Abnormal Exam Two

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Abnormal Exam Two
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2010-03-31 21:46:55
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Abnormal Exam Two
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  1. Schneider
    • First Rank Symptoms:
    • 1. thought insertion/broadcast/withdrawal
    • 2. made feelings/impusles/actions/somatica sensations
    • 3. third person auditory hallucinations
    • 4. delusional perception
    • 5. thought echo

    • 58% of patients show at least one FRS
    • 20% never show FRS
    • 10% who do not have schizophrenia show FRS
  2. Bleuler
    • The Four A's
    • 1. abnormal thought Association: breaking of mental operations (a splitting of the mind; not mpd)
    • 2. autism: turning inward
    • 3. ambivilance: strong but inconsistent and competing feelings
    • 4. affect: flat affect- lack of emotional display or inappropriate affect: emotions don't fit subject matter
  3. Emil Kraeplin
    auditory hallucinations, delusions, thought disorder, affective flattening, and impaired insight were common to hebephrenia, paranoia, catatonia and dementia simplex- a group of disorders he called dementia praecox
  4. Three subtypes of Schizophrenia
    • 1. Paranoid type: preoccupation with delusions and hallucinations- no disorganized speech, catatonia, or flat affect
    • 2. Disorganized Speech
    • 3. Catatonic Type: at least two of the following-->
    • - motoric immobility, catalepsy, stupor
    • - excessive purposless motor activity
    • - extreme negativism or mutism
    • - peculiarities of movement, stereotypes, odd mannerisms, or grimacing
    • - echolaila or echo praxia
  5. Related Psychotic Disorders
    • 1. Brief Psychotic Disorder: less than one month
    • 2. Schizophreniform Disorder: 1-5 months
    • 3. Schizoaffective Disorder: Mood and Schizophrenia at alternant times- 6 months or more
    • 4. Delusional Disorder: (monomania) not schizophrenic delusions- one month or more
    • 5. Shared Psychotic Disorder- Folie a Deux
  6. Typical Antipsychotics
    • Block: Delusions, Hallucinations, Disordered Thinking- Positive Symptoms
    • Drugs: Phenothiazines- Chloropromazine ((Larobit))
    • Butyrophenones- Halperidol
    • Thioxanthenes- Chloroprothixene

    • Nigrostriatal dopamine Pathway
    • EPS--
    • --putonias (muscle cramps)
    • --tremor- coarse parkinsons type tremor
    • --akinisa- decreased movement/ spoteniety
    • --tardive dykinesia- involuntary movements of the lower face
  7. Atypical Antipsychotics
    Block Dopamine in the Mesolimbic System and Blocks Serotonin (which inbibits Dopamine) in the mesocortical system, so acts as a serotonin antagonist

    helps allieviate negative and EPS

    metabolic changes- type II diabetes

    drugs: clozapine, risperdone, olanzapine
  8. Major Dyssomnias
    • 1. Primary Insomnia
    • 2. Primary Hypersomnia
    • 3. Narcolepsy
    • 4. Breathing Sleep Disorders: hyoventilation, sleep apnea
    • 5. Circadian Rythm Sleep Disorders
  9. Parasomnias
    • 1. Nightmares
    • 2. Sleep Terrors
    • 3. Sleepwalking- somnambulism
  10. Sexual Dysfunctions and Paraphilia
    • 1. Hypoactive Sexual Desire Disorder- little or no interest in sexual activity
    • 2. Sexual Aversion Disorder: the thought of sex or a brief casual touch may evoke fear, panic, or disgust
    • 3. male erectile disorder and female sexual arousal disorder
    • 4. inhibited orgasm- female and male orgasmic disorder
    • 5. premature ejactulation
    • 6. dyspareunia
    • 7. vaginismus
    • 8. hyperactive sex disorder

    • Paraphilias:
    • 1. Frotteurism
    • 2. Fetishism
    • 3. Voyeurism
    • 4. Exhibitionism
    • 5. transvestic fetishism
    • 6. sexual sadism and sexual masochisticism

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