Mood Disorders

Question 1

Anhedonia, weight loss, sleep changes, poor concentration, worthlessness, thoughts of death, fatigue. Dx? Rx?

Answer 1

Major depressive disorder (at least 5 SIGE CAPS.) SSRI is first line. (fluoxetine, paroxetine, citalopram, escitalopram, setraline)

Question 2

First line treatment for neuropathic pain and depression?

Answer 2

Duloxetine (SNRI)

Question 3

First line of treatment for depression when person has fear of weight gain and sexual dysfunction?

Answer 3

Bupropion ( No sexual side effects)

Question 4

Mania and depression? Hypomania and depression? Rx?

Answer 4

Bipolar type I(mania > 1 week and affects functioning.) and Bipolar type II (Hypomania < 1 week and does not affect functioning). Acute mania give lithium or valproic acid.

Question 5

Depressed mood and mild sadness that last for more than 2 years. Dx? Rx?

Answer 5

Dysthymia. Psychotherapy.

Question 6

Hypomania and mild depression for more than 2 years. Dx? Rx?

Answer 6

Cylothymia. Lithium or Valproate.

Question 7

Increased sleep, weight gain and increase appetite. (Couch potato) Dx? Ex?

Answer 7

Atypical depression SSRIs or MAOIs.

Question 8

Weight gain, increase sleep, depressed mood during the winter months. Dx? Rx?

Answer 8

SAD Seasonal Affective Disorder. Light therapy (Phototherapy)

Question 9

Sadness and mood lability, tearfulness after giving birth up to 2 weeks. Dx? Rx?

Answer 9

Postpartum blues. “Baby blues.” Supportive. Selft limited.

Question 10

Depressed mood, weight changes, sleep disturbances and excessive anxiety within 1-3 months after giving birth. Dx? Rx?

Answer 10

Postpartum Depression. Almost a prolongation of post partum blues with more severity. SSRIs.

Question 11

Depression, delusions and thoughts of harm towards baby within 2-3 weeks of giving birth. Dx? Rx?

Answer 11

Postpartum psychosis. Antipsychotics.

Question 12

When does grief considered major depression?

Answer 12

1. Morbid preoccupation with worthlessness. 2 Symptoms last longer than 2 months and adversely affects functioning.

Question 13

Name the disorder: Delusions and hallucinations for <1month? Rx?

Answer 13

Brief psychotic disorder. Self limited.

Question 14

Name the disorder: Delusions and hallucinations for 1 to 6 months?

Answer 14

Schizophreniform disorder.

Question 15

Name the disorder: Delusions and hallucinations for > 6 months.

Answer 15

Schizophrenia.

Question 16

Name the type of schizo: Delusions or hallucinations. Grandiose. Most common type of schizophrenia. Dx?

Answer 16

Paranoid.

Question 17

Name the type of schizo: Psychomotor disturbances ranging from retardation to excitation. Stupor, posturing, mutism, rigidity. Dx?

Answer 17

Catatonic

Question 18

Name the type of schizo: Marked regression to dis-inhibited behavior with little contact with reality. Disorganized speech and tangential thougths. Pts look disheveled and have bizarre emotional responses. Worse prognosis and earliest age of onset. Dx?

Answer 18

Disorganized

Question 19

Name the type of schizo: Lack of positive symptoms (hallucinations and delusions.) Still has presence of negative symptoms (flat affect, poor grooming, social withdrawal.) Dx?

Answer 19

Residual.

Question 20

Name the type of schizo: Does not meet criteria of other types of schizo. Dx?

Answer 20

Undifferentiated

Question 21

Pt has correct interpretation of reality but thinks stuff is still going on in the background (extreme conspiracy theorist) Still obeys, goes to work and pays bills. Dx?

Answer 21

Delusional Disorder.

Question 22

Pt presents with sweating, CP, trembling, chills, fear of dying and doom. Symptoms come on quickly and go away quickly. Dx? Rx?

Answer 22

Panic Disorder. Acute: Benzo Chronic: SSRI

Question 23

Thoughts that are intrusive, senselessness, distressing to the patient. Dx? Rx?

Answer 23

Obsessions. SSRI.

Question 24

Rituals, such as counting and check that are done to neutralize thoughts. Dx? Rx?

Answer 24

Compulsions. SSRI.

Question 25

Anxiety about everything, money, cars, food, people, school. Dx? Rx?

Answer 25

Generalized Anxiety Disorder. SSRIs: Venlafaxine and buspirone.

Question 26

1 symptom on most days for 12 months after death of loved one: Persistent longing for the deceased, Intense sorrow and emotional pain, preoccupation with the deceased, pre-occupation with circumstances of death. At leasts 6 symptoms on most days for 12 months: Cant accept the death, can reminisce on the god times, bitterness and anger, Self blame. Dx?

Answer 26

Persistent Complex Bereveament Disorder. Different from major depressive disorder because the symptoms occur after the death of a loved one.

Question 27

Which is a relative contraindication to ECT?

Answer 27

Space occupying lesions (tumor, blood, aneursym)

Question 28

What is commonly seen on PET scan on a patient with depression?

Answer 28

Reduced metabolic activity and blood flow in both frontal lobes on PET scan.

Question 29

An elderly man has been profoundly depressed for several weeks. He cries easily and is intensely preoccupied with trivial episodes from his past, which he considers unforgivable sins. This patient awakens every morning at 3 AM and cannot go back to sleep. Anything his family has tried and to cheer him up has failed. He has completely lost his appetite and appears gaunt and emaciated. Dx?

Answer 29

Melancholic Depression (loss of pleasure in all activities, lack of reactivity (nothing makes them feel better), intense guilt, significant weightloss, early morning awakenings and marked psychomotor retardation.)

Question 30

A young woman who has felt mildly unhappy and dissatisfied with herself for most of her life, has been severely depressed, irritable and anhedonic for 3 weeks. Dx?

Answer 30

Double Depression. (develops ina patient with dysthymic disorder.

Question 31

Non-bizzare delusions. Dx? Rx?

Answer 31

Delusional Disorder. Psychothrapy.