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NMSP Exam 1 > [CLMD] Mood Disorders [Hill] > Flashcards

[CLMD] Mood Disorders [Hill] Flashcards

1
Q

What are the (5) major neurotransmitters involved in mood disorders?

A

Norepinephrine

Dopamine

5-HT

GABA

Glutamate

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2
Q

What are the relative levels of dopamine during

(Depression)

and

(Mania)

A

Depression = Dopamine is LOW

Mania = Dopamine is HIGH

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3
Q

What are the levels of 5-HT during depression?

A

5-HT is LOW in depression

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4
Q

What is the major excitatory neurotransmitter of the CNS?

What is the major inhibitory neurotransmitter of the CNS?

A

Excitatory = Glutamate

Inhibitory = GABA

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5
Q

What is the definition of a major depressive episode?

A

At least (5) of the following for a 2-week period with at least one either (1) depressed mood or (2) loss of interest or pleasure

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6
Q

What is the gold standard questionaaire that is used in nearly every primary care office to assess for depression?

A

Patient Health Questionnaire (PHQ-9)

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7
Q

What is required for the diagnosis of major depressive disorder?

A

Diagnosis requires the presence of one or more major depressive episodes and the ABSENCE of any manic,hypomanic or mixed episodes

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8
Q

What are associated features with major depressive disorder (6)?

A

Psychotic

Anxious distress

Melancholic

Catatonic

Peripartum onset

Mixed features

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9
Q

What are the (5) stages of grieving?

A

Denial –> Anger –> Bargaining –> Depression –> Acceptance

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10
Q

What are some major categories of treatments for major depressive disorder??

A

Pharmacologic

Electroconvulsive therapy (ECT)

Transcranial magnetic stimulation

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11
Q

What is electroconvulsive therapy used for?

What is it?

A

Treatment resistant depression

Induces a seizure

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12
Q

Efficacy of electroconvulsive therapy (ECT)?

A

75-80% treatment response

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13
Q

What drug therapy has shown a 50% reduction in suicidal thoughts within 24 hours of major depressive disorder patients?

A

Ketamine

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14
Q

What is spravato?

A

Spravato aka esketamine

Nasal spray formulation of ketamine

Rapid acting and expensive

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15
Q

What is the name of the disorder related to this description:

Depressed mood for most of the day for at least 2 years in duration for adults and 1 year for children that has not been severe enough to meet criteria for a major depressive episode

A

Persistent depressive disorder (Dysthymia)

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16
Q

What is double depression?

A

Double depression = Dysthymic disorder + Major depression can occur simultaneously

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17
Q

What is depression w/ seasonal pattern?

A

Onset and remission of major depressive episodes at characteristic times of the year

Sleep more and eat more; fatigued

Light therapy is effective

18
Q

What is premenstrual dysphoric disorder (PMDD)?

A

Mood instability w/ anxiety, depression, irritability

Occur the week before menses

Treatment includes : (Exercise, diet, relaxation thearpy, SSRIs)

19
Q

Define a manic episode

A

Abnormally and persistently elevated, expansive or irritable mood lasting at least 1 week with at least three of the following:

  • Inflated self-esteem or grandiosity
  • Decreased need for sleep
  • More talkative
  • Flight of ideas/racing thoughts
  • Distractibility
  • Increased goal-oriented behavior
  • Excessive involvement iin pleasureable activities
20
Q

What is a hypomanic episode?

A

Similar to manic episode but it is less severe

Episodes only need to last 4 days and must not include psychotic features

No social/occupational impairment

21
Q

What is bipolar I disorder?

A

Single manic episode is necessary to diagnose

At least one manic or mixed episode

Can be psychotic episode, delusions and/or hallucinations

22
Q

Define bipolar II disorder?

Prevalence?

A

Patients have had at least one major depressive episode and one hypomanic episode in the absence of any manic or mixed episodes

More prevalent than Bipolar I

23
Q

What are the 1st line agents to treat bipolar disorders?

A

Mood stabilizers:

Lithium

Valproic Acid

24
Q

What is cyclothymic disorder?

A

Characterized as dysthymic disorder w/ intermittent hypomanic periods

Patient who over the last 2 years experiences repeated episodes of hypomania and depression (not severe enough to meet criteria for major depressive disorder)

25
Q

What is separation anxiety disorder?

A

Recurrent excessive stress when anticipating or experiencing separation from major attachment figures or home

26
Q

Describe a panic attack

A

A discrete period of intense fear or discomfort, in which four or more of the following developed abruptly and reached peak within 10 min and usually last <25 min

  • Palpitations
  • Sweating
  • Trembling/Shaking
  • Sensations of SOB
  • Chest pain/discomfort
  • Feeling dizzy
  • Fear of losing control
  • Paresthesia
  • Chills or hot flashes
27
Q

What is agoraphobia?

A

Anxiety about being in situations from which escape may be difficult or embarrassing or for which help may not be available in the event of panic

28
Q

Define social phobia (social anxiety disorder)

A

The fear, anxiety or avoidance is persistent

Typically lasting 6 or more months

29
Q

Define generalized anxiety disorder

A

Excessive anxiety and worry occuring more days than not for at least 6 months for MOST OF THE DAY about a number of events or activities

30
Q

Define obsessions

A

Recurrent and persistent THOUGHTS, impulses or images experienced as intrusive and inappropriate and causing marked anxiety or distress

31
Q

Define compulsions

A

Repetitive behaviors or mental acts that the person feels drive to perform

32
Q

What are a few obsessive compulsive RELATED disorders?

A

Hoarding

Trichotillomania (hair pulling)

Excoriation disorder (skin picking)

Substance-medication induced OCD

33
Q

What is the difference b/w OCD and Obsessive compulsive personality disorder (OCPD)?

A

OCPD = they don’t perceive they have a problem

OCD = they know their compulsions and obsessions are not reasonable (most of the time)

34
Q

What are examples of obsessions?

A

Contamination

Safety/harm

Unwanted acts of aggression

Unacceptable sexual or religious thoughts

Need for symmetry or exactness

35
Q

What are examples of compulsions?

A

Excessive cleaning

Checking, ordering and arranging rituals

Counting

36
Q

Define phobia

A

Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation

37
Q

What are examples of anxiety treatments?

A

Psychotherapy (supportive therapy, psychodynamic, cognitive behavioral therapy)

Psychopharmacology (SSRIs, SNRIs, TCAs, MAOIs, Buspirone, Benzos, Antipsychotics)

38
Q

What is the pneumonic for depression?

A

SIG E CAPS

Sleep-lack of

Interest-anhedonia

Guilt

Energy -lack of

Concentration - difficulty

Appetite - decreased or increased

Psychomotor- decreased

Suicidal ideation

39
Q

What is the pneumonic for manic?

A

DIG FAST

Distractability

Inflated self esteem/impulsive

Grandiosity

Flight of ideas

Activity

Speech pressured

Thoughtlessness

40
Q

What is the pneumonic for dysthymic?

A

CHASES

Concentration-poor

Hopelessness

Appetite-poor

Sleep- Insomnia

Energy-low

Self-esteem low

41
Q
A

NMSP Exam 1 (22 decks)

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