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physiology test 3 > mood disorders > Flashcards

mood disorders Flashcards

1
Q

name two of the most common mood disorders in the world?

A

major depressive disorder
bipolar disorder

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2
Q

the term depressive disorders is used to describe a group of mood disorders in which patients have ____ or ____ moods with other physical or cognitive symptoms that impair daily function.

A

sad or irritable

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3
Q

Name the four categories of depressive diorders?

A

major depressive disorder

disruptive mood dysregulation disorder

persistent depressive disorder

premenstrual dysphoric disorder

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4
Q

how can you categorize the differences between the types of depressive disorders is by?

A

nature of onset

duration

potential etiology

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5
Q

the onset of bipolar disorders is rare to occur before ____ and typically will have an onset during what stage of life

A

rare before puberty

increased during late adolescence & early adulthood

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6
Q

the typical age of onset for major depressive disorder is from ____ to ____.

A

mid 20s through the 50s

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7
Q

what is the average age onset for bipolar disorder

A

15 and 30 years

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8
Q

the peak age of onset for major depressive disorder is?

A

in the mid 30s

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9
Q

before the intial onset of mania in adolescents, what chatacteristics may they demonstrate

A

exhibit irritability, hyperactivity, impulsivity, emotional lability, poor judgement, marked anxiety, imsomnia, depression, and psychosis

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10
Q

Women are ____ as likely to suffer from major depressive disorder compared to men.

A

twice

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11
Q

for bipolar disorder, what is the first mood to be experienced by males specifically and females specifically

A

Females: major depressive episode

Males: manic episode

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12
Q

men expereince higher rate of ______ thinking and _____ attempts.

A

suicidal

suicidal

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13
Q

Mean are nearly four times as likely to die by ______. Why?

A

suicide

because men tend to choose more violent and more lethal suicide methods

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14
Q

mixed features, depressive episodes, and rapid cycling for bipolar disorder is more common in males or females?

A

females

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15
Q

bipolar episodes increase over the 1st ____years, then _____ as the individual ages

A

first 10 years

gradually level off and decline

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16
Q

______ is associated with higher rates of many chronic medical conditions.

A

major depressive disorder

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17
Q

over 80% of individuals with bipolar disorder will have more than ____ mood epidodes during their lifetime

A

4

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18
Q

if a patient is untreated with bipolar disorders, whta is likely to occur over the persons lifetime

A

can increase to 10 or more

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19
Q

What is the worlds leading cause of disability?

A

Major depressive disorder

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20
Q

Postmortem studies found there is small differences in some _____ regions and loss of tissue volume in the ______ in individuals with major depressive disorder.

this suggest what?

A

cortical

hippocampus

loss of particular brain functions or disturbances of network activity can induce the mood disturbances that are associated with major depressive disorder.

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21
Q

Cyclic mood disorder with bipolar, causes a patient to more through moods known as

A

Euthymic

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22
Q

Describe euthymic mood changes for bipolar disorders

A

with or without a period of normal mood

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23
Q

individuals with bipolar disorder can have mood flucuations that continue for ____ or _____

A

continues for months

OR

Can have one episode with no re occurrence of any mood type

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24
Q

the clinical presentation of a depressive phase of bipolar disorder is the same as ______ disorder

A

unipolar depression as a major depressive episode

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25
Q

monoamine theory of depression suggests that an imbalance of what is responsbile for the onset of major depressive disorder.

A

imbalance in normal monoamine neurotransmission may be responsible for the onset of major depressive disorder.

