Psychosis

Question 1

Three things needed to define psychosis

Answer 1

delusions, hallucinations, disorganized thinking/speech/behavior

Question 2

symptoms of schizophrenia

Answer 2

mania, severe depression, substance induced, medical condition, drug induced

Question 3

person believes “he or she is being tormented, followed, tricked, spied on, or ridiculed”, or that their food is being poisoned

Answer 3

delusions of persecution

Question 4

individual’s experiencing innocuous events or merecoincidences[1]and believing they have strong personal significance

Answer 4

ideas of reference

Question 5

False belief that another person, group of people, or external force controls one’s general thoughts, feelings, impulses, or behavior

Answer 5

delusions of control

Question 6

ixed, false belief that one possesses superior qualities such as genius, fame, omnipotence, or wealth.

Answer 6

delusions of grandeur

Question 7

person may, for example, believe that he or she has committed some horrible crime and should be punished severely. Another example is a person who is convinced that he or she is responsible for some disaster (such as fire, flood, or earthquake) with which there can be no possible connection.

Answer 7

delusions of guilt

Question 8

psychotically depressed man believes his internal organs have become infested with and partially consumed by large purple worms.

Answer 8

somatic delusions

Question 9

Three instances where you may see a patient having visual hallucinations

Answer 9

intoxication, withdrawal, delirium

Question 10

olfactory hallucinations are associated with an

Answer 10

epileptic aura

Question 11

what is the main cause of tactile perceptual disturbances

Answer 11

drug induced (cocaine or alcohol)

Question 12

hallucinating that you are being infested with bugs

Answer 12

Ekboms Syndrome

Question 13

ideat that something is crawling around your skin

Answer 13

formication

Question 14

MS, Alzheimers, Parkinson, tertiary syphilis, encephalitis, AIDS, neoplam, cerebrovascular, Huntingtons are all examples of

Answer 14

CNS causes of psychosis

Question 15

hypo/hypercalcemia, hypopituitarism, hypo/hyperthyroidism, Addison, Cushing are all examples of

Answer 15

endocrinopathies that cause psychosis

Question 16

B12, folate and niacin are examples of

Answer 16

nutritional/vitamin deficiencies that can cause psychosis

Question 17

What kind of hallucinations are seen in Lewy Body dementia?

Answer 17

happy hallucinations

Question 18

At what age do women and men present with schizophrenia?

Answer 18

women → 30

men → 20

Question 19

If a patient over 55 presents with schizophrenia like symptoms what is the likely diagnosis?

Answer 19

dementia

Question 20

Schizophrenia is also comorbid with

Answer 20

substance abuse

Question 21

lower socioeconomic status secondary to impaired social functioning

Answer 21

downward drift

Question 22

Pathophysiology of schizophrenia is

Answer 22

increased dopamine activity in certain neuronal tracts → disease is most likely due to excess dopamine

Question 23

what percent of schizophrenia patients smoke?

Answer 23

90%

Question 24

positive symptoms of schizophrenia

Answer 24

hallucinations, delusions, bizarre behavior, disorganized speech

Question 25

Negative symptoms of schizophrenia

Answer 25

blunted affect, anhedonia, apathy, alogia, avolition

Question 26

Psychotic disorders are ____ since they probably have origins in early development but are generally manifested in late adolescence as a result of the developmental trajectory of the brain

Answer 26

neurodevelopmental

Question 27

1% of ____ is lost per psychotic episode

Answer 27

gray matter

Question 28

How will gray matter loss look on an MRI or CT?

Answer 28

gray matter atrophy and enlarged ventricles

Question 29

DSM V criteria for schitophrenia - you need ___ or more symptoms present for at least ____

Answer 29

2 or more | one month

Question 30

To be diagnosed with schizophrenia you need at least one of your symptoms to be

Answer 30

hallucinations, delusions, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms

Question 31

For schizophrenia you have to have continuous disturbance for

Answer 31

6 months

Question 32

patients doesn’t talk, will give very simple answers to what they are asked

Answer 32

poverty of speech

Question 33

what types of associations may a schizophrenic patient have?

