Thought Questions FA Flashcards
DDX for Psychosis?
- Substance/meds
- Delirium / Dementia
- Bipolar…manic/mixed
- Major depression w/ psychotic features
- Delusional disorder
- Schizophrenia
- brief psychotic, schizophreniform, schizophrenia
- Schizoaffective
Name 4 positive symptoms of Schizo?
- Delusions
- Hallucinations
- Disorganized speech
- Bizarre behavior
Name the five A’s of negative symptoms of Schizo?
- Flat Affect
- Anhedonia
- Apathy/Avolition
- Alogia (poverty of speech)
- Alone - lack of interest in socialization
Attention (poor)
DSM V Criteria for Schizo
2+ from the following for at least 1 month. 1 must be from #1,2,3
- Delusions
- Hallucinations
- Disorganized speech
- Disorganized behavior/catatonic
- Negative Symptoms
In addition to 2 of the 5 criteria for Schizo, what else must be present?
Must cause significant social, occupational, or self-care functional deterioration
Why is it thought that increased dopamine activity is connected to Schizo?
- Antipsychotics effective in treating Schizo are dopamine antagonists
- Cocaine and amphetamines increase dopamine activity and both can produce Schizo-like symptoms
Are the following associated w/ worse or better prognosis in Schizo?
- later onset
- male gender
- negative symptoms
- positive symptoms
- acute onset
- mood symptoms
Later = good Male = bad Negative = bad Positive = good Acute = good Mood = good
Somatic symptom disorder vs.
Illness anxiety disorder
Somatic: excessive anxiety + preoccupation w/ 1+ unexplained symptoms
Illness anxiety: fear of serious illness despite few or NO symptoms…idea of an illness
What lab tests would you order before prescribing Lithium?
Creatinine, BUN, urinalysis
Thyroid function tests
ECG in pt’s w/ coronary risk factors
Which disorder do you remember dream content?
Which disorder can you be consoled?
Which disorder can child have incomplete awakenings?
Nightmare disorder - yes content, yes consoled
Sleep terror - no comfort, no recall, incomplete awakenings
Which substance abuse has:
- aggressive behavior
- tactile hallucinations
- excoriations
Methamphetamine abuse
- also poor dentition & delusions
Tactile - bugs crawling under the skin
What seen in amphetamine intoxication?
Agitation
Psychosis
Tachycardia, hypertension, diaphoresis
Mydriasis
Can subside in a few hoursWhat seen in opioid withdrawal?
Irritability
Lacrimation, rhinorrhea
N/V/Diarrhea, abdominal cramps
Muscle spasms, joint pain
Often last 3-5 daysArthralgia, thrombocytopenia, hematuria, proteinuria
Psychosis, depression, mania, anxiety
If young women, think SLE
- test for anti-dsDNA, anti-Smith, anti-U1 ribonucleoprotein