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26
Q

List some mania symptoms

A
  • inflated self-esteem or grandiosity
  • decreased need for sleep
  • talkative
  • flight of ideas
  • easily distracted
  • increase in goal directed activity
  • excessive involvement in activities that have potential for painful consequences
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27
Q

when a mania expisode occurs and the patient feels euphoric, this can result in what adverse effect

A

reduced medication compliance since the patient wants to experience these feelings of mania

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28
Q

list the neurobiological causes major depressive disorder (6 total)

A
  1. neurotransmitters (GABA and Glutamate)
  2. Hypothalamic-Pituitary-Adrenal (HPA) Axis
  3. Changes in number, density, and size of neurons
  4. anatomical changes in the brain (volume changes)
  5. Changes in brain activity (blood flow and glucose metabolism)
  6. Increased inflammatory markers (cytokines and CRP)
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29
Q

hypomania episodes are typically ____ than mania episode

A

shorter

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30
Q

how is hypomania diffrentiated from mania

A

by the need for hospitilization

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31
Q

what classification of mania is typically experienced when a patient is having a flight of ideas, extremely clever thinking, and increase in energy

A

hypomania (during a short episode)

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32
Q

if the mania experienced causes hospitalization and is classified as a manic episode, what will the patient get diagnosed as

A

bipolar 1 disorder

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33
Q

in the presence of bipolar disorder, a mized state typically occurs which what two symptom classes are experienced

A

mania and clinical drepression will occur simutaneously

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34
Q

Children with depression will often have new _____ problems and have increased _____ compliants

A

behavioral

somatic

35
Q

in bipolar disorder, what are examples of symptoms that can be experienced

A

agitation, anxiety, aggression, confusion, fatigue, impulsiveness, imsomnia, irritability, suicidal ideations, paranoia, delusions, pressured speech, racing thoughts, restlesness, rage

36
Q

adults with depression typically present with compliants of _____ mood, changes in ____ and ___ habits, and ______ sensitivity.

A

depressed

sleep and eating

rejection

37
Q

geriatric depression is characterized by ____ symptoms, including decreased in what four things?

A

neurovegetative

sleep

interest

appetite

energy

38
Q

what is rapid cycling defined as for bipolar disorder

A

having 4 or more episodes per year

39
Q

rapid cycling in bipolar disorder can be ____ due to antidepressants, unless there is an active treatment with a mood stabilizer present

A

induce or worsened

40
Q

the mental status exam is similar to the ____ ____ in medicine.

A

physical examination

41
Q

the DSM 5 classifies mania as

A

>1 week persistent elevated mood or irritable

at least 3 mania symptoms (4 if the mood is irritable)

42
Q

How is the mental staus exam completed? which assesses what?

A

through a direct patient interview

designed to assess current behavior, thoughts, perceptions, and functioning.

43
Q

every patient should have three things performed before diagnosing major depressive disorder. why?

A

complete physical examination

medication review

basic laboratory workup

because certain medical conditions, substance use disorders, and medications can cause depressive symptoms.

44
Q

what lab work should be obtained before making a diagnosis of major depressive disorder?

A

complete blood count with differential

thyroid function

electrolyte test

45
Q

how does the DSM5 classify hypomania

A
  • at least 4 days of abnormal and persistent elevated expansive, or irritable mood and increase activity or energy
  • associated with at least 3 mania symptoms (4 if mood is irritable)
  • NOT SEVERE ENOUGH to cause:
    • impairement in social/occupation
    • required hospitalization
    • psychotic features
46
Q

how does the DSM5 classify major depressive

A

>2 week period of either depressed mood or loss of interest or pleasure in normal activities with at least 5 symptoms of depression

47
Q

name the drug therapies associated with depressive symptoms?

A

antihypertensives

hormonal therapy

acne therapy

interferon products (for Hep C, MS)

48
Q

how does the DSM5 classify mixed features

A
  • full crieteria for depressive episode with at least 3 manic episodes
  • full criteria for manic or hypomanic episode with at least 3 depressive symptoms
49
Q

list substance use disorders associated with depressive symptoms?

A

alcoholism

marjuana abuse and dependence

nicotine dependence

opiate abuse and dependence

psychostimulant abuse and dependence

50
Q

is is essential to perform which test/exams in order to diagnose a patient with bipolar disorder

A

complete history, including medical, psychiatric, medication history, physical, neurological examination, and labratory test which must be done before diagnosis

51
Q

list general medical conditions associated with depressive symptoms?

