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CNS I > anxiety disorders > Flashcards

anxiety disorders Flashcards

At the end of the learning, students will be able to do the following regarding the anxiety disorders: Describe basic neuroanatomy and neurophysiology Choose the correct diagnosis from a vignette List important medical and psychiatric disorders in the differential diagnosis State important comorbidities and how they alter treatment Identify the correct pharmacologic and psycholotherapeutic treatments

1
Q

the instincual fear center

A

amygdala

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2
Q

is hyperactive in most anxiety disorders

A

hyperactive

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3
Q

NT involved in anxiety disorder

A

NE

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4
Q

NE released from

A

Locus Ceruleus

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5
Q

Locus Ceruleus located in the

A

Pons

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6
Q

gender distribution of anxiety disorders

A

2x females as males (except OCD)

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7
Q

DOC for anxiety disorders

A

SSRI

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8
Q

6 SSRIs

A

Sertaline, paroxetine, fluoxetine, fluvoxamine, citalopram, escitalopram

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9
Q

MOA of SSRI in Anxiety disorder

A

reducing locus ceruleus firing with chronic use

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10
Q

effective non-drug therapy for anxiety disorder

A

CBT

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11
Q

frequent co-morbidity in anxiety disorders

A

EtOH use disorder (self medication)

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12
Q

why does Alcohol seem to work in anxiety

A

GABAergeneric properties of EtOH

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13
Q

CBT most effective in anxiety when

A

meds are started first

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14
Q

works on faulty/distorted thoughts

A

cognitive therapy

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15
Q

works on breathing, relaxation, and graduated exposure

A

behavioral therapy

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16
Q

age of onset of panic disorders

A

20s

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17
Q

influx of ____(3) in PD pts can trigger panic attacks

A

CO2, sodium lactate, or bicarb

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18
Q

DX criteria for Panic Disorder

A

1) recurrent unexpected attacks
2) at least one attack has been followed by a month or more of persistant worry/change in behavior regarding the attacks
3) not another axis 1 or due to substances/other medical condition

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19
Q

sx of panic attacks

A

4 or more:
palp, chest pain, sweating, trembling, SOB, nausea, syncope, derealization/depersonalization, fear of going crazy.dying, numbness/tingling, chills/hotflashes

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20
Q

medical disorders to rule out in panic disorder

A

caffeine OD, heart/lung/thyroid disease, drug use

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21
Q

major ddx when panic disorder onsets later in life

A

heart/lung problems

22
Q

95% of people with this, have PD

A

agoraphobia

23
Q

associated with worse prognosis of PD

A

agoraphobia

24
Q

mainstay of PD treatment

25
Q

possiblly effective in PD, but associated with severe side effects

26
Q

used in emergent PD situations

27
Q

General Anxiety disorder dx criteria

A

excessive anxiety and worry, more days than not dor at least 6 months
3 or more of: restlessness/keyed up/on edge, easy fatigue, difficulty concentrating, irritaility, muscle tension, sleep disturbance
not another axis 1
causes distress/impairment

28
Q

somatic sx of GAD

A

GI troubles, headaches, insomnia, palpitations, muscle tension and aches, SOB/dyspnea, loss of libido

29
Q

major comorbidity with GAD

A

major Depression

30
Q

overlapping sx of MDD and GAD

A

anxiety, sleep problems, psychomotor agitation, dfficulty concentrating, irritabiliy, fatigue

31
Q

DOC for GAD

32
Q

particular SSRI approved for GAD

A

paroxetine/venlafaxine

33
Q

buspirone effective for

34
Q

most common comorbidity to OCD

A

tourette’s

35
Q

ego dystonia

A

knowing that the behavior is abnormal

36
Q

OCD is (dystonic/syntonic)

37
Q

anxiety disorder more common to adult women

38
Q

age when OCD is more common in males

A

adolescence

39
Q

age of onset of OCD

A

20s, rare in age 35

40
Q

66% of people with _____ have OCD

A

tourette’s

41
Q

PET shows increased activity of the (3)____ in OCD

A

orbotofrontal, ACC and caudate

42
Q

circuit abnormality in OCD

A

orbitofrontal-limbic-basal ganglia

43
Q

dx criteria of OCD

A

precense of either obsesions or compulsions that caue distress or are disabling

44
Q

type of CBT in OCD

A

exposure-response prevention

45
Q

DOC (current) in OCD

46
Q

old drug in OCD

A

clomipramine

47
Q

drug used in tourette’s+OCD or in refractory OCD

A

risperidone

48
Q

DX criteria in Social anxiety disorder (SAD)

A

fear of humilation of embarrassment to social sitations

49
Q

DOC in SAD

A

SSRI (possible MAOI and Benzo)

50
Q

drug for situational type of SAD

A

propanolol

51
Q

DOC for specific sphobia

52
Q

best treatment for specific phobia

A

systematic desensitivation

CNS I (36 decks)

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