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Psych Unit- Clin Med. II > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

What subtype of MDD has a close link to bipolar disorder?

A

Atypical Depression

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2
Q

List subtypes of MDD

A
  1. Seasonal. 2. Postpartum. 3. Melancholic. 4. Atypical. 5. Catatonic. 6. Psychotic
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3
Q

Distinguish atypical vs. melancholic depression

A

Melancholia- decreased sleep and eating. LACK of mood reactivity. Atypical- INCREASED sleep and eating. Presence of mood reactivity.

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4
Q

6 main features of melancholic depression patient may present with

A

anhedonia or lack of mood reactivity. Also have decreased sleep and eating (WEIGHT LOSS), wake up early in mornings, sx worse in AM, excessive guilt.

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5
Q

What often precedes dx of bipolar illness?

A

postpartum psychoses (in postpartum depression)

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6
Q

postpartum depression often associated with…

A

psychosis

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7
Q

Prior names of dysthymic disorder

A

depressive personality disorder or neurotic depression

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8
Q

Rapid cycling

A

if patient has 4 or more mood episodes in a given year

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9
Q

Bipolar disorder NOS

A

when distinction between bipolar type I, II, and cyclothymia cannot be made

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10
Q

seasonal affective disorder is variant of…

A

bipolar disorder

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11
Q

DDx of mania:

A

schizophrenia, personality disorders, substance intoxication, impulse control disorder, compulsive disorders, ADHD,

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12
Q

Medical conditions that may cause mood disorder:

A

Systemic infections- AIDS, EBV
Endocrine abnormalities- Thyroid, adrenal
CV DZ- after heart attacks
Carninomas- pancreatic cancer

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13
Q

Substances that may induce depression

A

AAC’SSS- Analgesics, antipsychotics, CV drugs (BB, digitalis), sedatives (alcohol, benzos), steroids and hormones (OC), stimulants (amphetamines, cocaine)

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14
Q

substances that may induce mania

A

DA agonists (may see in parkinson’s from medication), Sympathomimetics (cocaine, amphetamines, PCP intoxication), steroids

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15
Q

NE associated with

A

energy, motivation

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16
Q

DA associated with

A

enjoyment

17
Q

Serotonin associated with

A

well-being, decreasing anxiety

18
Q

MAO inhibitors have Side effects with..

A

aged cheese, wine, st. john’s wort, cured meats, other antidepressants

19
Q

increased suicidal ideation in adolescents and young kids- should be treated with…

A

prozac or lexapro (SSRI’s)- approved by FDA

20
Q

which drug has 2 month wash out

A

Prozac

21
Q

SSRI with long half life

A

Prozac

22
Q

Patient with MDD is given SSRI for tx. They have been sleeping a lot more lately, have gained 15 pounds, and have had many sexual side effects. They also experience withdrawal if missed dose. Want to switch to another med. What are they on and how would you switch?

A

Paxil (paroxetine). Taper off slowly. Consider changing meds or adding Wellbutrin (if sexual SE)

23
Q

SSRi’s used to treat…

A

depression, anxiety disorders, eating disorders, PMDD, OCD

24
Q

Wellbutrin avoided in….

A

thin ppl or with eating disorders- lowers seizure threshold

25
Q

Used to treat ADHD in adults.

A

Wellbutrin

26
Q

SNRI that is dose dependent

A

venlafaxine (effexor). inhibits 5-ht reuptake at low doses, then NE, then DA at very high doses

27
Q

atypical antidepressant that can cause weight gain

A

mirtazapine

28
Q

Patient has insomnia,depression, and very thin. Consider __ as med to treat.

A

Mirtazapine (Remeron)

29
Q

Mirtazapine often given to…

A

agitated elderly

30
Q

If first mood episode occurs less than 30 years old, treat for…

A

9-12 months minimum

31
Q

If 2 episodes have occured over 30 yo, treat for…

A

2 years - lifelong

32
Q

If first mood episode has occured over age 50, treat…

A

lifelong

33
Q

First line for bipolar

A

lithium

34
Q

types of tx for mania

A

mood stabilizer (anticonvulsants)-lithium, valproic acid, carbamazepine. Atypical antipsychotics/neuroleptics

35
Q

neuroleptics px in mania tx

A

Zyprexa, Geodon, Risperidol, Seroquel, Clozaril

36
Q

Watch thyroid levels and kidney function in what disorder?

A

BIpolar disorder- lithium tx interferes with thyroid hormone synthesis

37
Q

Meds associated with weight gain in mania tx

A

Lithium, valproic acid, Zyprexa, clozaril

38
Q

antipsychotic causing hyperprolactinemia

A

risperidone

39
Q

If on this antipsychotic for mania, careful to count WBC every 2 weeks…why?

A

Clozaril- causes agranulocytosis

Psych Unit- Clin Med. II (4 decks)

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