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Psychiatry > Anxiety > Flashcards

Anxiety Flashcards

1
Q

Treatment options for generalised anxiety disorder? (3)

A
  • ssri eg citalopram, fluoxetine, paroxetine. First line.
  • second line: venlafaxine (snri), buspirone
  • refractory or acute: benzos eg lorazepam, oxazepam, clobazam
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2
Q

Define panic attack criteria in terms of feeling, onset and symptoms (3)

A
  • Surge intense fear or discomfort
  • peak in minutes, last 10-20 min
  • 4 or more physical or psychological symptoms of intense anxiety/ intense autonomic arousal
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3
Q

Define panic disorder (3)

A
  • Recurrent, unexpected panic attacks
  • followed by continuous worries about the attacks for > 1 month
  • Or dysfunctional behaviour due to attacks
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4
Q

Prophylaxis of panic disorder?

A

Alprazolam and clonazepam (benzos)

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5
Q

What phobia is involved in social anxiety disorder (social phobia)?

A

Social situations where exposed to possible scrutiny about showing anxiety symptoms that will be negatively evaluated

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6
Q

What considerations must be taken before stopping anxiety medications? (6)

A
  1. One year complete remission (symptom free)
  2. Full functional restoration
  3. Patient has sense well-being
  4. it is right time in patient’s life-no upcoming stressors
  5. Stop slowly over months
  6. Reinstitute treatment if relapse! Follow up often.
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7
Q

How is normal and abnormal fear/anxiety differentiated? (4)

A 
• Destructive effect on functioning
• excessive subjective stress
• excessive duration
• excessive physical phenomena
( vs proportional normal)
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8
Q

Define limited symptoms attacks

A

Looks like panic attack but <4 characteristic features

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9
Q

Which term describes events that Looks like panic attack but <4 characteristic features

A

Limited symptom attacks

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10
Q

Name 3 things that may cause unprovoked panic attacks

A

• Panic disorder
• substances eg nicotine, alcohol
• medications esp sympathomimetics
Medical conditions eg arrythmia

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11
Q

Name 3 things that can cause provoked panic attacks

A

• Obsessions and compulsions
• phobias
• danger
Hallucinations, delusions

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12
Q

Biological treatment of panic disorder? First line

A

• Ssri:citalopram, fluoxetine etc - first line.

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13
Q

When may benzodiazepines be prescribed for panic disorder and which benzos are used (3)

A

• Quick response needed: lorazepam (“abortive”)
• to counteract ssri side effects
• refractory cases
Clonazepam (and alprazolam) for prophylax

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14
Q

Name 3 characteristics of other specified anxiety disorder

A

Do not meet criteria of other anxiety disorders. Explain why not in specification, eg
• Persistent, distressing, unprovoked limited symptom attacks without panic attacks

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15
Q

Name 4 characteristics that all phobic disorders have in common.

A

• Excessive, persistent , unreasonable and disproportionate fear and anxiety
• for a circumscribed stimulus eg object, situation
• Last 6 months or more!
• stimulus avoided or endured with much anxious distress
• impairs functioning/clinically significant distress
Not due to other msg (mental, substances, gen med disorder)

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16
Q

Timeline of panic disorder?

A

At least 1 month of symptoms

17
Q

In social anxiety disorder, what is the fear or anxiety about? (3)

A
  • Social situations
  • where exposed to possible scrutiny
  • About showing anxiety symptoms that will be negatively evaluated
18
Q

Name criteria A (situations) of agoraphobia (5)

A 
Marked fear or anxiety about 2 or more of the following : for 6 months
1. Using public transport
2. Being in open spaces
3. Being in enclosed spaces
4-standing in line or being in crowd
5. Being outside of home alone.
19
Q

Common psych comorbid with panic disorder

A

Agoraphobia

20
Q

Duration of social anxiety disorder?

A

6 months

21
Q

First line treatment of all phobic disorders?

