Medical Illness And Psychiatric Disorders

Front 1

May occur in up to ____ of HIV infected patients

Back 1

40%

Front 2

HIV: Suicide is elevated when?

Back 2

in the weeks or months after HIV antibody testing

Front 3

AZT, acyclovir, interferon INH and sulfonamides can cause _______ or _________.

Back 3

depression or delirium

Front 4

HIV associated conditions that can contribute to depression

Back 4

chronic pain
headache from HIV encephalitis
peripheral neuropathy

Front 5

Diagnostic Evaluation should include this when symptoms suggest CNS disorder (headache, focal neuro symptoms, signs of frontal lobe disease)

Back 5

Imaging studies and screening for cryptococcal disease and syphilis

Front 6

HIV-1 associated CNS disorders

Back 6

HIV associated minor cognitive disorder and HIV associated dementia

Front 7

HIV-1 can directly invade the central nervous system (CNS) T/F

Back 7

T

Front 8

HIV associated minor cognitive disorder

Back 8

may occur in patients who are otherwise asymptomatic or mildly symptomatic. The disorder is characterized by subcortical deficits of attention, information processing speed, learning and memory, and psychomotor skills. May be complicated by the presence of depression or anxiety, but is not caused by psychiatric problems.

Front 9

HIV Associated Dementia (HAD)

Back 9

progressive disorder that initially presents as apathy, inertia, cognitive slowing, memory loss, and social withdrawal
As it progresses, multiple cognitive functions become increasingly impaired
The terminal phases are characterized by global cognitive impairment, mutism, and severe psychomotor retardation

Front 10

When does HAD occur
What is the treatment

Back 10

usually not until after AIDS develops

Treatment with azidothymidine (Retrovir, AZT, DZV) has been associated with improvement in cognitive functioning

Front 11

In all acute psychotic disorders you should do this

Back 11

a magnetic resonance image of the brain and examination of cerebral spinal fluid should be carried out as soon as possible.

Front 12

Treatment Considerations: Clozapine

Back 12

contraindicated because of agranulocytosis

Front 13

Treatment Considerations: olanzapine (Zyprexa)

Back 13

well-tolerated with few drug interactions and positive studies in HIV+

Front 14

Treatment Considerations: Quetiapine

Back 14

contraindicated in combilation with ketoconazole, ritonavir, and macralide antibiotics

Front 15

Cerebrovascular Accident (Stroke)

Back 15

They often suffer sudden, multiple loss events

They may lose the neurological capacity to process these loss events

Stroke may affect areas of the brain directly involved in control of mood.

Front 16

peak incidence of MDD post-stroke

Back 16

between six months and two years

Front 17

point prevalence for depression in stroke

Back 17

between 10-34%

Front 18

Stroke victems with MDD are less likely to be alive three years following CVA. T/F

Back 18

T

Front 19

Risk of MDD and Location of CVA

Back 19

increases with proximity to the left frontal pole

pallidum (odds ratio 7.2)

Front 20

Pathological emotionalism is relatively common after stroke, affecting up to ____ of patients in the first six months post-stroke but tending to improve over the following year.

Back 20

20%

Front 21

______ of PD patients have MDD

Back 21

20-40%

Front 22

MDD can predate motor symptoms of parkinsons by 6 years T/F

Back 22

T

Front 23

Onset of depression in parkinsons & AIDS is often is biphasic. What does this mean.

Back 23

peaks on diagnosis and peaks when symptoms begin to get worse.

Front 24

Multiple Sclerosis % of MDD

Back 24

25-40%

Front 25

drugs for MS that can cause mood changes

Back 25

steroids
anti-spasticity drugs (including baclofen, dantrolene, and tizanidine)
discontinuation of baclofen and other anti-spasticity drugs
interferon treatment is a risk factor for depression in MS

Front 26

15% of MS patients die by suicide T/F

Risk factors?

Back 26

T

Male
young age of onset
previous history of depression, social isolation, and substance abuse
alcohol abuse.

Front 27

Huntington’s Disease

Back 27

Inherited disease of movement, cognition and emotion
Behavior changes and personality changes are core symptoms
Depression, irritability, or anxiety is often the first symptom

Front 28

Myocardial Infarction

Back 28

20% of patients hospitalized for MI are also suffering from Major Depression
Depression during initial hospitalization is related to poor quality of lif in the first year post-MI
Depression leads to a 3-fold increase in risk of death post-MI
Patients can be effectively treated