Anxiety Disorders

Question 1

What neurotransmitter imbalances are associated with anxiety disorders?

Answer 1

Increased NE activity

Decreased activity of GABA and Serotonin

Question 2

Panic Attacks are associated with certain medical conditions:

Answer 2

Mitral Valve Prolapse
Asthma
PE
Angina
Anaphylaxis

Question 3

Patient present with complaint of chest pain, but has normal angiogram: need to consider this on differential.

Answer 3

Panic Attack/Disorder

Question 4

Characteristic situations avoided in agoraphobia

Answer 4

Bridges
Crowds
Buses
Trains
Any open areas outside the home

Question 5

What is the most effective treatment for specific phobias?

Answer 5

Behavior Therapy: Systemic desensitization (graded and flooding) technique

Question 6

What can be used during desensitization therapy for phobias in order to control autonomic symptoms?

Answer 6

Short course of Benzodiazepines
or
Beta Blockers

Question 7

Treatment for Social Anxiety Disorder

Answer 7

The SSRI, Paroxetine, is FDA approved for treatment of this disorder

Question 8

For diagnosis of PTSD, symptoms must be present for

Answer 8

at least 1 month

Question 9

PTSD patients have high incidence of these

comorbidities

Answer 9

Substance Use Disorders and Depression

Question 10

What are the 3 main therapies for the treatment of PTSD?

Answer 10

Prolonged Exposure Therapy
Cognitive Processing Therapy
Eye Movement Desensitization and Reprocessing Therapy

Question 11

What is cognitive processing therapy?

Answer 11

Modified form of cognitive behavioral therapy in which thoughts, feelings, and meanings of the event are revisited and questioned

Question 12

What sort of medications should be avoided in the treatment of PTSD?

Answer 12

Addictive medications, especially Benzodiazepines, because of the high rate of substance abuse in these patients

Question 13

For diagnosis of Generalized Anxiety Disorder, symptoms must be present for…

Answer 13

most days of the week for at least 6 months

Question 14

What are two non-psychiatric conditions to rule-out when considering diagnosis of GAD?

Answer 14

Medical Conditions (hyperthyroidism) that can cause increased anxiety states and excessive caffeine intake

Question 15

What is the first line pharmacotherapy for GAD?

Answer 15

SSNRI Venlafaxine

SSRIs

Question 16

Most effective treatment approach for GAD…

Answer 16

Combination of psychotherapy (CBT) and pharmacotherapy

Question 17

Obsession

Answer 17

Recurrent and intrusive thought, feeling, or idea that is egodystonic

Question 18

Compulsion

Answer 18

A conscious repetitive behavior linked to an obsession that, when performed, function to relieve anxiety caused by the obsession

Question 19

What is the main difference between OCD and OCPD?

Answer 19

In OCD the obsessions and compulsions are egodystonic, whereas OCPD patients do not perceive a problem (egosyntonic).

Question 20

What illnesses are frequently comorbid with OCD?

Answer 20

Tourette Syndrome and

Attention deficit/hyperactivity disorder

Question 21

OCD is associated with abnormal neurochemical regulation of…..

Answer 21

Serotonin

Question 22

OCD is associated with these medical conditions (may be part of PMH)

Answer 22

Head injury
epilepsy
basal ganglia disorders
post partum conditions

Question 23

What is a major onset trigger of OCD?

Answer 23

Stressful life event found in up to 60% of patients

Question 24

What is the first-line pharmoacotherapy for OCD?

Answer 24

SSRIs, bu they require higher than normal doses to be effective (in comparison to depression)

Question 25

What behavioral therapy is used to treat OCD?

Answer 25

Exposure and Response Prevention Therapy

Question 26

What are the last resort treatments for treatment-resistant OCD cases

Answer 26

ECT or

Surgery: cingulotomy