Brainscape's Knowledge GenomeTM

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


See full index

MD3 > MH- Common presentations > Flashcards

MH- Common presentations Flashcards

1
Q

What is the key epidemiology of depression (i.e. lifetime prevalence, difference b/w men and women)?

A

~15 -20% population experience over a lifetime
Women have higher prevalence than men (2:1)
Men have higher rates of suicide than women (4:1)

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

What is the genetic influence in developing depression?

A

Strong genetic predisposition - strong FHx

Multiple genes thought to be implicated - i.e. genes involved with serotonin transporting

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

What are some key interpersonal predisposing factors to depression?

A

Early childhood - abuse, insecure attachment/lack of affection, poor parenting, maternal depression, parental loss

Adult experiences - lack of confiding relationship, dysfunctional or abusive relationship, lower SES, unemployment, social isolation

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

What are some factors that may precipitate depression?

A

Environmental factors and stressful life events (esp. loss)

Loss - bereavement, loss of role or autonomy

Ongoing issues with danger, entrapment or humiliation

Social isolation

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

Outline the principles of 2 behavioural/cognitive theories to the development of depression

A
  1. Seligman’s theory - learned helplessness model of depression - repeated exposures to stressful events - learn that you cannot change it and ‘give up’
  2. Beck’s triad (basis of CBT) - Your view/experiences of self, world and future inform your thoughts - can lead to negative thoughts - depress mood - further cycle of negative thoughts (worthlessness, guilt, helpless, hopeless)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Outline the principles behind the neurochemical theory of depression

A
  • Deficiency of neurotransmitters (serotonin, NA, DA) lead to depression and biological symptoms of depression
  • Decreased levels of their precursors and metabolites found in serum and CSF of depressed people
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is depression diagnosed? What are the core/cardinal symptoms?

A

Clinical diagnosis

Most have at least 2 of the following present for at least 2 weeks

  • Anhedonia (more characteristic)
  • Low/depressed mood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some biological symptoms in depression?

A
  • Sleep disturbance - initial insomnia, early waking, hypersomnia
  • Anorexia, wt loss
  • weight gain *
  • Aches/pains, headaches
  • Menstrual disturbance
  • psychomotor retardation
  • decreased libido
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some psychological/cognitive features of depression?

A
  • Memory loss, slowed thinking, difficulty attention/focusing
  • Anxiety
  • Suicidal ideation
  • Thoughts of helplessness, hopelessness, guilt, shame
  • Nihilism, pesimissm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are psychotic features of depression?

A

Delusions

  • Usually extension of themes of depression
  • Nihilistic, persecutary, shame/guilt, catastrophic, hypochondrial

Hallucinations

  • Auditory - derogatory voices
  • Rarely visual

Only occur in severe depression

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

What are DDx for depression?

A
  1. Physical causes - dementia, hypoactive delirium, parkinson’s disease, head injury, cancer, hypothyroidism, diabetes
  2. Normal sadness
  3. Bereavement
  4. Demoralisation
  5. Schizoaffective disorder/schizophrenia, Bipolar disorder
  6. Substance use
  7. Post-natal depression
  8. Adjustment disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are key features to ask on history when someone presents with low mood?

A
  1. HOPC - duration, severity (distress, function), associated biological & psychological symptoms
  2. Question for associated factors - risk factors, precipitating and perpetuating
  3. Risk assessment - self-harm and suicidal ideation
  4. Question to exclude physical causes, bipolar (previous manic episodes) and other psychotic disorders
  5. Question to identify co-morbid psychiatric disorders - anxiety, personality disorder, substance use
  6. Psychiatric history + FHx
  7. Medical and medication hx
  8. Collateral history - dementia, delirium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What examinations would you perform on someone presenting with low mood?

A
  1. Vitals + general health assessment (BMI)
  2. Endocrine - thyroid, cushing’s
  3. Neurological - neurodegenerative disorders, stroke
  4. Inspect for signs of self harm
  5. Signs of malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What investigations would you perform on someone presenting with low mood?

A
  1. Bloods - FBE, LFT, U&E, TFTs, Diabetes screen, Fe studies, B12, folate, Vit D

If indicated - test for cushing’s, addison’s and HIV

  1. Urine drug test if indicated
  2. CT/MRI if cerebral pathology suspected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the prognosis of depression?

A

> 50% will have at least one subsequent depressive episode

Each episode generally last ~8-9 months but can be reduced to ~2-3 months with effective treatment

Can resolve spontaneously if untreated/inadequately but last months - years and can become chronic

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

What are negative symptoms of schizophrenia?

A

Aboulia (lack of motivation/initiation)
Avolition (apathy)
Alogia (poverty of speech/thought, blocking)
Anhedonia (lack of interest/pleasure in things)
Affective flattening (blunting)

17
Q

When is clozapine indicated in Rx of schizophrenia

A

Treatment resistant - failure of at least 2 other antipsychotics (at least one being atypical) that were used at therapeutic doses & adequate time for effect

Treatment of severe tardive dyskinesia on other antipsychotics

18
Q

ASADFACES: Depression

A 
Appetite change
Sleep change
Anhedonia
Dysphoria
Fatigue
Agitation/retardation
Concentration (decreased)
Esteem (low)/guilt
Suicidal thoughts
19
Q

DIGFAST: Mania

A 
Distractibility
Indiscretion
Grandiosity
Flight of ideas
Activity increase
Sleep deficit
Talkativeness
20
Q

TRAUMA: PTSD

A 
Traumatic event
Re-experience
Avoidance
Unable to function
Month or more of symptoms
Arousal increased
21
Q

FINISH: anti-depressant discontinuation syndrome

A 
Flu-like symptoms
Insomnia
Nausea
Imbalance
Sensory disturbances
Hyper-arousal (anxiety, agitation)
22
Q

FEVER: NMS

A 
Fever
Encephalopathy
Vital sign instability
Elevated WBC/CK
Rigidity
23
Q

HARMED: serotonin syndrome

A 
Hyperthermia
Autonomic instability
Rigidity
Myoclonus
Encephalopathy
Diaphoresis
24
Q

IMPULSIVE: borderline personality disorder

A 
Impulsive
Moodiness
Paranoia or dissociation under stress
Unstable self-image
Labile intense relationships
Suicidal gestures
Inappropriate anger
Vulnerable to abandonment
Emptiness (feelings of)
25
Q

IWATCHDEATH: delirium causes

A 
Infection
Withdrawal
Acute metabolic
Trauma
CNS pathology
Hypoxia
Deficiencies
Endocrinopathies
Acute vascular
Toxins or drugs
Heavy metals

MD3 (21 decks)

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