Nurs 663: Depression and Cognitive
Fogginess (NEI) questions and
answers
Michael is a 74-year-old with depression and a family history of
Alzheimer's disease. Which of the following hypotheses describes
the potential relationship between depression and dementia?
A. Depression is a risk factor for dementia
B. Depression is a prodromal symptom of dementia
C. Depression and dementia share common risk factors
D. All of the above
D. All of the above
Rita is a 51-year-old patient with major depression who also exhibits
several hypomanic features. Which of the following is true regarding
the treatment of bipolar spectrum disorders?
A. Antidepressant monotherapy may improve rapid cycling
B. Antidepressant monotherapy is the first-line treatment for
depression with mixed features
C. Bipolar spectrum disorders often do not respond to
antidepressant monotherapy
Bipolar spectrum disorders often do not respond to antidepressant
monotherapy
James is a 64-year-old patient with cognitive impairment and
symptoms of depression. Neuroimaging reveals atrophy of the
frontotemporal region. Which of the following is a typical symptom
of semantic variant primary progressive aphasia (svPPA)?
A. Impairments in naming of everyday objects
B. Impairments in single-word comprehension
C. Impairments in speech output
A. Impairments in naming of everyday objects
Family Dynamics
The patient is married to her second husband for 16 years
Her first husband was controlling and tried to kill her after she left
him
, The patient's mother was psychiatrically hospitalized when the
patient was 13 years old for a "breakdown" and refused medications
The patient describes her mother as being "ecstatic," talking much
faster than usual, very insistent on following a guru to bring world
peace at times in her life
The patient's father was diagnosed with Alzheimer's and Parkinson's
diseases in his 50s
...
Current Symptoms and Treatment
The patient and her husband describe her mood as "ecstatic and
depressed again" with difficulties sleeping, working more, waking
up in the mornings with difficulties talking, increased fidgeting,
inability to stop an activity when asked, randomly obsessing about
things, and referential answers to questions
Over the past 9-12 months, the patient and her husband noticed
worsening short-term memory, difficulties expressing herself,
emotionality, and increased fearfulness
Mental status exam is remarkable for latency in speech, poverty of
content, and marked difficulty in expressing a thought
The patient is able to nod or shake her head to "yes-no" questions
and answer whether she does or doesn't agree with her husband
Current medicationsSynthroid 125 ug/dayVortioxetine 10 mg/day
...
What would be your preferred treatment step at this time?
A. Add a mood stabilizer
B. Discontinue vortioxetine
C. Discontinue vortioxetine and initiate a mood stabilizer
C. Discontinue vortioxetine and initiate a mood stabilizer
Case Outcomes
The patient has failed several antidepressant trials, including
augmentation strategies
The patient's mother appears to have hypomanic symptoms and
prior psychiatrist thought the patient might have bipolar disorder
Fogginess (NEI) questions and
answers
Michael is a 74-year-old with depression and a family history of
Alzheimer's disease. Which of the following hypotheses describes
the potential relationship between depression and dementia?
A. Depression is a risk factor for dementia
B. Depression is a prodromal symptom of dementia
C. Depression and dementia share common risk factors
D. All of the above
D. All of the above
Rita is a 51-year-old patient with major depression who also exhibits
several hypomanic features. Which of the following is true regarding
the treatment of bipolar spectrum disorders?
A. Antidepressant monotherapy may improve rapid cycling
B. Antidepressant monotherapy is the first-line treatment for
depression with mixed features
C. Bipolar spectrum disorders often do not respond to
antidepressant monotherapy
Bipolar spectrum disorders often do not respond to antidepressant
monotherapy
James is a 64-year-old patient with cognitive impairment and
symptoms of depression. Neuroimaging reveals atrophy of the
frontotemporal region. Which of the following is a typical symptom
of semantic variant primary progressive aphasia (svPPA)?
A. Impairments in naming of everyday objects
B. Impairments in single-word comprehension
C. Impairments in speech output
A. Impairments in naming of everyday objects
Family Dynamics
The patient is married to her second husband for 16 years
Her first husband was controlling and tried to kill her after she left
him
, The patient's mother was psychiatrically hospitalized when the
patient was 13 years old for a "breakdown" and refused medications
The patient describes her mother as being "ecstatic," talking much
faster than usual, very insistent on following a guru to bring world
peace at times in her life
The patient's father was diagnosed with Alzheimer's and Parkinson's
diseases in his 50s
...
Current Symptoms and Treatment
The patient and her husband describe her mood as "ecstatic and
depressed again" with difficulties sleeping, working more, waking
up in the mornings with difficulties talking, increased fidgeting,
inability to stop an activity when asked, randomly obsessing about
things, and referential answers to questions
Over the past 9-12 months, the patient and her husband noticed
worsening short-term memory, difficulties expressing herself,
emotionality, and increased fearfulness
Mental status exam is remarkable for latency in speech, poverty of
content, and marked difficulty in expressing a thought
The patient is able to nod or shake her head to "yes-no" questions
and answer whether she does or doesn't agree with her husband
Current medicationsSynthroid 125 ug/dayVortioxetine 10 mg/day
...
What would be your preferred treatment step at this time?
A. Add a mood stabilizer
B. Discontinue vortioxetine
C. Discontinue vortioxetine and initiate a mood stabilizer
C. Discontinue vortioxetine and initiate a mood stabilizer
Case Outcomes
The patient has failed several antidepressant trials, including
augmentation strategies
The patient's mother appears to have hypomanic symptoms and
prior psychiatrist thought the patient might have bipolar disorder
