Anxiety

Question 1

Phobia definition

Answer 1

Marked and persistent, irrational fear of objects, situations, phenomenas

Question 2

Main types of phobias

Answer 2

• Agoraphobia (open places, crowds)
• Social phobia
• Specific phobia

Question 3

Types of social phobia

Answer 3

• Generalized social phobia (occur early age and in most situations)
• Simple social phobia (around 20 yrs old, affects 1-2 social activities)

Question 4

Treatment of phobias (5)

Answer 4

1) Benzodiazepines
2) SSRIs
3) Cognitive therapy
4) Relaxation techniques
5) Behaviour therapy - most effective (desenzitization)

Question 5

Generalized anxiety disorder (GAD) definition

Answer 5

Excessive anxiety and worry - most days in last 6 months

Question 6

Psychological tests for GAD

Answer 6

• Beck Anxiety Innventory
• Hamilton Anxiety Scale
• Psychological status

Question 7

Differential diagnosis GAD

Answer 7

• Somatic diseases (CV, endocrine, metabolic, neurologic)
• Panic disorder
• Phobias
• OCD
• PTSD
• Acute stress reaction
• Anxiety due to psychoactive substance

Question 8

Therapy GAD

Answer 8

• Psychotherapy (cognitive and behaviour most effective)

- Pharmacotherapy (SSRI, SNRI, BZD, pregabalin, buspirone, hydroxine)

Question 9

Obsessions definition

Answer 9

“The thoughts” Recurrent and persistant thoughts, impulses or images which are intrusive, inappropriate and cause marked anxiety or distress

Question 10

Compulsions definition

Answer 10

“The actions”
Repetitive behaviour that the person feels driven to perform in response to an obsession or according to rules.
Aim is to reduce anxiety caused by the obsession

Question 11

Most frequent obsessions

Answer 11

• Bodily wastes, germs
• Fear of terrible happenings
• Symmetry, order
• Religious
• Numbers
• Sexual
• Sounds, words, music

Question 12

Most frequent compulsions

Answer 12

• Washing
• Rituals
• Checking doors, locks etc
• Ordering
• Counting
• Hoarding, collecting

Question 13

Causes of OCD

Answer 13

• Genetical

- Neurobiological: orbitofrontalis cortex, cingulum, caudate nucleus

Question 14

Psychological tests OCD

Answer 14

• Y-BOCS (Yale-Brown Obsession-Compulsive Scale)

- Psychitric anamnesis and status

Question 15

Therapy OCD

Answer 15

• Psychotherapy (behaviour, cognitive, psychoeducation, family therapy, relaxation)
• Pharmacotherapy: SSRI, clomipramine, BZD, beta-blockers

Question 16

Differential diagnosis PTSD

Answer 16

• Other anxiety disorders
• Depression
• Psychoactive substance induced disorder
• Delirium
• Psychotic disorder

Question 17

Panic attack - emergency treatment

Answer 17

• BZD (alprazolam, clonazepam, diazepam) - decrease panic attacks by 70-75 % almost immediately

Question 18

Doses of medications given during panic attack

Answer 18

• Alprazolam: 0,5 - 2 mg

- Lorazepam: 1 - 2,5 mg

Question 19

Differential diagnosis panic attack

Answer 19

• CV (e.g angina)
• Neurology (e.g Menier SY)
• Endocrinology
• Abuse, intox, withdrawal symptoms

Question 20

Anxiolytics

Answer 20

• BZD

- Non-BZD (buspirone - 5HT1a, pindolol)

Question 21

Benzodiazepines info

Answer 21

• Act on GABA A
• High potency: alprazolam, clonnazepam, lorazepam
• Low potency: diazepam, medazepam
• Strong addiction potential

Question 22

Benzodiazepines indications

Answer 22

• Anxiety disorders
• Insomnia
• Mania (clonazepam)
• Alcohol- and drug-related agitation
• Acute dystonia, akathisia, dyskinesia, epilepsy, premedication, muscle relaxation

Question 23

Sedato-hypnotics

Answer 23

• BZD

- Non-BZD (Z-drugs)