PSYCH 123 Depression

Question 1

What defines mild depression?

Answer 1

2 core symptoms + 2 others

Question 2

What defines moderate depression?

Answer 2

2 core symptoms +3/4 others

Question 3

What defines severe depression?

Answer 3

Core symptoms are severe and 4 others that are intense. Can be +/- psychotic symptoms

Question 4

What is step 1 of the stepped care model for management of depression?

Answer 4

Assessment and signposting

Question 5

For who would step 2 of the stepped care model for managing depression apply? How would you manage?

Answer 5

Those with persistent sub-threshold symptoms of mild/moderate depressions
Manage with self help e.g. CBT

Question 6

What would you start/implement if there are inadequate responses to interventions?

Answer 6

Antidepressants and high intensity psychological intervention.

Question 7

Where are neurotransmitters synthesized?

Answer 7

Neurones

Question 8

Where are most neurotransmitters located (excluding endocannabinoids)?

Answer 8

In the presynaptic terminal

Question 9

What happens when there is prolonged stimulation at Glutamate receptors?

Answer 9

Hyper-excitability: seizures and strokes

Question 10

What happens when Glutamate receptors are blocked and give an example of what they are commonly blocked by?

Answer 10

Sedation

Alcohol and Ketamine

Question 11

What Glutamate receptors are permeable to both Calcium and Sodium?

Answer 11

Kainate and NMDA

Question 12

What glutamate receptor is only permeable to Sodium?

Answer 12

AMPA

Question 13

What is the main inhibitory neurotransmitter in the nervous system?

Answer 13

GABA

Question 14

What drugs activate GABA receptors?

Answer 14

Benzodiazepines, lorazepam and alcohol

Question 15

What happens when GABA receptors are blocked?

Answer 15

Hyper-excitability

Question 16

What do astrocytes do?

Answer 16

Act as support cells or for damage repair

Question 17

What do oligodendrocytes do?

Answer 17

Myelinate nerve cells

Question 18

What are microglia?

Answer 18

Macrophages of the nervous system

Question 19

What do ependymal cells make and where are they found?

Answer 19

They make CSF and are epithelial cells lining the ventricles

Question 20

Where are the cell bodies of the neurones that make serotonin?

Answer 20

In the raphe nucleus

Question 21

Where is serotonin stored in the GI tract and what does its release trigger?

Answer 21

Enterochromaffin cells and triggers peristalsis

Question 22

Name a drug that activates and another that blocks the 5HT2A receptor.

Answer 22

Activates: LSD

Blocked by: clozapine - an atypical antipsychotic

Question 23

What is sumatriptan and what receptor does it activate?

Answer 23

It is a migraine treatment and activates 5HT1B

Question 24

What is the only serotinergic ionotropic receptor and name a drug that blocks it

Answer 24

5HT3 and is blocked by ondanseton an antiemetic

Question 25

Name a contraindication in the prescription of SSRI’s

Answer 25

Under 18 ( increased risk of suicide),

Question 26

Name briefly the mechanism of action of SSRI’s and give an example of two

Answer 26

They inhibit the synaptic reuptake of serotonin.

Citalopram and fluoxetine

Question 27

Name an SNRI

Answer 27

Tramadol or sibutramine

Question 28

Name a specific cardiac complication with citalopram

Answer 28

Prolonged QT interval

Question 29

Name some side effects of SSRI’s

Answer 29

Hyponatraemia, nausea, anaemia, GI distrubances, loss of libido

Question 30

In the cholinergic system where do the basal forebrain cholinergic neurones project to? What processes are they involved in?

Answer 30

The cortex and hippocampus.

Memory and cognition

Question 31

Where do the cholinergic neurones of the basal stem tegmenteum project to and what are they involved in?

Answer 31

Thalamus, brainstem and cerebellum

Arousal and the sleep wake cycle

Question 32

What two classes of receptor are there in the cholinergic system?

Answer 32

Nicotinic (ionotropic and excitatory) and Muscarinic (metabotropic)

Question 33

Name disorders that are to do with dopamine

Answer 33

Schizophrenia, Parkinsons and Tourrettes

Question 34

Where is noradrenaline made?

Answer 34

locus coerulus

Question 35

Name a tricyclic antidepressant

Answer 35

Amitryptilline, butryptilline

Question 36

How do TCA’s work?

Answer 36

Inhibit reuptake of NT (NA) by competing for binding at the presynaptic neurone

Question 37

Name some anti-muscarinic side effects of TCA’s

Answer 37

blurred vision, dry mouth, constipation and urinary retention

Question 38

Name some side effects as a result of blocking the alpha-1 receptor

Answer 38

Postural hypotension, tachycardia, ventricular dysrhythmias and prolonged QT interval

Question 39

Name some contraindications of TCA prescription

Answer 39

prostatism, narrow angle glaucoma, recent MI, heart block

Question 40

Where are endogenous opioids made and where do they project?

Answer 40

Hypothalamus –> peri-aqueductal grey and brainstem

Question 41

Name the 3 classes of opioids

Answer 41

Enkephalins, Dynorphins and endorphins