Psychiatry Cf Part 1/6

Front 1

What is this?

• Symptoms of major depression
• History of symptoms of major depression

Back 1

Major Depressive Disorder, Recurrent

Front 2

What are the first-line drugs for MDD, recurrent?

Back 2

• SSRIs

• SNRIs

• Buproprion

• Mirtazapine

Front 3

As a general rule, what drug should a patient take if they've already had a successful remission of a previous MDD episode?

Back 3

The same one that caused remission in the previous episode.

Front 4

What is the basic diagnostic criteria for MDD, Recurrent

Back 4

Two or more episodes of major depression.

Five or more of the following symptoms for most of the time for at least 2 weeks.

• Depressed Mood
• Anhedonia
• Significant Weight change or change in appetite
• Insomnia or Hypersomnia
• Psychomotor Agitation or Retardation
• Fatigue or Loss of energy
• Feelings of worthlessness or excessive guilt.
• Decreased Ability to concentrate or indecisiveness
• Thoughts of death or suicidal ideation

There has never been a manic, hypomanic, or mixed episode.

Symptoms cause significant distress or impairment in functioning.

Front 5

What are the additional diagnostic criteria for MDD, Recurrent?

Back 5

• Symptoms are not caused by substance abuse, medication, or a medical condition (hypothyroidism)
  
• Symptoms are not better accounted for by schizophrenia, schizoaffective disorder, delusional disorder, or a psychotic disorder not otherwise specified.
• Symptoms are not better accounted for by bereavement.

Front 6

1) Which drug class helps with Depression and GAD?

2) What are the conditions treated by Bupropion?

3) Which SNRI can also be used in diabetic neuropathy?

Back 6

1) SNRIs

2) Depression, Anxiety associated with Depression, Smoking

3) Duloxetine (Cymbalta)

Front 7

1) Which first-line depression drug is a tetracyclic?

2) What disorders can it help treat?

Back 7

1) Mirtazapine (Remeron)

2) Depression, Anxiety, it also helps to induce sleep.

Front 8

What's SIGECAPS

Which must be present to diagnose MDD?

Back 8

• Sleep Disorders
  
• Interest (Anhedonia)
• Guilt, Worthlessness
• Energy (fatigue)
• Concentration
• Appetite
• Psychomotor agitation or retardation
• Suicidal Thoughts

Anhedonia OR Depressed Mood

Front 9

1) What is the medical condition differential for MDD?

2) What is the substance differential for MDD?

3) What is the psychiatric illness differential for MDD?

Back 9

1) Hypothyroidism, MS

2) Antihypertensives, alcohol, steroids, cocaine withdrawal

3) Bipolar Disorder (depressed)

Front 10

What are the risk factors for suicide? (5)

Back 10

• Male
• Substance Abuse
• Prior attempts
• Older Age
• Family History of suicide

Front 11

1) What is the difference between postpartum blues and postpartum depression?

2) Which one is treated and how?

3) What is a complication of untreated Postpartum Depression? How is it treated?

Back 11

1) PP Blues only lasts for several days to a week and the symptoms are less severe.

2) PP Depression is treated similarly to depression

3) Psychosis. Treat with antipsychotics and think of admission.

Front 12

When is ECT indicated for a MDD episode?

Back 12

MDD with psychotic features or where rapid response is required.

Front 13

How long should depression be pharmacologically treated?

Back 13

6-9 months

Front 14

1) Which SSRI side effects start early?

2) Which SSRI side effects only occur later in treatment?

Back 14

1) Activation, GI symptoms, Tremor

2) Sexual Dysfunction, it doesn't occur for weeks or months.

Front 15

How does Bipolar Disorder in a child present?

Back 15

More with a mixed or dysphoric picture characterized with short periods of intense mood lability and irritability.

Front 16

What is the fist line treatment for Bipolar of no psychosis is present?

What is the tradtional recommendation?

Back 16

Monotherapy with a traditional mood stabilizer like lithium, divalproex, and carbamazepine OR an atypical antipsychotic like olanzapine, quetiapine, or resperidone.

Lithium or Divalproex

Front 17

How often do episodes have to occur to diagnose rapid-cycling bipolar disorder?

Back 17

4 episodes of both depression and mania/hypomania in a year.

Front 18

What is this?

- Patient with increased stress after job that requires more interpersonal contact.

- MSE is normal except for having constricted emotional range.

- Lack of delusions or hallucinations

Back 18

Schizoid Personality Disorder

Front 19

Do patients with ego-syntonic personality disorders tend to seek treatment?

Back 19

No. The best strategy for treatment will be best if it's more lifestyle changes.

Front 20

What is the difference between ego-syntonic and ego-dystonic?

Back 20

Ego-dystonic personality disorders tend to cause distress, be inconsistent with the patient, and are objectionable to the patient.

Ego-syntonic is acceptable, unobjectionable, and consistent with self to the patient.

Front 21

What is the difference between alloplastic defenses and autoplastic defenses?

Back 21

Alloplastic defenses are reactions to stress by changing the environment (eg. manipulation of others)

Autoplastic defenses are reactions to stress by changing their internal psychological processes (denial)

Front 22

Cluster A Personality Disorders?

Back 22

Odd, Bizarre, eccentric

Schizoid

Schizotypal

Paranoid

Front 23

Cluster B

Back 23

Anti-social

Narcissistic

Histrionic

Borderline

Front 24

Cluster C

Back 24

Obsessive Compulsive PD

Avoidant PD

Dependent

Front 25

What is Schizoid?

Back 25

• Loner
  
• Detached
• Flat affect
• Restricted Emotions
• Generally indifferent to interpersonal relationships outside of immediate family.

Front 26

Schizotypal?

Back 26

• Odd
• Eccentric
• Magical Thinking
• Paranoid
• Not psychotic
• Typical defense: Projection, regression, fantasy

Front 27

Paranoid?

Back 27

• Distrustful and Suspicious
• Constricted Affect
• Typical Defense: Projection

Front 28

Histrionic

What cluster? What is it?

Back 28

Cluster B

• Attention seeking
• Excessively emotional
• Reaction Formation defense

Front 29

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Back 29

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