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Psychosis Flashcards

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1
Q

is psychosis a differential

A

no its a description of symptom

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2
Q

do people with psychosis have insight

A

no

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3
Q

what is the most significant consequence of psychosis

A

impairment of normal function, cant deal with reality

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4
Q

which area of the brain is hyper stimulated in psychosis

A

subcortical dopamine

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5
Q

in schizophrenia they often have negative symptoms as well as the positive psychosis symptoms, which part of the brain causes this

A

mesocortical dopamine hypoactivity

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6
Q

are the symptoms in psychosis positive or negative

A

all positive

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7
Q

hallucination definition

A

brain creating the perception of something in the absence of an external stimulus

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8
Q

are hallucinations vivid (life like) or in their thoughts (and they know this)

A

vivid

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9
Q

hepatic hallucination definition

A

internal organs are moving about

something has been inserted inside you

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10
Q

2nd person hallucinations

A

can hear someone talking to you

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11
Q

3rd person hallucinations

A

can hear people talking about you (not to you)

running commentary

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12
Q

what are 3rd person hallucinations characteristic of

A

schizophrenia

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13
Q

can hear someone talking about you in London (out of hearing range)

A

extracampine hallucination

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14
Q

delusion definition

A

fixed and falsely held assumptions

a belief that is maintained despite proof that its wrong (they always have a reason)

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15
Q

delusion examples in depression

A

nilhilistic delusions
poverty
guilt

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16
Q

delusion examples in schizophrenia

A

persecution

religion

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17
Q

delusion examples in mania

A

grandiosity
paranoid
religion - eg gods voice

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18
Q

passivity phenomena definition

3 categories

A

parts of them are under the control of others

thoughts, actions or feelings being controlled

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19
Q

which category of passivity phenomena is most common

A

thought interference

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20
Q

‘someone is putting ideas into my head’

A

thought insertion

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21
Q

‘people can hear my thoughts’

‘everyone has access to my thoughts’

A

thought broadcasting

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22
Q

‘thoughts are being taken out of my head’

A

thought withdrawal

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23
Q

‘thoughts just dry up half way through thinking’

A

thought blocking

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24
Q

coincidental events that the person thinks are significant to them (self referential) or about something else

eg TV is transmitting messages
eg there are hidden messages in the newspaper about them

A

ideas of reference

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25
what does ideas of reference result in
paranoia
26
examples of formal thought disorder (4)
neologism knights move thoughts flight of ideas rhyming and punning
27
what is rhyming and punning characteristic of
mania
28
tangential thought process where each sentence doesn't seem to be connected (don't know how they got from A to B)
knights move thoughts
29
rapid change of topics when speaking but it makes sense how they got from A to B
flight of ideas
30
when people make up words that they assume you would know
neologisms
31
what is knights order thoughts characteristic of
schizophrenia
32
what is flight of ideas characteristic of
mania (bipolar)
33
what are the 3 differentials for visual hallucinations
delirium substance misuse lewy body dementia - not threatening hallucinations
34
how does passivity phenomena differ from formal thought disorder
formal thought disorder - neologisms (making up words), knights move thoughts, fight of ideas, rhyming and punning passivity phenomena - thought insertion/withdrawal/broadcasting/blocking
35
hepatic hallucinations are characteristic of
depressive psychosis hallucinations about internal organs moving, stuff inside you etc
36
risk factors for schizophrenia (4)
genetics/family history 2nd trimester viral illness (winter/spring birth) cannabis use large ventricles, reduced frontal lobe grey matter
37
typical age of onset of schizophrenia
15-25 males | 25-35 females
38
what chemical is in excess in schizophrenia
dopamine
39
which drug can release dopamine = cause psychosis
amphetamine
40
brain changes in schizophrenia
reduced frontal lobe grey matter enlarged ventricles educed grey matter in temporal cortex
41
3rd person auditory hallucinations give example what condition are they characteristic of
can hear people taking about them, but not to their face schizophrenia
42
as well as psychosis, what other symptoms do people with schizophrenia have
negative symptoms - reduced speech, reduced motivation
43
which positive symptoms (psychosis) do people with schizophrenia have
delusions - religious, persecutory hallucinations - 3rd person formal thought disorder - neologisms, knights move thoughts passivity phenomena - thought insertion/withdrawal/broadcasting/blocking
44
how many symptoms of schizophrenia do you need for diagnosis
just 1! or 2 if formal thought disorder
45
what is catatonic schizophrenia
schizophrenia with unusual posture (movement disorder)
46
what investigation can you do to rule a cause of psychosis when diagnosing schizophrenia
toxicology - for drug cause of psychosis (though usually present differently with visual hallucinations)
47
treatment of aggressive behavior in schizophrenia
lorazepam and haloperidol
48
first line treatment of schizophrenia
second generation atypical antipsychotics
49
how do second generation atypical antipsychotics work in treating schizophrenia
block serotonin receptor
50
examples of second generation atypical antipsychotics for schizophrenia (3)
risperidone olanzepine quetiapine
51
side effects of second generation atypical antipsychotics for schizophrenia
``` metabolic syndrome ( high BP, hyperglycaemia, high cholesterol) = weight gain sedation long QT syndrome ```
52
contraindications for second generation atypical antipsychotics for schizophrenia
type 2 diabetes (bc of metabolic syndrome SE)
53
indications for second generation atypical antipsychotics for schizophrenia
parkinsons (bc first generation typicals have extrapyramidal side effects)
54
which second generation atypical antipsychotic is first line in schizophrenia
risperidone
55
how do first generation typical antipsychotics work in treating schizophrenia
block dopamine receptor
56
alternative to second generation antipsychotics in schizophrenia
first generation typical antipsychotics
57
examples of first generation typical antipsychotics for schizophrenia (2)
haloperidol | chlorpromazine
58
main side effect of first generation typical antipsychotics for schizophrenia (1) how does this present (6)
extra pyramidal side effects eg parkinsonism ``` rolling pin tremor bradykinesia wide based gait tremor slurred speech loss of coordination ```
59
contraindications for first generation typical antipsychotics for schizophrenia
parkinsons (bc they cause extra pyramidal side effects)
60
indications for first generation typical antipsychotics for schizophrenia
type 2 diabetes | obesity
61
other than parkinsonism, what are the other side effects of first generation typical antipsychotics for schizophrenia (5)
``` tardive dyskinesia akathisia - restless dystonia - muscle spasms long QT syndrome hyperprolactinaemia - sexual dysfunction ```
62
what is tardive dyskinesia (SE of first generation typical antipsychotics)
involuntary movement of tongue/mouth develops over years
63
which first generation typical antipsychotic is used most in schizophrenia
haloperidol
64
third line treatment of schizophrenia after second generation atypical antipsychotics (risperidone) and first generation typical antipsychotics (haloperidol)
clozapine last line
65
if clozapine is best, why isn't it first line in schizophrenia
v bad side effects
66
side effects of clozapine (3)
agranulocytosis!!! myocarditis weight gain
67
what safety netting do you need to do if you prescribe clozapine
tell them to stop it and get help if they get a sore throat = risk of agranulocytosis
68
what is the suicide risk in schizophrenia
10% must follow up after a hospital discharge
69
how many people with schizophrenia get better
1/3
70
how many people with schizophrenia get better but aren't fully functioning
1/3
71
how many people with schizophrenia don't get better with drugs
1/3 suicide likely
72
how to monitor ?agranulocytosis with someone on clozapine
FBC STOP the clozapine1

J Psych (14 decks)

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