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Psychiatry > Feb. 21/24 > Flashcards

Feb. 21/24 Flashcards

1
Q

Schizophrenia Spectrum Disorders

A
  • schizophrenia
  • other psychotic disorders
  • schizotypal (personality) disorder
  • catatonia
  • brief psychotic disorder
  • schizophreniform disorder
  • substance/medication-induced psychotic disorder
  • psychotic disorder due to another medical condition
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2
Q

Key Features of Schizophrenia Spectrum

A
  • “Positive” Symptoms: delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behavior (catatonia)
  • “Negative” Symptoms: diminished emotional expression, avolition (dec. in motivation & self-initiated purposeful activity), alogia (diminished speech output), anhedonia (diminished ability to experience pleasure), asociality (lack of interest in social interaction)
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3
Q

Positive Symtoms

A
  • psychotic symptoms not seen in healthy people
  • “lose touch” with reality
  • symptoms can come & go
  • sometimes severe and at other times hardly noticeable depending on if individual is receiving treatment
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4
Q

Negative Symptoms

A
  • disruptions to normal emotions & behaviors
  • harder to recognize as part of the disorder & can be mistaken for depression or other conditions
  • “flat affect” person’s face does not move or they talk in a dull or monotonous voice
  • lack of pleasure in everyday life
  • lack of ability to begin & sustain planned activities
  • speaking little, even when forced to intact (need help with everyday tasks, often neglect basic personal hygiene, may make them seem lazy or unwilling to help themselves, but the problems are symptoms caused by the schizophrenia
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5
Q

Schizophreniform Disorder

A

-less than 6 months duration

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6
Q

Schizoffective Disorder

A

-major mood disorder concurrent with schizophrenia-like psychosis

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7
Q

Delusional Disorder

A

-circumscribed & often bizarre delusion, in an otherwise normal-appearing patient

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8
Q

Brief Psychotic Disorder

A

-transient psychosis, precipitated by stress

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9
Q

Schizotypal

A
  • personality disorder & schizophrenia spectrum disorder
  • characterized by a pervasive pattern of social & interpersonal deficits, reduced capacity for relationships, eccentricities, odd thinking & speech, suspiciousness, ideas of reference, & unusual perceptual experiences
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10
Q

Psychotic Disorders Common in Medical Settings

A
  • substance/medication induced psychotic disorder
  • psychotic disorder due to general medical condition
  • catatonia
  • delirium
  • dementia
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11
Q

Substance/Medication-Induced Psychotic Disorder

A
  • persistent, prominent delusions and/or hallucinations that developed during or soon after substance intoxication or withdrawal, or after exposure to a medication that is capable of producing these symptoms
  • NOT the same as delirium
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12
Q

Psychotic Disorder Due to Another Medical Condition

A
  • evidence from history, physical, & labs that the psychosis is due to the physiological effects of a medical condition, did not precede the onset of the medical condition, & does not exclusively occur during a delirium
  • Ex: malignant lung neoplasm, multiple sclerosis, brian injury, hypothyrodidism
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13
Q

Catatonia

A
  • severe psychomotor disturbance; may be associated with many different disorders, including schizophrenia, depressive stupor, and a variety of serious medical conditions
  • can be life-threatening
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14
Q

Delirium

A
  • characterized by altered mental status, lasting hours to days (potentially life threatening)
  • acute alteration of consciousness with fluctuating disturbances in cognition, perception, behavior, affect, & sleep due to underlying physical cause
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15
Q

Dementia

A

-syndrome of general loss of cognitive functions & significant functional deterioration

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16
Q

Dementia of the Alzheimer Type (DAT)

A
  • Genetic: ApoE4 genes, chro. 19, also chro: 1,4,21
  • cortical radiations of cholinergic neurons, esp. hippocampus & parietal & occipital lobes
  • beta amyloid, tau proteins, granulovacuolar degereration, neurofibrillary tangles
  • presenilin 1 & 2 amyloid precursor proteins
  • early short-term memory loss, apraxia, progressive confusion, inability to sequence, learn, or recognize people
  • later personality changes, depression, paranoia, visual hallucinations
  • most prevalent
  • incidence inc. with age
17
Q

