant syndrome
38
Q

tardive dyskinesia is characterized by

A

abnormal involuntary movements

psychiatric principles (8 decks)

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