Affective Continuum 1

Question 0

which area of the brain is affected by MDD

Answer 0

limbic system

Question 1

what disorder is caused by an interaction of enviornmental, genetic, neurobiologic, developmental, & life experiences

Answer 1

MDD (major depressive disorder)

Question 2

what does MDD do to the activity of the limbic system

Answer 2

⬇️ activity

Question 3

which 2 neurotransmitters are regulated by the limbic system

Answer 3

serotonin

norepinephrine

Question 4

what happens to neurotransmitter levels in MDD and which 2 are they

Answer 4

⬇️ norepinephrine & serotonin

Question 5

what does ⬆ activity in the cingulate gyrus & thalamus cause

Answer 5

rumination & worry

Question 6

what does ⬇️ activity in the frontal lobes cause

Answer 6

⬇️ concentration & motivation

Question 7

what are the 3 vegetative signs of depression

Answer 7

alteration in sleep
alteration in appetite
loss of energy

Question 8

a chronically depressed mood for 2+ years, not symptom free for > 2 months, depressed most days

Answer 8

dysthymia/pertinent depressive disorder

Question 9

how long must someone be depressed for it to be considered dysthymia

Answer 9

2+ years

Question 10

how long must a pt not be free of symptoms of depression for it to be considered dysthymia

Answer 10

> 2 months

Question 11

what is another name for dythymia

Answer 11

pertinent depressive disorder

Question 12

what type of depression is based on the seasons

Answer 12

MDD w/ seasonal pattern

Question 13

what are 3 common s/s of seasonal depression

Answer 13

⬆️ appetite
wt gain
hypersomnia

Question 14

what is a condition that develops within 2 weeks after the delivery of a baby - confusion, disorientation, attempts to harm baby

Answer 14

post-partum psychosis

Question 15

how long after delivery can post-partum psychosis occur

Answer 15

within 2 weeks

Question 16

condition where symptoms of MDD are accompanied by psychosis - hallucinations, delusions, etc.

Answer 16

MDD w/ psychotic features

Question 17

what are 3 suggestions for eating for pts w/ MDD

Answer 17

eat w/ others
high calorie meals
have family bring fav foods

Question 18

what is the induction of a grand mal seizure through the application of an electrical current to the brain

Answer 18

ECT

Question 19

what is the therapeutic effect of ECT

Answer 19

⬆️ serotonin, norepi, & dopmaine

Question 20

what are 3 side effects of ECT

Answer 20

confusion
headache
long term memory loss

Question 21

what are the long-term effects of ECT

Answer 21

unknown

Question 22

what is an experimental procedure that uses magnetic fields to stimulate nerve cells in the brain hoping to improve chronic depression symptoms

Answer 22

transcranial magnetic stimulation

Question 23

what procedure has the follow side effects:

headache, scalp discomfort, twitching of facial muscles, lightheadedness

Answer 23

transcranial magnetic stimulation

Question 24

what are 3 rare serious side effects of transcranial magnetic stimulation

Answer 24

seizure mania hearing problems

Question 25

what are behaviors that harm the person such as nail biting, hair pulling, self-mutilation

Answer 25

self-destructive/damaging acts

Question 26

includes a plan for suicide & the means to execute it

Answer 26

suicidal threat

Question 27

having thoughts of hurting or killing oneself

Answer 27

suicidal ideation

Question 28

self-destructive act that does not involve serious injury

Answer 28

suicidal gesture

Question 29

self-destructive act that had the potential outcome as death

Answer 29

suicide attempt

Question 30

theory - suicide is r/t the deteroriation in relationships w/in society; self-inflicted death seen as honorable

Answer 30

sociocultural theory

Question 31

theory - may result when people experience no close relationships, no personal freedoms, & no hope of getting them

Answer 31

interpersonal & intrapsychic theory

Question 32

theory - errors in receptors for serotonin that ⬇️ levels (bad), may be caused by genetics

Answer 32

biologic theory

Question 33

theory - constriction of thought is ⬆️ in people who are suicidal & have difficulty making choices

Answer 33

cognitive theory

Question 34

people will be direct & let people know they are planning to take their own life

Answer 34

overt cues

Question 35

pt is indiriect w/ cues - "no reason to go on", "I won't be seeing you anymore"

