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Physiology 2 > Anxiety > Flashcards

Anxiety Flashcards

1
Q

What is anxiety?

A

Feeling of unease which can range from mild to severe

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2
Q

What is innate, adaptive anxiety?

A

Response to threatening stimuli that is made up of lots of components that are species specific

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3
Q

What is learned adaptive anxiety?

A

Fears that are learned through life experiences

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4
Q

When does anxiety become an issue?

A 
When chronic and irrational and leads to:
Social disturbances
Avoidance behaviours
Incessant worry 
Concentration/ memory problems
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5
Q

What can anxiety cause physiologically?

A 
Tachycardia
Shortness of breath
Headache and dizziness 
Pins and needles
GI disturbances
Nausea
Fatigue
Insomnia
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6
Q

What are some causes of anxiety?

A 
Past experiences
Everyday life and habits
Diet
Physical and mental health
Alcohol and drugs
Genes
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7
Q

Why can past experiences cause anxiety?

A

Difficult experiences in childhood, adolescence and adulthood are a common trigger for anxiety

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8
Q

What things in the diet can trigger anxiety?

A

Sugar and caffeine

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9
Q

How can alcohol and drugs cause anxiety?

A

CNS depressant increases GABAergic neurotransmission and blocks glutamatergic neurotransmission
This disrupts the GABA/glutamate balance
Brain acts to counteract it which leads to low GABA and high glutamate

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10
Q

Is anxiety genetic?

A

There are links, but def not caused by a single gene - may have a complex genetic basis

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11
Q

What is the stress response?

A

coordinated reaction to threatening stimuli

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12
Q

What is the stress response regulated by?

A

HPA axis

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13
Q

How does the HPA axis regulate the stress response?

A

Hypothalamus secretes CRH -> pituitary which secretes ACTH -> adrenal gland which secretes cortisol

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14
Q

What does overexpressing CRH in rodent models lead to?

A

Increased anxiety-like behaviour

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15
Q

What does knocking out CRH receptors in rodent molecules lead to?

A

Less anxiety-like behaviours

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16
Q

What relevance does the amygdala have in anxiety?

A

Stimulates HPA axis to promote cortisol release - hyperactivity linked to anxiety

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17
Q

What relevance does the hippocampus have in anxiety?

A

Suppresses HPA axis to prevent excessive cortisol release - under activity linked to anxiety

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18
Q

What are the three new (2013) classifications of anxiety disorders?

A

Anxiety disorders, obsessive-compulsive disorders and trauma and stressor related disorders

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19
Q

What is the main book for classification of anxiety disorders?

A

DSM-5

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20
Q

What falls into the bracket of anxiety disorders?

A

Generalised anxiety disorder
Specific phobias
Social phobias
Panic disorder

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21
Q

What falls into the bracket of obsessive-compulsive disorders?

A

OCD, body dismorphic disorder, hoarding disorder, trichotillomania (hair pulling)

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22
Q

What falls into the bracket of trauma and stressor related disorders?

A

PTSD

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23
Q

What is generalised anxiety disorder characterised by?

A

Ongoing (>6 months) state of excessive anxiety lacking clear reason or focus
Difficult to control and impairs activities of daily living

24
Q

What are the symptoms of GAD?

A 
Restlessness
Fatigue
Excessive anxiety and worry
Increased muscle aches and soreness
Impaired concentration 
Irritability
Difficulty sleeping
25
Q

How many symptoms do you need to be diagnosed with GAD?

A

3 or more

26
Q

What are specific phobias?

A

Extreme fears provoked by exposure to a particular situation or object

27
Q

What do specific phobias often lead to?

A

Avoidance behaviours

28
Q

How long do specific phobias have to last to be diagnosed?

A

At least 6 months

29
Q

What are social phobias?

A

Significant anxieties provoked by exposure to certain types of social or performance situations

30
Q

What are the categories of diagnosis for social phobias?

A

Social situations almost always provokes immediate fear or anxiety that is out of proportion to the actual danger
Persistent for at least six months, impairing the activities of daily living
Not attributable to anything else

31
Q

What is panic disorder characterised by?

A

Recurring panic attacks without a seemingly clear cause or trigger

32
Q

What is a panic attack?

A

Abrupt surge of intense fear or discomfort, reaching a peak within minutes

33
Q

What is a panic disorder associated with?

A

Four or more of 13 symptoms

34
Q

What are some of the symptoms associated with panic disorder?

A

Increased heart rate, sweating, trembling, shortness of breath and fear of dying

35
Q

What is OCD characterised by?

A

Obsessive, repetitive actions with no purpose

36
Q

What are some examples of obsessions?

A

Recurrent intrusive thoughts, images, ideas or impulses

37
Q

What are some examples of compulsions?

A

Repetitive behaviours or mental acts that are performed to reduce anxiety associated with the obsessions

38
Q

What is necessary for an OCD diagnosis?

A

Obsessions and compulsions are time consuming (over an hour a day), impairing activities of daily living and not attributable to anything else

39
Q

What is PTSD characterised by?

A

Distress triggered by the recall of past traumatic experiences

40
Q

What is PTSD triggered by?

A

Exposure to certain situations - actual or threatened death, serious injury or sexual violence

41
Q

What is PTSD associated with?

A

One or more intrusion symptoms

42
Q

What are the intrusion symptoms?

A

Recurrent intrusive memories, nightmares, dissociative reactions and psychological and physiological distress at exposure to cues resembling the traumatic event

43
Q

What are the types of anxiety disorder treatment?

A

Psychological (cognitive behavioural therapy)

Pharmacological (anxiolytics)

44
Q

What are some examples of anxiolytics?

A

Benzodiazepines
5-HT 1A receptor agonists
Beta noradrenergic receptor antagonists

45
Q

What are benzodiazepines?

A

GABAa receptor positive allosteric modulators

46
Q

How do benzodiazepines work?

A

Bind to the benzodiazepine binding site between the alpha and gamma subunits and stabilise it in the open configuration

47
Q

Why are benzodiazepines preferred?

A

Don’t activate other receptors

48
Q

What are some examples of benzodiazepines and their durations?

A

Midazolam (<6hrs), lorazepam (12-18hrs), alprazolam (24hr) and diazepam (24-48hrs)

49
Q

What are serotonin 1A receptor antagonists primarily used to treat?

A

GAD

50
Q

What is one example of a serotonin 1A receptor antagonist?

A

Buspirone

51
Q

What are some side effects of serotonin 1A receptor antagonists?

A

Dizziness, nausea and headache

52
Q

How does buspirone work?

A

Activates serotonin 1A auto receptors which initially inhibits serotonin release but eventually it downregulates serotonin auto receptors (leading to increased excitation of seratonergic neurons)

53
Q

Which work quicker, benzodiazepines or serotonin 1A receptor antagonists?

A

Benzodiazepines

54
Q

What is an example of a beta noradrenergic antagonist?

A

Propanolol

55
Q

What do beta noradrenergic receptor antagonists do?

A

Reduce some peripheral manifestations of anxiety

Like tachycardia, sweating, GI problems and tremor

56
Q

What is the effectiveness of beta noradrenergic receptor antagonists dependant on?

A

Blocking peripheral sympathetic responses rather than central effects

Physiology 2 (38 decks)

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