NR547 Final Exam 2025/2026 Updated |
Complete Questions & Correct Answers
Exact Exam
What is the diagnostic criteria for persistent depressive disorder?
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?
CBT
SSRIs
SNRIs
Lifestyle interventions
Once a patient has been started on an antidepressant, before augmenting it what should happen
before?
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?
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?
Boosts energy and motivation, reduces sexual side effects
,What does an SSRI/SNRI + Mirtazapine do?
Improves sleep, appetite, mood
When should an SNRI + TCA be used?
Reserved for severe or resistant cases
What is amitriptyline and what is it used for?
Tricyclic antidepressant
Used for: depression, chronic pain, migraines, insomnia
What is nortriptyline and what is it used for?
Tricyclic antidepressant
Used for: depression, neuropathic pain
What is Imipramine and what is it used for?
Tricyclic antidepressant
Used for: depression, panic disorder, enuresis
What is Desipramine and what is it used for?
Tricyclic antidepressant
Used for: depression, ADHD, neuropathic pain
What is Clomipramine and what is it used for?
Tricyclic antidepressant
Used for: OCD, depression
What is Doxepin and what is it used for?
Tricyclic antidepressant
Used for: depression, sleep disorders
What are common side effects of tricyclic antidepressants?
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?
Rapid symptom relief is needed
Medications have failed
Intolerable side effects from medications
Patient cannot take medications
, What are the contraindications to ECT?
Recent stroke or increased ICP
Uncontrolled HTN
Cardiac arrhythmias
Severe osteoporosis
What is the diagnostic criteria for bipolar 1?
At least 1 manic episode (DIGFAST) + or - depressive episodes
Manic symptoms
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
Mood stabilizers + or - antipsychotics; AVOID antidepressant monotherapy (causes mania /
hypomania)
What is the diagnostic criteria for bipolar 2?
Hypomania + major depressive episodes
What is the HAM-D?
Clinician administered depression rating scale that monitors the severity of depression symptoms
with a focus on psychological and physical aspects of depression (scored 0-2 or 0-4).
What is the components of the HAM-D?
Mood, guilt feelings, SI, insomnia, work and activities, psychomotor agitation or retardation,
anxiety, somatic symptoms, hypochondriasis, loss of weight, insight
HAM-D score that indicates no depression?
0-7
HAM-D score that indicates mild depression?
8-16
HAM-D score that indicates moderate depression?
17-23
HAM-D score that indicates severe depression?
24 or >
Complete Questions & Correct Answers
Exact Exam
What is the diagnostic criteria for persistent depressive disorder?
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?
CBT
SSRIs
SNRIs
Lifestyle interventions
Once a patient has been started on an antidepressant, before augmenting it what should happen
before?
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?
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?
Boosts energy and motivation, reduces sexual side effects
,What does an SSRI/SNRI + Mirtazapine do?
Improves sleep, appetite, mood
When should an SNRI + TCA be used?
Reserved for severe or resistant cases
What is amitriptyline and what is it used for?
Tricyclic antidepressant
Used for: depression, chronic pain, migraines, insomnia
What is nortriptyline and what is it used for?
Tricyclic antidepressant
Used for: depression, neuropathic pain
What is Imipramine and what is it used for?
Tricyclic antidepressant
Used for: depression, panic disorder, enuresis
What is Desipramine and what is it used for?
Tricyclic antidepressant
Used for: depression, ADHD, neuropathic pain
What is Clomipramine and what is it used for?
Tricyclic antidepressant
Used for: OCD, depression
What is Doxepin and what is it used for?
Tricyclic antidepressant
Used for: depression, sleep disorders
What are common side effects of tricyclic antidepressants?
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?
Rapid symptom relief is needed
Medications have failed
Intolerable side effects from medications
Patient cannot take medications
, What are the contraindications to ECT?
Recent stroke or increased ICP
Uncontrolled HTN
Cardiac arrhythmias
Severe osteoporosis
What is the diagnostic criteria for bipolar 1?
At least 1 manic episode (DIGFAST) + or - depressive episodes
Manic symptoms
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
Mood stabilizers + or - antipsychotics; AVOID antidepressant monotherapy (causes mania /
hypomania)
What is the diagnostic criteria for bipolar 2?
Hypomania + major depressive episodes
What is the HAM-D?
Clinician administered depression rating scale that monitors the severity of depression symptoms
with a focus on psychological and physical aspects of depression (scored 0-2 or 0-4).
What is the components of the HAM-D?
Mood, guilt feelings, SI, insomnia, work and activities, psychomotor agitation or retardation,
anxiety, somatic symptoms, hypochondriasis, loss of weight, insight
HAM-D score that indicates no depression?
0-7
HAM-D score that indicates mild depression?
8-16
HAM-D score that indicates moderate depression?
17-23
HAM-D score that indicates severe depression?
24 or >
