Psychotic Disorders

Question 1

Presents in 20’s often after life stressor, thought process disorder, thought to be due to overload of dopamine and serotonin.

Answer 1

Schizophrenia

Question 2

Positive Symptoms of Schizophrenia

Answer 2

Bizarre Delusions
Hallucinations
Disorganized Speech
Disorganized or Catatonic Behaivor

Question 3

Negative Symptoms of Schizophrenia

Answer 3

Flat Affect
Cognitive Defects
Poverty of speech anhedonia

Question 4

Treatment for schizophrenia

Answer 4

First gen antipsychotics like haloperidol, fluphenazine, thioridazine, chlorpromazine

Question 5

What leads to the negative symptoms in schizophrenia?

Answer 5

Decreased dopamineric activity inthe mesolimbic pathwayWh

Question 6

What leads to positive symptoms in schizophrenia?

Answer 6

Increased dopaminergic activity in the mesolimbic pathway

Question 7

What leads to extrapyramidal symptoms in the use of antipscychotics

Answer 7

Antipsychotics particuarly first gen make a dopamine blockage all across the board so it will block dopamine in the nigrostriatal tract that could result in parkinsonism/EPS

Question 8

How do you get gynecomastia and galactorrhea?

Answer 8

Blockade of dopamine in the tuboinfundibular tract (disinhibtion of prolactin!)

Question 9

What is the criteria for a breif psychotic disorder?

Answer 9

Severe stressor–> psychotic features onset of greater than a day with duration less than a month

Question 10

What is the timeline for schizophreniform?

Answer 10

duration is 1-6 months

Question 11

How might we differentiate between schizophrenia and schizoaffective?

Answer 11

Schizoaffective is where we see the mood symptoms predominate. No mood symptoms at all means its schizophrenia.

Question 12

Which disorder: lasts greater than a day and less than a month and exhibits psychotic symptoms

Answer 12

Breif Psychotic Disorder, this can PROGRESS to schizophreniform

Question 13

Which Disorder: lasts greater than a month and less than six months

Answer 13

Schizophreniform

Question 14

Psychotic features lasting greater than 6 months without mood disorder

Answer 14

schizophrenia

Question 15

Psychotic features wtih mood like major depressive episode and mania

Answer 15

Schizoaffective

Question 16

What medications are used to treat POSITIVE symptoms?

Answer 16

Haloperidol, thiazide, chlorpromazine

Question 17

What medications are used to treat NEGATIVE symptoms?

Answer 17

Risperidone, quetipine, olanzapine, ziprasidone, ariprprazole

Question 18

Things are happening around us but we feel as though they are not happening to us

Answer 18

Dissociation

Question 19

How do we treat dissociative identity disorder?

Answer 19

intense psychotherapy to align the personalities into one, hypnosis

Question 20

How may dissociative identity arise?

Answer 20

Different identities/personalities arise as a means of protecting the self

Question 21

Inability to recall or inconsistency in recall often associated with acute emotionall traums or stressor

Answer 21

Discciative amnesia

Question 22

If there is travel involved in dossociative amnesia, what do we refer to it as?

Answer 22

Dissciative fugue

Question 23

Catatonia is defined by at least three of the following…

Answer 23

stupor, catalepsy, waxy flexibility, mutism, negativism, stereotypy, agitation, echolalia, echopraxia

Question 24

How do we treat catatonia?

Answer 24

Lorazepam, food/nutrition support, watch for risk of dvt and rhabdo

Question 25

How do we treat refracrory catatonia?

Answer 25

ECT

Question 26

Immobility, fever, elevated CK, autonomic instability are consistent with

Answer 26

Malignant catatonia, neuroleptic catatonia syndrome, serotonin catatonia, malignant hyperthermia

Question 27

Malignant catatonia is caused by...

Answer 27

Non drug induced! Immobility/rigidity, fever, elevated CK

Question 28

Neuroleptic catatonia syndrome is caused by...

Answer 28

antipsychotics, presents the same as malignant catatonia but is caused by the drugs

Question 29

How can you differentiate serotonin syndrome from malignant catatonia and NMS?

Answer 29

SS presents with leadpipe rigidity (myoclonus and hyperreflexia) and hx/current ssri use

Question 30

What drug leads to malignant hyperthermia?

Answer 30

Halothane

Question 31

How do we treat malignant hyperthermia?

Answer 31

Dantrolene

Question 32

Characerized by psychotic sx's (delusions, hallucinations, disorganization, negative sx's) along with significant mood episodes (MDD, manic episodes). Sx's must exceed 6 months

Answer 32

Schizoaffective disorder

Question 33

What is the timeline fro schizophreniform?

Answer 33

Demonstrating pyschoic features for greater than 1 months and less than 6 months. 2/3rds of patients ultimately develop schizophrenia

Question 34

How does schizopfreniform and schizophrenia impact other cognitive functions?

Answer 34

attention, working memory, verbal learning, memory, and executive function all are impacted