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Step 2 Psychiatry > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

Define Mood Disorder

A

1 or more major depressive episodes

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2
Q

Onset of MDD

A

usually in mid 20s

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3
Q

Male-to-female ratio for mood disorder

A

1:2

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4
Q

Symptoms of depressive episode

A

Sleep; Interest(decreased); Guilt; Energy (decreased); Concentration (decreased); appetite or weight; Psychomotor agitation or retardation; Suicide ideation

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5
Q

Requirement for MDD

A

depressed mood or anhedonia and 5 more S&S from SIG E CAPS for 2-week period

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6
Q

Atypical Depression

A

weight gain, hypersomnia, and rejection sensitivity

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7
Q

Postpartum Depression

A

Occurs within 1 month postpartum, psychotic symptoms are common

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8
Q

Seasonal Depression

A

Depressive episodes during a particular seasons, usually in the winter. Responds well to light therapy +/- antidepressants

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9
Q

Double Depression

A

major depressive episode in a patient with dysthymia. Has poorer prognosis that MDE alone

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10
Q

Pharmacotherapy Timeframe for MDD

A

effective in 50-70% patient, allow 2-6weeks to take effect; treat for 6+ months

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11
Q

Pharmacotherapy for MDD (drug classes)

A

SSRIs, Atypicals, SNRIs, TCAs, MAOIs

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12
Q

Best treatment combination for MDD

A

Pharmacotherapy + Psychotherapy

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13
Q

When to use ECT

A

Refractory depression or psychotic depression, or if rapid improvement in mood is needed; also used for intractable mania and psychosis

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14
Q

Adverse Effects of ECT

A

postictal confusion, arrhythmias, HA, and anterograde amnesia

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15
Q

TCA toxicity

A

3 C’s; Convulsions, Coma, Cardiac Arrhythmias

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16
Q

Medical conditions that can cause mood disorder

A

hypothyroid, parkinson, CNS neoplasm, ceoplasms, stroke (esp ACA), dementias, parathyroid

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17
Q

Substances that can cause mood disorders

A

illicit drugs, alcohol, antihypertensives, corticosteroids, OCPs

18
Q

A constellation of symptoms that resemble MDE but do not meet the criteria for MDE. Occurs within 3 onths of an identifiable stressor

A

Adjustment disorder with depressed mood

19
Q

Timeframe for normal bereavement

A

after loss of loved one, no severe impairment/suicidality. Should last

20
Q

milder, chronic depression with depressed mood present most of the time for at least 2 years; often resistent to treatment

A

Dysthymia

21
Q

Contraindications of ECT

A

MI/stroke, intracranial mass, and high anesthetic risk

22
Q

Length of time to wait to start MAOI if patient was on fluoxetine

A

5 weeks

23
Q

Length of time to wait to start MAOI if pateint was on SSRIs

A

2 weeks

24
Q

Time of onset for postpartum blues

A

within 2 weeks of delivery

25
Q

Sadness, moodiness, emotional lability. No thoughts about hurting the baby.

A

Postpartum “blues”

26
Q

Time of onset for postpartum psychosis

A

2-3 weeks postdelivery

27
Q

Delusions and depression after giving birth. May have thoughts about hurting the baby.

A

Postpartum psychosis

28
Q

Time of onset postpartum depression

A

1-3 months postdelivery

29
Q

Delusions and depression, sleep disturbances and anxiety, thoughts about hurting the baby

A

Postpartum depression

30
Q

Average age of onset for bipolar and gender preference

A

20y/o; male and female are equal

31
Q

Bipolar I

A

Involves at least 1 manic or mixed episode (usually requires hospitalization)

32
Q

Bipolar II

A

Involves at least 1 MDE and 1 hypomanic episode

33
Q

Rapid cycling

A

Involves 4+ episodes (MDE, manic, mixed, or hypomanic) in 1year

34
Q

Cyclothymic

A

Chronic and less severe, alternating periods of hypomania and moderate depression for >2years

35
Q

Symptoms of Mania

A

DIG FAST
Distractibility, Insomnia, Grandiosity/Goal directed, FLight of ideas, Acitivities/Agitation, Sexual indiscretions, Talkativeness/pressured speech

36
Q

Describe a manic episode

A

1 week or more of persistently elevated, expansive, or irritable mood plus 3 DIGFAST symptoms (can have psychotic symptoms)

37
Q

Acute therapy for bipolar mania

A

Antipsychotics

38
Q

Maintenance therapy for bipolar mania

A

mood stabilizers such as lithium, carbamazepine, valproic acid, lamotrigine

39
Q

Drug for refractory agitation associated with bipolar mania

A

Benzodiazepines

40
Q

Treatment for bipolar depression

A

Mood stabilizers 1st and then add an antidepressant to avoid inducing mania
ECT for refractory cases

41
Q

Treatment for patients with severe depression or bipolar II with predominantly depressive features

A

Augment antidepressants with low-dose lithium (blood levels 0.4-0.6mEq/L)

Step 2 Psychiatry (7 decks)

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