Anxiety and Adjustment Disorders

Question 1

Cardiac sx of Anxiety

Answer 1

Palpitations, tachycardia, hypertension

Question 2

Neuro sx of anxiety

Answer 2

Dilation of pupils (mydriasis), dizziness, light headedness, hypErreflexia, tremors, tingling in peripheral extremities

Question 3

Neurotransmitter imbalances associated with anxiety

Answer 3

GABA and serotonin decrease, increase in norepi

Question 4

Anxiety develops more frequently in which socioeconomic group

Answer 4

higher socioeconomic groups

Question 5

Panic Attacks Criteria

Answer 5

Palpitations, Abdominal distress, Numbness, nausea, Intense fear of death, Chocking, chills, chest pain, Sweating, Shaking, shortness of breath
(PANICS)

Question 6

discrete periods of heightend anxiety and fear that classically occur in patients with panic disorders

Answer 6

Panic attacks (also seen with phobic disorders, PTSD)

Question 7

When do panic attacks usually peak? when do they resolve? (in minutes)

Answer 7

peak within 10 minutes, resolve in less then 25 minutes

Question 8

How many of the PANIC sx must a patient have to be diagnosed with a panic attack

Answer 8

at least 4

Question 9

What conditions are panic attacks associated with?

Answer 9

Mitral Valve Prolapse, Pulmonary Embolism, Asthma, angina, and anaphylaxis

Question 10

characterized by spontaneous recurrent panic attacks with no obvious precipitant

Answer 10

Panic disorder

Question 11

Panic disorder patients suffer from panic attacks how often?

Answer 11

average of 2 times per week to several times per day

Question 12

To qualify for panic disorder, at least one of the attacks must be followed by a minimum of 1 month of the following:?

Answer 12

Persistent concern about having additonal attacks, worry about the implicaions of the attack (losing control or “going crazy”
a significant change in behavior related to the attacks

Question 13

Medical DDx of Panic Attacks/Disorder

Answer 13

CHF, angina, MI, thyrotoxicosis, temporal lobe epilepsy, MS, pheochromocytoma, carcinoid syndrome, COPD

Question 14

Medication/drugs DDx of Panic Attacks/Disorder

Answer 14

Amphetamines, Caffeine, nicotine, cocaine, hallucinogen intoxication, alcohol or opiate withdrawl

Question 15

panic disorders are more common in which sex

Answer 15

female (2 to 3 times more)

Question 16

Onset and genetic component of panic disorders?

Answer 16

Usually late teens to early thirties (avg 25), 4-8x greater risk in first degree relatives

Question 17

Characteristic situations avoided in Agoraphobia?

Answer 17

bridges, crowds, buses, trains, or any open areas outside the home

Question 18

fear of being alone in public places

Answer 18

agoraphobia

Question 19

Tx of panic disorder?

Answer 19

SSRI’s (paroxetine and sertraline (zoloft)) start at low doses and increase slowly. higher doses are for depression

Question 20

if a person is under 18 how long must they have a specific phobia for you to diagnose them?

Answer 20

at least 6 months

Question 21

Performance anxiety is often treated with?

Answer 21

beta blockers

Question 22

most common mental disorders in the united states are?

Answer 22

phobias

Question 23

Tx for specific phobias?

Answer 23

Behavior therapy is most effective

Question 24

Tx for social anxiety disorder?

Answer 24

paroxetine (paxil)

Question 25

recurrent and intrusive thought, feeling or idea that is egodystonic

Answer 25

obsession

Question 26

conscious repetitive behavior linked to an obsession that when performed functions to relieve anxiety caused by the obsession

Answer 26

compulsion

Question 27

patients with OCD often initially seek help from who?

Answer 27

nonpsychiatric physicians. (i.e dermatologist for their skin problems from excessive hand washing)

Question 28

OCD tx?

Answer 28

first line is SSRIs and second line is TCAs (clompiramine)

often requires higher doses then depression

Question 29

what if a patient doesn’t think there is anything wrong with their obsessions?

Answer 29

obsessive-compulsive personality disorder

Question 30

requires the presence of a traumatic experience, persistent avoidance, hyperarousal state, and reexperiencing the traumatic event all for more than a month

Answer 30

PTSD

Question 31

Which class of medications should be avoided in the treatment of PTSD because of the high rate of substance abuse in these patients

Answer 31

benzos

Question 32

excessive anxiety and worry about daily events and activities for at least 6 months

Answer 32

Generalized anxiety disorder