Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry > Depression > Flashcards

Depression Flashcards

1
Q

What is the frequency which depression is dx and treated

A

Recognized half the time but then treated only half the time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Etiology of Depression

A 
Most common pysch symptom
1 year prevelance: 
5% have major depression
5.4% have dysthymic disorder
in a given year see 11 million people w/ depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How efficacious is tx for depression

A

80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the variety of ways depression can present

A

• Multiple Somatic Complaints
• Anxiety
• Cultural influences
– “Nerves” “Headaches”-Latino, Mediterranean
– Weakness, Tiredness, “Imbalance”-Chinese, Asian cultures
– “Heartbroken” - Hopi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are common somatic complaints in pts with depression

A

tire, blahs, headache, malaise, poor sleep, abdominal/joint aches, stressed out, GI issues, loss sexual interest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the more common positive predictive somatic sypmtoms for depression

A

sleep issues, fatigue, non specific skeletal compliant, back pain, SOB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

There is a strong correlation between number of physcial symptoms and

A

prevalence of pyschiatric disorder: anxiety, mood or other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

We see high prevalance of depression in certain medical illnesses

A

cancer, stroke, diabetes, Parkinsons, MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Depressive Disorder, Dysthymic Disorder and MDD are all nesteled under

A

Depressive Disorders (type of mood disorder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the criteria for Major Depressive Episode

A 
Minimum 5 symptoms for at least two weeks (at least one of the follow two)
– Depressed mood (irritable in kids) 
– Loss of interest or pleasure
AND
4 of the following
– Weight loss or gain
– Insomnia or hypersomnia
– Psychomotor retardation or agitation
– Fatigue or energy loss
– Worthlessness or guilt
– Decreased concentration
– Death thoughts; suicidal thoughts, plans, acts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What things are NOT major depressive episode when present

A
  • B. Not Mixed Episode
  • C. Clinically significant distress or impairment
  • D. Not due to substance or general medical condition
  • E. Not Bereavement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

SIGE CAPS is way to remember MDD

A 
*5 or more in 2 week period
Sleep
Interest
Guilt
Energy
Concentration
Appetite
Pyschomotor
Suicidality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the 2 question depression screen?

A

2-question depression screen
– Over the past 2 weeks, have you felt down or hopeless?
– Over the past 2 weeks, have you felt little interest in doing things?
A “yes” to either question is a positive screen for depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does the PHQ-9 work?

A

Patient Health Questionaire (PHQ-9)
Over the last 2 weeks, how often have you been bothered by the following problems?
Ranked 0-3 for not at all through every day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does the scoring work for PHQ-9 screen?
5-9
10-14

A

5-9; minimal symptoms, support and educate to call if worse, follow up in 1 month
10-14: minor depression, dysthimia or mild major depression… antidepressant OR psychotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PHQ-9 score of 15-19

A

Major depressive: antidepressant or psychotherapy

17
Q

Score of over 20 on PHQ-9

A

psychotherapy and antidepressants

18
Q

What are some suidice myths

A
  • Suicide is a crazy act/rational act
  • Those who talk, won’t do it; those who act don’t talk
  • Broaching the subject plants the seed
  • Marriage protects
  • It doesn’t matter how much meds I prescribe, pts will stockpile
  • If depression explainable, no need for tx
  • A suicide attempt is simply a failed suicide
19
Q

What questions do we ask when assessing pts risk for suicide?

A

• “Have things gotten to the point where you
have felt like ending it all?”
• Specific plans?
• How available is the method? • How lethal is the method?

20
Q

Red flags for suicide

A

Red Flags: IS PATH WARM
Ideation/threatened or communicated
Substance Abuse/excessive or increased
Purposeless/no reasons for living Anxiety, Agitation/Insomnia Trapped/feeling no way out Hopelessness
Withdrawal from friends, family, society
Anger (uncontrolled)/rage/seeking revenge
Recklessness/risky acts - unthinking
Mood changes (dramatic)

21
Q

What are the three stages of Grief

A

Shock
preoccupation with deceased
Resolution

22
Q

What happens during the first stage of grief

A 
SHOCK:
• Emotions
– Numbness
– Sense of unreality
• Somatic – Crying
– Abdominal pangs/emptiness – Sighing
– Tightness in throat
Denial and disbelief
23
Q

What occurs during the second stage of grief

A 
• Thoughts – Dreams
– Thoughts of the deceased
• Motivational stage – Anhedonia
– Introversion
• Emotions – Guilt
– Anger
– Sadness
• Somatic
– Weakness
– Anorexia – Insomnia – Fatigue
24
Q

What occurs during the third stage of grief

A

• Thoughts
– Think of past with pleasure
• Motivational Stage
– Regain interest in activities – Form new relationships

25
Q

Recommended meds for depression

A
  • Tricyclic antidepressant (TCA)
  • Selective Serotonin Reuptake Inhibitors (SSRI)
  • Atypical
  • Monoamine Oxidase Inhibitors (MAOI)
26
Q 
– Imipramine (Tofranil)
– Amitriptyline (Elavil)
– Desipramine (Norpramin) – Nortriptyline (Pamelor)
– Doxepin (Sinequan)
– Clomipramine (Anafranil
A

All examples of TCAs

27
Q

When prescribing TCAs, what do we need to take into consideration

A 
side effect profile: 
• Effective First Line Treatment
• Preferred by Managed Care
• Compliance Issues Due to Side Effects – Dry mouth
– Sedation
– Orthostatic Hypotension
• Cardiac arrythmias with overdose
28
Q
  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Citalopram (Celexa)
  • Fluvoxamine (Luvox)- not approved for depression
  • Escitalopram (Lexapro)
A

all examples of SSRIs

29
Q

What do we need to keep in mind when prescribing SSRIs

A

DOSAGE; varies for all of them

30
Q

What are side effects seen with SSRIs

A 
Side effects
– Headache, dizziness
– Nausea, loose stools, constipation – Somnolence or insomnia
– Sweating, tremor, dry mouth
– Anxiety, restlessness
– Sexual Drive
31
Q
  • Bupropion (Wellbutrin/Zyban) • Trazodone (Desyrel)
  • Nefazodone (Serzone)
  • Venlafaxine (Effexor)
  • Mirtazapine (Remeron) • Duloxetine (Cymbalta) • Alprazolam (Xanax)
A

Atypical antipyschotics

32
Q
  • Phenelzine (Nardil)
  • Isocarboxazid (Marplan)
  • Tranylcypramine (Parnate) • Selegiline patch (Emsam)
A

MAOIs

33
Q

What are supplemental or alternative therapies to depression

A

• Lithium
• Augmentation therapy – Lithium
– T-3 L-triiodothyronine Cytomel
• Psychotherapy -
• ECT (Electro-Convulsive Therapy) • Vagal Nerve Stimulation
• Transcranial Magnetic Stimulation • Deep Brain Stimulation

34
Q

What are the 5 Rs of Depression tx

A 
Response
Remission
Relapse
REcovery
Recurrence

Psychiatry (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions