depression

Question 1

mean age of onset?

Answer 1

20s

Question 2

reduced function of which systems in the brain?

Answer 2

serotonin and noradrenergic

Question 3

3 main symptoms

Answer 3

low mood
anhedonia
anergia

Question 4

differential diagnosis?

Answer 4

hypothyroid, cushings, steroids, b blockers

Question 5

chronic mild depression for a minimum of 2 years in which episodes are either not long enough or severe enough to meet criteria for depression?

Answer 5

dysthymia

Question 6

what investigations can you do?

Answer 6

FBC, LFT, TFT

Question 7

classification of depression?

Answer 7

mild
moderate
severe 
mixed 
atypical

Question 8

In distress but able to continue with activities of daily living?

Answer 8

mild depression (need 2 core symptoms and 2 additional symptoms)

Question 9

need 2 core symptoms and 4 additional symptoms. associated with difficulty carrying out activities of daily living

Answer 9

moderate

Question 10

what is mixed depression ?

Answer 10

depression mixed with GAD

Question 11

severe depression definition ?

Answer 11

2 core symptoms + 4 additional symptoms. Associated with hopelessness, worthlessness, suicidal ideation, somatic symptoms and complete inability to carry out activities of daily living

Question 12

what is atypical depression?

Answer 12

biological symptoms are reversed. There is an associated increase in sleep, appetite and weight

Question 13

what is ECT reserved for?

Answer 13

very treatment resistant or life saving

Question 14

TCA - what might you see on ECG?

Answer 14

QT prolongation

Question 15

what is the normal QT time?

Answer 15

0.36-0.44 seconds

Question 16

what is serotonin syndrome ?

Answer 16

consumption of excessive amounts or multiple drugs that causes increase in amount of serotonin

Question 17

what drugs can cause serotonin syndrome?

Answer 17

SSRI, TCA, MAOI, amphetamine, opioids, anti consultants, triptans, lithium.

Question 18

what would a patient with SS present like ?

Answer 18

dilated pupils, nausea, diarrhoea, tachycardia, twitching, tremor, rigidity, hyper reflexia

Question 19

Investigation of SS?

Answer 19

toxicology screen

Question 20

management of SS?

Answer 20

stop drugs
supportive treatment
measures to cool patient
benzos to reduce anxiety and sedate the patient

Question 21

minimum duration for duration of symptoms to be classified as depression?

Answer 21

2 weeks

Question 22

safest TCA in overdose?

Answer 22

lofepramine

Question 23

ECT therapy - is there any risk of epilepsy from this?

Answer 23

no

Question 24

in older people, depression can manifest in ?

Answer 24

physical symptoms