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Prodigy Quick Review > Psychiatric Disorders > Flashcards

Psychiatric Disorders Flashcards

1
Q

How does one distinguish ordinary grief and sadness

from depression?

A

By the length and degree of the disturbances in mood
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 533-534.

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2
Q

Describe characteristics associated with major

depression.

A

Fatigue, worthlessness or guilty feelings, restlessness,
hypersomnia or insomnia, difficulty concentrating, suicidal
thoughts, fluctuating body weight and appetite, depressed
mood, lack of pleasure or interest in most all activities
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 534.

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3
Q

What psychiatric disorder is characterized by

depression and manic episodes?

A

Bipolar disorder or manic-depressive disease
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 538-539.

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4
Q

What percentage of patients who have major

depression commit suicide?

A

15%
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 533.

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5
Q

In order for ECT treatments to elicit a therapeutic
effect, how long must the electrically-induced seizure
last?

A

At least 25 seconds
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 537.

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6
Q

In what patient populations is ECT indicated?

A

Patients with severe depression who are suicidal, and patients
who are unresponsive to antidepressant medication.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 537.

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7
Q

What is the most common psychiatric disorder?

A

Depression
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 534.

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8
Q

Describe bipolar disorder.

A

Patients with bipolar disorder have excessive mood swings,
ranging from depression to episodes of mania. Normal
behavior often occurs in between these episodes.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 538-539.

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9
Q

What are the treatments commonly used for

depression?

A

Electroconvulsive therapy (ECT), antidepressants,
psychotherapy
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 534-535.

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10
Q

Are the cardiovascular side effects seen with ECT
caused by stimulation of the sympathetic or
parasympathetic nervous system?

A

Both. There is a 10-15 second stimulation of the
parasympathetic nervous system in which bradycardia and
hypotension occur, followed by hypertension and tachycardia
that lasts for several minutes as a result of sympathetic nervous
system activation.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 537.

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11
Q

What are the two most common causes of death

related to ECT treatment?

A

Cardiac dysrhythmias and myocardial infarction
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 537-538.

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12
Q

List side effects associated with ECT.

A

Hypotension and bradycardia (caused by parasympathetic
activation), tachycardia and hypertension (caused by
sympathetic activation), increased intragastric pressure,
increased ICP, increased IOP, an increase in cerebral blood
flow, cardiac dysrhythmias
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 537.

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13
Q

What is the most common drug used for induction of

anesthesia with ECT?

A

Methohexital 0.5-1.0 mg/kg IV
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 538.

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14
Q

What is the disadvantage to the use of propofol

during ECT?

A

It has anticonvulsant properties, thus reducing the duration of
the induced seizure.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 538.

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15
Q

How do antipsychotic medications used to treat

schizophrenia affect anesthesia?

A

The anesthesia provider must be mindful of the effects caused
by antipsychotic medications. These effects include QT interval
prolongation that can lead to torsades de pointes, sedation that
may lessen anesthetic requirements, seizures, elevation of
hepatic enzymes, and postural hypotension caused by alpha
adrenergic blockade
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 539-540.

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16
Q

What are the signs and symptoms of neuroleptic

malignant syndrome?

A

Severe muscle rigidity, hyperpyrexia, tachycardia,
dysrhythmias, hypertension, acidosis, diminished
consciousness, and rhabdomyolysis. Dehydration and
myoglobinuria can lead to renal failure.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 540.

17
Q

What is neuroleptic malignant syndrome?

A

A rare complication of antipsychotic drug treatment that is
potentially fatal and is hypothesized to be caused by central
nervous system depletion of dopamine.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 540.

18
Q

What are the four subtypes of schizophrenia?

A
  1. Disorganized 2. Catatonic 3. Paranoid 4. Undifferentiated
    Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
    6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 539.
19
Q

Schizophrenia has both positive and negative

symptoms. Describe both of these categories.

A

The positive symptoms of schizophrenia represent the distorted
sense of reality and exaggeration of normal behavior associated
with the disease and include such symptoms as hallucinations
and delusions. The negative symptoms reflect the decline in
normal function and encompass such symptoms as apathy,
flattened affect, changes in hygiene and apperance, and
occupational or social withdrawal.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 539-540.

20
Q

What is the treatment for bipolar disorder?

A

Episodes of mania warrant immediate pharmacologic treatment,
most often in the hospital setting in order to protect patients
from their harmful actions. Lithium is the hallmark
pharmacologic agent used, however antiepileptic and
antipsychotic drugs may also be used.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 539.

21
Q

Why is succinylcholine used during anesthesia for

ECT?

A

To lessen the magnitude of skeletal muscle contractions and
associated bone fractures that occur during seizure activity.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 537.

22
Q

When does neuroleptic malignant syndrome usually

occur?

A

Although it can occur at any point during the treatment with
antipsychotic drugs, it usually occurs within the first few weeks
of treatment, or when there is an increase in the dose of the
drug.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 540.

23
Q

What is the most common long-term effect

associated with the use of ECT?

A

Memory impairment
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 537.

24
Q

Why is methohexital the standard induction drug

used with ECT?

A

It has very little anticonvulsant effects, and it has a rapid onset
and recovery.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 537.

25
Q

What is serotonin syndrome and what can cause it?

A

Serotonin syndrome can occur due to ingestion of large
quantities of medications such as SSRI’s, MAOI’s, cyclic and
atypical antidepressants, cough medicines, drugs used to treat
migraine headaches, weight reduction drugs, opiates, and illicit
drugs such as ‘Ecstasy’. Symptoms are related to autonomic
hyperreactivity and include: hyperreflexia, delirium, clonus,
agitation, and hyperthermia.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 535.

26
Q

List characteristics of mania.

A

Flight of ideas, distractibility, inflated self-esteem, euphoric
mood, decreased sleep requirement, psychomotor agitation,
excessive talking
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 539.

27
Q

What is the treatment for neuropleptic malignant

syndrome?

A

The immediate discontinuation of antipsychotic medications and
supportive therapy such as cooling the body, hydration, and
ventilation.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 540.

28
Q

What is the cause of death in patients with

neuroleptic malignant syndrome?

A

Congestive heart failure, renal failure, cardiac dysrhythmias, or
hypoventilation
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 540.

29
Q

List the symptoms that accompany anxiety disorders.

A

Insomnia, nervousness, somatic complaints, and
hypochondriasis.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 540-541.

30
Q

What symptoms are associated with panic disorders?

A

Diaphoresis, paresthesias, tachycardia, dyspnea, chest pain,
nausea, and a fear of dying. Such symptoms can be
misconstrued as true medical conditions like epilepsy and
angina pectoris.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 540-541.

31
Q

List drug classes used in the treatment of panic

disorders.

A

MAOIs, SSRIs, cyclic antidepressants, and benzodiazepines
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 540-541.

Prodigy Quick Review (186 decks)

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