Answer 35

covert cues

Question 36

what are 2 questions to ask a pt about suicide

Answer 36

any thoughts of suicide? | what method would you use

Question 37

how many episodes will a bipolar person have in a lifetime

Answer 37

10

Question 38

what is a major r/f for bipolar disorder

Answer 38

genetics

Question 39

which 2 neurotransmitters can be ⬆️ w/ bipolar disorder

Answer 39

norepi | serotonin

Question 40

disorder - 1+ manic episode whicch can be accompanied by a depressed mood

Answer 40

bipolar I

Question 41

disorder - less extreme form of mania; "life of the party", pt unable to recognize changes

Answer 41

hypomania

Question 42

disorder - 1+ depressed mood that can be accompanied by 1+ hypomanic episode

Answer 42

bipolar II

Question 43

what is the action of lithium

Answer 43

not fully understood

Question 44

what are the 5 intended effects of lithium

Answer 44

``` acute mania bipolar maintainence ⬆️ effects of antidepressants ⬆️ effects of antipsychotics in schizo. improve behavior in impulse disorders ```

Question 45

what are some s/e of lithium

Answer 45

polyuria, polydypsia, tremor, wt gain, nausea, ⬆️ WBC, hypothyroidism, kidney damage

Question 46

which med can cause hypothyroidism & kidney damage

Answer 46

lithium

Question 47

what is the therapeutic range of Lithium

Answer 47

0.5 - 1.2

Question 48

what are the s/s of Lithium toxicity

Answer 48

vomiting, ataxia, tremor, stuttering, confusion, sedation, seizure, coma, death

Question 49

which condition has these s/s - vomiting, ataxia, confusion, tremor, stuttering, sedation, seizure, coma, death

Answer 49

Lithium toxicity

Question 50

what are the contraindications for taking Lithium

Answer 50

pregnant/nursing, renal disease, dehydration, electrolyte imbalance, diabetes, thyroid disease, urinary retention

Question 51

what other 2 labs should be monitored along with Lithium levels

Answer 51

creatinine | TSH

Question 52

which 2 types of meds can ⬆️ Lithium blood levels

Answer 52

NSAIDs | thiazide diuretics

Question 53

what is the commonly used anticonvulsant drug

Answer 53

valproic acid

Question 54

what are s/e of valproic acid

Answer 54

N, D, headache, dizzy, anxiety, confusion, sedation, diploplia, edema, tremor, wt gain, alopecia, jaundice

Question 55

what are 2 toxic effects of valproic acid

Answer 55

liver failure | blood dyscrasias

Question 56

what are 4 contraindications of valproic acid

Answer 56

liver disease kidney disease pregnant/nursing blood dyscrasias

Question 57

what is the blood level range for valproic acid

Answer 57

50 - 110

Question 58

besides blood levels, what other 3 labs should be checked w/ valproic acid

Answer 58

liver function kidney function CBC

Question 59

what 3 meds should be avoided w/ valproic acid

Answer 59

coumadin ASA NSAIDs

Question 60

what are the 2 categories of mood stabilizers

Answer 60

atypical antipsychotics | anxiolytics

Question 61

what is a commonly used atypical antipsychotic used to treat bipolar disorder

Answer 61

Klonopin

Question 62

how can you avoid nausea associated w/ taking Lithium

Answer 62

do not take on an empty stomach

Question 63

what are 3 s/s of liver dysfunction

Answer 63

yellow eyes abdominal pain fever

Question 64

how do anticonvulsants work

Answer 64

calm the brain down

Question 65

what type of med is valproic acid

Answer 65

anticonvulsant

Question 66

what type of med is Tegretol

Answer 66

anticonvulsant

Question 67

what type of med is Lamictal

Answer 67

anticonvulsant

Question 68

what type of med is Neurontin

Answer 68

anticonvulsant

Question 69

what type of med is Topamax

Answer 69

anticonvulsant

Question 70

which anticonvulsant has immense s/e

Answer 70

Tegretol

Question 71

which 2 anticonvulsants are less effective and are used more as an adjunct med

Answer 71

Lamictal | Neurontin

Question 72

which anticonvulsant is btter for eating disorders (bulemia), wt loss

Answer 72

Topamax

Question 73

what tx can be used for bipolar pts who are treatment resistant or refractory

Answer 73

ECT

Question 74

which type of drug is used for short term tx of acute mania for sedation, psychomotor slowing, & to ⬇️ agitation

Answer 74

atypical antipsychotic

Question 75

what type of drug is effective immediately to ⬇️ stimulation in the brain in bipolar disorder

Answer 75

Benzo anxiolytics

Question 76

theory - external stressors can activate the stres response which can trigger the 1st episode of mania

Answer 76

kindling theory

Question 77

what type is the initial bipolar episode in males

Answer 77

manic

Question 78

what type is the initial bipolar episode in females

Answer 78

depressive