Altered Thought Processes Flashcards

1
Q

what is psychosis

A

A syndrome of neurocognitive symptoms that impairs cognitive capacity,
leading to deficits of perception, functioning, and social relatedness

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2
Q

what are the 5 symptomatic domains of psychosis

A

Delusions
 Hallucinations
 Disorganized thought
 Disorganized or abnormal motor behavior
 Negative symptoms

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3
Q

what is primary psychosis

A

 A psychiatric cause, i.e. schizophrenia, schizoaffective DO
 Psychobiological origin (genetic & neural pathways) makes future episodes
more likely to occur

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4
Q

what is secondary psychosis

A

 Contributing cause, i.e. substance intoxication, delirium, or dementia
 Have a greater chance to recover

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5
Q

what can psychosis do

A

Unregulated neural circuits release inflammatory markers that degrade
the circuit
can cause dementia

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6
Q

is there a genetic link btwn scizophrenia

A

yes

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7
Q

neurobio of scizo

A

Dopamine hypothesis (associated
with positive symptoms)
* Increased dopamine production
* Increased release of dopamine
* Increased receptor sensitivity
* Increased dopamine receptors

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8
Q

other nts involved in scizo

A

norepinephrine, serotonin, acetylcholine, GABA, and glutamate, loss of grey matter, ventricular enlargement

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9
Q

excess or not enough serotonin in scizo

A

excess

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10
Q

what do glutamate levels do

A

Increase during stress
 First episode of psychosis
precipitated by stress
 Hippocampus becomes
hypermetabolic then atrophies
 Common finding in schizophrenia –
research to identify new biomarkers
to signal early illness, prevention, &
treatment

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11
Q

positive symptopns of scizo

A

overt symptoms that should not be present
hallucinations
delusions
disorganized thoughts

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12
Q

negative symtpoms of scizo

A

does not refer to attitude, but instead a lack of characteristics that should be present
reduced speech
lack of emotional and facial expression
diminished abiligt to begin and sustain activities
decreased ability to find pleasure in everyday
social w/draw

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13
Q

cognitive deficits

A

difficilties w/ following aspects of cognition can make it hard to live a normal life or earn a living
memory
attention
planning
decision making

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14
Q

what are delusions

A

Fixed false personal belief that does not
change when confronted with conflicting evidence

