Depression — Flashcards

Flashcard 1: depression

Answer:

Extra: early morning awakening incompletedecreased: NE, dopamine, serotonin

Flashcard 2: serotonin

Answer: raphe nucleus

Flashcard 3: A woman status post mastectomy says she feels ugly when she undresses.

Answer: Find out why the patient feels that way. Do not offer false reassurance or anything that could be interpreted as flirtation. (e.g. You still look great!)

Flashcard 4: What changes in sleep patterns are often seen in depressed patients?

Answer: 1. less delta-wave sleep 2. more REM sleep 3. more/earlier awakenings (decreased delta-wave sleep (stage N3) decreased REM latency increased REM early in sleep cycle increased total time in REM repeated nighttime awakenings early-morning awakening)

Flashcard 5: Major depressive disorder with seasonal pattern is most associated with what season? _____

Answer: Winter

Extra:  https://onlinemeded.org/spa/psychiatry/mood-disorders/acquire?ref=anki 

Flashcard 6: Huntington disease presents with chorea that can progress to _____ and dementia; also may have aggression

Answer: depression

Extra:   Watch Creutzfeldt Jakob Disease, Parkinsons Disease & Huntingtons Disease [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-neuro/videos/medical-pathophysiology-neuro-neurodegenerative-creutzfeldt-jakob-disease-parkinsons-disease-and-huntingtons-disease?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical]Watch associated Bootcamp video [https://app.bootcamp.com/med-school/neurology/videos/dementia?index=8] https://onlinemeded.org/spa/genetics?ref=anki Atlas: 

Flashcard 7: Primary hyperparathyroidism may lead to CNS disturbances, such as _____ and seizures

Answer: depression

Extra:   https://onlinemeded.org/spa/endocrinology?ref=anki 

Flashcard 8: Depression is characterized by _____ dopamine

Answer: decreased

Extra:  Watch associated Bootcamp video [https://app.bootcamp.com/med-school/neurology/videos/neurotransmitter-activity-in-psychiatric-disease?index=2] https://onlinemeded.org/spa/dna-to-protein/amino-acids/acquire?ref=anki 

Flashcard 9: What is noticably absent in patients with major depressive disorder with seasonal pattern? _____

Answer: Nonseasonal depressive episodes

Extra: Watch associated Bootcamp video [https://app.bootcamp.com/med-school/psychiatry/videos/psychotic-and-mood-disorders?index=4] https://onlinemeded.org/spa/psychiatry/mood-disorders/acquire?ref=anki 

Flashcard 10: Major depressive disorder episodes are characterized by depressed mood or anhedonia and at least four other "SIG E CAPS" symptoms lasting > 2 weeks S: _____ I: Interest decreases (anhedonia) G: Guilt or feelings of worthlessness E: Energy loss or fatigue C: Concentration problems A: Appetite/weight changes P: Psychomotor retardation or agitation S: Suicidal ideations

Answer: Sleep changes

Extra:   https://onlinemeded.org/spa/psychiatry/mood-disorders/acquire?ref=anki 

Flashcard 11: The risk factors for suicide completion may be remembered with the mnemonic "SAD PERSONS": S: Sex (_____) A: Age (teenage or elderly) D: Depression P: Previous attempt (highest risk factor) E: Ethanol or drug use R: Rational thinking impaired (psychosis) S: Sickness (medical illness) O: Organized plan N: No spouse or other social support S: Stated future intent

Answer: male

Extra: Watch associated Bootcamp video [https://app.bootcamp.com/med-school/psychiatry/videos/psychotic-and-mood-disorders?index=13] https://onlinemeded.org/spa/psychiatry/mood-disorders/acquire?ref=anki  

Flashcard 12: What demographic is associated with increased REM sleep and decreased REM latency? _____

