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Y3 Pyschiatry > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

Up to 1/3 of stroke PTx have major depression. T or F

A

T

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2
Q

65% of PTx post MI have depressive symptoms. T or F

A

T

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3
Q

Which area of the brain has a decreased volume in depression?

A

hippocampus

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4
Q

Typical depression has a _____ variation, and it worse in the _____

A

diurnal

morning

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5
Q

Is memory effected in depression?

A

yes it can be

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6
Q

What psychotic symptoms can depression cause?

A

2nd person auditory hallucinations

delusions (eg. hypochondriasis, poverty, guilt, nihilism)

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7
Q

How would someones mood be in depression in a MSE?

A

flat, unhappy, empty

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8
Q

How would someones affect be in depression in a MSE?

A

depressed, decreased range, decreased reactivity

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9
Q

Depression can cause ____ retardation, ____ weight, and patients ____ have insight

A

Depression can cause psychomotor retardation, decreased weight, and patients do have insight

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10
Q

How long must depression be present for a dx?

A

most of the time, every day for 2 weeks

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11
Q

What conditions should you be careful to exclude when diagnosing depression?

A

bipolar, thyroid disorder

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12
Q

Many of the side effects from antidepressants are transient. T or F

A

true

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13
Q

In the Mx of depression, if a drug is not providing adequate response, what are the possible explanations?

A

wrong Dx
wrong dose
wrong drug
compliancy

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14
Q

What is the 1st line Mx in depression if a patient isn’t eating or drinking

A

ECT

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15
Q

What is the 1st line Mx in depression if a patient has a very high suicide risk?

A

ECT

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16
Q

What area of the brain does ECT stimulate?

A

hippocampus

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17
Q

ECT induces a _____ lasting _____

A

seizure

15-20 seconds

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18
Q

What are the side effects of ECT?

A

tension HA
short term cognitive dysfunction / amnesia
myalgia
tooth damage

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19
Q

What are the contraindications to ECT?

A

phaeochromocytoma
MI last 3mth
recent CVA
brain SOL

20
Q

What type of depression causes anhedonia, decreased reactivity, wake 2hr early, worse morning wakening, psychomotor disturbance, <5% wt and a loss of libido?

A

Somatic depression

21
Q

Atypical depression causes a mood thats ____ following a positive event, _____ sleeping, _____ paralysis and _____ weight

A

Atypical depression causes a mood thats better following a positive event, increased sleeping, leaden paralysis and increased weight

22
Q

_____ syndrome is a form of psychotic depression that occurs in the ____ age group. an example would be “I can’t eat because my bowel’s have turned to dust”

A

Cotard syndrome

elderly

23
Q

Postnatal depression affects ____ women

A

1 in 10

24
Q

How long postpartum does postnatal depression occur?

A

1-4wks postpartum

25
Q

What type of psychotherapy stems around changing your behaviour & you’ll change your thoughts, to combat ‘thinking errors’?

A

CBT cognitive behavioural therapy

26
Q

What type of psychotherapy focuses on lifestyle changes, the importance of having therapy etc.? It should be a part of every consultation

A

psychoeducation

27
Q

What is bipolar disorder with mixed features?

A

patients exhibit symptoms of mania/ hypomania at the same time as depressive symptoms

28
Q

What is cyclothymia?

A

milder form of bipolar disorder where patients have alternating periods of elevated and low moods

29
Q

What is rapid cycling bipolar disorder?

A

patients rapidly switch between episodes of mania and depression (i think - double check this)

30
Q

What is the peak age range for diagnosis of bipolar disorder?

A

17-25 years

31
Q

How long does hypomania last in bipolar disorder? (without Tx)

A

4+ days

32
Q

How long does mania last in bipolar disorder? (without Tx)

A

> 1 week

33
Q

What is the difference in presentation between mania and hypomania?

A

hypomania has no psychotic symptoms and patients will likely still be functioing

34
Q

Is insight present in mania and hypomania?

A

no

35
Q

What psychiatry term describes speech in mania?

A

pressure of speech

36
Q

Describe someone’s mood in mania

A

expansive
elevated
irritable

37
Q

What drug class should you try and avoid in the management of bipolar disorder?

A

antidepressants

38
Q

In the management of acute mania in bipolar disorder, should you stop their maintenance antipsychotic?

A

no, increase dose

39
Q

Which antipsychotics are 1st line in the management of acute mania in bipolar disorder?

A

PO olanzapine, quetiapine, risperidone

40
Q

Which drugs are 2nd line in the management of acute mania in bipolar disorder?

A

lithium, valproate, carbamazepine

41
Q

What is the management of agitation in acute mania in bipolar disorder?

A

benzo

42
Q

What is the 1st line Mx of depressive symptoms in bipolar disorder? And what is the adjunct therapy?

A

antipsychotic quetiapine or olanzapine +- fluoxetine SSRI

also lamotrigine

43
Q

What are the advantages and disadvantage of lamotrigine in the Mx of depressive symptoms in bipolar disorder?

A

slow to produce effect

less transient SEs

44
Q

What is the 1st choice of maintenance medication in the Mx of bipolar disorder?

A

atypical (2nd gen) antipsychotic OR lithium

45
Q

What must you monitor in prescribing Lithium?

A

U+Es, TFTs, Ca

46
Q

What drugs that aren’t antipsychotics can be tried as maintenance medication in the management of Tx resistant bipolar disorder?

A

lamotrigine and valproate (both AEDs)

Y3 Pyschiatry (15 decks)

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