Anxiety Disorders

Question 1

excoriation is a disease that involves

Answer 1

skin picking

Question 2

the instinctual fear center of the brain; hyperactive in most anxiety disorders

Answer 2

amygdala

Question 3

neurotransmitter behind anxiety, also its location in the brainstem

Answer 3

norepinephrine

locus ceruleus (PONS)

Question 4

in anxiety disorders, the gender with more cases is

Answer 4

females > males, except OCD

Question 5

name the drugs that are effective for most general anxiety disorders

Answer 5

serotonergic antidepressants (SSRIs)
sertraline, paroxetine, fluoxetine, fluvoxamine, citalopram, escitalopram

Question 6

alcohol use disorders are prevalent especially in these anxiety disorders

Answer 6

panic disorder, OCD, phobias

Question 7

a treatment for anxiety disorders that’s as effective as meds

Answer 7

cognitive behavioral therapy

Question 8

etiologic theory of panic disorder

Answer 8

CO2 sensitivity theory- false suffocation alarm

Question 9

must rule these things out when diagnosing panic attacks

Answer 9

too much caffeine, stimulants, diet pills, xanthines, heart, lung, thyroid diseases

Question 10

mainstay of panic disorder treatment

Answer 10

SSRIs “start low, go slow”

• imipramine (MAOI) could be more effective, but has worse side effects
• benzos work, but must be careful
• CBT: breathing techniques, graduated exposure

Question 11

agoraphobia is marked fear or anxiety about 2 or more of the following

Answer 11

public transportation, open spaces, enclosed spaces, standing in line or being in crowd, being outside the home alone

Question 12

GAD diagnosis includes 3 or more of the following

Answer 12

restlessness, easily fatigued, difficulty concentrating/mind going blank, irritability, muscle tension, sleep disturbance

Question 13

highly comorbid disease in GAD

Answer 13

depression

Question 14

treatment for generalized anxiety disorder

Answer 14

SSRIs/venlafaxine, paroxetine

buspirone

benzos are 2nd, 3rd line of treatment

CBT

Question 15

fear of scrutiny, humiliation, or embarrassment

Answer 15

social anxiety disorder (social phobia); may be “performance only”; could have panic attacks and lead to social avoidance

Question 16

best treamtnet for social anxiety disorder, and performance anxiety

Answer 16

SSRIshave best evidence; beta blockers (propranolol) for performance type)

Question 17

common comorbidities with OCD

Answer 17

major depression, social phobia, Tourette’s*

Question 18

OCD not same as OC personality disorder; what percent of OCD px’s have premorbid obsessional traits?

Answer 18

15-35%

Question 19

in OCD, the female incidence equals the males, but in adolescents, there are more males than females. why?

Answer 19

tourette’s

Question 20

age of onset of OCD

Answer 20

20s, rare after age 35

Question 21

percentage of Tourette’s patients with compulsions

Answer 21

90% (relation to OCD*)

Question 22

pathophysiology of OCD

Answer 22

orbitofrontal-limbic-basal ganglia circuit abnormality

*increased metabolism in orbitofrontal and ant cingulate cortices and caudate nuclei

Question 23

common symptom patterns of OCD

Answer 23

contamination (washing)

pathological doubt (checking)

intrusive thoughts (sexual, aggressive)

symmetry (obsessional slowness)

Question 24

component of cognitive behavioral therapy good for OCD treatment

Answer 24

exposure-response prevention

Question 25

drugs for OCD

Answer 25

SSRI or clomipramine (not used often); add neuroleptic if Tourette’s (risperidone)

Question 26

now classified as an OCD related disorder because of the repetitive behaviors

Answer 26

body dysmorphic disorder

Question 27

treatment for body dysmorphic disorder

Answer 27

SSRIs; antipsychotics not helpful

Question 28

hair pulling disorder

Answer 28

trichotillomania