Anxiety and Trauma Flashcards
- Which of the following statements regarding panic disorder is true?
A. Panic attacks are expected and have an identifiable trigger
B. Panic attacks usually peak in intensity in about 1 hour.
C. Agoraphobia is always present.
D. It is more common in men.
E. Panic symptoms are self-limiting in duration.
E
- Which of the following substances/medications would not be expected to contribute to panic anxiety?
A. Albuterol
B. Olanzapine
C. Cannabis
D. Phenylephrine
E. Caffeine
B
- Pregabalin is a preferred treatment for a patient with GAD and a history of which of the following?
A. Comorbid depression
B. Alcohol dependence
C. Did not tolerate SSRIs
D. Renal impairment
E. Nonadherence
C
- The following treatment would be preferred for a 12-year-old with SAD.
A. Alprazolam
B. Fluoxetine
C. Pregabalin
D. Cognitive-behavioral therapy (CBT)
E. Individual supportive psychotherapy
D
- Which of the following statements is true regarding quetiapine in the treatment of anxiety disorders?
A. Is effective for treatment of panic disorder
B. Is associated with weight gain, sedation, and fatigue
C. Is effective in doses above 300 mg/day
D. Superior efficacy to SSRIs
E. Similar efficacy to CBT
B
- Which of the following medications is not appropriate initial treatment for a 23-year-old woman with GAD and no other comorbidities?
A. Pregabalin
B. Quetiapine
C. Sertraline
D. Venlafaxine
E. Fluoxetine
B
- Which of the following is true of CBT in the treatment of anxiety?
A. Only effective when delivered face to face
B. Is inferior to antidepressants in acute treatment of panic disorder
C. Is associated with more sustainable benefits than antidepressants
D. Is not effective for children with anxiety disorders
E. Is less expensive than medications
C
- A 23-year-old otherwise healthy woman with GAD has no past history of drug or alcohol abuse and no family history of substance abuse. She is started on lorazepam 0.5 mg three times daily. Which of the following side effects will you warn her about?
a. Risk of withdrawal symptoms upon discontinuation
b. Sedation
c. Anterograde amnesia
d. Slowed reaction time
e. All of the above
E
- Which initial antidepressant regimen is likely to be the best tolerated by a patient with panic disorder?
A. Duloxetine 60 mg daily
B. Bupropion 300 mg XL daily
C. Imipramine 50 mg three times daily
D. Paroxetine 10 mg daily
E. Buspirone 15 mg three times daily
D
- A 22-year-old woman with SAD has significant improvement in anxiety after 14 weeks of treatment with sertraline. How long should she remain on sertraline?
A. Discontinue now
B. Additional 3 months
C. Additional 6 months
D. Additional 1–2 years
E. Lifetime therapy
C
- A 26-year-old African American man with SAD has been stable on sertraline 100 mg/day for the past year. He reports to the clinic today with complaints of increased anxiety, agitation, and nausea. Upon further examination, you notice he last filled his sertraline Rx (90-day supply) 4
months ago. Medications: Ibuprofen 400 mg as needed for joint pain. He reports taking sertraline most days but ran out 4 days ago. What is most likely going on with AS?
A. Serotonin syndrome
B. Serotonin withdrawal
C. Neuroleptic malignant syndrome
D. Relapse of SAD
E. Rebound anxiety
B
- A 78-year-old black woman has HTN, DJD, osteoporosis, and GAD. Which of the following medications is the best choice for management of her GAD?
A. Pregabalin
B. Trazodone
C. Quetiapine
D. Escitalopram
E. Mirtazapine
D
- What is the best initial treatment for a 39-year-old man with comorbid panic disorder and alcohol use disorder?
A. Sertraline
B. Quetiapine
C. Pregabalin
D. Bupropion
E. Alprazolam
A
- What monitoring parameters should be followed in a 10-year-old initiated on fluoxetine for SAD?
A. Suicidal Ideation
B. School performance
C. Anxiety Symptoms
D. Nausea, headache, stomach ache
E. All of the above
E
- Which of the following GAD patients is most likely to be a CYP 2C19 poor metabolizer and will have an exaggerated response to diazepam 5 mg three times daily with increased sedation and CNS and cognitive side effects?
A. 25-year-old white woman
B. 25-year-old black woman
C. 45-year-old black man
D. 45-year-old Asian man
E. 45-year-old white man
D
- Buspirone is an effective treatment for which anxiety disorder?
A. Generalized anxiety disorder
B. Panic disorder
C. Posttraumatic stress disorder
D. Performance anxiety
A
- What is the equivalent dose of clonazepam when converting from alprazolam 4 mg?
A. 1 mg
B. 2 mg
C. 3 mg
D. 4 mg
B
- A 23-year-old man with SAD has achieved remission after 16 weeks of treatment with escitalopram. How long should he remain on escitalopram?
