Day 1 - Psych Part 1 Psychotic Flashcards Preview

Step 2 DIT Rapid Review > Day 1 - Psych Part 1 Psychotic > Flashcards

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

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.

2

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

3

Neuroimaging of pt w/ schizophrenia

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

4

Schizophrenia v. Delusional disorder

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

5

Drugs known to cause psychosis

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

6

2 main extrapyramidal side effects assoc. w/ antipsychotics

(1) Acute dystonia (2) Tardive dyskinesia

7

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)

8

Feat. characterize tardive dyskinesia from high-potency traditional antipsychotic

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

9

Tx tardive dyskinesia

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

10

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

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

11

Tx for Parkinsonian side effects from neurolepics

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

12

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

13

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)

14

High potency traditional neuroleptics

Haloperidol, Fluphenazine, Droperidol

15

Low potency traditional neuroleptics

Chlorpromazine, Thioridazine

16

Moderate potency traditional neuroleptics

Molindone, Loxapine, Trifluoperazine, Perphenazine

17

Atypical antipsychotics

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

Decks in Step 2 DIT Rapid Review Class (111):