109b - Trauma and PTSD Flashcards

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1
Q

How does regulation of the hypothalamic-pituitary-adrenal axis change in PTSD?

A

There is excess regulation

  • PTSD patients have abnormally low plasma cortisol levels
    • Increased cortisol suppression during a dexamethasone suppression test
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2
Q

What defines acute stress disorder?

A
  • Onset in the first month following trauma
  • Predicts later development of PTSD
  • Diagnosis requires symptoms of
    • Distressing memories, dreams, reactions, phsyiological response
    • Efforts to avoid ^
    • Inability to experience positive emotions
    • Altered sense of reality
    • Sleep disturbance, hypervigilence, problems concentrating

(Many listed to define diagnosis, these are general patterns - not diagnostic)

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3
Q

How is PTSD treated?

A
  • Psychotherapy
    • Cognitive processing
    • Prolonged exposure
  • Medications
    • SSRI, SNRI, or TCA
    • Prazosin
      • Can help with nightmares
    • Do not give benzos
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4
Q

What is the treatment for acute stress disorder?

A

Cognitive behavioral therapy

  • Decrease symptom severity
  • Decrease rates of conversion to PTSD
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5
Q

What is the role of benzodiazepines in the treatment of PTSD?

A

There is none!

Don’t give them!!

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6
Q

What is psychogenic amnesia?

A
  • Retrograde amnesia
    • Cannot recall own identity - “fugue state”
  • Prognosis is good
    • If the individual manages to avoid being framed for crimes he did’t commit
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7
Q

List 3 neurobiologic changes of PTSD

A
  • Excess regulation of the HPA axis -> low plasma cortisol
  • Decreased activity in anterior cingulate, ventromedial prefontal cortex -> Dysregulation of amygdala (goes into overdrive)
  • Decreased hippocampal volume
    • An effect of PTSD and a factor that predisposes people to PTSD
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8
Q

What syptom differentates acute stress disorder from PTSD?

A

People with ASD may experience an altered sense of reality of ones surroundings or self

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9
Q

How can PTSD be prevented?

A

By preventing trauma

(Unfortuantely, after the traumatic event no evidence-based treatment to prevent onset of PTSD)

But if a person has acute stress disorder after trauma, CBT can reduce rates of conversion to PTSD

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10
Q

Describe the natural course of PTSD

A
  • Onset may be delayed by deckads
  • Prognossis is good for may patients
    • Only 10% experience no change or worsening
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