A. Discontinue now
B. Additional 3 months
C. Additional 8 months
D. Additional 1 to 2 years
C
- What is the preferred initial pharmacotherapy for a patient with SAD?
A. Phenelzine
B. Sertraline
C. Propranolol
D. Pregabalin
B
- Which medication will result in most rapid improvement of panic symptoms?
A. Propranolol
B. Sertraline
C. Alprazolam
D. Valproate
C
- Which of the following is true of CBT in the treatment of panic disorder?
A. Only effective when delivered face to face
B. Is inferior to antidepressants in acute treatment of panic disorder
C. Is associated with more sustainable benefits than antidepressants
D. Is generally preferred treatment by patients with anxiety
C
- Which of the following is first-line treatment for posttraumatic stress disorder?
A. EMDR
B. Prazosin
C. Sertraline
D. Risperidone
A
- What is the best initial treatment for a 33-year-old man with comorbid panic disorder
and depression?
A. Sertraline
B. Imipramine
C. Mirtazapine
D. Bupropion
A
- A 27-year-old woman with panic disorder was initiated on lorazepam 4 mg PO twice
daily 4 months ago. The decision is made to taper the patient’s lorazepam. What would be the correct dose for the first week of the taper?
A. Lorazepam 3 mg twice daily
B. Lorazepam 2 mg twice daily
C. Lorazepam 1.5 mg three times daily
D. Duration of treatment is short and no taper is required.
A
- Which medication would have the quickest onset for relief of anxiety associated with GAD?
A. Pregabalin
B. Buspirone
C. Venlafaxine
D. Escitalopram
A
A 24-year-old woman reports episodes of an increased heart rate, shortness of breath, sweating, and feeling like something bad is going to happen. These episodes last about 10 minutes and occur about four times a week for the past 2 months. She is diagnosed with panic disorder and initiated on citalopram 20 mg daily.
- How should you measure her response to treatment?
A. GAD-7
B. PHQ-9
C. LSAS
D. PDSS
D
A 24-year-old woman reports episodes of an increased heart rate, shortness of breath, sweating, and feeling like something bad is going to happen. These episodes last about 10 minutes and occur about four times a week for the past 2 months. She is diagnosed with panic disorder and initiated on citalopram 20 mg daily.
- She returns to clinic 2 weeks later and states that the citalopram has made her anxiety worse. Since starting the medication, she feels anxious all the time.
What is the best treatment plan?
A. Continue citalopram 20 mg for another 2 weeks
B. Decrease dose to citalopram 10 mg
C. Decrease dose to citalopram 10 and start buspirone
D. Continue citalopram 20 mg and add lorazepam
B
A 24-year-old woman reports episodes of an increased heart rate, shortness of breath, sweating, and feeling like something bad is going to happen. These episodes last about 10 minutes and occur about four times a week for the past 2 months. She is diagnosed with panic disorder and initiated on citalopram 20 mg daily.
- She returns to clinic 3 months later reporting reduction of anxiety and panic attacks. She is currently taking citalopram 40 mg and since her symptoms have disappeared, she wants to know if she can stop the medication. What information should be provided to her about stopping the medication?
A. She can stop the citalopram 40 mg now.
B. She can decrease the dose to 20 mg for 1 week and then stop.
C. She should continue the citalopram 40 mg for 3 months.
D. She should continue the citalopram 40 mg for 12 months.
D
A 27-year-old woman with a history of depression and sexual assault 6 months ago is newly diagnosed with posttraumatic stress disorder. After the assault, she started cognitive process therapy but is reporting multiple concerns today. She reports not seeing her family for a month,
blaming herself for the assault, inability to walk along from work to her car, and nightmares of the assault almost every night. She reports drinking two to three glasses of wine every evening to help fall asleep. She denies tobacco or illicit drug use.
- What is the best initial treatment recommendation?
A. Alprazolam 0.25 mg three times daily
B. Sertraline 25 mg daily
C. Risperidone 1 mg twice daily
D. Pregabalin 50 mg three times daily
B
A 27-year-old woman with a history of depression and sexual assault 6 months ago is newly diagnosed with posttraumatic stress disorder. After the assault, she started cognitive process therapy but is reporting multiple concerns today. She reports not seeing her family for a month,
blaming herself for the assault, inability to walk along from work to her car, and nightmares of the assault almost every night. She reports drinking two to three glasses of wine every evening to
help fall asleep. She denies tobacco or illicit drug use.
- The patient returns to clinic 2 months after starting pharmacotherapy and titrated to maximum effective dose. She reports having dinner with her family twice in the last month, which is an improvement. She continues to have nightmares most nights. What
is the best recommendation to reduce nightmares?
A. Add zolpidem 10 mg every night
B. Add prazosin 1 mg every night
C. Add lorazepam 1 mg every night
D. Add phenelzine 15 mg every night
B
