Psych 6 Flashcards
(46 cards)
When should you consider diagnosis of MDE instead of bereavement following the lost of a loved one
Sx persist > 2 months, marked functional impairment, morbid preoccupations with unrealistic guilt or worthlessness, suicidal ideation, marked psychomotor retardation
First line tx for acute mania
Valproic acid
Side effects of valproic acid
- GI distress (e.g. nausea and vomiting)
- Increased appetite and weight gain
- Tremor
- Hepatotoxicity
- Pancreatitis
- Teratogenic
Side effects of lithium
- Acute lithium toxicity = GI symptoms (nausea, vomiting, diarrhea)
- Chronic lithium toxicity = Neurologic symptoms (e.g. tremor and ataxia)
- Hypothyroid = Symptoms may include weight gain, dry skin, hair loss, constipation
- Nephrogenic Diabetes Insipidus
Tx of persistent depressive disorder
Venlafaxine (SNRI) and Bupropion (DA/NE reuptake inhibitor)
What type of drug is Amoxapine
TCA
What percentage of new mothers is believed to experience postpartum blues?
30-75% in the 3 to 5 days after delivery
Differentiate between postpartum blues and postpartum depression
Blues = remit spontaneously in days to weeks
Depression = time of onset 3-6 months after delivery
Both have sleep disturbance, tearfulness, and depressed mood
How long after a stroke is a patient most likely to develop a post-stroke depression
6 months
Common trigger of manic episode in bipolar patients
+ tx?
Sleep deprivation
Can use long acting benzo to return normal sleep pattern and abort manic episode
What sx is associated with postpartum depression but not postpartum blues
Anhedonia
What is the most common side effect after ECT
HA
Most common complaints = HA, nausea, and muscle soreness. Memory impairment occurs but less frequently
Time frame of persistent depressive disorder
2 years in adults
1 year in kids!
Monitoring tests that should be done on patients taking Lithium
Creatinine, thyroid function, urinalysis
Sx that differentiate between bereavement and major depression
- Guilt about things other than actions taken or not taken by the survivor at the time of loved ones death
- Thoughts of death other than survivor feeling they would be better off with the loved one
- Morbid preoccupation with worthlessness
- Marked psychomotor retardation
- Marked and prolonged functional impairment
- Hallucinations other than the survivor hearing or seeing the loved one
Contraindication to ECT
MI within the past 4 weeks, increased ICP, aneurysms, bleeding disorders, conditions that disrupt BBB
What does brain imaging often display in depressed patients
Reduced metabolic activity and blood flow in both frontal loves on PET scan
What sx is the most accurate indicator of long-term suicidal risk in patients with MDD
Hopelessness
Describe sx of MDD with melancholic features
- Loss of pleasure in all activities
- Lack of reactivity (nothing can make patient feel better)
- Intense guilt
- Significant weight loss
- Early morning awakening
- Psychomotor retardation
Tx of MDD with melancholic features
TCAs
What is double depression
When a major depressive episode develops in a patient with dysthymic disorder
Likely diagnosis: Delirium + hemiparesis or other focal neuro signs or sx
CVA or mass lesion
Likely diagnosis: delirium + elevated BP + papilledema
Hypertensive encephalopathy
Likely diagnosis : Delirium + dilated pupils + tachycardia
Drug intoxication
