Mood disorders

Question 1

What is the most appropriate antidepressant to prescribe following an MI

Answer 1

Setraline

Question 2

antidepressant of choice if required in children/adolescents

Answer 2

fluoxetine

Question 3

why are MAOIs not routinely used?

what are they reserved for?

Answer 3

they can cause hypertensive crisis if you dont stick to strict dietary requirements (no tyramine containing foods)

Reserved for atypical depression

Question 4

tx of hypertensive crisis

Answer 4

alpha blockade

Question 5

adverse effects of SSRIs

Answer 5

sexual dysfunction, short term anxiety..

Question 6

which antidepressants can have adverse effects on cardiac function?

Answer 6

TCAs

Question 7

BZD overdose, antagonist?

Answer 7

flumazenil

Question 8

1st line drug tx for anxiety

Answer 8

BZD but recommended short term to avoid dependence

Question 9

Endocrine changes in major depression

Answer 9

^ CRH in CSF
^ secretion of cortisol
»» hippocampus SHRINKS in response to cortisol, and the hippocampus is essential in short term memory function
enlarged adrenal glands
50-70% fail to suppress cortisol following dexamethasone

^TRH in CSF

Question 10

atypical depression features

Answer 10

mood reactivity
significant weight gain
hypersomnia
leaden paralysis
interpersonal rejection sensitivity

Question 11

waking > 2 hrs before usual, depression worse in morning, loss of appetite etc… is a feature of ?

Answer 11

somatic syndrome

Question 12

Hypomanic episode - abnormally elevated/irritable mood for how long?

Answer 12

more than or equal to 4 days

Question 13

manic episode - sustained for how long?

Answer 13

more than or equal to a week

Question 14

True or False: 1/3 of sufferers of panic disorder develop agoraphobia

Answer 14

false, 2/3!!!!

Question 15

What percentage of those with social phobia abuse alcohol

Answer 15

20%

Question 16

1st line medical tx of GAD

Answer 16

SSRIs

Question 17

OCD - symptoms have to be occurring for ??

Answer 17

over an hour per day

Question 18

38% of obsessions in OCD are related to ?

Answer 18

dust. germs ..

Question 19

is heritability high or low in OCD?

Answer 19

high

Question 20

1st line tx in OCD

Answer 20

exposure and response prevention (ERP)

Question 21

what is the desired effect of antipsychotics

Answer 21

DA blockade in the mesolimbic circuits

Question 22

Bipolar 1 - has to have met criteria for ?

Answer 22

mania

Question 23

bipolar 2

Answer 23

never met manic criteria

but its NOT a milder form!!

Question 24

bipolar 3

Answer 24

hypomanic episode only occurs following antidepressants

Question 25

does a single episode of hypomania/mania class as bipolar disorder?

Answer 25

yes, even if you have net been depressed yet

Question 26

what do most sufferers of panic disorder develop

Answer 26

agoraphobia

Question 27

1st line OCD tx

Answer 27

exposure and response prevention (ERP) - highly effective in OCD

Question 28

multiple recurrent and frequently changing physical symptoms

Answer 28

somatisisation

Question 29

deliberately producing false symptoms

Answer 29

factitious disorder

Question 30

% of non epileptic attack disorder that actually have epilepsy

Answer 30

10%

Question 31

feigning illness for secondary gain

Answer 31

malingering

Question 32

Cluster A personality disorders

Answer 32

"weird" - schizoid (aloof) - schizotypical (awkward) - paranoid (accusatory)

Question 33

Cluster B personality disorders

Answer 33

"wild" - borderline - antisocial (bad) - histrionic (bullshit) - narcissistic (best)

Question 34

Cluster C personality disorders

Answer 34

"worried: - avoidant (coward) - obsessive-compulsive (compulsive) - dependent (clingy)

Question 35

first line drug treatment for panic disorder

Answer 35

SSRI

Question 36

conversion disorder

Answer 36

typically involves loss of motor or sensory function (may seem to be a stroke) patient does NOT consciously feign the symptoms

Question 37

dissociative disorder

Answer 37

psych symptoms - amnesia, stupor, fugue (forgetting personal identity, memories etc)