Test 4 - Psychosis Flashcards

1
Q

for schizophrenia, at least __ of the 5 sx must be present

for at least __ mo

one sx must be __ (3)

A

2 sx

1 mo

delusions, hallucinations, disorganized speech

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2
Q

sx of schozophrenia

A

delusions

hallucinations

disorganized speech

grossly disorganized or catatonic behavior

negative sx

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3
Q

negative sx ex (2)

A

diminished emotional expression

avolition

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4
Q

what distinguishes schizophrenia from schizophreniform d.o and brief psychotic d.o

A

6 mo duration of schizophrenia

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5
Q

shizophreniform d.o lasts

A

1-6 mo

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6
Q

brief psychotic d.o lasts

A

1 day - 6 mo

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7
Q

in schizophrenia, level of functioning is

A

markedly below level achieved prior to onset

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8
Q

shizophreniform d.o lasts

A

1-6 mo

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9
Q

for schizophrenia, you need to r.o psychosis dt

A

drugs/meds

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10
Q

brief psychotic d.o lasts

A

1 day - 6 mo

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11
Q

sensory perceptions in absence of external stimuli

A

hallucinations

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12
Q

firmly held false beliefs

A

delusions

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13
Q

disruption in form of organization of thinking - incoherence, difficulty communicating, loose associations, thought blocking, echolalia, clanging

A

thought d.o

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14
Q

sx that are subtle and often detected only when neuropsychological tests are performed

A

cognitive sx

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15
Q

cognitive sx include

A

poor executive functioning

inability to sustain attention

problems w. working memory

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16
Q

prodromal/residual phase of shizophrenia involves

A

social isolation

impairment of functioning

peculiar behavior

impaired personal hygiene

blunted/inappropriate affect

odd beliefs

unusual perceptual experiences

apathy

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17
Q

mood issues > thought issues when euthymic

A

schizoaffective d.o

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18
Q

psychosis present only during manic/depressive episodes

A

bipolar d.o

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19
Q

scz w. < 6 mo duration

A

schizophreniform d.o

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20
Q

psychotic sx for 1 mo

A

brief reactive psychosis

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21
Q

fails to meet active phase of schizophrenia

A

schizotypal personality do

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22
Q

persistent delusions

A

delusional do

23
Q

preoccupation w. one or more delusions or frequent auditory hallucinations

A

paranoid type

24
Q

paranoid type do does not include (3)

A

disorganized speech

disorganized/catatonic behavior

flat/inappropriate affect

25
Q

absence of prominent delusions, hallucinations, disorganized speech, or behavior

continued e.o disturbance (negative sx)

A

residual type

26
Q

evaluation of psychosis

A

physical/neuro exam

med review

mental status

labs

tox screen

+/- brain imaging/EKG

27
Q

extrapyramidal s.e (EPS) of antipsychotics

A

stiffness/shuffling gait

loss of automatic associated movements → parkinsinonian sx

28
Q

EPS occur when > __% of D2 receptors are occupied

A

80

29
Q

dose to block for tx of psychosis but avoid excessive blockaid to minimze EPS

A

minimal effective dosing

30
Q

low potency antipsychotics are associated w. (2)

A

postural hypotn

somnolence

31
Q

what is akathisia

A

sense of restlessness

32
Q

tx for akathisia

A

decrease dose

bb

bzd’s

33
Q

high potency/long exposure to conventional typical antipsychotics is associated w.

A

tardive dyskinesia

34
Q

tx for tardive dyskinesia

A

decrease dose

switch to novel agents → clozapine

35
Q

what is neuroleptic malignant syndrome

A

fever

muscle rigidity

two of: diaphoresis, dysphagia, tremor, incontinence, tachycardia, labile bp, leukocytosis, increased cpk

36
Q

atypical antipsychotics (risperdal, zyprexa) are associated w.

A

prolactin elevation

37
Q

prolactin elevation causes

A

amenorrhea

galactorrhea

gynecomastia

impotence

increased bone density

38
Q

wt gain and DM are mc in __ agents (2)

A

novel

atypical

ex. zyprexa

39
Q

clozapine can cause

A

agranulocytosis

40
Q

mellaril (thioridizine) is associated w.

A

cardiac s.e

41
Q

what drug offers best hope of tx after 2 other drugs have failed

A

clozapine

42
Q

if 2 antipsychotics fail,

A

chances for success diminish rapidly

43
Q

what might improve treatment resistant psychosis

A

augmentation w. mood stabilizers

supplementation w, another atypical antipsychotic

44
Q

delusion for one month

A

delusional d,o

45
Q

criteria for delusional d.o

A

one month

does not meet criteria for scz

fxn’ing not impaired (apart from delusion)

46
Q

for dx of delusional dx symptoms can not

A

be better explained by another d.o

47
Q

subtypes of delusions (6)

A

erotomanic

grandiose

jealous

persecutory

somatic

mixed

48
Q

delusion that another person is in love w. you

A

erotomanic

49
Q

belief that you have some defect or general medical condition

A

somatic delusion

50
Q

delusion that you are being malevolently treated

A

persecutory

51
Q

mixed delusions

A

more than one of the subtypes

52
Q

antipsychotics moa

A

dopamine antagonists

53
Q

key differentiator w. different antipsychotic meds

A

side effects ->

higher dopamine bockade, more eps w. higher potency/older meds

54
Q

issue w. 2nd gen antipsychotics

A

metabolic syndrome

DM