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Clinical Medicine > Screening Tools and Diagnostic Criteria > Flashcards

Screening Tools and Diagnostic Criteria Flashcards

1
Q

What is the screening tool(s) for Depression? What should happen if a patient tests postive?

A

PHQ 2–> PHQ 9
*Patient testing positive on PHQ 9 should be confirmed with DSM-V to diagnose depression and then be offered treatment

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2
Q

a score of 1-4 on the PHQ 9 shows signs of

A

minimal depression

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3
Q

a score of 5-9 on the PHQ 9 shows signs of

A

mild depression

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4
Q

a score of 10-14 on the PHQ 9 shows signs of

A

moderate depression

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5
Q

a score of 15-19 on the PHQ 9 shows signs of

A

moderately severe depression

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6
Q

a score of 20-27 on the PHQ 9 shows signs of

A

severe depression

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7
Q

what are some of the purposes of PHQ 9

A

-measuring severity
-diagnosis (with DSM-V)
-monitoring response to treatment (repeated every 4-6 weeks)

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8
Q

what needs to be ruled out to diagnose depression?

A

-symptoms are not due to another medical condition:
hypothyroid, anemia, sleep disorder
-symptoms are not due to the physiology effects of a substance/drug
-rule out bereavement
-rule out manic/hypomanic episode

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9
Q

in the elderly, what is the method of diagnosing depression? what is considered a positive screen?

A

start with PHQ-2, if positive move to:
-five item geriatric depression scale (GDS5)
-15 item geriatric depression scale (or PHQ 9)
2 positive answers suggest depression

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10
Q

what is GAD-7 screening for?

A

generalized anxiety disorder

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11
Q

When is further evaluation recommended for a GAD 7 screening

A

when the score is 10+

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12
Q

What three other common anxiety disorders is GAD 7 moderately good at screening?

A

-panic disorder
-social anxiety disorder
-post-traumatic stress disorder

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13
Q

What is the MDQ screening for?

A

Bipolar disorder

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14
Q

what is a positive screen for the MDQ

A

-When yes is checked to 7+ items
- yes to question #2 “moderate to severe impairment”

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15
Q

which Bipolar disorder is the MDQ better at screening?

A

Bipolar 1
-not as sensitive to bipolar Ii

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16
Q

why screen for bipolar disorder?

A

-getting clear indicators of mood instability
-patients are difficult to interview in a linear fashion
- hx of failed antidepressant trials
-significant agitation, irritability, anger on presentation
family history of bipolar disorder

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17
Q

what are the substance abuse screening tools?

A

AUDIT- C
DAST- 10
NIAAA- single item screening

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18
Q

When is the NIAAA single item screening positive?

A

test is positive if response is >1
* when women have had more than one day (having 4 or more drinks in a day)
*when men have had more than one day having 5 or more drinks in a day)

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19
Q

When is an AUDIT-C (alcohol use disorder identification test) positive?

A

positive for women = 3+
positive for men = 4+

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20
Q

what is CAGE screening for?

A

alcohol use

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21
Q

DAST 10 is screening for?

A

illicit substance use

22
Q

limitations to psychiatric surveys

A

-self report- under or over-reporting
-concern for stigma
-health literacy- reading, understanding, answering accurately
-PHQ9 and GAD7 are available in 50 languages, but there may be variation in interpretation
-tests have high sensitivity/ specificity overall, but none are perfect

23
Q

DSM-5 criteria for major depression disorder

A

Five or more symptoms have been present during the same TWO WEEK period and represent a change from previous functioning; at least one of the symptoms is
-depressed mood,
-lost of interest or pleasure

24
Q

what does the pneumonic SIGECAPS stand for?

A

-sleep disturbance
-decrease interest or pleasure
-excessive guilt or feelings or worthlessness
-energy complaints/fatigue
-concentration/attention problems
-appetite changes
-psychomotor changes
-suicidal ideation

25
Q

depressed mood for most of the day, for more days than not, for at least two years: diagnosis?

A

dysthymia (persistent depressive disorder)

26
Q

when depressed with dysthymia, a patient will have have two or more of the following symptoms?

A

-poor appetite or overeating
-decreased or increased sleep
-fatigue or low energy
-reduced self-esteem
-decreased concentration or problems making decisions
-feelings of hopelessness

27
Q

symptoms of dysthymia cannot be absent for how long?

A

symptoms are never absent longer than two consecutive monts

28
Q

development of emotional or behavioral symptoms in response to identifiable stressor (s) occurring within THREE months of onset of stressor

A

adjustment disorder

29
Q

what is adjustment disorder?

A

stressor causes significant functional impairment or causes distress out of proportion to the severity or intensity of the stressor

30
Q

does adjustment disorder meet the criteria for major depression? what does it exclude? when do symptoms stop?

A

1.No it does not meet the criteria
2. it excludes bereavement
3. once the stressor is terminated, symptoms do not persist more than additional 6 months

31
Q

what are some conditions that cause depression?

A

thyroid dysfunction
parkinson’s disease
huntington’s disease
multiple sclerosis
HIV
other endocrine disorders

32
Q

what are some medications that may worsen depression?

A

steroids
interferon
chantix (smoking medication)
contraceptives
some beta blocker and
calcium channel blockers

33
Q

Belief that some group/ wishes to harm, harass, or kill them

A

persecutory

34
Q

belief that a random or neutral gesture, event, or cue holds special meaning to self
*i.e, commonly believes that certain words or songs on TV are meant to deliver a special message to the individual)

A

referential

35
Q

belief that individual has specific significance, power, knowledge

A

grandiose

36
Q

false belief that another person, group, or external force can control one’s thoughts, feelings, impulses or behaviors

A

Control

37
Q

making up words

A

neologism

38
Q

rhyming all the words without apparent logical connection

A

clang

39
Q

repetition of words or ideas

A

Perseveration

40
Q

presents for at least 1 day but less than 1 month
- has to have one of the following: delusions, hallucinations, disorganized speech, grossly disorganized catatonic behavior
but returns to full remission of symptoms and premorbid level of functioning within 1 month of onset

A

Brief psychotic disorder

41
Q

presents with the same symptoms of schizophrenia but symptoms last between 1 and 6 months

A

Schizophreniform disorder

42
Q

presense of one or more non-bizarre delusions for at least 1 month (i.e, situations that could happen in real life, being stalked, poisoned, etc.)
Criteria A for schizophrenia never met
only has delusions without any hallucinations, disorganized speech, catatonic behavior or negative symptoms

A

Delusional disorder

43
Q

meets criteria for major depressive disorder episode, mania or mixed episode, DURING which criteria for schizophrenia is ALSO met. (Mixture of psychotic AND mood symptoms)

A

schizoaffective disorder

44
Q

psychosis due to medical condition

A

secondary psychotic disorder

45
Q

reduced motivation towards goals or desire, reduced ability to complete everyday tasks (may have poor hygiene)

A

avolition

46
Q

diminished speech

A

alogia

47
Q

reduced social drive, lack of sexual interest

A

a-sociality

48
Q

lack of pleasure in previous hobbies or interest

A

anhedonia

49
Q

reduced range of of emotions, feeling numb or empty inside

A

affective blunting

50
Q

monitor for tardive dyskinesia with

A

AIMS test periodically

51
Q

what is a mixed episode

A

an episode with simultaneous manic and depressive symptoms
-requires full criteria of mania/ hypomania and three depressive symptoms
often misdiagnosed as agitated depression

52
Q

insomnia disorder is described as

A

sleep difficulty occurs at least 3 nights per week and is present for at least 3 months

Clinical Medicine (5 decks)

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