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Step 2: Psych

Psych 1

QuestionAnswer
How long does normal bereavement last? PERIODICALLY for 6 months. Does NOT impair ability to function. (2wks continuously after 2m is considered depression)
Neurotransmitter change in: Anxiety d/o? increased NE, low 5HT, low GABA
Neurotransmitter change in: Depression? low NE, low 5HT, low DA
Neurotransmitter change in: Mania? high NE, high 5HT
Neurotransmitter change in: Alzheimer's? low ACh
Neurotransmitter change in: Huntington's? low ACh, low GABA
Neurotransmitter change in: Schizophrenia? high DA
Neurotransmitter change in: Parkinsons? low DA, high ACh
After how long can Major Depressive Disorder be diagnosed? 2 weeks w/ functional impairment
What medical conditions can cause depression? list of 6. hypothyroidism, hyperparathyroidism, Parkinsonism, ACA stroke, CNS neoplasm, Pancreatic Ca
What anti-HTN drug can cause depression? methyl-DOPA
Haloperidol (1st gen antipsychotic) can cause ____________ Depression
What antiviral can cause depression? a-IFN
T/F glucocorticoids can cause depression. True
What antineausea drugs can cause depression metoclopramide, prochlorperazine
What's the difference between Major Depressive Disorder w/ Psychosis and Schizoaffective Disorder? MDD w/Psychosis = Depression always present, psychosis comes and goes. Schizoaffective = Psychosis always present, depression comes and goes
What does SIG E CAPS stand for? Sx of Major Dep d/o: Sleep disturbance, Interest loss, Guilt, Energy reduction, Concentration impaired, Appetite changes, Psychomotor change, Suicidal ideas
What are the Sx of atypical depression? hyperphagia, hypersomnia, hypersensitivity to rejection, leaden paralysis
Which is better for treating atypical depression: MAOi or TCA? MAOi
First line Rx for seasonal affective disorder? light therapy + SSRIs/bupropion
Name 6 SSRIs Fluvoxamine, fluoxetine, sertraline, paroxetine, citalopram, escitalopram
What drug group do these belong to: Imipramine, amytriptaline, desipramine, nortrypitaline, clomipramine, doxepine TCAs
The 3 MAOi's are? Fenalzine, Tranylcypromine, selegiline
Bupropion is what drug class? NDRI
What drug class are venlafaxine, duloxetine, milnacipran, nefazodone SDRI
What are teh 2 tetracyclics mertazapine, trazadone
What drugs, combine with SSRIs, can cause serotonin syndrome? other SSRIs, MAOi's, SNRIs, along with: St Johns Wort, tryptophan, illegal drugs (cocaine, amphetamines), L-DOPA
What eye signs are present in serotonin syndrome? ocular clonus (slow horizontal movements
If a pt is suffering from serotonin syndrome, and is agitated in spite of benzos given, what's the next step? Give anti-serotonin agent (ciproheptadine)
SSRI withdrawal syndrome consists of what symptoms? What 2 SSRI's are nototious for it? dizzy, nausea, fatigue, chills, anxiety. Paroxetine, venlofaxine are the worst offenders.
How do you treat SSRI withdrawal syndrome? fluoexitine (long acting SSRI)
Children who are to be put on TCAs should be screened for _________ abnormalities. Cardiac (arrhythmias, syncope, etc)
Mild depression is called ________. What is the Rx? Dysthymic disorder. Rx = psychotherapy (SSRIs if that doesn't work)
3 s/e's of TCAs? cardiotoxic, neurotoxic, anticholinergic symptoms
First line Rx for depression and anxiety? SSRIs
SSRIs require ______wks to take effect. 3-4 wks.
s/e of SSRIs include? sex dysfxn, suicidal in adolescents, low platelets
What's first line Rx for depression w/ neurologic pain? SNRIs
What do you give after ABCs in TCA overdose? charcoal. gastric lavage if w/i 2hrs of ingestion.
How do you treat QRS prolongation of TCA overdose? Sodium bicarb trial, then infusion if effective
Depression with fatigue and ADHD is treated with ______________. Bupropion
Bupropion is avoided in patients with _____(2)_______ disorders, or taking ______(2)_________ eating disorder, seizure disorder, coming off EtOH or MAOi
Psychotic depression is treated with _____________. electro convulsive therapy
Depression with catatonic stupor is treated with ________________. ECT
Why is electroconvulsive therapy given to patients with severe suicidal ideation? Because drugs take 3-4w
What's the difference between manic and hypomanic episode? manic = >1wk, interferes with normal fxning. hypomanic = 3d+, no impairment. (bipolar II is hypomanic)
What are the first line drugs for bipolar disorder? (3) lithium, carbamezapine, valproate
Rapid cycling bipolar is treated with which 2 of the 3 typical Rx? carbamezapine, valproate
What specific kidney problem can lithium cause? Nephrogenic diabetes insipidus
True/False: you should add an antidepressant to mood stabilizers during depressive stage of bipolar d/o. False: no added benefit of giving anti depressants. It's better to add another mood stabilizer or antipsychotic. ECT if very severe depression
Adjustment disorder has the same causes as major depressive disorder, except for ___________. Bereavement.
Adjustment disorder begins _______months after stressor, and is usually releived within ____months of onset. 3months, 6 months
How do you treat adjustment disorder? psychotherapy
Cyclothymic disorder is a mild form of ______________. It must last _____. Bipolar disorder. (rapid cycling of mild depression and hypomanic episodes for >2y)
Created by: jsad