Anxiety Flashcards

Question

adverse effects of SNRI's

Answer 1

nausea, headache, anorexia, insomnia, somnolence, sexual dysfunction, withdraw syndrome, sweating, blurred vision, increased LFT's (duloxetine) contraindicated with MAOI

Answer 2

amitriptyline imipramine 2-6 weeks for therapeutic effects inexpensive

Answer 3

sedation orthostatic hypotension anticholinergic effects sexual dysfunction cardiac toxicity abrupt withdraw may cause nausea, headache, vertigo significant drug-drug interaction with MAOI- causes HTN crisis Fatal overdose

Answer 4

phenelzine tranylcypromine isocarboxazid used less often treats refractory depression but works better for atypical depression most serious side effect HTN crisis when taken with tyramine

Answer 5

food/drug interactions- avoid tyramine foods (aged cheese, smoked meats, yeast, red wine) CNS stimulation orthostatic hypotension can lead to rapid increases in BP, stroke, coma significant drug/drug interactions with antihypertensive, SSRI, indirect-acting sympathomimetics (ephedrine), TCA, meperidine

Answer 6

atypical antidepressant stimulant effect, decreased appetite 1-3 weeks for effect doesn't tend to affect libido or sexual function

Answer 7

anti-anxiety medication used in patients sensitive to SSRI tx relieves anxiety with less drowsiness and abuse potential non habit forming and low toxicity

Answer 8

propranolol, atenolol help manage short-term physical symptoms of anxiety by lowering BP and HR

Answer 9

clonazepam alprazolam lorazepam diazepam may be used in initial stage of treatment rapid onset (hours) high tolerability abrupt discontinuation can trigger severe withdraw and intense rebound anxiety

Answer 10

sedation ataxia impaired coordination slurred speech memory impairment and dizziness high risk for falls alcohol can potentiate effects

Answer 11

lowest dose necessary monitor for sedation and risk of falls restrict caffeine use avoid alcohol and other sedatives, alcohol can be fatal don't discontinue abruptly enhances action of GABA promotes sleep promotes amnesia (flunitrazepam- date rape drug) teratogenic

Answer 12

do not change dose or frequency without approval unsafe to handle heavy equipment alcohol can potentiate depressant effects caffeine and nicotine decrease effects avoid becoming pregnant, excreted in breast milk MAOI's require special diet cessation of Benzo's and antidepressants may cause withdraw take meds after meals

Answer 13

deep breathing physical exercise progressive relaxation mental imagery meditation biofeedback

Answer 14

excessive unrealistic fear about past and future, weather, school, health, family, finances treatment: paroxetine, buspirone can start as early as 6 years old

Answer 15

normal part of infant development 8 months of age and peaks at 18 months exhibit developmentally inappropriate levels of concern over being away from significant other fear of something horrific happening interferes with normal activities, causes sleep disturbances, nightmares, and physical symptoms adults: symptoms manifest as harm avoidance, worry, shyness, uncertainty, lack of self direction, impaired social and occupational functioning

Answer 16

persistent fear attached to a specific object, activity or situation that is out of proportion compelling desire to avoid anxiety causing thing always anticipated

Answer 17

most severe and persistent phobic disorder fear of being alone or in public places without escape feared places are avoided starts late adolescence or early adulthood females fear, anxiety, or avoidance cause clinical distress/impairment in social, occupational, or other areas of functioning associated with adverse childhood events, stressful life events, overprotective and emotional cool families, genetic component

Answer 18

SSRI antidepressants short term benzo's CBT desensitization and flooding

Answer 19

gradually introduced to anxiety/fear object or experience taught relaxation techniques at each step when anxiety becomes overwhelming

Answer 20

exposed to a large amount of an undesirable stimulus to decrease anxiety learns through prolonged exposure that survival is possible and anxiety diminishes

Answer 21

social anxiety provoked by exposure to a social or performance situation that could be evaluated negatively by others intense fear of being criticized by others fear of humiliation withdraw from situations can worry days/weeks before dreaded situation may interfere with work school causes: inherited traits, amygdala plays role in fear response, may be learned behavior

Answer 22

childhood mistreatment and adverse childhood events shyness having parents that are shy SSRI's and Benzo's are used to treat

