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Psychiatry > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

Treatment for Atypical Depression

A

MAOIs are particularly useful

SSRIs may also be effective

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2
Q

Atypical Depression is marked by:

A 
hypersomnia
hyperphagia
reactive mood
leaden paralysis
hhypersensitivity to interpersonal rejection
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3
Q

Seasonal Affective Disorder

A

At least 2 consecutive years of 2 MDD episodes during the same season in both years

*Winter is the most common Season

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4
Q

Triad for Seasonal Affective Disorder

A

Irritability
Carbohydrate Craving
Hypersomnia

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5
Q

Treatment for Seasonal Affective Disorder

A

Light Therapy
Standard Antidepressants
Preventative Therapy with Extended Release Bupropion

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6
Q

Rapid Cycling Specifier for mood disorders

A

Have had at least 4 major episodes of MD, manic, hypomanic or mixed episodes during the past 12 months

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7
Q

What kinds of drugs worsen depression?

A

Reserpine: depletes monoamines

Used as antihypertensive and antipsychotic by blocking NE to decrease BP or agitation

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8
Q

Tachyphylaxis

A

Used to describe a patient as Treatment refractory for depression

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9
Q

Selegiline

A

MAOI that inhibits MAO-B, unlike other MAOIs that inhibit MAO-A

At low doses or with transdermal patch, patient does not need to have diet restrictions to tyramine

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10
Q

Important Reaction with MAOI use

A

Tyramine Crisis: from consumption of cheese, wines, smoked meats, liver

Leads to hypertensive crisis, stroke, and death

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11
Q

Treatment for tyramine hypertensive crisis

A 
IV phentolamine (5mg)
alpha blockers

**PTs with difficult access to care should carry 10mg tablets of nifedipine (alpha blocking properties to decrease BP)

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12
Q

What medication should be discontinued prior to ECT?

A

Benzodiazepines

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13
Q

In ECT seizure should last

A

30-90 seconds

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14
Q

In ECT, if seizure lasts longer than 2 minutes what should be done?

A

Terminate seizure with IV Lorazepam (1-2mg)

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15
Q

Most troublesome long term side effect of ECT

A

Memory Impairment: Anterograde and Retrograde Amnesia

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16
Q

PTs with mixed episodes of mania have a poorer response to ________ so consider using _______

A

Poorer response to Lithium

Consider anticonvulsants

17
Q

What population of patients are at very high risk for developing depression?

A

Stroke Patients
Pancreatic Cancer also has a high association with depression
The Elderly

18
Q

What are the two most common kinds of sleep disturbances associated with depression?

A

Initial insomnia: difficulty falling asleep

Terminal insomnia: early morning awkenings

19
Q

What childhood factor is associated with the later development of depression?

A

Loss of a parent before the age of 11

20
Q

How long does it take for antidepressants to start working?

A

Usually 4-8 weeks, this should be the trial period

21
Q

What is Serotonin Syndrome?

A

Marked by autonomic instability, hyperthermia, and seizures

Can progress to rhabdomyolysis, renal failure, coma and death

*Risk factor is combo of MAOI and SSRI, or not allowing sufficient tapering time between switching from SSRI to MAOI and vice versa

22
Q

MDD with melancholic features

A 
Anhedonia
Early morning wakening
psychomotor disturbance
excessive guilt
aonrexia

*40-60% of hospitlized MDD patients

23
Q

MDD with Catatonic features

A 
Catalepsy
Purposeless motor activity
Extreme negativism or mutism 
Bizarre postures
Echolalia
24
Q

MDD with psychotic features

A

Characterized by presence of delusions or hallucinations
May be mood congruent or incongruent
*10-25 % of hospitalized MDD patients

25
Q

Catatonic type of MDD is usually treated with

A

Concurrent antidepressants and antipsychotics

26
Q

Catatonic type of MDD is especially responsive to

A

ECT

27
Q

Catalepsy

A

Immobility

28
Q

The 5 stages of grief of the Kubler-Ross Model

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
29
Q

What psychiatric disorder has the highest genetic link of all psychiatric disorders?

A

Bipolar I

30
Q

Which anticonvulsants are used to treat bipolar?

A

Carbamazepine
Valproate

*Act as mood stabilizers

31
Q

Anticonvulsants are especially useful for what kind of Bipolar Disorder?

A

Rapid Cycling BP

Also Mixed Episode BP

32
Q

Anticovulsants in the treatment of bipolar is associated with increased risk of:

A

suicide

33
Q

Which atypical antipsychotics are used in bipolar disorder and for what purpose?

A

Olanzapine, Quetiapine, Ziprasidone

Used to treat acute manic episodes

34
Q

Double Depression

A

PTs with major depressive disorder with dysthymic disorder during residual periods

35
Q

Post-Partum Major Depression has onset of

A

within 4 weeks after delivery, but can have onset just prior to giving birth

Psychiatry (6 decks)

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