Adult - Psychosocial Flashcards
(36 cards)
dysthymia defined
depression of long term standing
Three areas of causality for depression?
psychodynamic - anger directed inward
cognitive - negative belief system
biochemical
Depression mnemonic
IN SAD CAGES
INterest
Sleep disturbance
Appetite change
Depressed mood
Concentration difficulties Activity alteration - hypo hyper Guilty feelings Energy loss Suicidal ideaion
Important lab to order to rule out significant differential for depression:
TSH - R/O hypothyroid
Categories of feelings
mad sad glad afraid ashamed
Stages of grief
DABDA
denial anger bargaining depression acceptance
Most commonly prescribed antidepressant class
SSRIs
SSRI examples
paroxetine (Paxil) fluoxetine (Prozac) sertraline (Zoloft) citalopram (Celexa) flovoxamine (Luvox)
What are the advantages of SSRIs?
low overdose danger
fast symptom response
no postural hypotension
Risk of SSRI?
seratonin syndrome
high fever
Major concerns of tricylic antidepressant?
anticholinergic
suicide
prolonged QT
Examples of tricyclic antidepressants
amitriptyline (Elavil)
imipramine (Tofranil)
doxepin (Sinequan)
Dietary concerns with MAOi
wine + cheese = hypertensive crisis
Examples of MAOi
phenelzine (Nardil, Nardelzine)
Antianxiety medication classes
benzodiazepines antihistamines beta blockers tricyclics and MAOi buspirone (Buspar)
First rule out in anxiety
TSH to r/o hyperthyroid
What is the only anti-anxiety that is not classified as a tranquilizer?
buspirone (Buspar)
Groups in which suicide risk is particularly high?
adolescents and early adulthood
white males > 45 years
those > 65 years
Suicide mnemonic
SUICIDAL
Sex (men more successful if attempted) Unsuccessful attempts Identified family members with suicide attempts CI chronic Illness Depression, drug abuse, drinking Age of patient Lethal method available
Alcoholism mnemonic
CAGE
ever felt the need to Cut down?
have people Annoyed you by criticizing your drinking?
have you ever felt Guilty about your drinking?
have you ever had an Eye-opener drink in the morning to steady your nerves or get rid of a hangover?
What is the focus of the mental status assessment?
cerebral function
Mini-mental status exam mnemonic
ORAL 23 RWD
Orientation Recognition Attention Recall Language
2 - names of 2 objects
3 - follow 3 step command
Reading
Writing
Drawing
sudden, transient onset of clouded sensorium
delirium
“they’ll be back”
Common causes of delerium
toxins alcohol anesthesia trauma poor nutrition