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15
Q

what are persecutory delusions

A

paranoid

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16
Q

what are grandiose delusions

A

exaggerated feeling of importance

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17
Q

somatic delusions

A

body function

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18
Q

erotomanic delusions

A

in love with him or her

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19
Q

jealous delusions

A

irrational w/out cause

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20
Q

reference delusions

A

Events in environment refer to him
or her, i.e. radio is talking to them

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21
Q

what is paranoia

A

Extreme suspiciousness of others

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22
Q

what is magical thinking

A

Ideas that one’s thoughts or
behaviors have control over specific situations

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23
Q

wha is loose associaion

A

Shift of ideas from one unrelated topic to another

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24
Q

what are neologisms

A

Made-up words that have meaning only to the person who invents them

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25
what is concrete thinking
Literal interpretations of the environment
26
what are clang associations
Choice of words is governed by sound (often rhyming)
27
what is word salad`
Group of words put together in a random fashion
28
what is circumstantiality
Delay in reaching the point of a communication because of unnecessary and tedious details
29
what is tangentiality
Inability to get to the point of communication due to introduction of many new topics
30
what is perseveration
Persistent repetition of the same word or idea in response to different questions
31
what hallucination is most common in scizo
auditory
32
what are illusions
misperceptions of real external stimuli
33
what is echolalia
repeating words that are heard
34
what is echopraxia
repeating movements that are observed
35
what is apathy
disinterest in the enviornment
36
what is avolition
Impairment in the ability to initiate goal-directed activity
37
what is emotional ambivalence
Coexistence of opposite emotions toward same object, person, or situation
38
what is associality
Impaired interpersonal functioning and relationship external world
39
what is anergia
deficiency of energy
40
what is anosognosia
Impairment of a person’s ability to understand and perceive their illness
41
what is waxy flexibilty
Passive yielding of all movable parts of the body to any effort made at placing them in certain positions
42
what is posturing
voluntary assumption of inappropriate or bizarre postures
43
what is catatonia
Significant motor disturbance that may range from stupor (no motor activity) to excessive motor activity and agitation
44
FGA/Typical antipsychotics moa
block postsynaptic dopamine receptors in the basal ganglia, hypothalamus, limbic system, brainstem, and medulla address positive symptoms
45
loxapine
fga/typical antipsychotics
46
haloperidol
fga/typical antipsychotics
47
PIMOZIDINE
fga/typical antipsychotics
48
cholpromazine
fga/typical antipsychotics
49
fluphenazine
fga/typical antipsychotics
50
mesoridazine
fga/typical antipsychotics
51
perphenazine
fga/typical antipsychotics
52
prochlorperazine
fga/typical antipsychotics
53
sg2/atypical antipsychoitcs moa
weaker dopamine receptor antagonists than FGAs but are more potent antagonists of the serotonin 5HT2A receptors
54
clozapine
SGA/Atypical antipsychotics
55
risperodone
SGA/Atypical antipsychotics
56
paliperidone
SGA/Atypical antipsychotics
57
olanzapine
SGA/Atypical antipsychotics
58
quetiapine
SGA/Atypical antipsychotics
59
ziprasidone
SGA/Atypical antipsychotics
60
aripiprazole
SGA/Atypical antipsychotics
61
clozapine
SGA/Atypical antipsychotics risk for infection
62
lais
Historically used for treating clients with schizophrenia who relapse due to nonadherence.  Now clients may be treated with LAI if it is their preference without demonstrating a history of nonadherence  Injections administered every 2 or 4 weeks
63
antipsychotic side effects
Metabolic Syndrome * Extrapyramidal symptoms (EPS) dyskinesia * Neuroleptic malignant syndrome * Agranulocytosis (clozapine): * Anticholinergic effects * Hormonal effects (prolactin) * EKG changes (QT prolongation) * Sedation * Orthostatic hypotension * Nausea; gastrointestinal upset * Skin rash * Photosensitivity * Increased risk of mortality in elderly clients with dementia
64
symptoms of neroleptic malignant syndrome
fever, confusion, muscle rigidity, diaphoresis, and tachycardia. Life threatening
65
monitoring for agranilocytosis
monitor CBC with Diff/ANC (absolute neutrophil count)
66
what labs to look at with metabolic syndrome
↑weight, ↑cholesterol/lipids, ↑BG, ↑BP, ↑waist circumference
67
extrapyramidal symptoms
akathisia, pseudoparkonsonism, dystonia, tardive
68
what is dystonia
uncontrolled muscular spasm
69
s+s of eps
dystonia pseudoparkinsonism akathisia tardive dyskinesia
70
what is pseudoparkinsonism
tremor/bradykinesia
71
what is akathisia
restlessness
72
what is tardive dyskinesia
abnormal involuntary movements
73
treatment for dystonic reaction
im/iv diphenhydramine
74
most dystonic reactions occur where
neck and above
75
which drugs mostly cause eps
1st gen antipsychoics
76
what is used to treat eps
benzotropine and diphenhydramine
77
benzotropine
anticholinergic
78
what to know about fga
Positive symptoms - Risk for TD - EPS - Low risk of cardiometabolic side effects - Cheap
79
what to know about sgas
Positive Symptoms and some benefit with negative symptoms, - Very low risk of TD - Lower risk of EPS - Risk of cardiometabolic side effects - Clozapine is oldest SGA and has additional monitoring due to risk of agranulocytosis
80
what is aripiprazole tablet with sensor used to treat
scizo bipolar 1 mdd
81
monitoring for clozapine
weekly bloodwork report s/s of infection
82