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Mental Health > Anxiety > Flashcards

Anxiety Flashcards

1
Q

What is the main problem with using citalopram?

A

Prolongation of QT interval —> increase the risk of arrhythmias.

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2
Q

Name the physical symptoms of anxiety

A

Muscle tension - headaches, pain and dizziness.
Hyperventilation - dizziness, tingling fingers and toes.
Sympathetic overactivity - tachycardia, hypertension, ectopic beats, sweating, pallor, dry mouth, butterflies and nausea.

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3
Q

Name the psychological symptoms of anxiety

A

CNS - poor concentration, poor memory, derealisation.
Mood - fear, panic, worry, on edge, irritable.
Thoughts - danger, not coping, loosing control, worry about worry.

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4
Q

What are the unhelpful behaviours in anxiety?

A

Attempts at coping (caffeine, smoking, alcohol, drugs), avoidance, safety behaviours, reassurance.

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5
Q

Name the main types of anxiety disorders

A

Generalised anxiety disorder, panic disorder, phobias, health anxiety, insomnia, PTSD, OCD, acute stress reaction, adjustment disorders.

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6
Q

General investigations for anxiety?

A

Bloods - FBC, TSH
GAD-7 & PHQ-9
Collateral history

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7
Q

Treatments for anxiety?

A

Education, relaxation techniques, sleep hygiene and exercise.
CBT.
SSRIs e.g. sertraline, fluoxetine.
Benzodiazepines e.g. diazepam, lorazepam.
Beta blockers e.g. propranolol.

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8
Q

What is a phobia?

A

Marked and persistent fear/anxiety that is triggered by a specific object or situation, which aren’t currently dangerous, that leads to avoidance of that object/situation.

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9
Q

What are the types of phobia?

A

Agoraphobia, social phobia, specific phobia.

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10
Q

Management of phobia?

A

CBT - graded exposure (desensitisation).

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11
Q

What is generalised anxiety disorder?

A

Anxiety which is generalised and persistent but not restricted to or predominating in any particular environmental circumstance (free floating).

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12
Q

What is panic disorder?

A

Recurrent attacks of severe anxiety/panic which aren’t restricted to any particular situation/circumstance, so are therefore unpredictable.

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13
Q

What is PTSD?

A

Post traumatic stress disorder - delayed and/or extended response to a stressful event/situation of an exceptionally threatening/catastrophic nature.

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14
Q

What is OCD?

A

Obsessive compulsive disorder - recurrent intrusive thoughts (obsessions) that cause anxiety leading to repetitive behaviours (compulsions) that neutralise anxiety.

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15
Q

What is acrophobia?

A

Fear of heights.

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16
Q

What is tocophobia?

A

Fear of childbirth.

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17
Q

What are the clinical features of GAD?

A

Apprehension, motor tension and autonomic overactivity that is present for most days for several weeks-months. Free floating anxiety.

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18
Q

What is the main risk factor for GAD?

A

Chronic environmental stress.

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19
Q

Management for GAD?

A

Sleep hygiene and relaxation techniques.
CBT.
SSRIs e.g. sertraline or SNRIs e.g. venlafaxine.

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20
Q

Clinical features for panic disorder?

A

Sudden onset of palpitations, chest pain, depersonalisation, derealisation and fear. Only lasts minutes.

21
Q

Aetiology of panic disorder?

A

Inappropriately learned response to normal physiological symptoms, selective attention to body symptoms and avoidance of anxiety provoking situations reinforces behaviour.

22
Q

Management of panic disorder?

A

CBT, SSRIs, TCAs e.g. imipramine, clomipramine.

23
Q

Is social phobia more common in males or females?

A

Equally common in males and females.

24
Q

Phobic anxiety often coexists with what other psychiatric condition?

A

Depression.

25
Q

How do phobias occur?

A

Classical conditioning - association of a conditioned stimulus with an unconditioned response.

26
Q

How are phobias maintained?

A

Operant conditioning - punishment and negative reinforcement.

27
Q

Define agoraphobia

A

Fear of open spaces, crowds and difficult immediate escape to a safe space. Examples: fear of leaving home, entering shops or travelling alone.

28
Q

Define social phobia

A

Fear of scrutiny by other people in small groups, leading to avoidance of social situations.

29
Q

Define specific phobia

A

Phobias restricted to highly specific situations. Examples: fear of animals, heights, thunder, darkness, flying, closed spaces, public toilets, foods, dentists, blood and exposure to diseases.

30
Q

OCD is equally common in males and females. True or false?

A

True.

31
Q

Average age of OCD onset?

A

Childhood/early adulthood.

32
Q

Management of OCD?

A

CBT - exposure and response prevention.
SSRIs.
Clomipramine.

33
Q

Give examples of stressful events that could cause PTSD

A

Natural/man-made disaster, combat, serious accident, witnessing violet death, victim of torture/terrorism/rape.

34
Q

Clinical features of PTSD?

A

Repeated reliving of trauma in flashback or dreams, emotional blunting, detachment, anhedonia, avoidance, hyperarousal with hypervigilance, insomnia, anxiety and depression.

35
Q

Management of PTSD?

A

Eye movement desensitisation reprocessing (EMDR).
Trauma-focussed CBT intervention (narrative exposure therapy).
SSRIs e.g. sertraline.

36
Q

Define the acute stress reaction

A

Transient disorder of significant severity in response to exceptional physical and/or mental stress. Usually subsides within hours/days.

37
Q

Define adjustment disorder

A

Subjective distress and emotional disturbance arising in the period of adaptation to a significant life change or consequence of a stressful event.

38
Q

Define dissociative disorders

A

Partial/complete loss of normal integration between past memories, awareness of identity and immediate sensations, and control of body movements.

39
Q

What are the 3 common features of PTSD?

A

Re-experiencing, avoidance, hyperarousal.

40
Q

If SSRIs have shown to be ineffective in a patient with GAD, what is the next step?

A

Try a SNRI such as duloxetine or venlafaxine.

41
Q

Benzodiazepines vs barbiturates

A

Benzodiazepines increase the frequency of chloride channels. Barbiturates increase the duration of chloride channel opening.

42
Q

What is the first line pharmacological therapy for GAD?

A

SSRIs e.g. sertraline.

43
Q

Acute stress disorder vs PTSD

A

Acute stress disorder is an acute stress reaction that occurs in the 4 weeks after a traumatic event, as opposed to PTSD which is diagnosed after 4 weeks.

44
Q

What is the first line treatment for acute stress disorders?

A

Trauma focused CBT.

45
Q

When is an abnormal grief reaction more likely to occur?

A

Sudden and unexpected death, little support, problematic relationship before death.

46
Q

What is delayed grief?

A

When more than 2 weeks passes before grieving begins.

47
Q

Are pseudo-hallucinations part of normal grieving?

A

Yes.

48
Q

What is the first-line medication for panic disorder?

A

SSRIs

Mental Health (13 decks)

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