Answer: Patients with depression

Extra:  Watch associated Bootcamp video [https://app.bootcamp.com/med-school/psychiatry/videos/sleep-and-psychosomatic-conditions?index=4] https://onlinemeded.org/spa/psychiatry/sleep-physiology/acquire?ref=anki  Stages of sleep in adults (EEG) Wakefulness (W): relaxed stage of being awake (alpha waves) (A) transition between wakefulness and sleep (often still ascribed to the stage of wakefulness) (B) stage 1: falling asleep (lightest sleep with alpha and theta waves) (C) stage 2: beginning of sleep (light sleep with sleep spindles, theta waves, and K-complexes) (D) stage 3: transition between medium and deep sleep (delta waves) (E) stage 4: deep sleep (over 50% of delta waves) The last three patterns show the electroencephalogram (EEG), the electrooculogram (EOG; measures eye movement) and the electromyogram (EMG) of an index finger during REM sleep (dreaming sleep). The REM stages typically occur at the end of the sleep cycle and are not associated with any of the above-mentioned stages (i.e. they form their own stage). Comparison of sleep phases in healthy and depressed individuals Compared to a healthy person (A), a person suffering from depression (B) has a longer latency of sleep onset, reduced REM latency, prolonged first REM sleep, an increased occurrence of REM sleep in the second part of the night, and an increasing duration of REM sleep throughout the night. In general, depressed people sleep less deeply and are awake more often during the night. Both representations are simplified for didactic purposes (i.e. common, brief periods of arousal during the REM sleep are not shown here). 

Flashcard 13: Depression is characterized by _____ norepinephrine

Answer: decreased

Extra:  Watch associated Bootcamp video [https://app.bootcamp.com/med-school/neurology/videos/neurotransmitter-activity-in-psychiatric-disease?index=4] https://onlinemeded.org/spa/neurology?ref=anki 

Flashcard 14: What is the first line treatment for major depressive disorder? _____

Answer: CBT + SSRIs

Extra: Watch associated Bootcamp video [https://app.bootcamp.com/med-school/psychiatry/videos/psychotic-and-mood-disorders?index=4] https://onlinemeded.org/spa/psychiatry/mood-disorders/acquire?ref=anki 

Flashcard 15: SNRIs may be used to treat chronic pain (e.g. _____ pain)

Answer: neuropathic

Extra:   Sketchy Pharmacology: Neuro/Psych  https://onlinemeded.org/spa/psychiatry?ref=anki 

Flashcard 16: _____ therapy is used mainly for treatment-refractory depression, depression with psychotic symptoms, and acute suicidality

Answer: Electroconvulsive

Extra:   https://onlinemeded.org/spa/psychiatry/mood-disorders/acquire?ref=anki  

Flashcard 17: The five stages of grief per the Kubler-Ross model are _____, anger, bargaining, depression, and acceptance

Answer: denial

Extra:   https://onlinemeded.org/spa/psychiatry/mood-disorders/acquire?ref=anki 

Flashcard 18: Depression is characterized by _____ serotonin

Answer: decreased

Extra: Watch associated Bootcamp video [https://app.bootcamp.com/med-school/neurology/videos/neurotransmitter-activity-in-psychiatric-disease?index=4] https://onlinemeded.org/spa/neurology?ref=anki 1) Depression: everything is LOW 

Flashcard 19: Tricyclic antidepressants (TCAs) may be used for treatment-resistant _____

Answer: depression

Extra:   Sketchy Pharmacology: Neuro/Psych Watch Tricyclic antidepressants [https://dashboard.sketchy.com/study/medical/courses/medical-pharmacology/units/medical-pharmacology-neuro-psych/videos/medical-pharmacology-neuropsych-antidepressants-and-anxiolytics-tricyclic-antidepressants?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical]Watch associated Bootcamp video [https://app.bootcamp.com/med-school/psychiatry/videos/pharmacology?index=4] https://onlinemeded.org/spa/psychiatry?ref=anki 

Flashcard 20: When diagnosing neurodegenerative disorders, you must first rule out _____ as a cause of the presenting dementia

Answer: depression

Extra: Watch associated Bootcamp video [https://app.bootcamp.com/med-school/psychiatry/videos/psychotic-and-mood-disorders?index=4] https://onlinemeded.org/spa/psychiatry?ref=anki 

Flashcard 21: MAO inhibitors may be used to treat anxiety and treatment-resistant _____ depression (not first line)

Answer: atypical

Extra:   Sketchy Pharmacology: Neuro/Psych Watch MAO inhibitors [https://dashboard.sketchy.com/study/medical/courses/medical-pharmacology/units/medical-pharmacology-neuro-psych/videos/medical-pharmacology-neuropsych-antidepressants-and-anxiolytics-mao-inhibitors?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical]Watch associated Bootcamp video [https://app.bootcamp.com/med-school/psychiatry/videos/pharmacology?index=5] https://onlinemeded.org/spa/dna-to-protein/amino-acids/acquire?ref=anki 