Answer 23

persistent irrational fear of a specific object, activity or situation that leads to avoidance of the object, activity or situation provokes immediate fear or anxiety and is avoided fear and anxiety is out of proportion to actual danger common phobias include dogs, spiders, heights, storms, water, blood, closed spaces, tunnels, bridges, birds and insects meds have not proven beneficial treatment choice psychotherapy/desensitization/ flooding

Answer 24

chronic condition characterized by panic attacks suspended normal functioning perceptual field severely limited feelings of impending doom, fear of dying, fear of loosing control, or going crazy can occur out of the blue chest pain, discomfort, palpitations, pounding heart, accelerated HR, sweating, trembling or shaking, sensations of shortness of breath or smothering, feeling of chocking, paresthesia, dizziness overwhelming stress can induce circulating stress hormones which stimulate glutamate women more likely to experience panic disorder with agoraphobia

Answer 25

anticipatory anxiety- fearful expectation of panic anxiety onset avoidance anxiety- personal strategies used to increase feeling of control and decrease the risk of panic anxiety

Answer 26

CBT anti-depressants- SSRI's, SNRI, TCA, MAOI Benzo's- second line

Answer 27

rule of life threatening illness- especially cardiac stay with patient reassure them that you will not leave give clear direction minimal stimulation administer PRN anti-anxiety medications

Answer 28

repetitive unwanted thoughts/ obsession's repeated activities/ rituals compulsions time consuming distressing to family and friends onset in early 20's to mid 30's females females have higher incidence of checking and cleaning rituals, onset early 20's symptoms are gradual obsession's/compulsions are time consuming causing impairment in social, occupational functioning cognition may be impaired stress can increase symptoms sexual and physical abuse in childhood or trauma increases risk genetics are strongly associated with OCD

Answer 29

unwanted intrusive and persistent thoughts, impulses, or images that persist and recur so that they cannot be dismissed from the mind obsession's often seem senseless obsessions experienced or expressed are often not consistent with the individuals self perception or usual thought pattern causing extreme distress

Answer 30

performed repeatedly ritualistic goal of preventing or relieving anxiety and distress caused by obsession's temporarily reduces anxiety ex: handwashing, touching things in sequence, counting things, locking and unlocking doors

Answer 31

very difficult to treat SSRI's (clomipramine, fluoxetine, fluvoxamine, paroxetine, sertraline) CBT exposure thearpy EMDR transcranial magnetic stimulation (TMS) DBS

Answer 32

clomipramine fluvoxamine fluoxetine sertraline behavior therapy exposure therapy CBT

Answer 33

preoccupation with one or more perceived defect or flaw performed repetitive behaviors like checking mirrors, excessive grooming, skin picking, reassurance seeking) intrusive un-wanted, time consuming, difficult to control most common age of onset 12-13 years high risk of suicide

Answer 34

CBT SSRI's alternative therapies including biofeedback, meditation and relaxation

Answer 35

difficulty in discarding or parting with possessions, regardless of value distress or impairment in social, occupational or other areas of functioning affects both male and females emerge in adolescence, being to interfere in functioning in the 20's and significantly impairs functioning in 30's experience MDD and/or anxiety disorders SAFETY is a big concern

Answer 36

hair pulling disorder recurrent hair pulling, scalp, eyebrows and eyelides/lashes causes distress or impairment in social, occupational, or other areas of functioning women adolescence coinciding with or following puberty treatment includes both behavior therapy and pharmacotherapy with SSRI's

Answer 37

repeatedly pulling hair out, scalp, eyebrows, eyelashes increasing sense of tension before pulling, and when resisting pulling sense of pleasure after pulling noticeable hair loss hair pulling, biting, chewing or eating pulled hair can cause bowel blockage playing with pulled hair or rub it across lips significant distress or problems with work, school or in social situations related to pulling out your hair self-injury behaviors also pick their skin, bite nails or chew lips pull hair in private and generally try to hide the disorder from others

Answer 38

skin picking resulting in skin lesions face, arms and hands skin rubbing, squeezing, lancing, or biting women during adolescence coinciding with puberty often seen with OCD and trichotillomania treatment is combination of SSRI and CBT

Answer 39

directly experiencing a traumatic event witnessing in person, learning about traumatic event experiencing repeated or extreme exposure does not include exposure to electronic media like television, movies or photographs can occur a month following an exposure, but symptom delay of months or years is not uncommon

Answer 40

four core symptoms ( re-experiencing symptoms, avoidance, arousal and reactivity, cognitive and mood symptoms)

