NR547 FINAL EXAM WITH 100% CORRECT AND VERIFIED ANSWERS

NR547 FINAL EXAM
WITH 100%
CORRECT AND
VERIFIED
ANSWERS


What is the diagnostic criteria for persistent depressive disorder? - ANSWER:-->//Duration:
Depressed mood for most of the day, more days than not, for at least 2 years in adults

*children/adolescents: at least 1 year


Presence of at least 2 additional symptoms: poor appetite or overeating, insomnia or
hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making
decisions, feelings of hopelessness

,Symptom consistency: no symptom free periods lasting more than 2 months at a time during a 2
year period, no history of mania/hypomania

What is the treatment of persistent depressive disorder? - ANSWER:-->//CBT

SSRIs

SNRIs

Lifestyle interventions
Once a patient has been started on an antidepressant, before augmenting it what should happen
before? - ANSWER:-->//Make sure it is the adequate dose and duration
Make sure the patient is having good adherence

Minimize the side effects

Consider a dose adjustment

What are the appropriate recommendations to augment medications? - ANSWER:-->//1. Add a
second antidepressant (SSRI/SNRI)

2. Add an atypical antipsychotic (tx-resistant depression and MDD with psychosis)

3. Add a mood stabilizer (bipolar cases)

4. Add a dopaminergics or stimulant medication (low energy, apathy, cognitive symptoms)

5. Add a hormonal or nutritional support (helpful in patients with Subclinical hypothyroidism)

What does an SSRI + Bupropion do? - ANSWER:-->//Boosts energy and motivation, reduces
sexual side effects

What does an SSRI/SNRI + Mirtazapine do? - ANSWER:-->//Improves sleep, appetite, mood
When should an SNRI + TCA be used? - ANSWER:-->//Reserved for severe or resistant cases

What is amitriptyline and what is it used for? - ANSWER:-->//Tricyclic antidepressant

Used for: depression, chronic pain, migraines, insomnia

What is nortriptyline and what is it used for? - ANSWER:-->//Tricyclic antidepressant

Used for: depression, neuropathic pain

What is Imipramine and what is it used for? - ANSWER:-->//Tricyclic antidepressant
Used for: depression, panic disorder, enuresis

, What is Desipramine and what is it used for? - ANSWER:-->//Tricyclic antidepressant

Used for: depression, ADHD, neuropathic pain

What is Clomipramine and what is it used for? - ANSWER:-->//Tricyclic antidepressant

Used for: OCD, depression
What is Doxepin and what is it used for? - ANSWER:-->//Tricyclic antidepressant

Used for: depression, sleep disorders

What are common side effects of tricyclic antidepressants? - ANSWER:-->//Dry mouth,
constipation, blurred vision, urinary retention, cognitive impairment, orthostatic hypotension,
tachycardia, QT prolongation, sedation, weight gain, ED, decreased libido
What is the criteria for use of ECT? - ANSWER:-->//Rapid symptom relief is needed

Medications have failed

Intolerable side effects from medications

Patient cannot take medications

What are the contraindications to ECT? - ANSWER:-->//Recent stroke or increased ICP

Uncontrolled HTN

Cardiac arrhythmias
Severe osteoporosis

What is the diagnostic criteria for bipolar 1? - ANSWER:-->//At least 1 manic episode
(DIGFAST) + or - depressive episodes
Manic symptoms - ANSWER:-->//Elevated or irritable mood, grandiosity, decreased need for
sleep, pressure speech, flight of ideas/racing thoughts, risky behaviors, increased goal directed
activity or agitation

Treatment for bipolar 1 - ANSWER:-->//Mood stabilizers + or - antipsychotics; AVOID
antidepressant monotherapy (causes mania / hypomania)

What is the diagnostic criteria for bipolar 2? - ANSWER:-->//Hypomania + major depressive
episodes

Hypomanic symptoms - ANSWER:-->//Increases energy, confidence, sociability, creativity, or
productivity (no psychotic symptoms)

Treatment for bipolar 2 - ANSWER:-->//Mood stabilizers and atypical antipsychotics