Chapter 7 (Study Group) - Emotional and Mental Well-Being, Assessment and Interventionss Flashcards
Which of the following are true regarding stress?
a. It is a USPTFS grade B recommendation that screening for stress and a brief discussion on the role of stress in a healthy lifestyle is undertaken at all patient visits
b. It is not recommended to screen for stress as it is due to external life circumstances and cannot be treated
c. Work stressors increased the incidence of cardiovascular disease in a group of middle-aged women studied for 15 years
d. Stress can be assessed using the perceived stress scale assessment, which is a 10 item questionnaire. The higher the total score, the more perceived stress one is under.
D (BR manual p 233-234)
Which of the following is correct regarding depression?
a. Depression as an independent marker for mortality is twice as strong as that of smoking
b. A diagnosis of depression predicts diabetes, and vice versa (ie there is a bidirectional association)
c. Coronary artery disease is a risk factor for depression that generally precedes depression by several years
d. There is clear evidence that treatment of depression improves survival in patients with coronary artery disease
B (BP manual p.236-237)
Marty is a middle aged man with a past history of hypertension and angina. He comes to you for a health check. He appears anxious, so you include a PHQ-4 questionnaire in your assessment. His score today is 9. Which of the following is correct?
a. The PHQ-4 is a validated screening tool for stress and depression
b. Marty’s score reflects mild depression and anxiety. He should be given education and resources and re-screened at future visits
c. Marty’s score is ‘severe’. He should be further assessed for both depression and anxiety symptoms, including a suicide risk assessment
d. If Marty is depressed his cardiac risk could be elevated up to 15-20%, with major depression predicting increased risk from cardiac death, MAI, cardiac arrest and non-elective revascularisation over a 2 year follow up. Treatment with an SSRI improves survival and should be commenced immediately.
C (BR manual p. 236-237)
Which of the following are benefits of MBSR (mindfulness-based stress reduction)?
i. Reduces loneliness in older adults
ii. Increases resilience, self esteem, energy and enthusiasm for life
iii. Improves ability to relax
iv. Improves short and long term coping in stressful situations
v. Alleviates inflammation, anxiety and depression
a. All of the above
b. None of the above
c. ii, iv and v
d. iii, iv and v
A (BR manual p 246)
Which of the following would you not use as a depression screening tool?
A. PHQ-2
B. PHQ-4
C. HAM-D
D. PAR-Q
D False - Physical activity readiness questionnaire
Which of the following is not a risk factor for suicidal ideation in diabetics?
A. Insulin therapy
B. Adverse effects from diabetic medications
C. Duration of diabetes
D. Unsatisfactory glycaemic control (HbA1c ≥ 6.5%)
B False - p237
With regards to medications used in depression, which of the following statements is correct?
A. SSRIs/SNRIs have a NNT of 3
B. Medications should not be combined with physical activity due to risk of torsades de point from QTc prolongation
C. TCAs often need to be stopped due to side effects in 1 out of 4 to 30 patients
D. MAOs monoamine oxidase inhibitors can interact with the TMAOs made in the gut in those who consume meat so should only be prescribed to those on a strict vegan diet
C True - p239
Which of the following is not considered a necessary suffering?
A. Old age
B. Illness
C. Repeating stories of the past
D. Separation from those we love
C Correct - p244
What is often not an element of a MBSR program?
A. Usually 9 classes structured over 8 weeks
B. In class, participants experience 2 hours of mindfulness practice, and complete a colouring in workbook
C. Upon conclusion of the program, studies are expected to be maintain 45mins a day of mindfulness practice, 6 days a week
D. Informal mindfulness involves attentiveness to routine activities
B p244
With regards to the ability to multi-task in a simulation of driving and completing an auditory test, how many people could adequately perform this task?
A. 0.25%
B. 2.5%
C. 25%
D. 52%
B p247
Which of these statements is not true?
A. Depression was 40% more likely to develop in adults who frequently ate fast food compared to those who avoided it
B. Higher rates of mood disorders are seen when deficiencies in potassium, magnesium and vitamin D are present
C. There is no clear evidence that increasing omega 3 fatty acids treats depression
D. Exercise shows a small positive effect on treatment of depression compared to no treatment
B Higher rates of mood disorders are seen when deficiencies in folate, b12, calcium, iron, selenium, zinc and omega 3 FA’s are present
Which of these statements is FALSE?
A. The USPSTF 2016 recommendation is to only screen adults and adolescents for depression in primary care settings that have adequate support systems in place
B. It is recommended to screen for depression with PHQ-9
C. A score of 27 indicates high stress on the perceived stress scale assessment
D. 70 % of primary care visits are related to stress and lifestyle
B screen with PHQ-2
Which of these statements is true related to making the diagnosis of MDD on DSM- 5 ?
A. Symptoms must be present for at least 3 months
B. The person must have at least depressed mood most of the day or loss of interest or pleasure must be present
C. Gender does not effect the capacity to detect depression
D. Fatigue or loss of energy must be present
B true
A incorrect- 2 weeks, C incorrect– male gender can be harder to detect /willing to express emotions, D- incorrect- one of the 7 further symptoms ( 4 need to present)
Which of these statements is FALSE?
A. The GAD-2 is a suggested way to screen for anxiety
B. GAD can be diagnosed if a person has the symptoms described in the DSM-5 for GAD at least one month
C. If a patient has symptoms that are attributable to another disorder such as PTSD then a diagnosis of GAD is unlikely
D. Difficulty concentrating is a symptom of anxiety
B GAD can be diagnosed if a person has the symptoms described in the DSM-5 for GAD at least six months
