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IM 6 Test 4 > Depression and Suicide > Flashcards

Depression and Suicide Flashcards

1
Q

which gender is twice as likely to be diagnosed with depression

A

women

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2
Q

women/men are more likely to seek help for depression and women/men are more likely to self-medicate with alcohol/substances

A

women more likely to get help

men more likely to self-medicate

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3
Q

which age group has the highest suicide rates and why

A

older men

older people use lethal means first

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4
Q

twins and depression rates

A

50% in monozygotic twins

20% in dizygotic twins

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5
Q

biochemical theories for depression

A

decreased level of serotonin

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6
Q

altered hormone regulation

A

increased cortisol

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7
Q

stress diathesis model

A

stressors and early life trauma may impact individual biological vulnerabilities

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8
Q

cognitive theory

A

negative thinking patterns

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9
Q

learned helplessness

A

older adults, women, impoverished

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10
Q

major depressive disorder diagnostic

A

5+ present in 2 weeks:

  • depressed mood
  • inability to feel pleasure
  • insomnia/hypersomnia
  • weight loss or gain
  • psychomotor agitation or retardation
  • loss of energy
  • feelings of worthlessness/guilt
  • impaired concentration
  • suicidal ideation
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11
Q

MDD psychotic features X2

A

hallucinations

delusions

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12
Q

MDD catatonic features X3

A

non-responsive
psychomotor retardation
withdrawal

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13
Q

MDD peripartum onset

A

during the pergnancy and following delivery

may include psychotic features and risk to infant

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14
Q

seasonal affective disorder

A

most commonly occurs in fall or winter, remits in sprint

overeating
anergia
hypersomnia

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15
Q

Premenstrual dysphoric disorder (PMDD)

A

occurs in luteal phase

emotionally labile
anger or irritable
depressed mood

may also include lack of energy, overeating, sleep disturbances

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16
Q

baby blues

A

feeling depressed/anxious, crying for no reason

improvement within 1-2 weeks

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17
Q

postpartum depression

A

strong feelings of sadness, anxiety, despair

symptoms DO NOT subside

occurs within 1-3 weeks PP

may last for a year after birth

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18
Q

postpartum psychosis

A

extremely rare with rapid onset (within 3 days)

agitated, anxious, disorganized behavior

delusions are baby focused

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19
Q

QPR

A

question
persuade
refer

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20
Q

SADPERSON

A

male sex

age (<19 >45)

depression/hopelessness

previous suicidal attempts

excessive ethanol/drug use

rational thinking loss

separated/widowed/divorced

organized plan/attempt

no social support

stated future intent

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21
Q

suicide risk screening questions

A

do you want to hurt yourself?
do you have ideas of taking your own life?
have you made plans to take your own life?
Do you have the means and what are they?
have you tried to take your life before?

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22
Q

suicide risk screening points

A

0 = no risk

1-2 = moderate

3-5 = high risk

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23
Q

tylenol antidote

A

mucomyst

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24
Q

benzodiazepine antidote

A

flumazenil

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25
Q

opioid antidote

A

naloxone

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26
Q

1:1 suicide precautions

A

continual observation at arm’s length for actively suicidal

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27
Q

15 min precautions

A

observe every 15 minutes and document affect/behavior/location

28
Q

nursing responsibilities for suicide precautions

A

can implement and then get orders but cannot discontinue without doctors orders

29
Q

why are MAOI’s not first line

A

food and drug interactions

almost anything aged

almost any med

30
Q

phenelzine class

A

MAOI

31
Q

tranylcypromine class

A

MAOI

32
Q

isocarboxazid class

A

MAOI

33
Q

selegiline class and route

A

MAOI patch

34
Q

why are TCA’s often not used

A

anticholinergic effects

35
Q

anticholinergic effects saying

A

cant see
cant pee
cant spit
cant shit

36
Q

suicidal ideation and TCA’s

A

do not use - potential for lethal overdose

37
Q

when does full effect occur with TCA’s

A

4-8 weeks

38
Q

amitriptyline class

A

TCA

39
Q

doxepine class

A

TCA

40
Q

imipramine calss

A

TCA

41
Q

desipramine class

A

TCA

42
Q

nortriptyline class

A

TCA

43
Q

biggest risks in SSRI/SNRI use

A

serotonin syndrome or increased suicidal thoughts

44
Q

fluoxetine class

A

SSRI

45
Q

sertraline class

A

SSRI

46
Q

paroxetine class

A

SSRI

47
Q

citalopram class

A

SSRI

48
Q

escitalopram

A

SSRI

49
Q

fluvoxamine class

A

SSRI

50
Q

vilazodone class

A

SSRI

51
Q

venlafaxine class

A

SNRI

52
Q

duloxetine class

A

SNRI

53
Q

desvenlafaxine class

A

SNRI

54
Q

bupropion

A

NDRI

55
Q

trazodone

A

atypical antidepressant

56
Q

mirtazapine class

A

NASSA

57
Q

ECT

A

only when previous medication has failed

58
Q

ECT remission rate

A

70-90% in depression

59
Q

ECT and pregnancy

A

safe

60
Q

when is ECT not effective X3

A

personality d/o
substance use d/o
situational depression

61
Q

ECT course

A

6-12 treatments

2-3 times/weeks

62
Q

how long does an ECT seizure alst

A

30-6- seconds

63
Q

Vagus nerve stimulation

A

device left in chest wall with wire threaded around vagus nerve that delivers electrical impulses

64
Q

what does VNS do

A

increase levels of neurotransmitters

65
Q

DBS

A

experimental therapy for tx resistant depression

surgical implant of pacemaker device implanted in subclavicle region

IM 6 Test 4 (6 decks)

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