Flashcard 22: The main clinical features of antidepressant discontinuation syndrome can be remembered with the mnemonic FINISH: Flu-like symptoms I_____ Nausea Instability Sensory disturbances Hyperarousal

Answer: nsomnia

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 23: When major depression fails to respond to an initial SSRI, patients can be switched to what other first-line antidepressants? _____

Answer: Different SSRI SNRI Bupropion Mirtazapine Serotonin modulators (e.g. vilazodone)

Extra:  https://onlinemeded.org/spa/psychiatry?ref=anki 

Flashcard 24: At what age do you start screening for major depressive disorder (MDD) in adolescents: _____

Answer: 12-years-old

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 25: Both the elderly and depressed experience _____ early awakenings (terminal insomnia)

Answer: increased

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 26: Depression = ↑ secretion of _____

Answer: cortisol

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 27: Both the elderly and depressed experience _____ slow wave sleep (stage N3)

Answer: decreased

Extra:  https://onlinemeded.org/spa/neuroscience?ref=anki 

Flashcard 28: Any patient who reports feeling hopeless, even if the initial symptoms are somatic, should be asked about _____

Answer: suicidal ideation

Extra:  https://onlinemeded.org/spa/psychiatry/mood-disorders/acquire?ref=anki 

Flashcard 29: Depression can often present in the office with _____ of compliants

Answer: somatic

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 30: Next step after finding SSRIs work but cause sexual dysfunction? _____

Answer: Wait for a short time, then decrease dose of SSRI

Extra:  https://onlinemeded.org/spa/psychiatry?ref=anki 

Flashcard 31: Major depression disorder has an atypical presentation with _____ in the elderly

Answer: physical symptoms (e.g. headache)

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 32: What is the criteria for long-term maintenance antidepressant therapy? _____

Answer: Patients with ≥ 2 major depressive episodes

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 33: _____ psychotherapy is an evidenced-based therapy for depression that focuses on the link between depressive symptoms and interpersonal relationship conflicts

Answer: Interpersonal

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 34: The most common psychiatric complication of MS is _____

Answer: depression

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 35: Sexual assault increases the risk factor for what other psychiatric condition? _____

Answer: MDD and suicidal ideation and attempts Not borderline personality, homicidal ideation/attempts, panic disorder, persecutory delusions

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 36: An adequate antidepressant trial is generally considered to be at least _____ at a therapeutic dosage

Answer: 4 - 6 weeks

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 37: Electroconvulsive therapy is often preferred to achieve a rapid response in depressed elderly patients who are _____

Answer: unable to eat and drink, psychotic, or actively suicidal

Extra:  https://onlinemeded.org/spa/psychiatry/mood-disorders/acquire?ref=anki 

Flashcard 38: Most significant risk factor for postpartum depression is _____

Answer: prior depression

Extra:  https://onlinemeded.org/spa/psychiatry?ref=anki 

Flashcard 39: Childhood depression is often associated with _____

Answer: stomach aches and headaches

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 40: β-blockers can worsen what psychiatric condition? _____

Answer: Depression

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 41: 5/9 depressive SIGECAPS lasting > 2 weeks is suggestive of _____

Answer: major depressive disorder

Extra:  https://onlinemeded.org/spa/psychiatry/mood-disorders/acquire?ref=anki 

Flashcard 42: Depression is associated with _____ REM latency and _____ total REM sleep

Answer: decreased

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 43: _____ and associated anxiety may be prodromal features in more than one-third of patients with pancreatic cancer

Answer: Depression

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 44: Ask about tobacco, alcohol, and depression? _____

Answer: Yes

Extra:  https://onlinemeded.org/spa/epidemiology-and-stats/screening/acquire?ref=anki 

Flashcard 45: First time MDD = _____ of SSRI therapy at working dose Recurrent MDD = _____ of SSRI therapy at working dose

Answer: 6 months

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 46: Adolescent major depression may present with _____ rather than depressed mood

Answer: irritability

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 47: Postpartum _____ is characterized by depressed affect, anxiety, and poor concentration for > 2 weeks

