Clinical Conditions Exam 2: Depression And Cardiovascular Disease

Front 1

a common mental disorder.... with loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, poor concentration... can become chrnoic or recurrent and lead to substantial impairments in an individuals ability to take care of his or her everyday responsibilities

Back 1

depression

Front 2

how many people worldwide suffer from depression?

Back 2

121 million

Front 3

what is the leading cause of disability worldwide?

Back 3

depression

Front 4

how many suicides/ year (cause of depression)

Back 4

850,000

Front 5

what percentage of people have access to effective treatment for depression?

Back 5

fewer than 25%

Front 6

what are some of the causes of depression?

Back 6

genetic
biochemical
environmental

Front 7

the following are general symptoms of what diagnosis?

- feelings of sadness
- irritability
- loss of interest in activities
- reduced sex drive
-insomnia
-change in appetite
- slowed processes
-decreased concentration
-loss of energy
-feelings of worthlessness
-forgetful
-thoughts of suicide
-crying spells

Back 7

depression

Front 8

how do symptoms of depression differ for children, adolescents, and adults?

Back 8

children: sadness, hopelessness, irritability

adolescents: anxiety, anger, avoidance of social interaction

adults: fatigue, disomnia, loss of appetite and sex drive, worthlessness

Front 9

what are the 3 main types of depression?

Back 9

major depressive disorder

dyshthymic disorder

manic depression

Front 10

what are the 3 criteria for depression

Back 10

1. cause significant distress
2. impair daily functioning
3. not caused by medical condition or substances

Front 11

type of depression:

- symptoms last for most of day, every day, for two weeks
-1 symptom must be depressed mood or decrease in interest in activities

must also have at least 4 of the following symptoms:
- significant weight change
-change in sleeping habits
- fatigue
-slowness or excessive moevment
-feeling worthless
-concentration issues
-thoughts of suicide

Back 11

major depressive disorder

Front 12

type of depression

-depressed mood almost constantly for at least two years

also at least 2 of the following symptoms:
-decrease or increase in appetite
- cahgne in sleeping habits
- fatigue
- low self esteem
-concentration issues
-feeling hopeless
-persistent but less severe symptoms than Major depression

Back 12

dysthymic disorder

Front 13

type of depression:

- can be called bipolar disorder
- periods of mania and depression
-manic episode: persistent elevated or irratble mood that is extreme, lasts at least one week

symptoms include at least 1 of the following:
- inflated self esteem, decreased sleep, compeeled to always talk, racing thoughts, easily distracted, excessive moevment, incerase in goal orietned activities, involvement in potentially risky behavior

Back 13

manic depression

Front 14

what types of Medications are available for depression?

Back 14

SSRI
SNRI
MAOI
trcyclics

Front 15

type of medical intervention for depression..

- celexa, lexapro, luvox, paxil, prozac, zoloft
-for early stages or minor depressive illness
- blocks reabsorption of serotonin by nerve cells in brain-- more serotonin in brain increases neurotransmission and improved mood

- may cause: nausea, dry mouth, headache, anxiety, and insomnia

Back 15

SSRI: Selective Serotonin Reuptake inhibitor

Front 16

type of medical intervention for depression..

- cymbalta, efexor, pristig
- targets serotonin (related to mood) and norepinephrine (related to alertness)

Back 16

SNRI: selective serotonin and norepinephrine

Front 17

type of medical intervention for depression:

- nardil, parnate
- monoamine oxidase inhibitors block this burn up of serotonin, norepinephrine, and dopamine
- should limit amount of chicken liver, cheese, broad-bean pods, herring
- wave of deaths in 1960s when medication is introduced
- reintroduced as last resort when no other drugs are successful

Back 17

MAOI: monoamine oxidase inhibitors

Front 18

type of medical intervention for depression:

- adapin, anafranil, elavil, endep, ludiomil, norpramin, pamelor, petrofrane, sineguan

- first defense against developing depression in 1958 with release of imipramine
- today it is not as popular as other types of medication

Back 18

tricyclics

Front 19

what are the three main types of psychotherapy for depression
?

Back 19

1. cognitive behavioral
2. interpersonal
3. psychodynamic

Front 20

type of intervention for depression that targets the way we think and act
- most effective on mild and moderate depression

Back 20

cognitive behavioral

Front 21

type of intervention for depression that believes that depression is a result of unresolved issues from early childhood

Back 21

psychodynamic

Front 22

type of intervention for depression that... deals with conflicts within a persons relationships and the rolls they play in depression

Back 22

interpersonal

Front 23

electrical stimulation to the brain
- most effective to serious depression
-ministered in a hospital setting

Back 23

electroconvulsive therapy

Front 24

what percentage of people with severe depression have the chance of recurrence within the first two years?

first 5 years?

Back 24

30-50%

50-75%

Front 25

a disorder in which the heart is unable to pump an adequate amount of bloode to meet the metabolic demands of the body at rest or during exercise

Back 25

congestive heart failure

Front 26

what are the 2 types of congestive heart failure?

Back 26

systolic heart failure

diastolic heart failure

Front 27

when the heart cannot pump blood out of the heart very well

Back 27

systolic heart failure

Front 28

when the heart muscles are stiff and cannot fill up with blood easily

Back 28

diastolic heart failure

Front 29

class of heart failure:

- no physical limitations, but have clinical risk factors such as diabetes, hypertension, obesity or coronary artery disease

Back 29

class 1

Front 30

class of congestive heart failure..

