31 - mood problem / 35 - sleep disturbance Flashcards Preview

Sheff 91 core clinical problems > 31 - mood problem / 35 - sleep disturbance > Flashcards

Flashcards in 31 - mood problem / 35 - sleep disturbance Deck (27)
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1
Q

Core sx of depression

A

persistent sadness or low mood;and/or

loss of interests or pleasure

fatigue or low energy

2
Q

Name 2 screening tools for depression

A

Hospital anxiety and depression score

Patient health questionnaire

Beck depression inventory

3
Q

What should you always ask about in someone presenting with depression

A

suicide

4
Q

1/2/3rd line for depression mx?

A

1st line: psychotherapy such as cognitive behavioural therapy. Add an SSRI such as fluoxetine if moderate to severe.

2nd line: consider a different SSRI or a tricylic antidepressant

3rd line: try an ‘exotic’ antidepressant: venlafaxine, monoamine inhibitor etc. Continue talking therapy!

5
Q

What treatment might you consider in severe depression?

A

Electroconvulsive therapy very effective in severe depression. Consider if not eating/sleeping

6
Q

difference between mania and hypomania?

A

psychotic features eg delusions

7
Q

Name some sx of mania

A

euphoria, increased feelings of self-worth, overactivity, decreased appetite, increased energy, irritability, fast speech, flight of ideas. May include delusions of grandiosity and mood congruent hallucinations.

8
Q

Mx of bipolar ? Manic / depressed / maintenance

A

Manage mania with acute anti-psychotic (olanzapine, risperidone, quetiapine), try lithium or sodium valproate if unsuccessful.

In depressive episodes avoid non-SSRI antidepressants, be aware or inducing mania or rapid cycling. Consider anti-psychotics as above.

For maintenance use lithium as a mood stabiliser (blood test of levels to avoid kidney damage). Control of eating and sleeping patterns.

9
Q

Some sx of baby blues

A

weepy, irritable, Transient mood lability, difficulty sleeping, disconnection with baby and anxiety.

10
Q

Mx of baby blues

A

reassurance and counselling

medication not needed

11
Q

Postnatal depression.
Sx?
How long?

A

Classic depressive symptoms: hopelessness, sadness, anhedonia, etc.
Last two weeks or longer.

(Dads get it too)

12
Q

Rfs for postnatal depression?

A

baby blues, previous mental illness, usual risks for depression, unplanned pregnancy, no support network, abuse,

13
Q

mx of post natal depression?

A

psychosocial are best
SSRIs
Refer to specialist services

14
Q

Which scale for postatal depression?

A

edinburgh scale

…in the past days have you : felt more anxious for no good reason etc.

15
Q

How long is normal grieving

A

6/12 - consider medication past this

16
Q

2 common side effects of SSRIs / name a couple. What to keep in mind when stopping?

A

weight gain,sexual dysfunction

Fluoxetine, citalopram, sertraline,

Discontinuation syndrome

17
Q

TCAs eg? side effects?

A

Amitriptiline, clomipramine

weight change, visual blurring, dry mouth

18
Q

Eg SNRI

A

venlafaxine

19
Q

Whats needed with lithium?

A

regular blood monitoring

20
Q

which gland releases melatonin?

A

pineal

21
Q

Mx of insomnia?

A

CBT and sleep hygiene

Long term sleeping pills evidence is poor - benzos / z-hypnotics

22
Q

What is meant by good sleep hygiene?

A

The bed is only for sex and sleeping.
Separate your work and sleep environments.
Exercise during the day.
Avoid coffee and other stimulants in the evening.
Ensure the bedroom is cool, dark and quiet.
If you are having difficulty falling asleep for 30mins, go and do something else like a warm shower or glass of milk
Reduce screen time in the evening

23
Q

sleep scoring system?

A

epworth score

24
Q

associations with obstructive sleep apnea

A

snoring
tiredness in day
central obesity

25
Q

How to diagnosis narcolepsy?

A

sleep studies

26
Q

mx of narcolepsy

A

lifestyle changes, methylphenidate, modafinil

27
Q

triggers of attacks in narcolepsy?

A

laughter, fear, anger, arousal

Decks in Sheff 91 core clinical problems Class (51):