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Psyc Test 1 > Schizo > Flashcards

Schizo Flashcards

1
Q

Psychosis mood disorders

A

Schizoaffective
Bipolar
Major Depression w/ psychotic

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2
Q

Psychosis 2ndary to Med condition

A

Brain tumor, tertiary syphilis, HIV

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3
Q

Personality disorders

A

Schizoid personality
Schizotypal personality
Paranoid Personality

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4
Q

Delusion

Bizarre vs. Non-bizarre

A
  • Bizarre = not at all possible in reality

* Non-bizarre = possible in reality

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5
Q

Hallucination vs. delusion

A

Hallucination = a false sensation/perception

Delusion = a false belief

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6
Q

Disorders of thought

A
  • Ideas of reference
  • loose associations/derailment/flight of ideas = one topic to next, RELATED topics
  • Tangientiality= UNRELATED answers to questions
  • word salad = nearly incomprehensible
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7
Q

Negative symptoms vs. Positive symptoms

timeline

A

Negatives usually come first on a timeline, then positives later

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8
Q

Working memory

A

Immediate conscious perception and linguistic processing

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9
Q

Attention

Mini mental status exam

A

WORLD backwards

Serial 7s

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10
Q

Congnitive s/s

A

Working memory
Executive function
Attention
Learning

LACK= fall out of society, worse prognosis

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11
Q

Mesolimbic vs. mesocortical pathway

A

Mesolimbic = too much Dopa (+ S/S)

Mesocortical = too little dopa
(- S/s)

Nigrostriatal pathway = too little dopa (EPS)

Tuberoinfundibular = too little dopa (release prolactin = breasts)

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12
Q

Glutamate in schizophrenia

A

Regulates dopamine = releases or starts GABA (inhibit)

NMDA receptor has role (PCP)

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13
Q

what part of brain involved

A

Many, not localized

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14
Q

Schizophrenia

Dx

A

Must have 2 + at least 1 starred:

  • Delusions*
  • Hallucinations*
  • Disorganized speech*
  • Grossly disorganized/catatonic behavior
  • neg symptoms

6 months over all, positive symptom for min 1 month

NO MOOD DISORDER FOR MAJORITY of DURATION

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15
Q

Schizophrenia exclusion

A

*no major depressive, manic, mixed episode in active-phase symptoms
(If so, brief duration)
*not due to drug/med condition

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16
Q

Must have catatonia

A
  • motor immobility
  • excessive activity motor
  • extreme negativism
  • peculiarities of voluntary movement = posturing
  • stereotyped movements
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17
Q

Catalepsy

A

Muscular rigidity, fixity of posture regardless of stimuli

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18
Q

Echolalia

A

Mimicking sounds

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19
Q

Echopraxia

A

Mimicking movements

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20
Q

Treating catatonia

A

Benzos

Gaba inhibitory effects
In state = info overload

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21
Q

Genetic causative agents

A

Chromosome 6 (too much C4-A)

Pruning of synapses during brain development
Prefrontal pruning - going on too long

Men get first, women later (time normal pruning stops)

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22
Q

DX + Treating early w/ anti-psychs

A
  • Change course

* Longer brain is under stress, more NT toxicity damaging brain

23
Q

Schiz Brain abnormality

A

*hypoperfusion = globus pallidus
*anterior hypothalamus smaller
*ventricles enlarged
*sulci enlarged
BRAIN TISSUE LOSS = degenerative

24
Q

Brain damage = precipitating factors

A

Birth trauma
Viral infections
Nutritional issues

25
Q

Diathesis-stress model

A

Genes + stressors (life events)

26
Q

Downward drift vs. social causation

A

Drift = dz causes you to drop social class

So more seen in lower socioeconomic status

27
Q

Course

A 
*Prodromal:
 Negative s/s
  -males 18-25
  -females 25-30
  -late >40 (women)
  • Acute
  • Positive s/s
  • Recovery/Residual
  • improve/hospital/institution/suicide
28
Q

