Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AIP: Self-harm > Psychosis > Flashcards

Psychosis Flashcards

1
Q

What is the definition of psychosis?

A

a mental state in which reality is greatly distorted

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

What are 3 of the key features of psychosis?

A
  1. Delusions
  2. Hallucinations
  3. Thought disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a delusion?

A

fixed false belief, which is firmly held despite evidence ot the contrary and goes against the individual’s normal social and cultural belief system

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

What is a hallucination?

A

a perception in the absence of an external stimulus; common feature of psychosis

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

What is thought disorder?

A

impairment in the ability to form thoughts from logically connected ideas

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

What is the commonest psychotic disorder?

A

schizophrenia

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

What is the incidence of psychosis in England?

A

31.7 per 100 000 people

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

What ethnicities may be at higher risk of psychosis?

A

black and ethnic minority populations

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

What 2 groups can the cause sof psychosis be split into?

A

organic and non-organic

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

What are 9 non-organic causes of psychosis?

A
  1. Schizophrenia
  2. Schizotypal disorder
  3. Schizoaffective disorder
  4. Acute pscyhotic episode
  5. Mood disorders with psychosis
  6. Drug-incuded psychosis
  7. Delusional disorder
  8. Induced delusional disorder
  9. Puerperal psychosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are 10 organic causes of psychosis?

A
  1. Drug-induced psychosis
  2. Iatrogenic (medication)
  3. Complex partial epilepsy
  4. Delirium
  5. Dementia
  6. Huntington’s disease
  7. Systemic lupus erythematosus
  8. Syphilis
  9. Endocrine disturbance e.g. Cushing’s syndrome
  10. Metabolic disorders inc. vitamin B12 deficiency and porphyria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How are acute and transient psychotic disorders different from schizophrenia?

A

psychotic episode lasts <1 month and so doesn’t meet critiera for schizophrenia

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

How does schizotypal disorder differ from schizophrenia?

A

it is characterised by eccentric behaviour, suspiciousness, unusual speech and deviations of thinking and affect that is similar to those suffering from schizophrenia

however, do not suffer from hallucinations or delusions

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

What is persistent delusional disorder?

A

development of single or set of delusions for a period of at least 3 months in which the delusion is the only, or most prominent, symptom with other areas of thinking and functioning well preserved (unlike schizophrenia)

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

What is often the nature of the delusion(s) in persistent delusional disorder?

A

often persecutory, grandiose or hypochondriacal

onset and content often related to patient’s life situation

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

What is induced delusional disorder (Folie a deux)?

A

aka shared paranoid disorder - presence of similar delusions in two or more individuals

Folie imposee - dominant person forms belief during psychotic episode and imposes on someone else

Folie simultanee: 2 people considered to suffer independently from psychosis, influence content of each other’s delusions, to become identical or very similar

17
Q

What is late paraphrenia?

A

late onset schizophrenia; hallucinations and delusions are prominent but thought disorders and catatonic symptoms rare

18
Q

What are 4 possible features of thought disorder?

A
  1. Alogia: little information conveyed by speech
  2. Tangentiality: answers diverge from topic
  3. Clanging: association of words based on sound rather than concepts - e.g. putting words together that rhyme
  4. Word salad: linking real words incoherently - nonsensical content
19
Q

What are 4 associated features with psychosis?

A
  1. Agitation/ aggression
  2. Neurocognitive impairment e.g. memory, attention or executive function
  3. Depression
  4. Thoughts of self harm
20
Q

What is the peak age of first episode of psychosis?

A

15-30 years

21
Q

What are 5 things to remember in OSCEs for history-taking from psychotic patients?

A
  1. Most commonly paranoid scizhophrenia, displaying positive ± negative symptoms
  2. Need to ask questions to elicit psychotic symptoms with empathetic and supportive approach
  3. Consider other differentials - organic and psychiatric, includingmood disorders and drugs
  4. Good social history: day to day activities and interest - may help elicit negative symptoms
  5. Ask questions about insight and risk to determine management
22
Q

Which team should be involved for a first presentation of psychosis due to a psychiatric cause such as schizophrenia?

A

Early Intervention In Psychosis team

23
Q

What are 5 possible investigations in psychosis?

A
  1. Blood tests
    • FBC
    • TFTs
    • Glucose
    • HbA1c
    • Serum calcium
    • U+Es
    • LFTs
    • Cholesterol
    • Vtamin B12 and folate
  2. Urine drug test: illicit drugs
  3. ECG: antipsychotics can cause prolonged QT interval
  4. CT scan: to rule out organic causes such as space-occupying lesions
  5. EEG: to rule out ptemporal lobe epilepsy as possible cause of psychosis
24
Q

What are 8 blood tests to consider performing in psychosis and why would you do each?

A
  1. FBC - anaemia, infection
  2. TFTs - thyroid dysfunction can present with psychosis
  3. U+Es - electrolyte disturbance
  4. Glucose or HbA1C - atypical antipsychotics can cause metabolic syndrome
  5. LFTs -before starting antipsychotics
  6. Serum calcium - hypercalcaemia can cause psychosis
  7. Cholesterol - before starting atypical antipsychotics, can cause metabolic syndrome
  8. Vitamin B12 and folate - deficiencies can cause psychosis
25
Q

What are the maangement options for behavioural disturbance/aggression and agitation in psychosis?

A

consider oral therapy first (oral lorazepa or haloperidol); if unsuccessful or effect required within 30 min, move onto injection

e.g. IM lorazepam or IM haloperidol

IM benzo usually first line if no history of antipsychotics; can use haloperidol if confirmed history of typical antipsychotic exposure

26
Q

If there is an acute dystonic or parknsonian reaction to haloperidol what must be used?

A

Procyclidine injection 5-10 mg IV or IM (must be available before treatment with IM haloperidol)

27
Q

What must be given if respiration rate falls to <10 per minute after lorazepam has been used?

A

flumazenil (must have available before giving benzo treatment)

AIP: Self-harm (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions