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Psychiatry Key Information > Anxiety > Flashcards

Anxiety Flashcards

1
Q

what is anxiety?

A

excessive worrying and nervousness around a situation that is not usually stressful

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2
Q

what hormones does the stress response release?

A

catecholamines

cortisol

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3
Q

physical symptoms of anxiety

A 
sweating
trembling
dizzy, faint
dry mouth, choking sensation
chest pain
nausea
abdominal discomfort
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4
Q

cognitive symptoms of anxiety

A 
losing control
mentally tense
difficulty concentrating
derealisation
depersonalisation
racing thoughts
meta-worry
preference for order and routine
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5
Q

behavioural symptoms of anxiety

A

avoidance
exaggerated startle response
difficulty sleeping
restlessness

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6
Q

types of anxiety disorders

A
  1. generalised anxiety disorder
  2. panic disorder
  3. phobias= agoraphobia, social phobia, specific phobia
  4. obsessive compulsive disorder (OCD)
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7
Q

define generalised anxiety disorder

A

persistent and generalised anxiety not restricted to any particular environment

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8
Q

what do you need to rule out in generalised anxiety disorder?

A 
substance misuse
medical conditions (hyperthyroidism)
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9
Q

how often does generalised anxiety disorder need to happen?

A

most days for at least 6 months

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10
Q

who gets generalised anxiety disorder?

A

2:1 females

20-40

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11
Q

management of generalised anxiety disorder

A

CBT/ self-help/ psychoeducation
SSRIs/SNRIs
pregabalin
BZDs

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12
Q

what is panic disorder?

A

recurrent attacks of severe panic not restricted to any setting or circumstance

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13
Q

what can panic disorder occur with?

A

agoraphobia

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14
Q

what needs to be ruled out in panic disorder?

A 
substance misuse
medical conditions (caffeine intoxication, hyperthyroidism)
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15
Q

commonest age for panic disorder?

A

mid-30s

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16
Q

management of panic disorder

A

self-help/ CBT
SSRIs/ SNRIs/ tricyclics
BZDs (short-term only)

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17
Q

what medications should be avoided in panic disorder

A 
sedating antihistamines
BZDs
beta blockers
buspirone
bupropion
18
Q

describe phobias

A

early onset
recognise fear as irrational
typified by avoidance

19
Q

what is agoraphobia

A

fear of open spaces

20
Q

presentation of agoraphobia

A

avoidance is predominant with never leaving the house

21
Q

what is social phobia?

A

fear of social situations with the possibility for scrutiny by others

22
Q

what can social phobia result in?

A

poor school and employment performance

23
Q

management of social phobia

A

CBT
SSRIs/SNRIs
MAOI (moclobemide)
BZDs

24
Q

define a specific phobia

A

marked and persistent fear that is excessive to specific object or situation

25
Q

presentation of specific phobia

A

exposure promotes anxiety response

recognises fear is excessive and often avoid

26
Q

management of specific phobia

A

behavioural therapy with graded exposure, can include CBT

SSRIs/SNRIs if required

27
Q

what is OCD?

A

ideas and thoughts entering the head in a stereotyped way leading to repeated, unenjoyable rituals that are recognised as pointless

28
Q

presentation of OCD

A

symptoms must be present for at least 2 weeks

most experience 1 major depressive episode

29
Q

management of OCD

A

CBT, including response prevention
SSRIs/ clomipramine
augmentation with antipsychotic

30
Q

when are beta blockers used in anxiety?

A

somatic symptoms e.g. palpitations, tremor

31
Q

action of BZDs

A

target the GABA-A receptor making the channel more permeable to Cl- influx when GABA binds

32
Q

what does the Cl- influx in the GABA channel cause?

A

hyperpolarisation inhibiting AP

33
Q

problems with BZDs when used over 2 weeks

A
  • sedation
  • withdrawal, dependency, abuse
  • alcohol interaction
34
Q

other binding sites of the GABA

A

barbiturate
general anaesthetic
BZD
GABA site

35
Q

examples of BZDs

A

lorazepam
diazepam
chlordiazepoxide

36
Q

what do BZDs do?

A

reduce anxiety
sedation
muscle relaxation
anticonvulsant effect

37
Q

risks in use of BZDs

A

paradoxical aggression
anterograde amnesia
dependence

38
Q

presentation of BZDs withdrawal

A 
abdominal cramps
panic attacks
chest pain
sweating
blurred vision
dizziness
headaches
N&V
39
Q

what causes withdrawal in use of BZDs?

A

rapid removal and neuroadaption of the GABA response

40
Q

define derealisation

A

world is not real around you

41
Q

define depersonalisation

A

detached from self

Psychiatry Key Information (34 decks)

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