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CLINICAL YR: Psych > 18% Anxiety disorders; Trauma- and stress-related disorders > Flashcards

18% Anxiety disorders; Trauma- and stress-related disorders Flashcards

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1
Q

(SmartyPance)

treatment for adjustment disorder

A

psychotherapy

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2
Q

(SmartyPance)

reaction out of proportion to a stressor

A

adjustment disorder

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3
Q

(SmartyPance)
disproportionate RESPONSE TO A STRESSOR that would normally be expected which BEGIN WITHIN 3 MONTHS of the stressor and END WITHIN 6 MONTHS after stressor resolved

A

adjustment disorder

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4
Q

(SmartyPance)

define panic disorder

A

an occurrence of THREE PANIC ATTACK (sudden unexpected periods of intense fear or discomfort) episodes in THREE WEEKS

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5
Q

(SmartyPance)

treatment for an occurrence of 3 panic attacks in 3 weeks

A

SSRIs (paroxetine, sertraline, fluoxetine)
Benzodiazepines (acute attacks)
CBT (relaxation, desensitization, examining behavior consequences)

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6
Q

(SmartyPance)
for defining panic disorder ~
at least one of the attacks has been followed by ______

A

…one month (or more) of one or both of the following:

1 - persistent concern or WORRY ABOUT ADDITIONAL PANIC ATTACKS or their consequences

2 - a significant MALADAPTIVE CHANGE IN BEHAVIOR related to the attacks

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7
Q

(SmartyPance)

what disorder is treated with SSRIs, benzos, and CBT?

A

panic disorder

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8
Q

(SmartyPance)

define generalized anxiety disorder

A

EXCESSIVE ANXIETY and worry OCCURRING MORE DAYS THAN NOT for at least SIX MONTHS about a number of events or activities (such as work or school performance)

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9
Q

(SmartyPance)
a 35 y/o female with a complaint of worry which she cannot control for the last year. She tells you her symptoms daily consist of sleep disturbances, difficulty concentrating, and irritability. She reports her symptoms started around age 17 but have worsened.

A

Generalized anxiety disorder

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10
Q

(SmartyPance)

diagnosis for Generalized Anxiety Disorder requires three or more of the following symptoms

A

RESTLESSNESS or feeling keyed up or on edge
FATIGUE - being easily fatigued
CONCENTRATING - difficulty concentrating or mind going blank
IRRITABILITY
MUSCLE TENSION
SLEEP DISTURBANCE (difficulty falling or staying asleep, or restless, unsatisfying sleep)

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11
Q

(SmartyPance)

what two exclusions are made for diagnosing generalized anxiety disorder?

A

disturbance is not attributable to the physiological effects of a substance or another medical condition

disturbance is not better explained by another mental disorder

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12
Q

(SmartyPance)

two key features of generalized anxiety disorder

A

its difficult to control the worry

the anxiety causes clinically significant distress or impairment

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13
Q

(SmartyPance)

four mainstays of treatment for generalized anxiety disorder

A

1 - SSRIs (paroxetine and escitalopram); SNRIs (venlafaxine)

2 - buspirone (start at 5mg PO bid or tid, takes 2 wks to start working)

3 - benzos (short term use), beta blockers

4 - psychotherapy

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14
Q

(SmartyPance)

duration of a social phobia to be defined as social phobia

A

6 months

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15
Q

(SmartyPance)

first line therapy for specific phobias

A

exposure therapy

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16
Q 
(RoshReview)
"Which of the following patients would be most likely to present with generalized anxiety disorder?"
a) 16 y/o boy
b) 21 y/o woman
c) 35 y/o man
d) 45 y/o woman
A

b) 21 y/o woman

GAD typically begins in early adulthood, slightly more common in women

17
Q

(RoshReview)
which of the following is a risk factor for panic disorder?

a) advanced age
b) male sex
c) neuroticism personality trait
d) obesity

A

C) NEUROTICISM PERSONALITY TRAIT

  • panic disorder most often begins in adolescence or young adults
  • panic disorder is more common in female sex
  • obesity does not increase risk of panic disorder
18
Q

(RoshReview)

“what psychiatric comorbidities are most commonly associated with post-traumatic stress disorder?”

A

depressive disorders
anxiety disorders
substance use disorders

19
Q

(RoshReview)

alterations in behavior (reactivity) commonly seen with PTSD (4)

A

reckless or self-destructive behavior
hypervigilance
concentration difficulty
sleep disturbance

20
Q

(RoshReview)

risk factors for PTSD (5)

A 
females
personal psychiatric hx
childhood trauma or abuse
poor social support
lower SES
21
Q

(RoshReview)

timeline of s/s of PTSD

A

w/in a few months of inciting event

22
Q

(RoshReview)

preferred first line treatment of PTSD

A

psychotherapy

meds should be considered for pts who are unable or unwilling to undergo psychotherapy

23
Q

(PPP 596)

what can be done for PTSD affects on sleep?

A

TRAZADONE - may be helpful for insomnia

PRAZOSIN - may be used for nightmares and hypervigilance

24
Q

(PPP 596)

management of PTSD

A

SSRIs - first line med treatment (paroxetine, sertraline, fluoxetine)

CBT - psychotherapy including individual or group counseling, relaxation techniques

25
Q

(PPP 596)

PTSD qualifying diagnostic criteria

A

AT LEAST 2 NEGATIVE ALTERATIONS IN COGNITION AND MOOD

AT LEAST 2 AROUSAL & REACTIVITY SYMPTOMS

26
Q

(RoshReview)

what are three risk factors for panic disorder?

A

FH of panic disorder
NEUROTICISM PERSONALITY TRAIT
childhood physical or sexual abuse

27
Q

(RoshReview)

a common finding in panic disorder is

A

agoraphobia

28
Q

(PPP 568)

MOA of buspirone

A

partial 5HT-1A receptor agonist & dopamine receptor antagonist

29
Q

(PPP 568)

when is buspirone prescribed?

A

GAD

- - does not cause sedation & does not potentiate the CNS depression of alcohol

30
Q

(PPP 568)

how long does it take buspirone to take full effect?

A

1-2 weeks

31
Q

(PPP 569)

two key pieces of diagnostic criteria for specific phobias

A
  • persistent intense fear or anxiety of a specific situation, object or place
        • at least 6 months
  • everyday activities must be impaired by distress or avoidance of the situation or object
32
Q

(PPP 569)

how do we manage specific phobias?

A

exposure
desensitization therapy

short-term benzos or beta-blockers can be used in some pts

33
Q

(PPP 568)

first line management of generalized anxiety disorder

A

SSRIs (fluoxetine, paroxetine, escitalopram)
or
SNRIs (venalfaxine)

34
Q

(PPP 568)

what is an adjunct to SSRIs for treatment of GAD?

A

buspirone can be adjunct to SSRIs (does not cause sedation)

CLINICAL YR: Psych (8 decks)

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