Anxiety *** Flashcards

1
Q

RF for anxiety

A

Fam hx, childhood anxiety, stress, abuse

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2
Q

Sx

A

Restlessness
Palpitations
SOB
Hyperventilation
CP
Sweating
Dyspepsia
Fatigue
Insomnia
Dizziness
Abdo pain

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3
Q

GAD

A

Excessive + difficult to control anxiety + worry
Restlessness, feeling on edge or muscular tension

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4
Q

panic disorder

A

Recurrent, unexpected attacks in absence of triggers
Concern about future attacks
Sweating, trembling, derealisation, palpitations, nausea, tingling

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5
Q

PTSD

A

Exposure to actual or threatened death
Flashbacks
Nightmares
Hypervigilance or irritability
Avoidance of stimuli
Negative alterations in cognition and mood

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6
Q

OCD

A

Obsessions - recurrent, persistent thoughts, causes anxiety
Compulsions - behaviours that pt must do to help anxiety

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7
Q

agoraphobia

A

Fear about situation
Avoidance of situation due to fear that it would be difficult to escape from

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8
Q

phobias

A

Fear about certain object - restricting lifestyle
Exposure almost always causes reaction
Avoidance of situation

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9
Q

social anxiety

A

Fear of social situations in which there is a possibility of scrutiny
Avoidance of social situations because of this
Can use Liebowitz social anxiety

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10
Q

Substances that can cause anxiety

A

Amphetamines
Cocaine
Withdrawal from alcohol
New use of marijuana

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11
Q

GAD score thresholds

A

5-9 = mild anxiety
10-15 = moderate
15+ = severe

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12
Q

What to ask in anxiety history, other conditions to r/o

A

Other psychiatric conditions (other anxiety disorders, MDD)
Functional screen - MOAP
Mood (depression, mania)
Organic causes (substance use, delirium)
Anxiety (obsessions, compulsions, panic)
Psychosis (hallucinations, delusions)
Suicide
Hyperthyroidism
Pheochromocytoma
Cardiac/ pulmonary disease
Central structural pathology
Hypoglycemia
Substance use

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13
Q

Labs for new anxiety presentation

A

CBC
Fasting lipids
Fasting glucose
TSH
Liver enzymes
Electrolytes
Urine tox

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14
Q

Rx for anxiety (not inc pharmacotherapy)

A

Self management - BounceBack or apps
Community resources - support groups
Regular FU in office
Refer to psychiatry or psychology
Counselling
Exposure
Safety response inhibition
Corrective strategies
Arousal management
Surrender of safety signals
Pharmacotherapy

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15
Q

Rumination disorder + rx

A

repeated regurgitation of food, rx w/ habit reversal and breathing exercises

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16
Q

Risks of benzo use

A

physical dependence, psychological dependence, falls risk

17
Q

What is azaprione and when do you use it?

A

Buspirone - used as an adjunct in anxiety

18
Q

Best tolerated, most effective meds for GAD

A

duloxetine, pregabalin, venlafaxine, escitalopram. Also effective: sertraline

19
Q

Rules for prescribing benzos

A

avoid in elderly, avoid high doses, address fear, consider dependence, don’t combine w/ opioids

20
Q

Rx for tourette’s

A

tetrabenazine or risperidone (dopamine blockers), botox, habit reversal training

21
Q

Pica causes

A

behavioural/ delusional e.g. schizophrenia, autism or anemia, malnourishment

22
Q

Pica Rx if behavioural

A

methylphenidate (CNS stimulant), olanzapine

23
Q

Complication of pica

A

FB, obstruction, bezoar - need XR

24
Q

Sx of panic attack

A

sweating, hot flashes, nausea, tachycardia, SOB, tingling, fear of dying, CP, choking

25
Q

Other forms of anxiety disorder

A

specific phobia, social anxiety disorder, panic disorder, agoraphobia, unspecified anxiety disorder