Primary Care - Depression

Front 1

SIGECAPS

Back 1

Sleep
interest
guilt
energy
concentration
appetitie
psychomotor
suicidality

Front 2

melancholia criteria

Back 2

anhedonia plus three of:
diurnal variation
pervasive adn irremediable depressed mood
marked psychomotor retard or agitation
sig weight loss or anorexia
excessive or inappropriate guilt
early morning awakening

Front 3

what type of depression responds best to phramacotherapy

Back 3

melancholia

Front 4

what depressed patients have high risk for suicide

Back 4

with psychotic features such as hallucinations and delusions

Front 5

criteria for atypical depression

Back 5

mood reactivity plus two of
- leaden paralysis
- hypersomnia
- rejection hypersensitivity
- overeating
- weight gain

Front 6

major complaint in major depression

Back 6

anhedonia, NOT depressed mood

Front 7

what's depressed mood or anhedionia for less than two weeks, not due to a stressor? due to a stressor?

Back 7

depressive d/o NOS (or nothing)
vs
adj d/o with depressed mood

Front 8

cancers associated with depression

Back 8

brain
pancreatic

Front 9

type of thyroid disease associated with depression

Back 9

hyper and hypo

Front 10

IDs associated with depression

Back 10

HIV
syphilis
hepatitis
lyme

Front 11

what is dysthymic d/o

Back 11

chronic form of depression with 2 years of symptoms on more than half the days

Front 12

which responds better to drugs, depression or dysthymia

Back 12

depression

Front 13

time criteria for dysthymic d/o

Back 13

2 years (1 for adol and kids)
never without symptoms for more than 2 months at a time
no MD during first two years

Front 14

symptom criteria for dysthymic

Back 14

poor appetitie or overeating
insomnia or hyper
low energy or fatigue
low self-esteem
poor concentration or difficulty decidin
feelings of hopelessness

Front 15

at what time point in bereavement do you consider MD as a diagnosis

Back 15

> 2 mos

Front 16

time criteria for adj disorder

Back 16

within 3 months of identifiable stressor

Front 17

treatment for adj d/o

Back 17

psychotherapy not drugs

Front 18

effect of SSRIs in pregnant women

Back 18

small risk in newborn of a transient withdrawal syndrome

Front 19

drugs of choice for pregnant depressed women

Back 19

SSRIs but NOT paroxetine

Front 20

which patients have a high risk of having recurring chronic depression

Back 20

people who are elderly when their first episode is diagnosed

Front 21

elderly person with insomnia, anorexia and fatigue

Back 21

depression

Front 22

drug for elderly depressed person

Back 22

SSRI

Front 23

tx for pseudodementia

Back 23

drugs
ECT

Front 24

most specific symptom for bipolar disorder

Back 24

hypomanic episode

Front 25

criteria for manic episode

Back 25

1 week (or anything if need hospitalization)
3 or more of these during mood disturbance (4 if only irritable):
- grandiosity
- decreased sleep
- talkative
- flight of ideas, racing thoughts
- distractibility
- increased goal directed
- excessive pleasurable activity

not a mixed episode
marked impairment
not from substance

Front 26

criteria for hypomanic

Back 26

at least 4 days
3 or more, 4 if irritable, of:
- grandiosity
- less sleep
- talkative
- FOI
- distractibility
- goal directed
- pleasurable activities

unequivocal change in function
mood/function change observable
not casing impairment
not due to substance

Front 27

which is more lethal in suicide attempts, SSRI or TCA

Back 27

TCA

Front 28

goal of acute phase tx for depression

Back 28

remission for a minimum of 6-8 weeks

Front 29

what absolutely must be present in acute phrase t

Back 29

psychiatric management

Front 30

how to differentiate non-, partial response, partial remission

Back 30

less than 25% decrease in baseline sx
vs
26-49% decrease
vs
50% or greater ecrease with residual

Front 31

what is first response if patients don't fully respond in acute phase

Back 31

increase dose

Front 32

when do you start reviewing causes of lack of moderate improvement in depression symtoms

Back 32

after initial 4-8 weeks
(first increase dose, then consider other things)

Front 33

how long is the continuation phase

Back 33

16-20 weeks

Front 34

minimum length of tx for depression

Back 34

remission plus 16-20 weeks of continuation therapy

Front 35

what's purpose of maintenance phase tx for depression

Back 35

preventing recurrence

Front 36

dosing in maintenance phase

Back 36

same as in acute and continuation

Front 37

phases of medication

Back 37

Acute
Continuation
Maintenance

Front 38

which antidepressants are best for MD

Back 38

they're all good

Front 39

what are TCAs better for

Back 39

severe depression
depression with melancholia
depression with physical pain

Front 40

what shouldn't be given to heart patients

Back 40

TCAs
NRI

Front 41

contraindications for TCAs and NRIs

Back 41

CV (esp conduction)
BPH
urinary retention
closed angle glaucoma

Front 42

what are venlafaxine, milnacipran, duloxetine

Back 42

SNRIs

Front 43

antidepressants for chronic pain and diabetic neuropathy

Back 43

duloxetine
paroxetine

Front 44

what does bupropion inhibit

Back 44

norepi
dopamine
(not serotonin)

Front 45

what are MAOIs better at

Back 45

atypical depression

Front 46

what does nefazodone block

Back 46

5-HT serotonin receptors

Front 47

what does mirtazapine block

Back 47

alpha 2 adrenergic receptors
specific serotnin receptors
histamine receptors

Front 48

on PHQ 9 what is scale

Back 48

0-4 non
-9 mild
-14 moderate
-19 moderately severe
-27 severe