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Psychiatry > Schizophrenia/Psychosis > Flashcards

Schizophrenia/Psychosis Flashcards

1
Q

Schneider’s first rank symptoms

A

DAPT

  • delusions
  • auditory hallucinations
  • passivity phenomena
  • thought disorderS
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2
Q

define Psychosis

A

A severe mental disorder in which thought and emotions are so impaired that contact is lost from reality

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3
Q

5 differentials for Psychosis

A
  • brain tumour
  • temporal lobe epilepsy
  • thyroid disease
  • high dose steroids
  • encephalitis
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4
Q

3 infections of the nervous system that can cause psychosis

A
  • AIDS
  • neurosyphylis
  • encephalitis
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5
Q

2 endocrine causes of psychosis

A
  • cushings syndrome

- thyroid disease

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6
Q

investigations in someone presenting with psychosis

A
  • fbc
  • lfts
  • tfts
  • bone function
  • renal function
  • routine MRI (if presence of neurological symptoms)
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7
Q

management of 1st episode of psychosis

A
  • oral antipsychotic medication

- psychological interventions: 1) CBT 2) family intervention

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8
Q

average age in males + females for schizophrenia

A 
men = 22 
women = 26
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9
Q

prevalence of schizophrenia

A

1%

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10
Q

4 Positive symptoms of schizophrenia

A
  • hallucinations
  • delusions of: control, passivity, sensations, perceptions
  • thought alienation
  • persistent delusions
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11
Q

5 negative symptoms

A
  • thought disorders
  • self neglect
  • blunted mood
  • reduced speech + withdrawal
  • decreased motivation
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12
Q

Delusion is ___

A

fixed, false belief that is unshakeable despite evidence of the contrary

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13
Q

Hallucinations are ___

A

perceptions with no external stimulus

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14
Q

types of thought disorders (4)

A
  • thought insertion
  • thought withdrawal
  • thought broadcasting
  • repetition of thoughts
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15
Q

presentation of catatonic behaviour

A
  • waxy flexibility
  • negativism
  • sudden excitement
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16
Q

following the first episode of psychosis, what percentage of patients experience a relapse within

a) 1 year
b) 5 years

A

a) 30%

b) 80%

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17
Q

precipitating factors for psychosis (2)

A

Life events

Street drug use: amphetamines + cannabis

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18
Q

maintaining factors for schizophrenia (3)

A
  • street drug use
  • disruptive family environment
  • poor adherence to medx
19
Q

4 susceptibility genes

A
  • Neuregulin
  • DISC
  • Dysbindin
  • ZNF804A
20
Q

birth risk factors for developing schizophrenia (4)

A
  • birth asphyxia
  • childhood encephalitis/brain injury
  • winter birth
  • urban birth
21
Q

ethnicity risk factor for Schizophrenia

A

africo caribbean ethnicity

22
Q

childhood risk factors for developing schizophrenia (4)

A
  • cannabis use at age 15
  • separation from parents
  • childhood brain injury/encephalitis
  • childhood sexual abuse
23
Q

area of brain responsible for negative symtoms

A

prefrontal cortex

24
Q

area of brain responsible for hallucinations

A

superior temporal gyrus

25
Q

area of brain responsible for positive symptoms

A

medial temporal lobe: hippocampus

26
Q

4 dopamine pathways

A

1) nigrostriatal pathway
2) mesolimbic pathway to midbrain
3) mesocortical pathway
4) tuberoinfundibular pathway

27
Q

pathological dopamine pathway in schizophrenia

A

mesolimbic pathway to midbrain; to regions associated with: reward, motivation, memory, affect

28
Q

3 typical antipsychotics

A
  • Haloperidol
  • Pimozide
  • Fluphenazine
29
Q

4 atypical antipsychotics

A
  • Clozapine
  • Olanzapine
  • Risperidone
  • Quitiapine
  • Apriprazole
30
Q

extra pyramidal side effects of antipsychotics (4)

A
  • akathisia
  • dystonia
  • tardive dyskinesia
  • parkinson like rigidity
31
Q

akathisia is

A

restless legs

32
Q

dystonia is

A

painful muscle contractions

33
Q

metabolic side effects of antipsychotics (3)

A
  • raised cholesterol
  • T2DM
  • weight gain
34
Q

rare but serious side effect of Clozapine

A

Agranulocytosis

35
Q

antimuscarinic SE of antipsychotics (4)

A
  • dry mouth
  • blurred vision
  • urinary retention + constipation
36
Q

which antipsychotic initially requires weekly blood tests

A

clozapine

37
Q

monitoring required prior to commencing antipsychotics

  • cardiovascular
  • endocrine
  • activity + diet
A
  • FBC, U+E, LFTs
  • BP + pulse
  • ECHO + ECG
  • fasting blood glucose
  • HbA1c
  • prolactin
  • lipids
  • waist circumference
  • assess nutritional status, diet + physical activity
38
Q

antipsychotic that reduces seizure threshold

A
  • clozapine
39
Q

rare but potentially fatal side effect of antipsychotics

A

neuroleptic malignant syndrome

40
Q

signs of neuroleptic malignant syndrome

A
  • fever
  • tachy
  • muscle rigidity
  • pallor
  • urinary incontinence
41
Q

management of neuroleptic malignant syndrome

A
  • active cooling
  • ICU
  • stop antipsychotics
  • amantadine for rigidity
  • benzodiazepine for agitation
  • aggressive IV fluid resus
42
Q

complications of neuroleptic malignant syndrome (4)

A
  • raised potassium
  • renal failure
  • rhabdomyolysis
  • seizures
43
Q

psychological treatments for Schizophrenia

A

CBT

Family interventions

44
Q

aim of CBT

A

focuses on helping patients understanding their symptoms better + develop ways of coping

Psychiatry (9 decks)

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