Anxiety Disorder: Post-Traumatic Stress Disorder Flashcards
What is post traumatic stress disorder (PTSD)?
1 - an abnormal fear of a specific event
2 - disorder developed from an exceptionally threatening or horrifying event
3 - exceptional fear of every day objects
4 - compulsive fear of other people
2 - disorder developed from an exceptionally threatening or horrifying event
- patients experience or witness an event
- involved actual or threatened death or serious injury
- response involved is intense fear, helplessness or horror
To be diagnosed with PTSD, according to the ICD-11, the stressor must have been markedly distressing to almost everyone. Which of the following are the main features of PTSD?
1 - delayed response to stressor
2 - re-experiencing the traumatic event
3 - dissociative symptoms (numbness, depersonalisation, derealisation)
4 - avoidance of thoughts /memories of stressor
5 - persistent heightened fear of threat
6 - depression
7 - increased arousal
8 - all of the above
8 - all of the above
- symptoms must last for at least several weeks
Post traumatic stress disorder is a response to exceptionally threatening or catastrophic event. How long must a patient present with symptoms, since being exposed to the stressor before a diagnosis can be made according to the ICD-11?
1 - 1 week
2 - >1 month
3 - >6 months
4 - >12 months
2 - >1 month
Which of the following must be present for a diagnosis of PTSD to be made?
1 - others must have experienced the stressor
2 - patient has physical symptoms
3 - patient had a significant impairment in functioning
3 - patient had a significant impairment in functioning
In PTSD, how soon can symptoms present?
1 - within days of the event
2 - within weeks of the event
3 - within 6 months of the event
4 - >12 months from the event
1 - within days of the event
- BUT goes undiagnosed for prolonged periods
In accordance with the ICD-11 diagnostic criteria, from the onset of symptoms, how long before a patient with PTSD symptoms go away?
1 - 6 days
2 - 6 weeks
3 - 6 months
4 - 6 years
3 - 6 months
Are patients with PTSD at an increased or decreased risk of other psychiatric conditions?
- increased risk
In a patient with PTSD, which of the following are re-experiencing aspects of the PTSD?
1 - flashbacks
2 - nightmares
3 - intrusive images and memories
4 - all of the above
4 - all of the above
In a patient with PTSD, which of the following are examples of avoidance of the PTSD?
1 - reminders of trauma external
2 - thoughts and memories of trauma
3 - returning to location of trauma
4 - all of the above
4 - all of the above
Patients with PTSD are at an increased risk of other co-morbidities, but it is often difficult to identify if these are primary or secondary. Which of the following are common co-morbidities in PTSD?
1 - depression
2 - anxiety
3 - substance misuse
4 - somatisation (physical symptoms caused by stressor)
5 - all of the above
5 - all of the above
There are a variety of differentials that must be considered when trying to diagnose PTSD. Which of the following should be included in the most likely differentials?
1 - substance misuse
2 - acute stress reaction
3 - adjustment disorder
4 - depressive disorder
5 - anxiety disorder
6 - OCD
7 - dissociative disorders
8 - all of the above
8 - all of the above
In PTSD, what % of patients recover and what % of patients become chronic?
1 - 10% recover and 10% become chronic
2 - 30% recover and 10% become chronic
3 - 30% become chronic and recover
4 - 10% recover and 40% become chronic
3 - 30% become chronic and recover
- 30% recover within 3 months, but most in a year
- 30% become chronic
What is the 1st line therapy for PTSD?
1 - medication
2 - psychological treatment
3 - electroconvulsive therapy
4 - hospitalisation for intense therapy
2 - psychological treatment
- trauma focused CBT
- eye movement desensitisation and reprocessing
If the first line treatment for PTSD fails or is not possible, which involves:
- trauma focused CBT
- eye movement desensitisation and reprocessing
What is the second line treatment approach?
1 - antipsychotics
2 - anti-depressants
3 - electroconvulsive therapy
4 - hospitalisation for intense therapy
2 - anti-depressants
- SSRIs = Venlafaxine has the best evidence base
If the first and 2nd line treatment for PTSD fails, what is the final treatment option?
1 - antipsychotics with anti-depressants
2 - anti-depressants with electroconvulsive therapy
3 - electroconvulsive therapy
4 - therapy with antipsychotics and with anti-depressants
4 - therapy with antipsychotics and with anti-depressants
- SSRIs = Venlafaxine has the best evidence base
- antipsychotics = Olanzapine has best evidence base