Answer 41

flashbacks bad dreams frightening thoughts

Answer 42

staying away from places, events, or objects that are reminders of traumatic experiences avoiding thoughts or feeling related to the traumatic event

Answer 43

being easily startled feeling tense or on edge difficulty sleeping angry outbursts

Answer 44

trouble remembering key features of the traumatic event negative thoughts about oneself or the world distorted feelings like guilt and blame loss of interest in enjoyable activities

Answer 45

pre-trauma factors- lower socioeconomic status, parental neglect, person or family psychiatric disease, female, poor social support peri-trauma factors- severity, intensity, frequency, and duration of trauma, initial severity of person's reaction to trauma, unpredictability and uncontrollability of the trauma post-trauma factors- lack of social support, life stress, failure for early identification and treatment women are twice as likely than men to develop PTSD

Answer 46

trauma focused psychotherapy- exposure, CPT, eye movement desensitization and reprocessing (EMDR) meds: SSRI- sertraline, paroxetine, fluoxetine SNRI- Venlafaxine

Answer 47

recalling stressful past events and reprogramming the memory to give a positive spin uses rapid eye movements to facilitate the process of EMDR

Answer 48

have one or more mental health illnesses depression anxiety disorders substance use disorders

Answer 49

occurs with first month of exposure to extreme trauma, combat, rape, physical assault, near death experience or witnessing a murder symptoms begin 3 days to one month following the traumatic event person continually re-experience the event, avoids situations that remind him/her of the event and has increased anxiety and excitation that negatively affects lifestyle must have at least 3 of the following- numbing, detachment, reduction of awareness of ones surroundings, derealization, depersonalization, dissociate amnesia usually resolves within 2-28 days following exposure to trauma if symptoms continue beyond 1 months diagnosis is changed to PTSD ** this differs from PTSD because they disassociate

Answer 50

18 and younger symptoms of traumatic stress can be confused with symptoms of ADHD treatment depends on childs age, symptoms, and general health early diagnosis and treatment is important CBT, EMDR currently no FDA approved meds for children SSRI's may improve social and school functioning

Answer 51

counterbalance perceived deficiencies by emphasizing strengths ex: woman anonymously donates to her colleague's GoFundMe

Answer 52

the unconscious transformation of anxiety into a physical symptom with no organic cause ex: almost always a pathological defense

Answer 53

escaping unpleasant, anxiety-causing thoughts, feelings, wishes, or needs by ignoring their existence ex: Man reacts to loved ones death by saying no, I don't believe you to initially protect himself from the overwhelming news

Answer 54

the transference of emotions associated with a particular person, object, or situation to another nonthreatening person, object, or situation ex: a child yells at his teddy bear after being bullied at school all day

Answer 55

a disruption in consciousness, memory, identity, or perception of the environment that results in compartmentalizing uncomfortable or unpleasant aspects of oneself. ex: an art student is able to mentally separate herself from a noisy environment as she becomes absorbed in her work

Answer 56

attributing to oneself the characteristics of another person or group. May be conscious or nonconscious ex: an 8yr old girl dresses up like her teacher and puts together a pretend classroom for her friends

Answer 57

events are analyzed based on remote, cold facts and without passion, rather than incorporating feeling and emotion into the processing ex: despite loosing his farm in a tornado, a man leads his child to safety

Answer 58

the unconscious rejection of emotionally unacceptable features and attributing them to others no example this is considered an immature defense mechanism

Answer 59

justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanations that satisfy the teller and the listener ex: employee says " I didn't get a raise because my manager doesn't like me"

Answer 60

unacceptable feelings or behaviors are controlled and kept out of awareness by developing the opposite emotion or behavior. ex: recovering alcoholic constantly talks about the evils of drinking

Answer 61

reverting to earlier, more primitive and child like pattern of behavior that may or may not have been exhibited previously ex: a 4yr suddenly starts sucking his thumb and asking for a baby bottle

Answer 62

unconscious exclusion of unpleasant or unwanted experiences, emotions, or ideas from conscious awareness ex: after a marital fight, a man forgets his wife's birthday

Answer 63

an unconscious process of transforming negative impulses into less damaging and even productive impulses ex: a woman who is mad at her boss channels her feelings into housework until her house is sparkling clean

Answer 64

the conscious decision to delay addressing a disturbing situation or feeling

Answer 65

a person makes up for a regrettable act or communication ex: after flirting with her male secretary, a woman buys her husband concert tickets