- slightly limited in their physical activity

Back 30

class 2

Front 31

class of congestive heart failure:

- comfortable at rest but minimal activity produces fatigue, dyspnea, palpitations or angina

Back 31

class 3

Front 32

class of congestive heart failure:

symptoms at rest with increased discomfort with the least phyiscal activity

Back 32

class 4

Front 33

how many americans have CHF

Back 33

5.7 million

Front 34

how many new cases of CHF diagnosed every year

Back 34

550,000 cases

Front 35

coronary heart failure affects what percentage of people aged 75+

Back 35

10%

Front 36

the following are causes for what diagnosis?

- congenital heart disease
- heart attack
- heart valve disease
- arrythmias
-coronary artery disease
-hypertension
-cardiac ischemia
-cardiomyopathy
-myocarditis

Back 36

congestive heart failure

Front 37

the following are signs and symptoms for what diagnosis?
- shortness of breath
- cough
-swelling of feet and ankles
-swelling of the abdomen
- weight gain
- irregular or rapid pulse
-difficulty sleeping
- fatigue
- loss of appetite
-decreased alertness or concentration
- decreased urine production
-nausea and vomiting

Back 37

congestive heart failure

Front 38

what are different ways CHF is diagnosed?

Back 38

blood tests
chest x-rays
electrocardiogram
echocardiogram
stress test
ct scan
MRI
angiogram

Front 39

is CHF a chronic disease?

Back 39

yes

Front 40

what is the mortality rate % for CHF within 1 year of diagnosis

2-5 years?

Back 40

1 year: 20%
2-5 years : 50%

Front 41

this is usually caused by artherosclerosis
- occurs when fatty material and other substances form a plaque build up on the walls of arteries

Back 41

coronary artery disease

Front 42

this diagnosis is responsible for 1/3 of all deaths in individuals over age 35

estimated that 1/2 of all middle aged men and 1/3 of middle aged women in US will develop this...

Back 42

coronary artery disease

Front 43

this diagnosis is caused by...
-fatty deposits in the inner lining of an artery

Back 43

coronary artery disease

Front 44

who is at increased risk for CAD?

Back 44

genetics
diabetes
high blood pressure
metabolic syndrome
smokers
chronic kidney disease

Front 45

the following are signs and symptoms for what diagnosis
?

- chest pain/ discomfort
-heart feels heavy and pain in neck arms stomach or upper back
- pain occurs with activity or emotion and goes away with nitroglycerin

Back 45

coronary artery disease

Front 46

how is coronary artery disease diagnosed?

Back 46

history
electrocardiogram
treadmill or exercise stress test
coronary angiography
myocardial perfusion imaging
stress echocardiography
electron beam computer

Front 47

this diagnosis has a different prognosis for everyone...
- some people maintain a healthy life by changing diet, exercise
-others need medical procedures

Back 47

coronary artery disease

Front 48

heart muscle dies as a result of blockage or a coronary artery

blocked by something such as thrombus or embolus

Back 48

myocardial infarction

Front 49

how many people suffer from a heart attack each year in US?

Back 49

1.3 million

Front 50

what is the leading cause of morbidity and mortality in US:?

Back 50

myocardial infarction

Front 51

how many people die within 24 hours of the onset of ischemia?

Back 51

1/3

Front 52

myocardial infarction often occurs in people over what age?

Back 52

48

Front 53

are men or women between ages 40-70 more likely to have MI?

Back 53

men

Front 54

what is the most common cause of MI?

Back 54

acute thrombus blocking artery that was already partially obstructed

Front 55

how do you diagnose an MI?

Back 55

blood test
electrocardiogram

Front 56

what is the main medical intervention for an MI?

Back 56

to pen the blocked artery and restore blood flow

20 minutes important!!

Front 57

how many heart attacks result in death?

Back 57

1/3

Front 58

this is the medical intervention for this diagnosis...

- administering oxygen
- thrombolytic therpay such as streptokinase, urokinase, or tissue plasminogen activator (drugs to get rid of clots) administered within 20 minutes of onset
.... this restores the blood flow
- angioplastry
-coronary artery stent
-coronary artery bypass graft

Back 58

myocardial infarction

Front 59

if someone survives past ___ hours after a heart attack they are likely to survive and if no other complications, fully recover

Back 59

2 hours

Front 60

the intensity of the heart attack is related to....

Back 60

time heart muscles need to heal

Front 61

with this type of heart attack..

- little damage done to heart muscle; return to normal activities after 2 weeks

Back 61

small heart attack

Front 62

in this type of heart attack:

- moderate damage to the heart muscle; requires limited and gradual increase in activity for up to four weeks

Back 62

moderate heart attack

Front 63

this level of MI:

much damage to the heart muscle; recovery period of six weeks or longer

Back 63

large heart attack

Front 64

this medication helps reduce chest pain

Back 64

nitroglycerin

Front 65

this medication prevents clots from forming along with clopidogrel

Back 65

aspirin

Front 66

these help reduce the strain on the heart and lower BP

Back 66

beta blockers

Front 67

this prevents heart failure and lower BP

Back 67

ACE inhibitors

Front 68

this type of medication reduce blood cholesterol levels to prevent plaque from increasing which can reduce the risk of another heart attack

Back 68

lipid lowering medication

Front 69

the amount of energy used by the body to perform a physical activity or daily task

Back 69

MET