Brainscape's Knowledge GenomeTM

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


See full index

PSYCH EOR > Depression, Bipolar and Anxiety 36% > Flashcards

Depression, Bipolar and Anxiety 36% Flashcards

You may prefer our related Brainscape-certified flashcards:
Psychology 101 flashcards GRE® Psychology flashcards
1
Q

Define GAD

A

chronic excessive worry >6 months + 3 or more of the following symptoms: (MISC RF)

  • restlessness
  • fatigue
  • concentration problems
  • irritability
  • muscle tension
  • sleep disturbance for 6 months or more
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

define panic disorder

A

anxiety disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror +

  • accompanying chest pain
  • choking
  • or other frightening sensations.

>2 panic attacks w/ sx lasting >1 mo and woried about another attack

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

A group of anxiety disorders involving a pathological fear of a specific object or situation

A

Phobia

•Symptoms 10-15min prior to specific stress event

•6+ months of fear/anxiety about an object/situation

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

define panic attack

A

•Episode of intense fear or discomfort that develops abruptly; usually peaks within 10min, last <60min

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

Panic Disorder Criteria: + si/sx

A

Recurrent, unexpected panic attacks

2+ attacks x1 month and 1+ criteria sx

4/13 physical symptoms

Si/Sx

  • persistent concern/worry of another attack
  • worry of losing control during attack
  • maladaptive behavior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

define agorphobia

Tx?

A

Fear of going into places where you may not be able to escape

SSRI, CBT, or both

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

defien Social Phobia/ Anxiety

A

6+ months of intense fear of social situation or performance where you can be scrutinized

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

tx of phobic disorders

1st line

2nd line

triggers

agoraphobia

A

1st line: CBT/exposure therapy

2nd line: SSRI, Benzos

Specific, predictable trigger: Benzos

Agoraphobia: SSRI & CBT

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

tx of

panic attacks

panic disorder

acute panic attacks

A

Panic Attacks: Benzos (Lorazepam, Alprazolam)

Panic Disorder

  • SSRI (Paroxetine, Sertraline, Fluoxetine)
  • CBT

Acute Attacks: Benzos

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

Tx of GAD

A

SSRIs (Paroxetine, Escitalopram)

SNRI (Venlafaxine)

Benzos

Buspirone

•CBT x6-12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

35-year-old female with a complaint of worry which she cannot control for the last year. She tells you that her symptoms daily consisting of sleep disturbances, difficulty concentrating, and irritability. She reports her symptoms started around age 17 but have worsened.

Dx??

Tx options

A

GAD: persistent and excessive worry pertaining to multiple events or domains that continues for 6 months or more

Treatment

  • SSRIs: Paroxetine and escitalopram; SNRIs: Venlafaxine
  • Buspirone is also effective; the starting dose is 5 mg PO bid or tid. However, buspirone can take at least 2 weeks before it begins to help
  • BZD (short-term use), BBs
  • Psychotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

26-year-old first-year PA student with a medical history significant for GERD comes to your office because of frequent episodes of palpitations. The palpitations are sudden in onset and are accompanied by sweating and a sense that she is going to “pass out.” The episodes typically last no more than 10 minutes, and although the patient feels as if she may pass out, she never has. The episodes first appeared when she started PA school and have increased in frequency to the point where she is afraid to attend lectures out of fear of having an “attack.”

Dx??

Tx??

A

Panic Disorder

Treatment

  • SSRIs: Paroxetine, Sertraline, Fluoxetine
  • Benzodiazepines: for acute attacks (watch for abuse)
  • CBT (relaxation, desensitization, examining behavior consequences)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

a lab technician calls to tell you that a 22-year-old man you have sent for a blood draw is very anxious. He says he is terrified of having his blood drawn and almost faints at the sight of the needle.

A

Phobia - Same as panic disorder – symptoms begin 10-15 minutes prior to stress event except in this case it is a specific stress event (i.e flying, blood, social situations, spiders etc. etc.)

