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Board Studying. > Bipolar and Depression > Flashcards

Bipolar and Depression Flashcards

1
Q

overlapping sx req for mixed episodes

A

3

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2
Q

sleep changes in MDD

A

decreased slow wave sleep
increased sleep onset latency
total sleep time dec
dec REM latency
inc number of eye movements in REM

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3
Q

prophylactic bipolar tx in pregnant won to reduced relapse rates

A

lithium at 36 weeks or no later than 48 hours following delivery

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4
Q

rapid cycling in bipolar

A

at least 4 major depressive, manic, or hypomanic episodes in past year.
must be distinct- have partial remissions for 2 mo or switch directly into opposite type of episode

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5
Q

completed suicide rate in bipolar pts

A

10-15%

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6
Q

percentage of pts with parkinsons with depression

A

40-50%

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7
Q

SSRIs cause more of this in the elderly

A

SIADH, 3x greater risk

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8
Q

slows progression of parkinson’s disease

A

selegiline

temporarily decreases amot of levopdopa and cabidopa needed to control sx as well as increasing dopamine

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9
Q

man age onset for first manic or depressive episode of bipolar 1 do

A

18

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10
Q

associated with mania in geriatric patients

A

right hemispheric or subcortical lesions

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11
Q

ECT more likely to cause delirium in this population

A

elderly

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12
Q

definiton of remission during acute-phase treatment from an episode of MDD

A

at least 3 weeks with absence of both sad mood and reduced interest and no more than 3 remiaing sx of depressive episode

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13
Q

time of teratogenic effects of depakote

A

3-6 weeks

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14
Q

incidence of depression on isotretinoin

A

4-11%

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15
Q

FDA approved for bipolar depression

A

quetiapine IR or XR
latuda
cariprazine
olanzapine plus fluoxetine

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16
Q

percentage of bereaved ppl who meet criteria for MDD

A

20%

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17
Q

risk of SSRIs in pregnancy according to studies

A

preterm birth

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18
Q

percentage of children with intial depressive episodes that have spontaneous resolution

A

40%

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19
Q

minimum duration of sx to diagnose hypomanic episode

A

4 days

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20
Q

scales to follow depression treatment responses

A

Hamilton Depression Scale (Ham-d)
Montgomery Asberg Depression Rating Scale (MADRS)

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21
Q

minimum time to diagnose persitent depressive do in adults

A

2 years

1 year for cyclothymic in kids

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22
Q

HIV med that inc risk of depression

A

non nucleoside reverse transcriptase

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23
Q

exposure level of common antidepressants in breast milk

A

zoloft and paxil are low to undetectable

celexa and prozac are higher.

24
Q

PMDD

A

for most menatrual cycles, patients need 5/11 specific symptom in the final week before the onset of mensus

criteria B, one of more must be present:

marked affective lability
marked irritability
marked depressed mood
marked anxiety

criteria C, one of more must additionally be present:
decreased interest
trouble concentrating
lethargy
changes in appetite
hypersomnia or insomnia
sense of being out of control
physical sx of mentruation

25
PDD, persistent depressive disorder
6% of adults mild depressive sx that persist for 2 years or more with no more than 2 mo without sx. can also have MDD, use specifier with persistent major depressive episode, with intermittent major depressive episodes, with current episodes, etc.
26
foods to avoid while on MAOI
cheese (Except cottage and cream caviar liver smoked/picked/cured fish and meat ripe avocados canned figs, yeast extract, chianti red wide, fava beans, raisins, prunes, beer with yeast. in moderation: chocolate coffee
27
meds to avoid with MAOI
cold meds, allergy meds, decongestants, cough meds, stiumulants, meperidine, SSRI, buproprion, remeron, nefazodone, trazodone, effexor
28
best treatment for atypical depression
monoamine oxidase inhibitors like selegiline. atypical sx: emotional reactivity, hypersensitivity to loss of rejection, hypersomnia, hyperphagia.
29
first episode of bipolar in both women and men is usually...
depressive
30
adverse effects to newborn following SSRI/SNRI exposure in 3rd trimester
respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomitting, hypoglycemia, hypo or hypertonia, hyperreflexia, jitterness, irritability, constant crying, tremor
31
percentage of pts with BP1 who have recurrence of mood sx after single manic episode
>90%
32
selegine can cause this to show in UDS
methamphetamine is metabolized into l-methamphetamine and l-amphetamine
33
ECT
produces a generalized seizre for 30-60 sexonds, unknown mechanism FDA approved: catatonia, treatment resistant severe depression 3 days pwer week from 7-12 treatments in an acute series common SEs- acute confusion, memory loss, HA, jaw pains, nausea
34
efficacy for management of chronic anxiety in pts with severe lung disease can assist iwth improvement in respiratory status
buspirone
35
FDA approval for paroxetine
MDD, OCD, Social anxiety, GAD, panic DO, PTSD, PMDD, menstrual hot flashes. more SEs than other SSRIs: sexual dysfuntion, weight gain, constipation , sedation. half life is ~ 21 hrs,
36
preferred for breastfeeding mothers with post partum depression
zoloft, paxil due to low amount in breast milk
37
medical conditions that cause sx of mania
CNS tumors syphillis delirium encephalitis influenza multiple sclerosis q fever
38
meds that can cause manic sx
meds: amphetamines, cocaine, isoniazid, sterioids
39
minimum duration of symptoms for hypomanic episode
4 days
40
liver fucntion test every 6-12 mo
carbamazepine and depakote
41
selegine patch
bypasses gastric tract. lessening nee for dietary restriction at lowest dose
42
most effective treatment for major depression
ECT- induces generalized tonic clonic seizures ECT has no absolute risk
43
less effective ECT electrode placement but reduces side effects
unilateral NONdominant. the other modality is bilateral
44
Type of ECT memory loss
MC is anterograde inability to form new memories most persistent type of memory loss is retrograde amnesia to solve: inc interval, change type ie bilateral to unilateral electrode placement, use ultra brief pulse instead of brief.
45
percentage of bereaved ppl that meet criteria for depression
20
46
persistent complex bereavement DO
12 mo adults 6 mo children pt has to deal with 6 sx of reactive distress or social/identity disruption
47
Meds CI with ECT
theophylline- can cause seizures and status other meds to use with caution or avoid: hypoglycemics Beta blockers (can cause asystole) lidocaine (can reduce seizure induction) lithium (can cause prolonged seizure and confusion) benzos
48
PMDD
5 out of 11 symptoms in final week before menses 12 month prevalence is 1.8% -5.8%
49
cyclothymic disorder time req
1 year for kids 2 years for adults numerous perods with hypomanic symptoms that do not meet criteria for manic episodes AND numerous periods with depressive sx that do not meet critera for depressive epiosde. criteria for MDD and mania cannot be met 15-50% develop bipolar DO.
50
atypical depression
weight gain inc appetite marked mood reactivity leaden paralysis interpersonal rejection sensitvity
51
TMS
electromagnetic coil that creates strong magnetic field for microseconds at a time.
52
activating antidepressants
prozac wellbutrin zoloft
53
% of chidlren with depressive epsiode that will resolve spontaneously
40%
54
average duration of ECT
10 weeks on average gradually shift from weekly to monthly. and then maintaining monthly for at least 6 mo after remission. indications for continuation: 1. hx of recurrent episodes responsive to ECT 2. ineffective med trials 3. patient preference
55
hepatitis treatment that inc risk for depression
interferon alpha inc risk by 20-40%
56
DZ with greatest number of disability days
MDD

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