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AMC MCQ - Key points > MDD > Flashcards

MDD Flashcards

1
Q

Describe the male-to-female ratio in Major Depressive Disorder.

A

It is 1:2.

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2
Q

What is the typical age range for Major Depressive Disorder, aside from the elderly?

A

Age20-30.

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3
Q

How long must symptoms persist for a of Major Depressive Disorder?

A

At least 2 weeks.

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4
Q

Define hypersomnia in the context of Major Depressive Disorder.

A

Excessive sleep.

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5
Q

Do individuals with Major Depressive Disorder experience anhedonia?

A

Yes, it involves a loss of interest in all pleasant activities.

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6
Q

Describe the treatment duration for Major Depressive Disorder.

A

At least 6 months.

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7
Q

What is the drug of choice for pharmacotherapy in Major Depressive Disorder?

A

SSRI (Selective Serotonin Reuptake Inhibitors).
Counseling (CBT) + medication

  • Monotherapy preferred
  • 1st episode: Treatment for 6-12m
  • > 1 episode: Treatment for 3-5y
  1. SSRI (Sertraline)
  2. Change to another SSRI
  3. Augmentation therapy by adding Lithium (1st) and atypical antipsychotics (2nd).
  4. Change to an SNRI
  5. ECT (Very severe)
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8
Q

How long does it typically take for the effects of SSRI to appear in Major Depressive Disorder treatment?

A

2-6 weeks.

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9
Q

What is the recommended duration of treatment for suicidal patients with Major Depressive Disorder?

A

2 years.

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10
Q

Describe the treatment approach for withdrawal in Major Depressive Disorder.

A

It should be done over at least 2 weeks.

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11
Q

What is the recommended treatment for severe depression in older individuals with Major Depressive Disorder?

A

ECT (Electroconvulsive Therapy).

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12
Q

Define cyclothymic disorder in the context of depression.

A

It involves depression with episodes of hypomania.

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13
Q

How is atypical depression characterized in Major Depressive Disorder?

A

By increased appetite, weight gain, and excessive sleep.

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14
Q

What is the most important factor to check in a suspected depressed patient?

A

Mood.

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15
Q

Describe the most common timing for depression in terms of seasons.

A

Winter.

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16
Q

What is the most common season for suicide?

A

Spring.

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17
Q

What is the most common season for Seasonal Affective Disorder?

A

Winter.

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18
Q

What is the term for depression with memory impairment in Major Depressive Disorder?

A

Pseudodementia.

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19
Q

Describe the most important question to ask a depressed patient

A

Inquire about suicidal thoughts.

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20
Q

What is the highest probability factor for suicide according to the content?

A

History of previous suicidal attempt.

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21
Q

What action should be taken once suicidal thoughts are in a patient?

A

Consider involuntary admission.

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22
Q

Who are considered the most risky patients in terms of suicide according to the content?

A

Those who have a plan of suicide.

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23
Q

Describe the typical age range for Bipolar Disorders according to the content.

A

Around 20 years old.

24
Q

What is the gender distribution in Bipolar Disorders according to the content?

A

Equal between males and females.

25
Q

List symptoms of mania as per the content.

A

Distractibility, insomnia, grandiosity, goal-directed behavior, flight of ideas, agitation, sexual indiscretions, talkativeness.

26
Q

Define Hypomania based on the content.

A

A less severe episode of mania that does not cause marked impairment or require hospitalization, with no psychotic features.

27
Q

What is the management approach for acute and marked psychosis in Bipolar Disorders according to the content?

A

Consider involuntary admission.

28
Q

What is the first-line drug for Bipolar Disorders as mentioned in the content?

A

Lithium.

29
Q

What is the second-line drug for Bipolar Disorders according to the content?

A

Valproic acid.

30
Q

What drug is recommended for pregnant or lactating patients with Bipolar Disorders based on the content?

A

Lamotrigine

31
Q

What treatment is suggested for resistant and severe cases of Bipolar Disorders in the content?

A

Consider Electroconvulsive Therapy (ECT).

32
Q

What should be considered for patients with marked psychotic symptoms in Bipolar Disorders according to the content?

A

Antipsychotic drugs.

33
Q

Describe the gender distribution in Schizophrenia according to the content.

A

More common in males aged 18-25, with equal prevalence between males and females.

34
Q

What are the epidemiological statistics mentioned for Schizophrenia in the content?

A

1% in the general population, higher rates in relatives and twins.

Schizophrenia affects around 30,000 adults in Australia, with a median lifetime risk of 7.2 per 1000 people. Worldwide, it contributes to 1% of the global disease burden. The disorder typically manifests in late adolescence to early adulthood and can lead to significant disability and increased risk of physical illnesses. The financial burden of schizophrenia is substantial, accounting for a significant portion of healthcare expenditures due to the associated disability and comorbid conditions.