Treatment

  • Exposure therapy (first line), teach to relax and try to understand/overcome the fear
  • SSRI + CBT
  • Benzodiazepines (i.e prior to flying)
  • Treat agoraphobia just as GAD with SSRIs and CBT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name indication and MOA of Buspirone

A

Add on for anxiety

5HT-1a receptor agonist

•dopamine receptors

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

Hydroxyzine (Vistaril, Atarax) DDI & CI

A

DDI :

  • Potassium
  • MAOIs
  • CNS depressants

CI

  • Allergy
  • 1st trimester prego
  • *only use po route
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

CI for BZDs

A
  • Pregnancy
  • Allergy
  • Myasthenia gravis
  • Glaucoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tx optiosn for Bipolar

A

Lithium - (1st line)

Valproate (Depakote enteric coated) *increase GABA

Lamotrigine – *inhibit glutamate

Carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

side effect we are concerned for w/ Lithium

A

Ebstein anomaly is a rare heart defect in which the tricuspid valve — isn’t formed properly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Carbamazepine side effects

A

Nausea, rash, pruritis,

hyponatremia, fluid retention

leukopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

when tx Bipolar what medications do you need LFTs?

Renal labs?

A

LFTS- valporate, carbamazepine, lamotrigine

Renal - Lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

•SJS, TEN need to be watched for when starting what bipolar medications?

A

lamotrigine

carba

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

acute and long term effects of lithium

A

Acute: GI, tremor, thirst, polyuria, weight gain, loose stools

Long term: LITH-PA

  • Leukocytosis
  • insipidus (renal)
  • tremor
  • hypothyroidism
  • parathyroid
  • arrhythmia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what bipolar med is CI in pregnancy and safest in preg

A

safest - lamictal

CI - lithium, valporate, carba

24
Q

Differentiate b/w Bipolar 1 and Bipolar 2

A

Bipolar 1 – (mania > Depression)

  • manic episodes alternating with depression; psychosis during manic episodes

Bipolar 2 - (depression > Mania)

  • Low-level mania with profound depression; no psychosis
    *
25
Q

27-year-old man accompanied by his girlfriend. In the office, he seems to be running from topic to topic without a clear message. His speech is pressured. The patient’s girlfriend reports that he took steroids recently for a bad sinus infection and since he started them, his behavior has been abnormal. After discontinuing the medication, he has still been having symptoms. He has not had a normal night of sleep for the past ten days, and he just bought a new sports car though he has no need for one or the money to afford it. She also reports that she has caught him with multiple other women in the past few days, though they were in a committed relationship

Dx??

Txx?

A

Bipolar 1

Tx:

  • Lithium (first line )
  • Acute mania: Lithium, valproate, SGAs (olanzapine, aripiprazole), carbamazepine
  • Mania maintenance: SGAs, Gabapentin, lamotrigine (Lamictal)
  • If agitation add antipsychotics (haloperidol, risperidone) or benzodiazepines
26
Q

Tx of:

Acute mania:

Mania maintenance:

If agitation

A

Acute mania:

  • Lithium
  • valproate
  • SGAs (olanzapine, aripiprazole)
  • carbamazepine

Mania maintenance: SGAs, Gabapentin, lamotrigine (Lamictal)

If agitation

  • add antipsychotics (haloperidol, risperidone) or benzodiazepines
27
Q

SGAs used to tx acute mania

A

olanzapine, aripiprazole

28
Q

19-year-old male who has had bouts of sadness for the course of 1 year in which he says that oftentimes cannot even get out of bed so he tells his parents he is ill. Jim states that he recently felt so energized that he could not keep his thoughts straight and jumped from one idea to another. During this energized state, he did become irritable and others stated that he was louder than usual and wondered if he took something that increased his energy. During the week of high energy, he maxed out two of his credit cards and is not sure how he will pay them off before he goes to school in the fall. It was only a week later that he became so depressed that he did not find any pleasure in anything he did, was so tired he did not want to get out of bed which has continued to be a struggle today.

Dx?

Tx??

A

Bipolar 2

Treatment:

  • Lithium First line
  • Depressive episodes-
    • SSRIs
    • quetiapine
    • or olanzapine + fluoxetine
29
Q

24-year-old male with c/o episodes of depression alternating with times of increased energy, restlessness, and decreased sleep for 2 years.

dx??