Vascular Dementia “multi-infarct” dementia

A
  • diffuse cortical in vascular distribution
  • small infarcts
  • variable, stepwise deterioration
  • often co-exists with DAT
  • second most prevalent
  • related to other cardiovascular risk factors
18
Q

Huntington Disease (HD)

A
  • 36-250 CAG repeats on chro. 4
  • destruction of caudate, radiations of caudate
  • inc. huntingtin protein
  • paranoia, impulsive dyscontrol, memory loss, paranoia, chorea
  • characteristic “Butterfly” pattern on neuroimaging
  • autosomal dominant
19
Q

Parkinson Disease (PD)

A
  • cortical radiations of dopamine neurons originating in basal ganglia
  • Lewy bodies (alpha synuclein)
  • changes due to cholinergic deterioration
  • tremor, rigidity, cogwheeling; memory loss, paranoia, apathy, aggression
20
Q

Lewy Body Dementia

A
  • similar to PD but spares temporal areas
  • lew bodies (alpha synuclein)
  • severe motor symptoms, visual hallucinations early, memory loss, personality change
  • much rarer than DAT but second most common primary degeneration dementia
21
Q

Pick Disease (primary frontotemproal dementia)

A
  • frontal & temporal lobe atrophy
  • impulsive/disinhibited or anergic/apathetic poor hygiene, loss of social skills, aphasia, no insight, memory may be spared
  • subclassified: with or without aphasia
22
Q

Dementia secondary to other diseases/deficiencies/injury

A
  • mixed, frontotemporal symptoms may predominate early on
  • memory loss, personality change, often motor abnormalities, depression
  • partly preventable
  • progression varies with underlying condition
23
Q

Primary HIV infection of CNS or AIDS-related infections

A
  • damage may be focal or diffuse
  • typically prominent frontal symptoms; personality change, movement disorders
  • may remit with treatment of underlying infection
24
Q

Multiple Sclerosis

A
  • characteristic scattered lesions throughout the brain
  • symptoms worsen during flares
  • may be partially reversed or arrested by treatment
25
Q

Autoimmune Disorders (systemic lupus erythematosus)

A
  • effects of vasculitis

- rapidly progressiv in uncontrolled disease (seizures)

26
Q

Alcohol Related

A
  • diffuse toxic damage, sometimes prominent cerebellar damage
  • permanent but may not progress if drinking stopped
27
Q

Thiamine Deficiency (related to alcoholism or malnutrition)

A
  • selective deterioration of mamillary bodies
  • early acute stage “Wwenicke’s encephalopahty” reversible with treatment
  • later “Korsakoff’s psychosis” irreversible, severe loss of short term memory
28
Q

Following closed head injury

A
  • diffuse axonal injury, cerebral contusions & scarring
  • acceleration of DAT type changes
  • often frontal damage, personality change, & diminished executive functions
  • younger people may recover considerable function
  • depression, mania, or psychosis may occur, depending on site of injury
29
Q

Hypothyroidism

A
  • sluggishness, loss of motivation, slowed thought

- may be reversible with thyroid repalcement

30
Q

B12/Folate Deficiency (intrinsic or secondary to alcoholism)

A
  • often associated with anemia or peripheral neuropathy

- may be improved with vitamin replacement

31
Q

Normal Pressure Hydrocephalus

A
  • compression of cortical tissue surrounding cerebral ventricles
  • prominent gain disturbances & incontinence, personality changes
  • may remit with early diagnosis, shunting
32
Q

Posterior Brain

A

-perceptual integrating brain

33
Q

Anterior Brain

A

-action brain

34
Q

Secondary Syndromes

A

-typical psychiatric syndromes or specific patterns of cognitive impairment that occur in the course of various medical conditions

Psychiatry (7 decks)

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