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5. Psychiatry > 3- Psychotic Disorders > Flashcards

3- Psychotic Disorders Flashcards

(47 cards)

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1
Q

What is a loss of contact w/ reality evidenced by delusions, hallucinations, disorganized thoughts/speech/behavior?

A

Psychosis

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2
Q

What are false beliefs, despite disproving evidence?

A

Delusions

Types: paranoids or persecutory, grandiose, reference, somatic

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3
Q

What are sensory perceptions in the absence of a stimulus?

A

Hallucinations

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4
Q

What is the most common type of hallucination?

A

Auditory

Also: visual, tactile, olfactory, gustatory

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5
Q

What NT pathway is implicated in psychosis?

A

Dopamine

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6
Q

Substances that mimic dopamine (cocaine, L-dopa, meth) will cause sx of what?

A

Schizophrenia

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7
Q

Substances that mimic glutamate at the NMDA (Ketamine/PCP) receptor will cause sx of what?

A

Schizophrenia

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8
Q

Substances that mimic serotonin (LSD, Mescaline, Ecstasy) will cause sx of what?

A

Schizophrenia

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9
Q

The following are examples of what?

  • Derailment, tangentiality
  • Incoherence, word salad
  • Neologism
  • Echolalia
  • Blocking, paucity
A

Disorganized speech

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10
Q

Pts w/behavior that is not goal directed, are unable to complete simple tasks, and/or have immobility or waxy flexibility are exhibiting what type of behavior?

A

Disorganized or catatonic behavior

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11
Q

What sx of psychosis result in decrease or absence of function?

A

Negative sx

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12
Q

Apathy, anhedonia, asociality, and alogia (lack of speech) are an example of what sx?

A

Negative sx

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13
Q

What medications will be more effective against negative sx?

A

Atypical antipsychotics

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14
Q

Pts w/ plausible but false delusions have what form of delusional disorder?

EX: followed by police. NOT alien abductions, chips in brain

A

Non-bizarre

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15
Q

What is the DSM5 criteria for delusional d/o? (5)

A
  1. Non-bizzarre delusions for 1+ month
  2. Criterion A for schizophrenia has NEVER been met
  3. Mood episodes are brief relative to delusions
  4. Functioning NOT markedly impaired, behavior not obviously odd or bizarre
  5. Not due to substance or GMA
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16
Q

What delusional d/o subtype is characterized by another person (usually of higher status/celebrity) being in love with the pt?

A

Erotomanic

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17
Q

What delusional d/o subtype is characterized by inflated power, worth, knowledge or special relationship to deity or famous person?

A

Grandiose

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18
Q

What delusional d/o subtype is characterized by claims that spouse/ SO being unfaithful?

A

Jealous

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19
Q

What delusional d/o subtype is characterized by being treated malevolently, conspired against, spied on, followed, etc?

20
Q

What delusional d/o subtype is characterized by physical defect or GMC?

21
Q

What delusional d/o subtype is characterized by features of more than 1 subtype, but none predominate?

22
Q

What d/o is sudden onset of 1+ positive sx that last 1 day-1 month w/ return to normal and has a high suicide risk?

Study These Flashcards
A

Brief psychotic d/o

23
Q

What is the DSM 5 criteria for brief psychotic d/o? (3)

Study These Flashcards
A
  1. Presence of 1+ of the following: delusions, hallucinations, disorganized speech, disorganized/catatonic behavior
  2. Duration 1 day to 1 month w/ full return to premorbid level of functioning
  3. No due to schizophrenia, schizoaffective or mood d/o, substance or GMC
24
Q

What % of pts w/ schizophreniform d/o recover vs what % progress to schizoaffective d/o?

Study These Flashcards
A

1/3 recover

2/3 progress

25
Can a pt with schizophreniform d/o have normal social/occupation functioning?
Yes
26
What is the DSM5 criteria for schizophreniform d/o? (3)
1. Presence of 2+ of the following: delusions, hallucinations, disorganized speech, disorganized/catatonic behavior 2. Duration 1 month to 6 months 3. No due to schizophrenia, schizoaffective or mood d/o, substance or GMC
27
The general population has a 1% risk of developing schizophrenia. What is the risk in pt w/ 1st degree relative w/ schizophrenia?
10x general public
28
What is the avg age of onset for schizophrenia in M and F?
M: 18-25 F: 25-35
29
Is schizophrenia a life long condition?
Yes
30
T or F: Pts w/ schizophrenia have a decreased life expectancy?
TRUE M: 15 yrs earlier F: 12 yrs earlier
31
What is the DSM5 criteria for schizophrenia? (4)
1. Presence of 2+ of the following: negative sx, delusions, hallucinations, disorganized speech, disorganized/catatonic behavior 2. Dysfunction in 1+ area of life 3. Duration 6 months (1 month of criteria A + prodrome/residual period) 4. Not due to schizoaffective or mood d/o, substance or GMC * Specify w/ or w/o catatonia
32
What factors will lead to a better prognosis in pts w/ schizophrenia? (8)
- Female - Good premorbid functioning - Later onset - Acute onset w/ precipitating factor - Brief duration, early intervention, tx compliance - High SES, married, good support sx - Positive sx - Mood disturbance or Fhx of mood d/o
33
What d/o is schizophrenia + mood d/o (bipolar or depression)?
Schizoaffective d/o
34
What is the DSM5 criteria for schizoaffective d/o? (4)
1. Presence of 2+ of the following: negative sx, delusions, hallucinations, disorganized speech, disorganized/catatonic behavior && concurrent episode of major depression, mania, or mixed episode 2. 2+ wks of delusions/hallucinations W/O mood sx 3. Mood sx are present for significant portion of illness 4. Not due to substance or GMC
35
What is first line med tx for schizophrenia?
1st gen antipsychotic: Chlorpromazine > Haloperidol - low dose and titrate - DO NOT use 2 antipsychotics @ same time
36
What is the goal of the first phase of tx (acute stabilization) in pt w/ schizophrenia?
Safety to self/others
37
What are indications for hospitalization of pts w/ schizophrenia? (3)
1. Danger to self/others 2. Command auditory hallucinations 3. Unable to care for self
38
What is the goal of the maintenance phase of tx in pt w/ schizophrenia?
Sx control/prevent relapse
39
What is the biggest issue of the maintenance phase of tx in pt w/ schizophrenia?
Med compliance
40
What are 2nd gen antipsychotics? (5)
``` Aripiprazole Clozapine Olanzapine Quietapine Risperidone ```
41
What things should you consider when rx meds for schizophrenia?
1. Dx/ R/o non-psychiatric causes 2. Personal/family hx of response to meds (will have similar responses to meds) 3. Atypicals cause increased mortality in elderly
42
What 2nd gen antipsychotic is a partial D2 agonist and metabolically neutral?
Aripiprazole
43
What 2nd gent antipsychotic has a risk of agranulocytosis?
Clozapine
44
What 2nd gen antipsychotic can cause weight gain?
Olanzapine
45
What 2nd gen antipsychotic can cause hyperprolactinemia, EPS?
Risperidone
46
What are the general SE of antipsychotic meds?
EPS - Dystonia - Parkinsonism - Akathisia (restlessness) - Tardive dyskinesia (tongue darting, finger dancing, blinking) - Neuroleptic malignant syndrome
47
What are positive sx of schizophrenia?
Delusions | Hallusinations

5. Psychiatry (19 decks)

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