A

Cyclothymic disorder

Alternating hypomanic episodes with a long-standing low mood state (dysthymia)

30
Q

tx of cyclothymic disorder

A

Lithium first line

Anticonvulsant medications, (valproate and carbamazepine,)

Psychotherapy

31
Q

define MDD

A

5 or more SIEGECAPS for≥ 2 weeks nearly every day and at least one of the symptoms is depressed mood or anhedonia

  • Sadness
  • Interest/anhedonia
  • Guilt
  • Energy
  • Concentration
  • Appetite
  • Psychomotor activity
  • Suicidal
32
Q

define PDD

A

Chronic depression - depressive symptoms for > 2 years

  • never been without the depressive symptoms in for more than 2 months at a time.
  • never been a manic episode or a hypomanic episode
33
Q

tx MDD

A

SSRIs are the first line treatment

  • Continue to increase dosage q3–4wk until symptoms in remission.
  • Full medication effect is complete in 4–6 weeks. Augmentation with 2nd medication may be necessary.
  • See within 2–4 weeks of starting medication and q2wk until improvement, then monthly to monitor medication changes
34
Q

tx PDD

A

SSRIs and other antidepressants

Psychotherapy

Physical exercise

35
Q

Repeated episodes of significant depression and related symptoms during the week before menstruation??

A

Premenstrual dysphoric disorder

36
Q

Tx Premenstrual dysphoric disorder

A

Treatment:

  • SSRIs first-line treatment (fluoxetine, sertraline, paroxetine, escitalopram)
    • can be used continuously or instituted the week prior to menses.
  • Birth control, low-dose estrogen,
  • SNRIs venlafaxine
  • (GnRH) -
37
Q

MDD Substypes and Tx (4)

A

Seasonal: depressive sx at the same time each year, MC winter

  • TX: SSRI, light therapy, Bupropion

Atypical: mood reactivity with depression (improve in response to positive events)

  • TX: MAOI Inhibitors (A/B: Nardil, Parnate, Marplan; B only: Selegiline)

Melancholia: anhedonia (inability to find pleasure in things), lack of mood reactivity, depression, severe weight loss/loss of appetite, excessive guilt, psychomotor agitation, or retardation & sleep disturbance (increased REM time and reduced sleep). Sleep disturbances may lead to early morning awakening or mood that is worse in the morning

Catatonic: motor immobility, stupor, extreme withdrawal

38
Q

define types of bipolar:

mania

hypomania

mixed

rapid

A
  • Mania: abnormal or persistently elevated, expansive or irritable mood for at least 1 WEEK
  • Hypomania: mania sx for 4 DAYS; no impairment
  • Mixed: criteria for one and 3+ sx of other
  • Rapid: 4+ ep/yr
39
Q

Dx??? Tx??

Fear of going into places where you may not be able to escape

•6+ months of fear/anxiety about 2+ scenarios

A

Agoraphobia

Tx: SSRI, CBT, or both

40
Q

define social anxiety

Tx? performance anxiety Tx?

A

6+ months of intense fear of social situation or performance where you can be scrutinized

Tx: CBT, SSRI/SNRI or both

Performance: Beta Blockers

41
Q

define phobic disorders

tx?? (1st, 2md, triggers, agoraphobia)

A

•Symptoms 10-15min prior to specific stress event

•6+ months of fear/anxiety about an object/situation

Tx

1st line: CBT/exposure therapy

2nd line: SSRI, Benzos

Specific, predictable trigger: Benzos

Agoraphobia: SSRI & CBT

42
Q

define Bipolar 2

A

>1 hypomanic episode w/ at least 1 depressive episode where sx last >4 days

43
Q

define bipolar 1

A

1 manic episode (hospitalization) and >3 sx going on for >1 wk

(DIG FAST)

  • Distractibility
  • insomnia
  • grandiosity
  • flight of ideas
  • activity (increased)
  • Speech (rapid/pressured)
  • thoughtlessness
44
Q

define adjustmnt disorder

tx

A

occurs w/in 3 mo of stimuli and resolves w/in 6 mo

tx: psychotherpay

45
Q

SSRI w/ longest 1/2 life

A

fluoxetine

46
Q

SSRI also tx OCD

A

fluvoxamine

47
Q

most sedating SSRI

A

paroxetine

48
Q

Bupripion is CI in what disorders??

Why

A

anorexia, bullemia, epilepsy – dec Sz thershold

49
Q

common side effect of trazodone

A

priapism

50
Q

tyramine induced HTN crisis is a concern w/ what class od meds?

A

MAOI (segelline)

51
Q

class of meds that is cardiotoxic and prolong QTc

A

TCA

52
Q

TI of Lithium

is it cleared renally or hepatically?

A

0.6-1.2

renally

53
Q

valporic acid TI

CI in??

monitor???

A

60-120

pregnancy - NTD

LTFs- spike in transaminases

54
Q
A
55
Q
A
56
Q
A

PSYCH EOR (8 decks)

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