Psychotic Disorders

Question 1

How do I differentiate various psychotic disorders on exam day?

Answer 1

Duration of symptoms

Question 2

positive symptoms in psychotic disorders is associated with which receptors?

Answer 2

Dopamine receptors

Question 3

Negative symptoms in psychotic disorders are associated with which receptors?

Answer 3

Muscarinic receptors

Question 4

Bizarre Delusions, Disorganized speech/behavior and hallucinations are what type of symptoms? Negative for positive?

Answer 4

Positive

Question 5

Flattened affect, social withdrawal, anhedonia, apathy, poverty of thought are what type of symptoms?

Answer 5

Negative symptoms

Question 6

Psychotic symptoms have been present for at least 1 month, there has been a significant impact on social or occupational functioning for at east 6 months. Pt has delusions, hallucinations & disorganized speech. Dx?

Answer 6

Shizophrenia

Question 7

Psychotic symptoms: delusions, hallucinations and disorganized speech for less than 6 months but over 1 month. Dx?

Answer 7

Schizophreniform

Question 8

Most effective antipsychotic to treat negative symptoms? (Neg symptoms are associated with muscarinic receptors)

Answer 8

Atypical Antipsychotics

Question 9

Meaning of phrenia

Answer 9

> 6 months

Question 10

Meaning of phreniform

Answer 10

> 1 month but <6 months

Question 11

A stressful life event that precipitates psychotic disorder and symptoms occur for < 1 month and patient returns to basleine. Dx

Answer 11

Brief psychotic disorder

Question 12

When a patient has had symptoms for years with no impairment of baseline functioning, what 2 dx should i be thinking of on test day?

Answer 12

non-bizzare delusional disorder, personality disorders

Question 13

Perform these tests for patients with psychosis that are not schizophrenia.

Answer 13

Drug screen first!!!!!

TSH, basic electrolytes, calcium, HIV, VDRL, EEG (temporal lobe epilepsy)

Question 14

The greatest risk of factor for progression to schizophrenia?

Answer 14

Schizophreniform disorder

Question 15

The time when schizophreniform patients are at greatest risk of depression and suicide?

Answer 15

After episode of psychosis resolves

Question 16

What to do with a patient with bizarre or paranoid symptoms?

Answer 16

Hospitalize

Question 17

Treatment of patients psychotic patient with agitation?

Answer 17

Benzodiazepines & Antipsychotics x 6 months unless history of repeat episodes then plan ofr long-term antipsychotics. Must initiate long-term psychotheraphy

Question 18

2 disorders that you can treat with antipsychotics

Answer 18

Huntington and Tourette syndrome

Question 19

What to do when a patient on a low potency antipsychotic causes orthostatic hypotension, acute urinary retention, dry mouth, blurry vision and delirium?

Answer 19

Change to an Atypical antipsychotic

Question 20

AntIpsychotic associated with prolonged QT, arrhythmias, chest pain, dyspnea, palpitations etc

Answer 20

Thioridazine

Question 21

Patients on this antipsychotic need routine eye exam while on the medication because it causes abnormal retinal pigmentation.

Answer 21

Thioridazine

Question 22

side effects that cause noncompliance in females on antipsychotics.

Answer 22

Weight gain due to hyperprolactinemia. May also have galactorrhea and amenorrhea.

Question 23

Antipschotic associated with agranulocytosis which requires CBC with diff before start of therapy and weekly after that?

Answer 23

Clozapine/Clozaril/versacloz

Question 24

Side effects that cause noncompliance in males on antipsyhotics?

Answer 24

Impotence and inhibition of ejaculation (alpha blocker effect).

Question 25

Antipsychotic with the greatest weight gain?

Answer 25

Olanzepine

Question 26

High potency antipsychotics like Haloperidol and Fluphenazine have the disadvantage of being associated with ?

Answer 26

EPS (Extrapyramidal systems)

Question 27

This Atypical antipsychotic is reserved for treatment- resistant patients because of Agranulocytosis?

Answer 27

Clozapine

Question 28

These drugs have little or no risk of EPS so they are the drug of choice for initial therapy in psychosis:

Answer 28

Atypical antipsychotics: Quetiapine ( Seroquel ), Risperidone ( Risperdal ), Olanzepine ( Zyprexa ), Clozapine ( clozaril)

Question 29

Atypical antipsychotics end with what word? except for which one?

Answer 29

Pine | Except for Risperidone

Question 30

First choice antipsychotics when insomnia is a problem?

Answer 30

Olanzepine, quetiapine, ziprazidone and aripiprazole

Question 31

First choice for schizophrenia when sedation is a problem?

Answer 31

Risperidone

Question 32

6 receptors affected by Risperidone?

Answer 32

5HT, D1, D2, alpha 1, alpha 2 and H1