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Psychiatry > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

1
Q

What is generalised anxiety disorder?

A

GAD is a mental health condition that causes excessive worry that impacts a peron’s day to day life

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2
Q

What screening tool can be used to diagnose generalised anxiety disorder?

A

GAD-7 questionnaire

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3
Q

What is the NICE recommended step-wise approach of anxiety treatment?

A

Step 1 - education and monitoring
Step 2 - low intensity psychological interventions (self help or groups)
Step 3 - high intensity psychological interventions (CBT) or drug treatment
Step 4 - specialist input

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4
Q

What is the first line drug treatment of GAD?

A

SSRIs or mirtazapine

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5
Q

What is the typical SSRI used to treat GAD?

A

Sertraline 50mg OD (can be increased to 200mg)

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6
Q

What is the second line drug treatment of GAD?

A

An alternative SSRI or an SNRI

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7
Q

Give 3 examples of SSRIs

A

Sertraline
Citalopram
Fluoxetine

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8
Q

Give 2 examples of SNRIs

A

Duloxetine
Venlafaxine

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9
Q

What is the third line drug treatment of GAD?

A

Pregabalin

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10
Q

What are the side effects of SSRIs?

A

Agitation
Nausea
Dizziness
Dry mouth
Suicidal thoughts

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11
Q

What monitoring is needed for patients on SSRIs?

A

Weekly follow up during the first month for increased risk of suicidal thoughts and self-harm

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12
Q

What are the key features of generalised anxiety disorder?

A

Feeling restless
Easily fatigued
Poor concentration
Irritability
Muscle tension
Sleep disturbance
Feeling nervous or on edge
Being unable to control worry
Feeling as though something bad is going to happen
GI symptoms

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13
Q

What other mental health disorders can cause anxiety?

A

Depression
PTSD
Panic disorder
Social phobia
Somatisation disorder
Hypochondriasis

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14
Q

What medications can commonly cause anxiety?

A

Salbutamol
Theophylline
Herbal medicines
Corticosteroids
Antidepressants
Alcohol
Illicit drugs

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15
Q

What are the risk factors for generalised anxiety disorder?

A

Family history
Physical and emotional stress
History of physical, emotional or sexual trauma
Other anxiety disorder
Chronic health condition
Female sex

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16
Q

How long must a person have had excessive worry to be diagnosed with GAD?

A

At least 6 months

17
Q

What investigations can be performed to help rule out organic causes for GAD?

A

TFTs
Urine drug screen
24 hour catecholamine urine test
Pulmonary function
ECG

18
Q

What are the differentials of GAD?

A

Panic disorder
Social anxiety disorder
OCD
PTSD
Depression
Substance related anxiety
Situational anxiety
Hyperthyroidism
Adjustment disorder
Withdrawal from CNS depressant
Phaeochromocytoma

19
Q

What is panic disorder?

A

Unpredictable and recurrent episodes of severe anxiety not confined to any specific situation or circumstances

20
Q

What is the epidemiology of panic disorder?

A

Bimodal distribution - peak incidence at ages 20 and 50
More common in females
Concurrent agoraphobia in 30-50% of cases

21
Q

What are the features of panic disorder?

A

Difficulty in breathing
Chest discomfort
Palpitations
Hyperventilation
Depersonalisation
Sweating
Shaking

22
Q

What are the differentials of panic disorder?

A

Generalised anxiety disorder
Agoraphobia
Depression
Alcohol or drug withdrawal
Hyperthyroidism
Hypoglycaemia

23
Q

What is the first line pharmacological management of panic disorder?

A

SSRI

24
Q

What is the first line treatment of panic disorder?

A

CBT

25
Q

What is the second line pharmacological management of panic disorder?

A

Clomipramine

26
Q

What is agoraphobia?

A

Fear of open spaces and associated features such as crowds, and difficulty of immediate escape

27
Q

What are the characteristics of a panic attack?

A

Discrete episode of fear or intense discomfort
Starts abruptly
Reaches a crescendo in a few minutes
At least one symptom of autonomic arousal

28
Q

What are the criteria for a diagnosis of panic disorder?

A

Recurrent panic attacks
At least one panic attack that is followed by a month of worrying about the attacks
As well as maladaptive changes made because of the panic attack

29
Q

What is agoraphobia?

A

Fear of public spaces or fear of entering a public space from which there would be difficulty escaping

30
Q

What is the criteria for diagnosis of agoraphobia?

A

Fear of at least two of the following - crowds, public spaces, travelling alone, travelling away from home
Symptoms of anxiety in the feared situations
Significant emotional distress due to the anxiety or avoidance
Recognised as excessive or unreasonable
Symptoms restricted to feared situation

31
Q

What is social phobia?

A

Fear of social situations which may lead to scrutiny by others, embarassment, humiliation or criticism

Psychiatry (23 decks)

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