Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Psychiatry > Psychosis > Flashcards

Psychosis Flashcards

(62 cards)

Start Studying
1
Q

Causes of psychosis

A

Drug induced, steroid induced, temporal lobe epilepsy, delirium, dementia, schizophrenia, depression, mania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Schizophrenia risk factors + symptoms (Schneiders, positive + negative)

A

Risk factors: adverse life events, cannabis, obstetric complications, encephalitis, males Schneiders first rank symptoms: Auditory hallucinations (3rd person, running commentary) Thought interference (insertion, withdrawal, broadcasting) Delusions of control/ passivity Schizophrenia usually has an insidious prodromal phase with subtle problems in language, cognitive ability + behaviour Positive symptoms: hallucinations, delusions Negative symptoms: flattened affect, apathy, anergy, anhedonia, alogia (decreased speech)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Dopamine hypothesis + dopamine pathways

A

Dopamine agonists (levodopa, amphetamines) cause schizophrenia like symptoms Dopamine antagonists (antipsychotics) can help treat schizophrenia +ve symptoms = due to dopamine overactivity in mesolimbic system -ve symptoms = dopamine underactivity in mesocortical system Nigrostriatal pathway = when dopamine is reduced by antipsychotics in this pathway, you get Parkinson like symptoms + EPSEs Tuberoinfundibular pathway = when dopamine is reduced by antipsychotics in this pathway, you get prolactinaemia (dopamine has negative feedback with prolactin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ICD 10 criteria for schizophrenia

A

Symptoms present for most of the time for at least 1 month 1) Thought interference 2) Delusions of control, passivity, delusional perception 3) Auditory hallucinations 4) Persistent delusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Types of schizophrenia

A

Paranoid - common, paranoid delusions, hallucinations + perceptual disturbances Hebephrenic - prominent affective changes, inappropriate mood, thought disorder, negative symptoms Catatonic - psychomotor disturbances, stupor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Physical investigations for schizophrenia

A

FBC, U+E, LFT, TFT, HbA1c, lipids Drug screen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment for schizophrenia

A

1st: antipsychotic (usually atypical) 2nd: try another AP, then combine 3rd: clozapine 4th: add benzo, lithium or anticonvulsant Continue on drug for 12-24 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Antidopaminergic drug effects

A

Improves +ve symptoms SE: EPSEs, hyperprolactinaemia, NMS, weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Serotonergic drug effects

A

Improves -ve + affective symptoms SE: anxiety, insomnia, weight gain, DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Antihistaminergic drug effects

A

Sedation, weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Antiadrenergic drug effects

A

Postural hypotension, tachycardia, sexual dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anticholinergic drug effects

A

Dry mouth, blurred vision, urinary retention, constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Extrapyramidal SE

A

Acute dystonia Akathisia Parkinson like symptoms Tardive dyskinesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Acute dystonia - S+S, high risk groups, treatment

A

Acute reaction to AP Painful spastic contractions of muscles Tongue protrusion, torticollis, oculogyric crisis Common with haloperidol Common in young males Give anticholinergics (procyclidine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Akathisia S+S, treatment

A

Acute reaction to AP Restlessness Give anticholinergics (procyclidine) or propranolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Parkinson like symptoms S+S, high risk groups, treatment

A

Acute reaction to AP Tremor, rigidity, bradykinesia Common in elderly females Give anticholinergics (procyclidine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tardive dyskinesia - S+S, high risk groups, treatment

A

Long term reaction to AP Involuntary repetitive movements (tongue, lips, face, extremeties, chorieform hand movements) Worse with stress More common in elderly women DON’T give anticholinergics Switch to clozapine/ quetiapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

NMS - S+S, pathology, complications

A

Neuroleptic malignant syndrome Reaction to AP due to blockage of hypothalamospinal tracts Hyperthermia, muscle rigidity, altered mental state and autonomic instability (labile BP, tachycardia) Rhabdomyolysis - high CPK Can cause respiratory, CV + renal failure, seizures + DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Schizoaffective disorder

A

Schizophrenia + affective symptoms in same episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Persistant delusional disorder

A

Single delusion - may be hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Orthello, de Clerambaults + Ekboms syndrome

A

Orthello = partner is cheating de Clerambaults = being loved by someone inaccessible (celebrity, famous) Ekboms = skin is infected by parasite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cortards, Capgras + Fregoli syndrome

A

Cortards = delusion you no longer exist/ dead/ rotting Capgras = familiar person replaced by imposter Fregoli = familiar person is disguising themself as strangers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Folie impose/ communique

A

Impose = only A suffers from primary psychotic disorder, B’s delusions disappear if separated Communique = B maintains delusions when separated from A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Folie simultanee/ induite

