Depression, Anxiety, and Dementia Flashcards

1
Q

Define mood

A

Sustained emotion that impacts our perception of the world and how we function in it

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2
Q

What neurotransmitters are involved in the neurobiology hypothesis?

A

Norepinephrine, dopamine, and seratonin

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3
Q

Conditions associated with major depressive disorder?

A

Neuro disorders, cancers, autoimmune, CV conditions

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4
Q

Risk factors for depression

A

previous depression, family history, lack of social support, stressful life event current substance use, medical comorbidity

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5
Q

When do you need medication for depression?

A

Suicidal, loss of function, impacts daily life

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6
Q

DSM 5 requirements for depression

A

Need 5

  1. Depressed mood or or loss of interest and pleasure
  2. Weight loss or gain
  3. Insomnia or hypersomnia
  4. Psychomotor agitation or retardation
  5. Fatigue or loss of energy
  6. Worthlessness or guilt
  7. Diminished ability to think or concentrate
  8. Reucurrent thought of death
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7
Q

Differential diagnosis of major depressive disorder?

A

Major depression with psychotic feature, bipolar disorder, dysthymic disorder, cyclothymic disorder, seasonal affective disorder, adjustment disorder with depressed mood, post part depression

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8
Q

What does SIG E CAPS

A

Sleep changes, interest lost, guilt, energy, cognition, appetite, psychomotor, suicide

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9
Q

Best treatment for depression?

A

Medication and psychotherapy

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10
Q

SSRIs medications

A

fluoxetine ( prozac)
Citlaopram (celexa)
Escitalopram (lexapro)
Paroxetine (paxil)

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11
Q

SSRI side effects?

A

motor restlessness, anxity and agitiation, insomnia, sedation sexual dysfunction, serotnin syndrome

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12
Q

What should you do for SSRi side effects?

A

Take them at night

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13
Q

TCA side effects?

A

Anticholinergic and sedative side effects

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14
Q

Major problem of TCA?

A

Cardiovascular toxicity with over dose

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15
Q

Atypical Antidepressants?

SNRI

A

Venlafaxine (effexor), duloxetine (cymbalta), nefazodone (serzone)

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16
Q

When do you stop antidepressants?

A

6-9 months after depression symptoms

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17
Q

First line drug for depression?

A

SSRIs

18
Q

Differential diagnosis of anxiety

A

Hypo/hyperthryoid, mitral valve disorders, TBI, B12 deficiency, CNS disorders, OTC abuse of mediations, electrolyte imbalances

19
Q

What rules out anxiety?

A
  1. History does not fit (no significant life stressors or family history)
  2. later in life
  3. states that happened at same time as headache or decrease in cognitive function
20
Q

What is Adjustment disorder?

A

Development in response to identifiable stress with distress that is out of proportion to the severity that might influent function.

21
Q

Generalized anxiety disorder

A

> 6 months, excessive anxiety and worry with or without panic attacks

22
Q

Panic Disroder

A

> 1 month, persistent worry, maladaptive behavior

23
Q

Acute Stress Disorder and PTSD?

A

Length of time with PTSD longer than a month, with multiple systemic affected

24
Q

What should you screen for with anxiety?

A

Depression and substance abuse. Always screen for all three at the same time.

25
Q

Most common complaint for anxiety?

A

Insomnia

26
Q

First line drug for anxiety?

A

SSRIs

27
Q

Who do SNRIs work best for with anxiety?

A

Those with chronic pain, non-specific

28
Q

Who are benzos best for?

A

Short term solution that does not call for significant impairment of functionality (i.e. speech, plane ride)

29
Q

Who shouldn’t bento’s be prescribed for?

A

The elderly

30
Q

Who is BuSpar good for?

A

Chronic anxiety without abuse potential

31
Q

Differential Diagnosis for dementias?

A

B12, folate, thyroid disease, neurosyphilis, organ failure, HIV, stroke, Huntington’s, delirium, UTI

32
Q

Most common type of dementia?

A

Alzheimers

33
Q

When should you start treatment for alzheimer’s?

A

As soon as possible

34
Q

Vascular dementia?

A

Sudden or gradual onset with patchy, focal neurological deficits from stroke, TIA, DM, MI and CAD (risk factors)

35
Q

What is Pick’s disease?

A

Like FT dementia, but early onset and familial tendencies

36
Q

Lewi body Dementia?

A

Usually with Parkinson’s dementia, occurs quickly, with neuroleptic sensitivity

37
Q

frontotemporal Dementia

A

Usually less than 60 y.o. with decline in interpersonal conduct and emotional blunting

38
Q

What shouldn’t you prescribe with dementias?

A

Antipsychotics

39
Q

Who can help differentiate the different dementias?

A

Neuropsychologist

40
Q

What score suggests a problem on MMSE?

A

25 and less suggests organic disease (book says 27)