MGRADES EXAMS
NURS 5461 Depression UPDATED
ACTUAL Exam Questions and CORRECT
Answers
Limbic System. amygdala - CORRECT ANSWER - Gauge and modulate emotions/ thoughts
of death and guilt,
Limbic system hippocampus - CORRECT ANSWER - Affects memory/concentration less
size/ neurogenesis in depression
Frontal cortex - CORRECT ANSWER - Linked to depressed mood and problems
concentrating. Reduced in size and hyopactive in D, difficulty in thinking/planning-->rely on
amygdala so response is emotion based
Basal ganglia - CORRECT ANSWER - Linked to psychomotor agitation or retardation
Hypothalamus - CORRECT ANSWER - r/t loss of appetite, weight loss anhedonia (loss of
pleasure) -- neurovegetative signs.
Neurotransmitters and depression - CORRECT ANSWER - ↓Serotonin: mood, sleep,
impulsivity symptoms ↓Dopamine: pleasure, reward, psychomotor activity, fatigue, low energy,
cognition ↓Norepinephrine: mood, arousal, appetite , planning, concentrating ↓ GABA: anxiety,
agitation of depression ↑glutamate & NMDA receptors in frontal lobe (↑ neuronal cell death
Glial cells - CORRECT ANSWER - ↓ in number and density in depression Glial cells protect
neurons by stabilizing glutamate & supplying glucose to the neurons (stick like glue)
Synthesize & release neurotropic factors (Brain Derived Neurotropic Factor: BDNF)
these can stabilize with ADM-
Extra cellular glutamate accumulates - CORRECT ANSWER - Excess of glucocorticoids
(HPA axis) Decreased GLIA PFC Fewer glial glutamate transporters Neurons get exposed to
, MGRADES EXAMS
glutamate and can no longer function Progressive depression Damage to neurons (neurotoxicity)
2x greater risk of dementia with depression! not enough stabilization with GABA
PFC hyperactivity - CORRECT ANSWER - ↑CRF released from hypothalamus ACTH
released from pituitary Glucocorticoids (cortisol) released from adrenal cortex Excessive
glucocorticoid release may cause hippo-campal atrophy Atrophy leads to chronic activation of
HPA axisDepression, anxiety result. Antidepressants can reverse
Hypothalamic Dysregulation Circadian Rhythms of Sleep - CORRECT ANSWER - Delayed
sleep onset
Shortened REM latency
Increased length of 1st REM period
Abnormal delta sleep
May be reported as lack of sleep or atypical feature
of hypersomnia
Antidepressant meds treat circadian dysregulation
and can restore normal sleep architecture
If you do not use standardized tool - CORRECT ANSWER - Use two screening questions
instead: Over the past 2 weeks, have you felt down, depressed, or hopeless?" • and "Over the past
2 weeks, have you felt little interest or pleasure in doing things?"
History and clinical interview - CORRECT ANSWER - Do full interview if screening
indicates symptoms • Assess target symptoms: sleep, appetite, anhedonia, mood , suicidal
thinking, guilt, concentration, low energy, etc • Onset, course & duration, severity of symptoms;
recent or chronic stressors • New or occurred before? • Impact of these symptoms -on job,
education, family, friends • Current & past psych history (e.g. hospitalized?) • All medications-
OTC, herbs (past and current) • Substance abuse? (current, past)
Objective data - CORRECT ANSWER - Physical exam, wt, ht, labs (thyroid, anemia,
nutritional deficiency, UTI?), screening tools • Mental Status exam: • Appearance, mood, affect,
psychomotor, attitude, thought process, thought content, perception, judgment, insight, memory,
concentration, fund of knowledge, full Mental Status exam
NURS 5461 Depression UPDATED
ACTUAL Exam Questions and CORRECT
Answers
Limbic System. amygdala - CORRECT ANSWER - Gauge and modulate emotions/ thoughts
of death and guilt,
Limbic system hippocampus - CORRECT ANSWER - Affects memory/concentration less
size/ neurogenesis in depression
Frontal cortex - CORRECT ANSWER - Linked to depressed mood and problems
concentrating. Reduced in size and hyopactive in D, difficulty in thinking/planning-->rely on
amygdala so response is emotion based
Basal ganglia - CORRECT ANSWER - Linked to psychomotor agitation or retardation
Hypothalamus - CORRECT ANSWER - r/t loss of appetite, weight loss anhedonia (loss of
pleasure) -- neurovegetative signs.
Neurotransmitters and depression - CORRECT ANSWER - ↓Serotonin: mood, sleep,
impulsivity symptoms ↓Dopamine: pleasure, reward, psychomotor activity, fatigue, low energy,
cognition ↓Norepinephrine: mood, arousal, appetite , planning, concentrating ↓ GABA: anxiety,
agitation of depression ↑glutamate & NMDA receptors in frontal lobe (↑ neuronal cell death
Glial cells - CORRECT ANSWER - ↓ in number and density in depression Glial cells protect
neurons by stabilizing glutamate & supplying glucose to the neurons (stick like glue)
Synthesize & release neurotropic factors (Brain Derived Neurotropic Factor: BDNF)
these can stabilize with ADM-
Extra cellular glutamate accumulates - CORRECT ANSWER - Excess of glucocorticoids
(HPA axis) Decreased GLIA PFC Fewer glial glutamate transporters Neurons get exposed to
, MGRADES EXAMS
glutamate and can no longer function Progressive depression Damage to neurons (neurotoxicity)
2x greater risk of dementia with depression! not enough stabilization with GABA
PFC hyperactivity - CORRECT ANSWER - ↑CRF released from hypothalamus ACTH
released from pituitary Glucocorticoids (cortisol) released from adrenal cortex Excessive
glucocorticoid release may cause hippo-campal atrophy Atrophy leads to chronic activation of
HPA axisDepression, anxiety result. Antidepressants can reverse
Hypothalamic Dysregulation Circadian Rhythms of Sleep - CORRECT ANSWER - Delayed
sleep onset
Shortened REM latency
Increased length of 1st REM period
Abnormal delta sleep
May be reported as lack of sleep or atypical feature
of hypersomnia
Antidepressant meds treat circadian dysregulation
and can restore normal sleep architecture
If you do not use standardized tool - CORRECT ANSWER - Use two screening questions
instead: Over the past 2 weeks, have you felt down, depressed, or hopeless?" • and "Over the past
2 weeks, have you felt little interest or pleasure in doing things?"
History and clinical interview - CORRECT ANSWER - Do full interview if screening
indicates symptoms • Assess target symptoms: sleep, appetite, anhedonia, mood , suicidal
thinking, guilt, concentration, low energy, etc • Onset, course & duration, severity of symptoms;
recent or chronic stressors • New or occurred before? • Impact of these symptoms -on job,
education, family, friends • Current & past psych history (e.g. hospitalized?) • All medications-
OTC, herbs (past and current) • Substance abuse? (current, past)
Objective data - CORRECT ANSWER - Physical exam, wt, ht, labs (thyroid, anemia,
nutritional deficiency, UTI?), screening tools • Mental Status exam: • Appearance, mood, affect,
psychomotor, attitude, thought process, thought content, perception, judgment, insight, memory,
concentration, fund of knowledge, full Mental Status exam