A

Simultanee = both A+B suffer from primary psychosis but share same delusion Induite = both A+B suffer from primary psychosis but transfer their delusions to each other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Typical antipsychotics - names, action
Older gen - haloperidol, chlorpromazine Increase prolactin, EPSEs Block all 4 dopamine pathways Dopamine receptor antagonists at D2
26
Atypical antipsychotics - action, effect
Only block mesolimbic + mesocortical Effective against positive and negative symptoms Anticholinergic + antihistaminergic side effects Also good mood stabilisers
27
Haloperidol - SE, uses
High risk of EPSE + high prolactin High risk of NMS Sexual dysfunction QTC prolongation - must have ECG before starting Good antiemetic Good for rapid tranquilisation
28
Chlorpromazine - uses, SE
Antiemetic properties SE: photosensitivity, hepatotoxicity, weight gain, antiadrenergic (bradycardia, hypotension), sedation, hyperprolactinaemia
29
Clozapine - uses, SE, complications, OD, effect of smoking
Effect on D4 - used for treatment resistant schizophrenia or psychosis in Parkinsons Complications: agranulocytosis, GI hypomotility (constipation, bowel obstruction) SE: hypersalivation, weight gain, anticholinergic + adrenergic, sedation, diabetes, urinary incontinence Can cause myocarditis (flu symptoms, chest pain, tachycardia) + cardiac myopathy Causes hypotension OD causes seizures Smoking reduces plasma levels of clozapine - levels rise when stopping smoking
30
Amisulpride SE
Increases prolactin - avoid in women No sedation or anticholinergic SE
31
Risperidone action, SE
Acts on tuberoinfundibular pathway - biggest increase in prolactin - avoid in women Also causes postural hypotension + sexual dysfunction
32
Aripiprazole uses, SE, action
Small dose decreases prolactin - use with other APs Causes akathisia Doesn't prolong QTC interval No metabolic SE Good antidepressant Partial dopamine agonist
33
Olanzapine SE
Most sedative + weight gain Diabetes risk
34
Quetiapine SE, uses
Less EPSEs, more metabolic SEs Good mood stabiliser Good for psychosis in dementia
35
Hyperprolactinaemia cause, S+S
DA inhibits prolactin release S+S: sexual dysfunction, reductions in bone mineral density, menstrual disturbances, breast growth, increase in risk of breast ca
36
Weight gain with antipsychotics - why, which APs are high + moderate risk
Due to serotonin antagonism + hyperprolactinaemia High risk: clozapine + olanzapine Moderate risk: risperidone, quetiapine, paliperidone, chlorpromazine
37
QT prolongation - why, which drugs
Block cardiac K+ channels Risk factor for ventricular arrhythmia + torsades de pointes High risk: TCAs, SSRIs, haloperidol
38
APs with high risk of sexual dysfunction
Haloperidol, risperidone, chlorpromazine
39
APs with high risk of diabetes
Olanzapine, clozapine
40
APs causing anti-adrenergic SE
Clozapine, chlorpromazine
41
TCAs - action, SE
Serotonin + noradrenaline reuptake inhibition Anticholinergic + antihistaminergic effects QT prolongation, ST elevation Postural hypotension + sedation (due to alpha adrenergic blockage)
42
MAOis - action, SE, complications
Inhibit MAO-A (noradrenaline, serotonin + tyramine) + B (dopamine, tyramine) Postural hypotension, restlessness, oedema, nausea, sexual dysfunction Risk of hypertensive crisis
43
MAOis cheese reaction - what happens, S+S, tyramine foods
Tyramine causes catecholamine release = tachycardia, sweating, HTN, arrhythmias, stroke Tyramine foods = cheese, yeast, hung game, red wine, pickled herring
44
Mirtazapine - type, action, SE
NASSA Enhances NA transmission Causes weight gain + sedation No CV + anticholinergic side effects
45
Antidepressant discontinuation symptoms
Flu like, insomnia, agitation, irritability, shock-like sensations, vivid dreams
46
Carbamazepine - action, SE
Blocks sodium channels - reduces glutamate release + decreases turnover of DA + NA Hepatic enzyme inducer SE: dizziness, diplopia, drowsiness, ataxia, blood dyscrasias First line for partial seizures
47
Sodium valproate - action, SE, contraindications
Inhibits catabolism of GABA Can reduce aggression SE: blood dyscrasias, weight gain, hair loss, pancreatitis, sedation Major human teratogen - strong caution in women of child bearing age
48
Benzodiazepine receptors (+ effects)
omega 1 = hypnotic omega 2 = anxiolytic omega 3 = myorelaxant
49
Benzo withdrawal effects
Anxiety, tremor, pain, fatigue, psychosis, seizures, abnormal sensations
50
Z drug action
Zopiclone = anxiolytic + hypnotic Zolpidem + zaleplon = only hypnotic
51
Types of visual hallucination
Lilliputian = hallucination where subjects appear smaller (micropsia) = common in delirium Elementary = flashes of light Extracampine = seeing things outside your visual field ie someone standing behind you Reflex = sensory stimulus causes a hallucination in another modality (bright lights cause auditory hallucinations)
52
Charles Bonnet syndrome
Intact cognition Ocular pathology Visual hallucinations Affects people with visual loss (usually due to macular degeneration) - often see animals in the corner of the room
53
Auditory illusion
When auditory stimulus is misheard or misinterpreted
54
Schneiders first rank symptoms
Delusions Auditory hallucinations Thought disorder Passivity experience
55
Opisthotonus
Excessive spine extension
56
Oculogyric crisis
Painful superolateral deviation of the eyes
57
Buccolingual crisis
Bizarre grimacing/ facial expressions
58
Autochthonous delusion
Delusion that comes out of nowhere 'light bulb'
59
De Clerambault delusion
Delusion that a famous person is in love with you
60
Delusional mood
When someone feels like something around them is going on but not sure what
61
Risk of developing schizophrenia (general population, twin, sibling or parent with schizophrenia)
Monozygotic twin has schizophrenia = 50% Parent has schizophrenia = 10-15% Sibling has schizophrenia = 10% No relatives with schizophrenia = 1%
62
Hypnogogic + Hypnopompic hallucinations
Hypnogogic = occur as falling to sleep Hypnopompic = occurs as you wake up, continues as you open your eyes

Psychiatry (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions