Anxiety *** Flashcards
RF for anxiety
Fam hx, childhood anxiety, stress, abuse
Sx
Restlessness
Palpitations
SOB
Hyperventilation
CP
Sweating
Dyspepsia
Fatigue
Insomnia
Dizziness
Abdo pain
GAD
Excessive + difficult to control anxiety + worry
Restlessness, feeling on edge or muscular tension
panic disorder
Recurrent, unexpected attacks in absence of triggers
Concern about future attacks
Sweating, trembling, derealisation, palpitations, nausea, tingling
PTSD
Exposure to actual or threatened death
Flashbacks
Nightmares
Hypervigilance or irritability
Avoidance of stimuli
Negative alterations in cognition and mood
OCD
Obsessions - recurrent, persistent thoughts, causes anxiety
Compulsions - behaviours that pt must do to help anxiety
agoraphobia
Fear about situation
Avoidance of situation due to fear that it would be difficult to escape from
phobias
Fear about certain object - restricting lifestyle
Exposure almost always causes reaction
Avoidance of situation
social anxiety
Fear of social situations in which there is a possibility of scrutiny
Avoidance of social situations because of this
Can use Liebowitz social anxiety
Substances that can cause anxiety
Amphetamines
Cocaine
Withdrawal from alcohol
New use of marijuana
GAD score thresholds
5-9 = mild anxiety
10-15 = moderate
15+ = severe
What to ask in anxiety history, other conditions to r/o
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
Labs for new anxiety presentation
CBC
Fasting lipids
Fasting glucose
TSH
Liver enzymes
Electrolytes
Urine tox
Rx for anxiety (not inc pharmacotherapy)
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
Rumination disorder + rx
repeated regurgitation of food, rx w/ habit reversal and breathing exercises