A

Cbt! Systematic desensitisation

22
Q

Critenia a of generalised anxiety disorder? (3)

A

Excessive anxiety and worry (apprehensive expectation )
Occurring more days than not for at least 6 months in adults, 4 weeks kids
About a number of events or activities

23
Q

Critenia B of generalised anxiety disorder? (control)

A

Individual finds it difficult to control the worry

24
Q

Critenia C of generalised anxiety disorder? (symptoms) (6)

A

3 or more : (only 1 in children) at least 6 months

C FIRST

• difficulty concentrating or mind going blank

• easily fatigued

• irritability

• restless/keyed up or on edge

• sleep disturbance

• muscle tension

25
Q

Name 4 disadvantages of using benzodiazepines to treat gad, and 1 advantage.

A

Disadvantages: cognitive blunting (memory and conc) , slowing motor speed , withdrawal, habit forming
Advantage: responds within days (ssri take 6-8 weeks)

26
Q

Define selective mutism

A

Constant failure to speak in social situations in which there is expectation for speaking, despite speaking in other situations. at least one month.

27
Q

During which ages is separation anxiety normal?

A

Starts at one year
Peak 9 months - 18 months
Diminish 2 and a half to 5 years
Normal when entering day care or school for first time.

28
Q

What Is criteria a of separation anxiety disorder? (Symptoms) (8)

A

Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least 3:
1. Recurrent exessive distress when anticipate / experience separation from home or major attachment figures
2 persitent excessive worry about losing figures or possible harm eg illness, injury , disasters , death.
3. Persistent excessive worry about experiencing untoward event eg get lost, kidnapped, accident, ill, that causes separation
4. Persistent reluctance/refusal to go out, away from home, to school, work, elsewhere because fear separation
5. Persistent excessive fear or reluctance about being alone without figures in any setting
6. Persistent reluctance or refusal to sleep away from home or go to sleep without being near
7. Repeated nightmares involving separation
8. Repeated complaints physical symptoms eg headache, stomachache, vomiting etc when separation occurs or is anticipated

29
Q

What Is criteria B of separation anxiety disorder? (time period)

A

Fear, anxiety, avoidance persistent lasting at least 4 weeks in children and adolescents
6 or more months in adults

30
Q

Which adults pathology is Especially predicted if a child had separation anxiety disorder?

A

Panic disorder (and agoraphobia)

31
Q

Which children with separation anxiety disorder have a better prognosis? (3)

A

Younger (adolescents greater degree of dysfunction)
Maintain school activities, attendance and relationships (vs withdrawal and avoidance)
Treatment initiated in childhood (untreated will persist to adulthood)

32
Q

First line treatment of anxiety disorders in Children?

A

Cbt

2nd line ssri

33
Q

Name 12 symptoms of panic attacks

A

Need at least 4.

STUDENTS Fear 3Cs

  • sweating
  • trembling
  • unsteadiness, dizziness
  • depersonalization, derealization
  • excessive hr, palpitations
  • nausea
  • tingling
  • sob
  • fear of dying /losing control/ going crazy
  • chest pain
  • chills
  • choking
34
Q

Which is the only phobic disorder that responds to medical treatment

A

Social anxiety disorder

35
Q

Name 4 types other specified anxiety

A
  • limited symptom attacks
  • generalised anxiety disorders not occurring most days
  • khyâl cap (wind attacks) disorder
  • ataque de nervous (attack of nerves)
36
Q

Name 5 types (specifiers) specific phobia

A
  • Animal
  • natural environment eg heights, storms
  • blood - injection - injury
  • situational (airplane, closed spaces)
  • other eg loud noises, clowns
37
Q

Name 3 specifiers substance or medication induced anxiety disorder

A
  • With onset during intoxication
  • with onset during withdrawal
  • with onset after medication exposure
38
Q

How many symptoms most be met for panic attack

A

4

Psychiatry (31 decks)

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