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39 Cards in this Set
- Front
- Back
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What family traits make depression more likely?
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1st degree relative with depression
monozygotic twins pt's with short allele of serotonin transport gene |
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Pt's with depression possibly have a decreased level or activity of __ and __
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serotonin and norepinephrine
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Pt's with cerebral insult or __ have a higher prevalence of depression
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chronic illness
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Depression is known as __ turned inward
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anger turned inward
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a canine experiment showed that depression is...
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learned helplessness
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__% of pt's with anxiety disorders become depressed
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30%
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What are some dx/dx of depression?
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bipolar disorder
sleep deprivation dysthymia alcoholism SAD cushing's chr. fatigue syndrome med. side effects hypothyroidism mood disorder post-partum depression |
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A __ mood most of the day, every day is the sign of depression
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depressed
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What are other complaints that pt's with depression mention?
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-diminished interest or pleasure in activities
-significant wt. loss or gain -insomnia or polysomnia -fatigue or loss of energy -worthlessness or guilt -diminshed concentration -recurrent thoughts of death or suicide -5 or more of the above during at least 2 wks=depression |
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What lab test is used to dx depression?
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none, stupid...could check TSH, serum cortisol, drug screen, CT or MRI is you suspect CNS etiology
-BECKS depression screen |
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What are the 4 parts of all human beings?
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Biological
Psychological Social Spiritual |
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What nutritional supplements may help tx depression?
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B vitamins, 6-12-folate
selenium omega 3 |
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What lifestyle modifications should you suggest to your pt's with depression?
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ETOH avoidance
exercise good diet increased sunlight exposure medications may not be enough |
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Which antidepressants hold the potential for increased suicidal ideations?
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all of them
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What other therapy (medical) can be used to tx depression when medications are contraindicated?
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ECT 3x week for 8-12 treatments
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ECT can lead to __ term memory loss
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short term memory loss
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What psychological treatments should be recommended for depressed patients?
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cognitive behavior therapy
repeated thought restructuring behavioral therapy |
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Cognitive therapy identifies what problems?
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thoughts or thought patterns contributing to emotions of anxiety or depression
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What is the goal of cognitive therapy?
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to embrace more rational and helpful thoughts are identified and embraced
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What does cognitive therapy try to get pt's to understand about emotions?
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that an event, leads to beliefs, thoughts, and attitudes = a person's emotions, we control our thoughts, beliefs, and attitudes they don't control us
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Many depressed people flucuate between what 2 behaviors?
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passive and aggressive
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"I" statements are what type of behaviors?
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assertive
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"Me" statements are what type of behaviors?
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aggressive
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Anxiety is a stimulation of the __ nervous system.
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sympathetic nervous system
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Relaxation is learning to re-engage the __ nervous system.
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parasympathetic nervous system
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Some relaxation techniques to teach your depressed patient's include?
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stretching
deep breathing systematic muscle relaxation here and now focus positive imagery |
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What social treatments may be appropriate for depressed patients?
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marriage therapy
family therapy vocational rehab social work services support group therapy |
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What spiritual therapies can also be an option for depressed patients?
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referral to pastor, priest, rabbi
church involvement 12 step groups forgiveness asking God for help loving God, others, and self |
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Wellbutrin (bupropion) has what major side effect that you must be aware of?
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lowers seizure threshold so is contraindicated in pt's with seizure disorder
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TCA's have anticholinergic effects which are contraindicated in pt's with what urinary condition?
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urinary retention, works well for urinary urgency (Imipramine is used for incontinence) but contraindicated in URINARY RETENTION
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TCA's also have what s/e on the heart?
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prolonged Q-T interval, do not give to suicidal patients
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Most antidepressants, especially SSRI's have what common s/e?
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decreased libido, and sexual responsiveness
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What antidepressant does NOT have sexual side effects?
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Wellbutrin (bupropion)
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MAOI's are not 1st line antidepressants as you have to avoid what dietary foods?
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wine, cheese, etc as they could cause serious problems like htn crisis.
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T/F
MAOI's are best used in combination with other types of antidepressants? |
false! can't combine, in fact you must have 3 week washout before starting something new
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What else is a common use of wellbutrin (bupropion)?
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to quit smoking
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What antidepressant helps with neuropathic pain?
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amitryptyline
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What anti-depressant is good to use in a depressed pt with insomnia?
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trazadone
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If a pt. fails SSRI's what other class of medications can be used that increase not only serotonin but norepinephrine?
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SNRI's
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