Answer: depression

Extra:  https://onlinemeded.org/spa/psychiatry/mood-disorders/acquire?ref=anki 

Flashcard 48: _____ should be considered for terminally ill patients with limited life expectancy and severe acute depression and/or those at risk of suicide

Answer: Methylphenidate

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 49: Pseudodementia refers to cognitive impairment that is secondary to _____

Answer: major depressive disorder

Extra:  https://onlinemeded.org/spa/neurology/dementia/acquire?ref=anki 

Flashcard 50: Patients with a single episode of major depressive disorder should continue antidepressants for an additional _____ following the acute response to decrease risk of relapse

Answer: 6 months

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 51: Should you be screening the general adult population, including pregnant and postpartum women for depression? _____

Answer: Yes, please do

Extra:  https://onlinemeded.org/spa/psychiatry?ref=anki 

Flashcard 52: Depression and leaden paralysis (heavy limbs) is most likely _____

Answer: atypical depression

Extra:  https://onlinemeded.org?ref=anki 

Flashcard 53: How long do SSRIs and SNRIs take to achieve maximum effect?_____

Answer: 1 - 2 months

Flashcard 54: Persistent depressive disorder is also known as _____

Answer: dysthymia

Flashcard 55: Both the elderly and depressed experience _____ slow wave sleep (stage N3)

Answer: decreased

Flashcard 56: Atypical depression is associated with _____-phagia

Answer: hyper

Flashcard 57: Which gender attempts suicide more often? _____

Answer: Females

Flashcard 58: When diagnosing neurodegenerative disorders, you must first rule out _____ as a cause of the presenting dementia

Answer: depression (psych disorder)

Flashcard 59: _____ are an effective treatment for atypical depression, but not first-line due to their risk profile

Answer: MAO inhibitors

Flashcard 60: Depression is associated with _____ REM latency

Answer: decreased

Flashcard 61: Atypical depression is associated with _____, which is being able to experience improved mood in response to positive events, albeit briefly

Answer: mood reactivity

Flashcard 62: What demographic is associated with increased REM sleep and decreased REM latency? _____

Answer: Patients with depression

Flashcard 63: SSRIs inhibit the pre-synaptic reuptake of _____

Answer: serotonin (5-HT)

Flashcard 64: Tricyclic antidepressants (TCAs) may be used for treatment-resistant _____

Answer: depression

Flashcard 65: Depression is associated with _____ total REM sleep

Answer: increased

Flashcard 66: In major depressive disorder with seasonal pattern, _____ symptoms are common (ex. hypersomnia, hyperphagia, leaden paralysis)

Answer: atypical

Flashcard 67: What is the treatment for postpartum depression? _____

Answer: CBT and SSRIs

Flashcard 68: In elderly patients with suspected dementia, screening for _____ should be performed to rule out other possible causes

Answer: depression

Flashcard 69: MAO inhibitors may be used to treat anxiety and treatment-resistant _____ depression (not first line)

Answer: atypical

Flashcard 70: Both the elderly and depressed experience _____ early awakenings (terminal insomnia)

Answer: increased

Flashcard 71: Depression is characterized by _____ serotonin

Answer: decreased

Flashcard 72: What is the first line treatment for major depressive disorder? _____

Answer: CBT + SSRIs

Flashcard 73: What is the first-line treatment for atypical depression? _____

Answer: CBT and SSRIs

Flashcard 74: Neuro/Psych Adverse effects of tricyclic antidepressants (TCAs) include respiratory _____ and hyperpyrexia

Answer: depression

Flashcard 75: Major depressive disorder with seasonal pattern is most associated with what season?_____

Answer: Winter

Flashcard 76: Can a person with grief meet the criteria for major depressive episode? _____

Answer: Yes

Flashcard 77: Which atypical antidepressant is useful for treating anorexic or elderly depressed patients? _____

Answer: Mirtazapine

Flashcard 78: What is noticably absent in patients with major depressive disorder with seasonal pattern?_____

Answer: Nonseasonal depressive episodes

Flashcard 79: In addition to schizophrenia, _____ antipsychotics are used to treat treatment-resistant depression

Answer: atypical

Flashcard 80: Which atypical antidepressant is useful for treating depressed patients with insomnia? _____

Answer: Mirtazapine