For more details, refer to the RACGP guidelines on schizophrenia management.

35
Q

What are the common findings in CT and chemistry related to Schizophrenia as per the content?

A

Enlarged ventricles, decreased cortical volume, abnormal serotonin and dopamine levels.

36
Q

List the types of Schizophrenia described in the content.

A

Paranoid, Disorganized, Catatonic.

According to the RACGP guidelines, schizophrenia is primarily categorized based on symptom patterns and responses to treatment. The types of schizophrenia traditionally included are:

  1. Paranoid Schizophrenia: Characterized by prominent delusions and auditory hallucinations.
  2. Disorganized Schizophrenia: Marked by disorganized speech and behavior, and flat or inappropriate affect.
  3. Catatonic Schizophrenia: Dominated by motoric immobility or excessive motor activity.
  4. Undifferentiated Schizophrenia: Symptoms do not clearly fit into the other categories.
  5. Residual Schizophrenia: Presence of negative symptoms and absence of prominent delusions, hallucinations, or disorganized behavior.

For more detailed information, visit the RACGP page on schizophrenia.

37
Q

Describe the most common cause of death in individuals with schizophrenia.

A

Cardiovascular diseases (CVS) are the most common cause of death in individuals with schizophrenia.

38
Q

brief psychotic disorder based on its duration.

A

Brief psychotic disorder is characterized by a duration of less than one month.

39
Q

What is the differential diagnosis for schizophrenia based on duration?

A

Duration less than one month: brief psychotic disorder; Duration 1-6 months: Schizophreniform disorder; Duration more than 6 months: schizophrenia.

40
Q

Explain what schizoaffective disorder is.

A

Schizoaffective disorder is a condition characterized by a combination of schizophrenia and either depression or bipolar disorder.

41
Q

What are the treatment options for severe and resistant cases of schizophrenia?

A

Electroconvulsive therapy (ECT) is recommended for severe and resistant cases of schizophrenia.

42
Q

List some good prognostic indicators in schizophrenia.

A

Good prognostic indicators in schizophrenia include: negative family history, female sex, acute onset, presence of precipitating factors, presence of catatonic symptoms, presence of positive symptoms, absence of negative symptoms, normal CT scan, stable family relationship, stable work, stable personality.

43
Q

Explain the treatment for weight gain secondary to antipsychotic drugs.

A

The treatment for weight gain secondary to antipsychotic drugs is orlistat.

44
Q

What is the first step in the treatment of any psychiatric patient?

A

The first step in the treatment of any psychiatric patient is to establish a good relationship with the patient.

45
Q

Describe the differential diagnosis for a teenager with a drop in academic performance.

A

The possible differentials for a teenager with a drop in academic performance include: schizophrenia, depression, and drug abuse.

46
Q

Describe autotrophic asphyxia.

A

Autotrophic asphyxia is a type of sexual satisfaction achieved by causing self-asphyxia, such as by tying a rope around the neck.

47
Q

Define hypoxophilia.

A

Hypoxophilia refers to a condition where an individual is sexually aroused by a lack of oxygen or by asphyxiation.

48
Q

How is suicide risk different between genders?

A

Females tend to make more suicide attempts, but males are more likely to be successful in their attempts.

49
Q

Do physicians play a role in suicide prevention?

A

Yes, physicians can play a crucial role in suicide prevention by identifying risk factors, asking about suicidal ideation, and taking appropriate steps like involuntary hospitalization if necessary.

50
Q

Describe the high-risk groups for suicide according to the content.

A

High-risk groups for suicide include immigrants, individuals who have recently lost employment, and those experiencing early dementia.

51
Q

What is the first step mentioned in the content for dealing with a suicidal individual?

A

The first step mentioned is involuntary hospitalization.

52
Q

Define ‘loosening of association’ as mentioned in the content.

A

Loosening of association refers to a thought disorder where a person’s thoughts become disconnected or fragmented, leading to incoherent speech.

53
Q

Describe the suicide statistics mentioned in Australia according to the content.

A

In Australia, suicide is the second most common cause of death. There is no evidence of an increased risk of suicide if a doctor asks about suicidal ideation.

54
Q

What are some risk factors for suicide mentioned in the content?

A

Risk factors for suicide include being male, having a history of previous suicide attempts, major depression, and the availability of firearms.

55
Q

Do marital status and homelessness play a role in suicide risk according to the content?

A

Single males who are homeless are most likely to attempt suicide, while married individuals are least likely to do so.

AMC MCQ - Key points (49 decks)

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