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Psychiatry > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

1
Q

What are the associated physical responses to anxiety?

A

↑ HR, ↑BP, ↑RR, nausea, muscle tingling

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2
Q

What is a panic attack? (ICD 10)

A
  • A discrete episode of intense fear or discomfort
  • Starts abruptly
  • Reaches a maximum within a few minutes and lasts at least some minutes
  • At least 4 specific symptoms of anxiety
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3
Q

Anxiety symptoms involving mental state?

A
  • Feeling dizzy/ unsteady/faint/ lightheaded
  • Derealisation= feeling that objects are not real or depersonalistaion= feeling that people are not real
  • Fear of losing control/going crazy/ passing out/dying
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4
Q

What are the autonomic arousal symptoms of anxiety?

A
  • Palpitations/ Pounding heart/ Increased HR
  • Sweating
  • Trembling/ Shaking
  • Dry mouth
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5
Q

What are the symptoms that involve the chest

and abdomen?

A

• Difficulty breathing/ Feeling of choking/ Chest pain or
discomfort
• Nausea or abdominal distress

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6
Q

What are the general symptoms of anxiety?

A

• Hot flushes/ cold chills/ numbness/ tingling

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7
Q

What are the 6 types of anxiety conditions?

A
  • Phobic Anxiety disorders
  • Other Anxiety disorders
  • Obsessive Compulsive disorder
  • Reactions to severe stress and adjustment disorders
  • Dissociative (conversion) disorders
  • Somatoform disorders
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8
Q

Types of phobic anxiety disorders?

A
  • Agoraphobia
  • Social phobia
  • Specific (isolated) phobias
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9
Q

Types of other anxiety disorders?

A
  • Panic disorder [episodic paroxysmal anxiety]

* Generalized anxiety disorder

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10
Q

Types of reactions to severe stress and adjustment disorders?

A
  • Acute stress reaction
  • Post-traumatic stress disorder
  • Adjustment disorders
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11
Q

Types of dissociative (conversion) disorders?

A

Amnesia, fugue, stupor, motor, convulsions, trance & possession states, anaesthesia and sensory loss

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12
Q

Types of somatoform disorders?

A
  • Somatisation disorder

* Hypochondriacal disorder

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13
Q

How do you classify generalised anxiety disorder?

A

A period of at least 6 months with prominent tension, worry and feelings of apprehension about everyday events and problems

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14
Q

How do you classify panic disorder?

A

• Recurrent attacks of severe anxiety (panic)= panic attacks
• Not restricted to any particular situation or set of
circumstances
• Unpredictable.
• Dominant symptoms include sudden onset of palpitations, chest pain, choking sensations, dizziness, and feelings of unreality (depersonalization or derealisation).
• 4 panic attacks in 4 weeks, lasting min-10min
sudden onset

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15
Q

What is agoraphobia and mean age of onset? (ICD 10)

A 
Cluster of phobias embracing:
• fears of leaving home,
• entering shops,
• crowds and public places
• travelling alone in trains, buses or planes.
  • Panic disorder is a frequent feature of both present and past episodes.
  • Depressive and obsessional symptoms, and social phobias are also commonly present as subsidiary features.
  • Avoidance of the phobic situation is often prominent
  • Some agoraphobics experience little anxiety because they are able to avoid their phobic situations.

20-35 years F>M

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16
Q

What is social phobia and mean age of onset? (ICD 10)

A
  • Fear of scrutiny by other people leading to avoidance of social situations.
  • More pervasive social phobias are usually associated with low self-esteem and fear of criticism.
  • May present as a complaint of blushing, hand tremor, nausea, or urgency of micturition
  • the patient sometimes being convinced that secondary manifestation of their anxiety is the primary problem.
  • Symptoms may progress to panic attacks.

Adolescence F>M

17
Q

What are specific phobias and mean age of onset? (ICD 10)

A
  • Phobias restricted to highly specific situations e.g. animals, heights, dentistry, or the sight of blood or injury.
  • triggering situation is discrete but contact with it can evoke panic

Childhood F=M

18
Q

Psychological treatments for anxiety?

A
  • Self Help
  • Cognitive Behaviour Therapy (CBT)
  • Applied relaxation
  • Psycho education
  • Exposure (systematic desensitisation)
19
Q

Medical treatments for anxiety?

A

•SSRIs
•Beta blockers can help with peripheral symptoms eg
tremor
•Benzodiazepines best avoided apart from in very short term e.g to help someone with fear of flying fly home to a funeral

20
Q

What are the essential features of OCD?

A

The essential feature is recurrent obsessional thoughts and compulsive acts.

21
Q

What are some good questions to ask to assess OCD?

A
  • Do you wash or clean a lot?
  • Do you check things a lot?
  • Is there any thought that keeps bothering you that you’d like to get rid of but can’t?
  • Do your daily activities take a long time to finish?
  • Are you concerned about putting things in a special order or are you very upset by mess?
22
Q

What is the treatment for OCD?

A

• Psychotherapy
• CBT
• ERP exposure & response prevention
• Repeated graded exposure to anxiety provoking
stimuli
• Drug treatment
• SSRI (fluoxetine, sertraline)
• TCA (clomipramine)
Combined psychotherapy & drug treatment generally better than each alone

23
Q

What is PTSD?

A

Experience life threatening or catastrophic event, likely to cause “pervasive distress in almost anyone eg disaster, serious accident,torture, rape, witnessing death etc

Onset usually follows trauma with a latency period of 1-6 months

24
Q

What is the treatment for PTSD?

A
  • Trauma focused CBT
  • Repeated graded exposure
  • Testimony based techniques
  • EMDR (Eye movement desensitisation and reprocessing)
  • Antidepressant (paroxetine or mirtazepine)
25
Q

What are the characteristics and treatment of dissociative disorder?

A

Disorder of physical function usually under voluntary
control eg inability to walk

Difficult/Rehab/physio

26
Q

What are the characteristics and treatment of somatoform disorders?

A

Repeated presentation of physical symptoms eg pain

Difficult/CBT/SSRI

27
Q

What are the characteristics and treatment of hypochondriasis?

A

Fear or worry about developing a disorder

CBT/SSRI

Psychiatry (22 decks)

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