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Flashcards in Psych Deck (32):
1

Major Depression requirements for dx

2 weeks with 5 or more symptoms of SIGECAPS if anhedonia or depressed mood

Sleep, interest, guilt, energy,, concentration, appetite, psychomotor (leaden paralysis or antzy), suicide

2

True or false, hyperparathyroidism can cause depression?

Yes, think calcium and psychiatric overtones

3

Dopamine blockers canc ause depression

Like metaclopramide, prochlorperazine, haloperidol

4

Med used for viral hepatitis that causes depression?

Interferon alpha

5

Atypical depression is what?

Treatment?

Like Karly.

Responds to MAOi's (though SSRI is first line)

6

Peripartum depression is up to 4 weeks later. Psychotic features can happen b/c of depression

oh!

Important to differntiate mood disorder secondary to pyschoses and schizoaffective

7

Persistent depressive disorder

2 years or longer without 2 months without symptoms.

Need depressed mood plus 2 SIGECAPS

8

Desvenlafaxine, duloxetine, milnacipran, venlafaxine are what?

SNRIs and dizziness, serotonin syndrome, SEX DYSFUNCITON!

9

Serotonin syndrome sx?

Mental status change, autonomic excitation, neuromuscular hyperactive, OCULAR CLONUS

10

Drugs that increase risk of serotonin. ESPECIALLY the antibiotic

SSRI, SNRI, MAOIs, St johns, tryptophan (precursur)

LINEZOLID

11

Tx of serotonin syndrome?

Discontinue
Supportive and vitals
Benzos for sedation
If temp above 41, PARALYZE and mechanically cool

If still agitated, use cyproheptadine

12

What is cyproheptadine used for?

Still agitated after bento given after serotonin syndrome

it is serotonin antagonist

13

Neuromalignant syndrome vs Serotonin syndrome?

NMS is gradula onset and rigidity wearas 5HT is hyperkinesis and clonus

both have autonomic instability, hyperthermia and muscle problems

14

Bupropion mechanism?

what is nice about it?

Bad about it? (contraindications)

weight loss, keeps awake, NO SEXUAL DYSFUNCTION

Lowers seizure threshold

15

Mirtazapine mechanism. Side effect?

Alpha 2 blocker, so more adrenergic.

Causes sedation and wt gain

16

TCA overdose

Tri C's

Cardiotoxic, tachy, hypotension
CNS toxic (coma, seizure)
AntiCholinergic

17

Tx of TCA overdose?

ABC
Activated charcoal
Cardiac monitoring

DRUG LEVEL
SODIUM BICARB
BENZOS IF SEIZURE

18

ECT indication

Depression refractory, psychotic depression, severe suicidality, mania, psychosis, rapid response required...

19

What does bipolar II disorder need for dx?

Major depressive and at least one hypomanic episode

20

Manic episode requires what for dx?

3 symptoms of DIG FAST

1 weeks
Impair funcitoning or require hospitalization or psychotic feature

21

Does hypomania impair functioning or cause psychosis?

Nope

22

Tx bipolar?

Lithium

Anticonvulsants (If renal failure)
Atypical antipsychotics added if above don't work
ECT could be done

23

Depression history should be sure to look for episodes of mania.

B/c SSRI could send to mania

24

Tx for Neph Diabetes Insip if needing lithium?

HCTZ and amiloride b/c amiloride blocks sodium channels that allow sodium into renal cells

25

Ebstein anomoly is what?

Tricuspid into RV. RV hypoplasia, Regurg. Patent Foramen ovale

26

Lithium side effects?

LMNOP

Movement Metallic taste
Nephrogen Diab Insip
hypOthyroid (or any thyroid issue)
Preggers issue (ebstein)

27

Cyclothymic disorder is what?

tx?

2 years of hypomanic or depressive symptoms going back and forth

Tx mood stabilizers and psychotherapy (like mini bipolar!)

28

Dissociative identity disorder

Derpersonalization/derealization

Id is multiple personalities/identities

Depersonaliztion is detachment from body

Derealization is feelings things around aren't real )in a dream state)

29

Panic disorder dx when?

Tx?

4 symptoms causing panic attack

THEN MALADAPTIVE behavior of fear of them. Worry at least one month

Tx by:
CBT
SSRI
Benzos to stop acute panic attack (bentos can cause rebound)

30

GAD Dx: LENGTH OF TIME?

Tx

Deression and anxiety same monkey in different shirt

Worry happening more days than not for 6 months with at least three symptoms!

Tx:
SSRI, SNRI or BUSPIRONE
CBT can help

31

Social anxiety tx?

Must be interfering or worrying about them

CBT, SSRI, SNRI

Benzo and Beta blockers may help for performance.

32

Buspirone is what?

Second line anti anxiety med. Can be added to help the SSRI and SNRI (which are first line)

Affinity for serotonin and dopamine receptors