Answer 33

loose → tangential, circumstantial

Question 34

three phases of schizophrenia

Answer 34

prodromal → psychotics → residual

Question 35

what is going on in the prodromal stage?

Answer 35

accumulation of cognitive and functional impairment → start to see changes in mood, behavior, academic performance, self care, social withdrawal, sleep patterns, cognitions

Question 36

what percent of schizophrenic patients remain significantly depressed?

Answer 36

40-50%

Question 37

Symptoms of schizophrenia that indicate better prognosis

Answer 37

later onset, good social support, positive symptoms, mood symptoms, acute onset, female sex, few relapse, good premorbid function

Question 38

Symptoms of schizophrenia that indicate worse prognosis

Answer 38

early onset, poor social support, negative symptoms, family history, gradual onset, male sex, many relapses, poor premorbid function, cormorbid substance abuse

Question 39

which pharmacotherapy has better effect on the positive symptoms of schizophrenia?

Answer 39

FGA

Question 40

Common side effects of FGA

Answer 40

EPS, tardive dyskinesia, NMS

Question 41

MOA of FGA

Answer 41

dopamine antagonist

Question 42

MOST of SGA

Answer 42

5HT2 and D2 antagonists

Question 43

side effects of SGA

Answer 43

metabolic syndrome, EPS, hypotension, prolonged QTc, hyperprolactinemia

Question 44

best treatment for negative symptoms of schizophrenia

Answer 44

clozapine

Question 45

After giving patient antipsychotic they experience back spasms →

Answer 45

dystonia

Question 46

after giving patient antipsychotic they experience tremor, bradykinesia, and rigidity →

Answer 46

Parkinsonism

Question 47

After giving patient antipsychotic they experience darting and writhing movements →

Answer 47

tardive dyskinesia

Question 48

After giving patient antipsychotic they experience AMS, muscle rigidity, autonomic dysregulation (fever, hypertension, tachycardia) →

Answer 48

NMS

Question 49

"lack of insight" is a symptom of severe mental illness where the person is unable to understand and perceive their illness

Answer 49

anosognosia

Question 50

why do patients with schizophrenia or bipolar disorder refuse meds and therapy?

Answer 50

anosognosia

Question 51

What percent of schizophrenia and BPAD patients experience anosognosia?

Answer 51

schizophrenia → 50% | BPAD → 40%

Question 52

Duration to be considered a Brief Psychotic Disorder

Answer 52

< 30 days

Question 53

Symptoms of Brief Psychotic Disorder

Answer 53

delusions, hallucinations, disorganized speech (derailment or incoherence), grossly disorganized/catatonic behavior

Question 54

Onset of Brief Psychotic Disorder is most likely due to

Answer 54

acute stress

Question 55

Prognosis of Brief Psychotic Disorder

Answer 55

return to premorbid baseline

Question 56

Duration for schizophreniform disorder

Answer 56

1-6 months

Question 57

duration for schizophrenia

Answer 57

> 6 months

Question 58

Schizophrenia + Manic Depression

Answer 58

schizoaffective disorder

Question 59

Patients with schizoaffective disorder meet the criteria for

Answer 59

major depressive episode, manic episode, or mixed episode when also meeting the criteria for schizophrenia

Question 60

Schizoaffective disorder a patient must have ____ for 2 weeks in the absence of mood symptoms

Answer 60

positive symptoms

Question 61

In schizoaffective disorder what must be present for a substantial portion of the psychotic illness

Answer 61

mood symptoms

Question 62

belief that a person is in love with the affected individual, despite contrary evidence

Answer 62

erotomanic delusion

Question 63

fantastical beliefs that one is famous, omnipotent, wealthy, or otherwise very powerful. The delusions are generally fantastic and typically have a religious, science fictional, or supernatural theme

Answer 63

grandoise delusion

Question 64

 fixed, false belief that one's bodily functioning, sensation, or appearance is grossly abnorma

Answer 64

somatic delusion

Question 65

A person with this type of delusional disorder believes that his or her spouse or sexual partner is unfaithful.

Answer 65

jealous delusion

Question 66

People with this type of delusional disorder have two or more of the types of delusions listed above.

Answer 66

mixed type delusion