Prognosis

Better

A 
Late/sudden onset
Female
Higher function prior
Good compliance
Family History
Paranoid subtypes
29
Q

Prognosis

Worse

A 
Early age of Onset
Male
More Negative s/s
Lower functioning prior
Substance abuse
Disorganized type
30
Q

EPS effects from Rx

A

*actue

31
Q

Higher potency typical anti-psycs effects on

A

*Strong D2 receptor block
+cut Positive s/s
-EPS, hyperprolactinemia

32
Q

Low potency binds to

A

histamine alpha adrenergic or histaminic

33
Q

EPS

Acute dystonia

A

Torticollis, opisthotonos, oculygyric crisis,

24-48 HOURS FROM ANTI-PSYC INITIATION

34
Q

EPS

Akathasia

A

Restlessness –> movement

Days-weeks after anti-psyc treatment start

35
Q

EPS

Parkinsonism

A

Traid, rigidity, tremors

Within DAYS of initiating anti-psyc Rx

36
Q

EPS

Tardive dyskinesia

A

Long-term, early as 1 month after antipsyc onset

Lip smacking common

37
Q

Dystonia

Tx

A

Benztropine

38
Q

Parkinsonism

Tx

A
  • reduce anti-psyc
  • benztropine
  • change to atypical anti-psyc
39
Q

Akathisia

Tx

A
  • reduce anti-psyc
  • beta blocker (propranolol)
  • Benzo (valium)
  • change to atypical antipsyc
  • benztropine
40
Q

Tardive Dyskinesia

Tx

A
  • regular AIMS to detect early
  • cease anti-psyc if possible
  • change to atypical anti-psyc
  • lowest dose possible
41
Q

Neuroleptic Malignant Syndrome

A
  • Mental status change
  • acute, rapid onset
  • autonomic instability
    • fever/hyperpyrexia
    • tac/HTN
    • diaphoresis
  • neuromuscular findings
    • lead pipe rigidity
  • labs
  • CPK UP, myoglobinuria - renal failure
  • leukocytosis
42
Q

Atypical anti-psycs

A

D2 + 5HT2a in mesolymbic circuit

43
Q

Noncompliance?

A

Depot drugs

44
Q

Assertive Community Treatment

A

Very good,

Personalized care

Not available in many states (“freedom of client to refuse care”)

45
Q

Brief Psychotic Disorder

A

1 day to 1 month

46
Q

Schizophreniform

A

LESS THAN 6 MONTHS

Schizo s/s, NO Schizoaffective/mood disorder

47
Q

Delusional Disorder

A
  • women more
  • NO FUNCTIONALITY LOSS
  • NO DISORGANIZED THOUGHT/BEHAVIOR
  • mood congruent beliefs = false beliefs consistent w/ patient mood
  • mood non-congruent beliefs =
48
Q

Schizoaffective Disorder

A
  • PSYCHOTIC SYMPTOMS 2 WEEK PERIOD + W/O MOOD SYMPTOMS

* other schizophrenia s/s

49
Q

Bipolar/depression

A

PSYCHOSIS w/in MOOD DISORDER PHASE

Just need 1 manic episode for bipolar

50
Q

Schizoid

NOT ON TEST

A

Excessive detachment from social relationships, restricted range of expression of emotions
NO ACUTE PSYCHOTIC S/S

51
Q

Schizotypal

NOT ON TEST

A

*acute discomfort with/Reduced capacity for close relationships by cognitive or perceptual distortions + eccentricities of behavior

NO ACUTE PSYCHOTIC SYMPTOMS

52
Q

Delusional disorder types

A
  • persecutory
  • Erotomaniac
  • Grandoise
  • Jealousy
  • Somatic
53
Q

Disorganization s/s

A
  • speech
  • thought
  • catatonia
  • Stereotypy = repeated, non-goal directed movement (rocking)
  • Mannerisms (odd)
  • Echopraxia
  • Automatic obedience
  • Negativism

Psyc Test 1 (7 decks)

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