Anxiety Flashcards
Is anxiety normal?
Yes
It is a normal response to threat or danger
Which gender is more affected with GAG
Females
Aetiology of anxiety
Genetic predisposition
Stress (work, noise, hostile, home)
Events (losing or gaining a spouse, moving job, moving home)
Ect..
GI symptoms anxiety
Dry mouth Swallowing difficulties Lump in throat Dyspepsia Nausea Flatulence Frequent loose bowels Butterflies in tummy
Resp. symptoms anxiety
Tight chest
Hyperventilating
Difficulty inhaling
CVS symptoms anxiety
Palpitations
Missed beats
Chest pain
Genitourinary symptoms of anxiety
Frequency/urgency of micturition
Amenorrhoea
Dysmenorrhoea
Erectile failure
CNS symptoms of anxiety
Dizziness
Sweating
Muscle symptoms of anxiety
Muscle tension
Tremor
Headache
Muscle pain
Sleep symptoms of anxiety
Sleep disturbance Initial insomnia Frequent waking Nightmares Night terrors
Ddx psychiatric conditions for GAD
Depression
Schizophrenia
Dementia
Substance misuse
DDx physical conditions for GAD
Thyrotoxicosis Phaechromoytoma Hypoglycaemia Asthma Arrhytmias
What is the main risk with prescribing sedatives
They ave a high risk of dependency
Rx of GAD
Clear plan for management
Explanation and education
Advice re caffeine, alcohol, exercise
Relaxation training
CBT
Hypnosis
SSRI
(rarely sedatives)
What is agoraphobia
Cluster of phobias Fear of crowds Fear of travel Fear of events away from home Fear of no easy way to escape or get help
What is a social phobia
Inappropriate anxiety in situation where person feels observed or could be criticised
Examples of where someone with social phobia could face anxiety
Restaurants
Shops or queues
Public speaking
What is a specific phobia
When the persons anxiety is Restricted to a specific situation
Give examples of specific phobias
Odontophobia (dentists)
Arachnophobia (spiders)
Coulrophobia (clowns)
Symptoms of social phobia
When in social places or places where they could be observes/criticsed
Anxiety symptoms Nausea Blushing Toilet urgency Tremor
Rx for panic attacks
Try CBT
Rx for social phobia
CBT
Education and advice
Medication Rx for anxiety
SSRI
or
TCA
What is PTSD
Delated or protracted reaction to a stressor of exceptional severit
Examples of events which could cause PTSD
Combat Natural or human cause disaster Rape Torture Witnessing any of the above
Who is at greater risk of developing PTSD
Women = 20% Men = 8%
Vulnerability factors of PTSD
Mood disorder Previous trauma (esp. as child) Lack of social support Female Partly genetic
Protective factors of PTSD
Higher education and social group
Good paternal relationship
What are the 3 key elements to PTSD
Hyperarousal
Re-experiencing phenomena
Avoidance
Describe hyperarousal in PTSD
Persistent anxiety Irritability
Insomnia
Poor concentration
Describe re-experiencing phenomena in PTSD
Intense intrusive images
Flashbacks when awake
Nightmares during sleep
Often with increased BP, increased pulse and sweating
Describe avoidance in PTSD
Emotional numbness Cue avoidance Recall difficulties Diminished interests Drug/alcohol misuse Poor concentration
According to NICE guideline when should survivors be screened for PTSD?
1/12
Rx for mild symptoms of PTSD
Watchful waiting
Review in further month
Rx for more severe PTSD
Trauma focused CBT
Eye movement desensitisation and reprocessing (EMDR)
Medication Rx for PTSD
SSRIs
TCAS
Risk of dependance with sedatives
What is the prognosis for PTSD
Usually 50% recover in 1yr