A

endocrine disorders (hypothyroidism, addision disease, cushing disorder)

deficiency states (percinous anemia, Wernicke encephalopathy, severe anemia)

infections (AIDS, encephalitis, HIV, mononucleosis, STDs, TB)

Collagen disorder

Systemic Lupus Erythematous

Metabolic Disorders

Electrolyte Imbalances (hypokalemia, hyponatremia)

hepatic encephalopathy

cardiovascular disease (coronary artery disease, congestive heart failure, myocardial infarction)

Neurologic disorders (alzheimers disease, epilepsy, Huntingtion disease, MS, pain, Parkinson Disease, poststroke)

Malignant Disease

52
Q

What labratory test should be performed for a patient with bipolar disorder

A

complete blood count

blood chemistry

thyroid function test

urinalysis

urine drug screen

53
Q

the essential feature of bipolar disorder is a history of ______

A

mania or hypomania that is not caused by any other medical condition, psychiatric disorder, or substance abuse

54
Q

what are the 3 categories of bipolar disorder

A

bipolar I disorder

bipolar II disorder

cyclothymic disorder

55
Q

______ is classified as someone having at least 2 years of hypomanic symptoms nad depresseive symptoms but they do not meet full criteria for hypomania or depressive disorder

A

cyclomythia disorder (under bipolar category)

56
Q

for depression, the mood doesnt reach the levels for hypomania or mania, rather it achieves levels of depression allowed to occur classified as

A

unipolar depression

57
Q

_____ has periods of both depression and mania

A

bipolar 1

58
Q

_______ has periods of depression but the periods of mania that occur are not quite as extreme adn do not last as long as normal mania episodes (AKA hypomania)

A

bipolar II

59
Q

_______ is present in individuals experiencing emotional highs and lows similar to bipolar, however the mood shifts in this disease arent as extreme

A

cyclothymia

60
Q

According to the DSM 5 for a major depressive episode, a patient must experience what?

A

5 or more depressive symptoms, at least one theses symptoms must be a depressed mood or loss of interest or pleasure,

symptoms must have been present nearly every day in the same two week period,

and resulted in change in the patient’s level of functioning.

61
Q

In a normal person, moods shifts will still occur allowing them to have days that they will feel happier and sadder, however these moods

A

do not have as severe changes as the moods that are experienced in bipolar disorder or cyclothymia

62
Q

an MRI, CT, or PET scan can reveal changes in the _____ for bipolar disorder

A

amygdala volume and the presenece of white matter hyperintensities

63
Q

bipolar is previously known as?

A

manic depressive illness

64
Q

_______ that connect the amygdala, hippocampus, and

A
65
Q

Bipolar disorder is ______ mood disoder characterized by?

A

cyclic

mood disorder characterized by unusual shift in mood, energy, activity levels, and the ability to carry out day-to-day tasks

66
Q

The mood changes in bipolar

A
67
Q

in bipolar disorder, the mood change is typically how far apart

A

months to years, not minute to minute or day to day

68
Q

when comparing bipolar disorder with the general population, what type of mortality rate do these patients have

A

2.3 times higher mortailty rate

69
Q

suicide attempts occur in up to ___% of individuals with bipolar along with ___% of individuals actually complete the act of suicide

A

50%

10-15%

70
Q

what age group does bipolar disorder develop in

A

late teens or early adult years

71
Q

at least half of all bipolar cases occur before what age

A

25, with their first symptoms occur in childhood

72
Q

Women with bipolar disorders are most likely to suffer from a greater number of _____episodes and these episodes are _____

A
  • depressive episodes
  • longer and more severe
73
Q

Men in bipolar disorder are more likely to experience a greater number of ______ episodes compared to women

A

manic episodes

74
Q

Major depressive disorder is differentiated from bipolar disorder due to the absence of?

A
75
Q

Mania is defined as an abnormally elevated or ________ mood.

A
76
Q

Major depressive disorder is characterized by symptoms such as inappropriate ________, increased _________, decreased need for _______, and ______ thoughts.

A

Elation

irritability

sleep

grandiose

77
Q
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physiology test 3 (11 decks)

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