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PAEA Psychiatry EOR Topics
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PAEA Psychiatry EOR TopicsMDD diagnosis requires ___ or more symptoms every day for ___ weeks that is
causing impairment in social, occupational, or other important areas of funtioning
- CORRECT ANSWER-≥5 symptoms
2 weeks
what are the symptoms of MDD? - CORRECT ANSWER-SIG E CAPS
-*S*leep (insomnia or hypersomnia)
-*I*nterest (decreased pleasure/interest in doing things)
-*G*uilt (or feelings of worthlessness)
-*E*nergy (loss or fatigue)
-*C*oncentration (loss or indecisiveness)
-*A*ppetite (loss or hyperphagia resulting in wt. loss or gain)
-*P*sychomotor (retardation or agitation)
-*S*uicidal Ideation
depression is thought to be caused by decreased levels of - CORRECT
ANSWER-serotonin, norepinephrine, and/or dopamine
how long does it take for most anti-depressants to start working enough that the
patient notices a difference? - CORRECT ANSWER-3 weeks with max effect at 3
mos
Dx? depressed mood for most of the day, more days than not for ≥2 years -
CORRECT ANSWER-Persistent Depressive Disorder (Dysthymia)
persistent depressive disorder (dysthymia) requires how many symptoms to be
present for at least 2 years? - CORRECT ANSWER-≥2 symptoms of depression
(SIG E CAPS)
cyclothymic disorder is similar to persistent depressive disorder (dysthymia) in
that symptoms must be present for ____ years and not absent for more than
____ months at a time - CORRECT ANSWER-2 years
2 months
,what meds are considered 1st line in treating depressive disorders like MDD and
PDD? - CORRECT ANSWER-SSRI's (fluoxetine/Prozac, sertraline/Zoloft,
paroxetine/Paxil, citalopram/Celexa, escitalopram/Lexapro, fluvoxamine/Luvox)
what is another way treatment resistant depression can be treated? - CORRECT
ANSWER-electroconvulsive therapy (ECT)- inducing a brief seizure causes the
release of NTs
all antidepressants carry a BBW for - CORRECT ANSWER-suicidal ideation
(thoughts, not attempts) in children, adolescents, and young adults; if this occurs,
consider it a side effect of a med instead of worsening depression & change
meds
which antidepressants can lower the seizure threshold? which is the worst? -
CORRECT ANSWER-ALL! Bupropion is worst
which antidepressants can cause QT prolongation? which is the worst? -
CORRECT ANSWER-ALL except for *combined SSRIs* (vilazodone/Viibryd,
vortioxetine/Brintellex), *MAOIs* (Isocaboxazid/Marplan, phenelzine/Nardil,
tranylcypromine/Parnate, selegiline transdermal patch), and *"fringe drugs"*
(buproprion/Wellbutrin, mirtazapine/Remeron, trazodone)
*citalopram*/Celexa (SSRI) has a BBW for QT prolongation
which SSRI is category D/X in pregnant patients for causing pulmonary HTN in
newborns? - CORRECT ANSWER-paroxetine/Paxil
1st, 2nd, and 3rd line medication treatment for depression - CORRECT
ANSWER-1st- SSRIs
2nd- SNRIs, bupropion, mirtazapine
3rd- TCAs & MAOIs
all of these work best when combined with CBT
what are some common SEs of SSRIs? - CORRECT ANSWER-GI upset, sexual
dysfxn, HA, changes in energy level, anxiety, insomnia, wt changes, SIADH
, acute AMS, seizures, coma, restlessness, diaphoresis, tremor, hyperthermia,
N/V, abdominal pain, mydriasis, and tachycardia are all signs of? which is caused
by? - CORRECT ANSWER-serotonin syndrome
caused by SSRI + MAOI use or inadequate wash out time between switching
meds
list the SNRIs - CORRECT ANSWER-venlafaxine/Effexor, desvenlafaxine/Pristiq,
duloxetine/Cymbalta
which antidepressant can cause worsening of glaucoma? - CORRECT
ANSWER-duloxetine/Cymbalta
amitriptyline, doxepin, cimipramine, imipramine, trimipramine, nortriptyline,
amoxapine, desipramine, protriptyline are what class of medications? -
CORRECT ANSWER-TCAs for depression; "-amine" & "-triptyline"
what are some reasons TCAs should generally be avoided in the elderly? -
CORRECT ANSWER--cardiotoxicity (QT prolongation)
-anticholinergic SEs (can't pee, can't see, can't spit, can't shit)
-increases fall risk, confusion & sedation
what antidepressant is often used to overdose and can be detected on EKG of
OD pts as prolonged QT and wide complex tachycardia? - CORRECT
ANSWER-TCAs "-amine" & "-triptyline"
list the MAOIs - CORRECT ANSWER-isocarboxazid/Marplan, phenelzine/Nardil,
tranylcypromine/Parnate, selegiline transderm patch
hypertensive crisis occurs with what class of antidepressants when tyramine
containing foods are ingested (fermented: beer, cheese, wine, etc.) - CORRECT
ANSWER-MAOIs
what antidepressant works by inhibiting reuptake of dopamine and
norepinephrine? - CORRECT ANSWER-bupropion/Wellbutrin
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