85B Anxiety Disorders

Question 1

Anxiety Disorder

Answer 1

• excessive
• persistent
• unfounded nervousness
• interferes with activities

Question 2

Effects of overwhelming anxiety

Answer 2

• lower skilled motor movements
• decreased intelligence
• decreased learning and memory
• less assertiveness

Question 3

Anxiety Disorders: disease burden

Answer 3

• Afflicts 30% of population currently
• Early clinical onset, recurrence
• Comorbidity common (depression)
• Premature morbidity
• Leading source of disease-related disability for women worldwide.
• Second leading cause of functional disability for women worldwide in 2020.

Question 4

Criteria for Panic Disorder

Answer 4

• Recurrent unexpected panic attacks
• At least one of the attacks has been followed by 1 month or more of the following:
  
  • Persistent worry about having additional attacks
  • Worry about the implications of the attack or its consequences (losing control)
  • A significant change in behavior related to the attacks

Question 5

Criteria for Panic Attack

Answer 5

• symptoms peak with 10 minutes
• 4 of…
  
  • heart palpitations
  • sweating/trembling
  • numbness
  • SOB
  • chest pain….

Question 6

Causes of anxiety - deficiency

Answer 6

vitamin b12

Question 7

causes of anxiety - miscellaneous conditions

Answer 7

hypoglycemia
carcinoid syndrome
systematic malignancies
PMS
febrile illness

Question 8

causes of anxiety - toxic conditions

Answer 8

alcohol and drug withdrawl
vasopressor agents
penicillin
mercury, arsenic, phosphorus
aspirin intolerance

Question 9

Agoraphobia

Answer 9

anxiety of being in a public (outside, bus, bridge, etc and having a panic attack

Question 10

Panic disorder management - overview

Answer 10

pharmacotherapy

evidence-based psychotherapy

Question 11

panic disorder management - pharm

Answer 11

SSRIs
Benzodiazepine (alprazolam-xanax)
Tricyclics
MAOI

Question 12

panic disorder management - psychotherapy

Answer 12

anxiety management (breathing, relaxation)
cognitive testing
behavioral exposure (repeated controlled contact)

Question 13

Social phobia - criteria

Answer 13

fear of being humiliated/embarrassed
Anxiety around unfamiliar people
Recognize fear is excessive
Avoid social situations/endured with distress
Significant interference with normal functioning

Question 14

OCD - criteria

Answer 14

Obsessions OR compulsions

repetitive behaviors causing distress/time waste

Question 15

OCD - onset

Answer 15

most between 10-23 years; male=female

Question 16

OCD neurobiology

Answer 16

Serotonin

Increased activity in caudate, orbital gyri and cingulate gyri

Question 17

OCD management overview

Answer 17

Pharm
Psychotherapy
Psychosurgery

Question 18

OCD management - Pharm

Answer 18

SSRIs

Clomipramine (Anafranil)

Question 19

OCD management - psychotherapy

Answer 19

behavioral therapy

supportive therapy

Question 20

OCD management - psychosurgery

Answer 20

cingulotomy
subcaudate tractomy
anterior capsulotomy

Question 21

Generalized Anxiety Disorder (GAD) - criteria

Answer 21

> 6 months of worry out of proportion
difficulty controlling
physical symptoms (sleep issues, restlessness, irritability, tension)
Causes significant distress or impairment

Question 22

GAD - management

Answer 22

Pharm (benzodiazepines, SSRIs)

Psychotherapy (education, behavioral, supportive)

Question 23

Cognitive behavioral therapy

Answer 23

educate about anxiety
breathing exercises to control hyperventilation
exposure to cues