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
absence of prominent delusions, hallucinations, disorganized speech, or behavior continued e.o disturbance (negative sx)
residual type
26
evaluation of psychosis
physical/neuro exam med review mental status labs tox screen +/- brain imaging/EKG
27
extrapyramidal s.e (EPS) of antipsychotics
stiffness/shuffling gait loss of automatic associated movements → parkinsinonian sx
28
EPS occur when \> \_\_% of D2 receptors are occupied
80
29
dose to block for tx of psychosis but avoid excessive blockaid to minimze EPS
minimal effective dosing
30
low potency antipsychotics are associated w. (2)
postural hypotn somnolence
31
what is akathisia
sense of restlessness
32
tx for akathisia
decrease dose bb bzd's
33
high potency/long exposure to conventional typical antipsychotics is associated w.
tardive dyskinesia
34
tx for tardive dyskinesia
decrease dose switch to novel agents → clozapine
35
what is neuroleptic malignant syndrome
fever muscle rigidity two of: diaphoresis, dysphagia, tremor, incontinence, tachycardia, labile bp, leukocytosis, increased cpk
36
atypical antipsychotics (risperdal, zyprexa) are associated w.
prolactin elevation
37
prolactin elevation causes
amenorrhea galactorrhea gynecomastia impotence increased bone density
38
wt gain and DM are mc in __ agents (2)
novel atypical ex. zyprexa
39
clozapine can cause
agranulocytosis
40
mellaril (thioridizine) is associated w.
cardiac s.e
41
what drug offers best hope of tx after 2 other drugs have failed
clozapine
42
if 2 antipsychotics fail,
chances for success diminish rapidly
43
what might improve treatment resistant psychosis
augmentation w. mood stabilizers supplementation w, another atypical antipsychotic
44
delusion for one month
delusional d,o
45
criteria for delusional d.o
one month does not meet criteria for scz fxn'ing not impaired (apart from delusion)
46
for dx of delusional dx symptoms can not
be better explained by another d.o
47
subtypes of delusions (6)
erotomanic grandiose jealous persecutory somatic mixed
48
delusion that another person is in love w. you
erotomanic
49
belief that you have some defect or general medical condition
somatic delusion
50
delusion that you are being malevolently treated
persecutory
51
mixed delusions
more than one of the subtypes
52
antipsychotics moa
dopamine antagonists
53
key differentiator w. different antipsychotic meds
side effects -\> higher dopamine bockade, more eps w. higher potency/older meds
54
issue w. 2nd gen antipsychotics
metabolic syndrome DM