Day 1 - Psych Part 1 Psychotic Flashcards Preview

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Flashcards in Day 1 - Psych Part 1 Psychotic Deck (17):

Dx criteria of Schizophrenia

At least 2 of following for at least 1 month: Delusions/Hallucinations, Disorg. speech, Grossly disorg. or catatonic behavior, Negative sx w/ social/occupational impairment for 6 mo.


Difference bn following disorders: (1) Schizotypal (2) Schizophrenia (3) Schizoaffective (4) Schizoid (5) Schizophreniform (6) Brief psychotic disorder

(1) Personality disorder, odd thoughts/behaviors/appearance (think: may dress like a pickle) (2) Social/occupational impairment, duration for at least 6 mo. (3) Schizophrenia w/ mood disorder, can have psychosis w/o mood disorder but not vice versa (that would be MDD w/ psychotic features) (4) Personality disorder w/ voluntary social isolation (think: schizoids avoid) (5) Schizophrenia sx but duration


Neuroimaging of pt w/ schizophrenia

Enlargement of ventricles, both lateral and third; Reduction in cortical volume


Schizophrenia v. Delusional disorder

Both delusions; Delusional disorder - non-bizarre delusions, no disorganized speech or behavior


Drugs known to cause psychosis

Hallucinogens - LSD, PCP; Stimulants - cocaine, amphetamines; Tactile hallucinations w/ withdrawal from alcohol, barbiturates, or benzos; Steroids - corticosteroids, anabolic steroids


2 main extrapyramidal side effects assoc. w/ antipsychotics

(1) Acute dystonia (2) Tardive dyskinesia


Pt on antipsychotic p/w neck spasm forcing head in unusual direction - dx & tx

Acute dystonia; Benadryl (diphenhydramine) - add more anticholinergic into system (or Benztropine)


Feat. characterize tardive dyskinesia from high-potency traditional antipsychotic

Choreoathetosis (tongue, face, neck, tongue, limb, trunk)


Tx tardive dyskinesia

D/c or reduce neuroleptic; Consider switching to antipsychotic with less extrapyramidal side effects (e.g., Atypicals - Risperidone or even Clozapine)


Time frame expect to see Parkinsonian side effects in pt taking antipsychotics

4 days to 4 months (i.e., Extrapyramidal side effects)


Tx for Parkinsonian side effects from neurolepics

Anticholinergics like benztropine or diphenhydramine; Amantidine (dopamine agonists); Decrease or d/c Neuroleptic


S/sx neuroleptic malignant syndrome

Mental status changes - agitated delirium with confusion (not psychosis); Rigidity w/ or w/o tremor, Hyperthermia, Autonomic instability - tachycardia, labile/high fever, tachypnea, diaphoresis, Rhabdomylosis


Tx neuroleptic malignant syndrome

Stop offending med; Supportive care in ICU (IVFs, cooling blankets, reducing HTN - clonidine or nitroprusside), DVT prevention, Benzos; Dantrolene (other options - dopamine agonists = Bromocriptine or Amantidine)


High potency traditional neuroleptics

Haloperidol, Fluphenazine, Droperidol


Low potency traditional neuroleptics

Chlorpromazine, Thioridazine


Moderate potency traditional neuroleptics

Molindone, Loxapine, Trifluoperazine, Perphenazine


Atypical antipsychotics

Olanzipine, Quetiapine, Clozapine, Risperidone, Ziprasidone, Aripiprazole, Paliperidone

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