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Neuropsyciatry > Anxiety disorders > Flashcards

Anxiety disorders Flashcards

1
Q

what is the The Stress Response compose of?

A
  1. limbic system
  2. limbic-hypothalamo-pituitary- adrenal axis
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2
Q

what is the The Limbic System composed of?

A
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3
Q

where is the hippocampus? what does it do? what is it? what is its subparts

A
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4
Q

where is the Amygdala? what does it do? what is it?

A

an almond-shaped structure deep within the temporal lobe,

is a collection of nuclei lying beneath the uncus

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5
Q

effects of Prefrontal cortex & Anterior cingulate gyrus on hypothalamus?

A
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6
Q

role of hypothalamus in the stress response

A
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7
Q

role of the limbic-hypothalamo- pituitary-adrenal axis in the stress response

A

MAIN ACTION THROUGH CORTISOL

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8
Q

what is the general adaptation syndrome?

A

3 stages that the body goes through during prolonged exposure to stressors

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9
Q

So when does the stress response become a pathalogical?

A

the prolonged release of cortisol!

when you cannot escape a stressor(s), or when ‘trivial’ stressors elicit a strong stress response. However, patients with anxiety disorders may go through all of the stages above

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10
Q

Symptoms of anxiety

A
  • Palpitations
  • Sweating
  • Trembling or shaking
  • Dry mouth
  • Difficulty breathing
  • Chest pain or discomfort
  • Nausea or abdominal distress (e.g. butterflies in stomach) • Feeling dizzy, unsteady, faint or light-headed
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11
Q

compare and contrast symtoms of thyrotoxicosis w/ anxiety?

A

same:

palpitations, restlessness, increased bowel movements, tremor

differences:

  • no goitre
  • may not have oncreased apeptite and weight loss
  • thyrtoxicosis> u see vasodilation (warm & sweaty)
  • Anxiety>> u see vasoconstriction (cold and clammy)
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12
Q

types of Anxiety disorders

(Gimme 6 types)

A
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13
Q

Treatment of anxiety disorders: (pharmacological vs non)

A

SSRI> selective seritonin reuptake

increases levels of seritonin at the pre-synaptic cleft

Biological

  • Short term benzodiazepines
  • SSRIs

pregabalin >> gaba analogue

Psychological

Cognitive behavioural therapy
o Getting patients to reflect on their feelings/thoughts/behaviours

Social

  • Support groups, charities etc
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14
Q

why should we NOT use benzodiazepines in the long term?

A
  1. leads to intolerence
  2. dangerous in overdose
  3. addicting
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15
Q

define obsession

A

‘a thought that persists and dominates an individual’s thinking despite them knowing that it is entirely without purpose, or has persisted and dominated their thinking beyond the point of relevance or usefulness’

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16
Q

Examples of obsessions

A

Most important thing to remember… Obsessions are unpleasant

17
Q

define Compulsions

A
18
Q

Diagnostic criteria for OCD

A

• Obsessions/compulsions/both present on most days for a period of at least 2 weeks

• Obsessions and compulsions share all of the following features

  • Originate in the mind of the patient
  • Repetitive and unpleasant
  • Acknowledged as excessive or unreasonable
  • Patient tries to resist, but at least one obsession/compulsion is unsuccessfully resisted
  • Carrying out the obsessive thought or act is not in itself pleasurable
  • Obsessions/compulsions must causes distress or interfere with the

patient’s social or individual functioning

19
Q

Epidemiology of OCD

A
  • Usually begins in adolescence or early adulthood
  • 33% start between 10 and 15 years old

• 75% started by age 30

  • Lifetime prevalence of around 2%
  • M : F 1 : 1 (but childhood OCD more common in boys)
  • Lots of doctors show traits!
20
Q

Pathophysiology of OCD

list suggested theories

A
  • Re-entry circuits in basal ganglia
  • Reduced serotonin
  • Reduced activity in dorsolateral prefrontal cortex
  • Reduced activity in orbitofrontal cortex
  • Increased activity in cingulate cortex
  • PANDAS
21
Q

Re-entry circuits in basal ganglia

A
22
Q

Tourette’s syndrome

A

is a condition that causes a person to make involuntary sounds and movements called tics.

Tics are fast, repetitive muscle movements that result in sudden and difficult to control body jolts or sounds.

23
Q

what r PANDAS

A

Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection

  • Sudden onset of OCD symptoms or tics after infection with Group-A beta-haemolytic strep. usually 3-12 yrs
  • Usually dramatic onset of psychiatric or behavioural problems
  • Antibodies ‘cross-react’ with neurons in basal ganglia, causing symptoms
  • responds to treatment w/ antibiotics and usual OCD managment
24
Q

Treatment of OCD therapies vs drugs

A

CBT> it only provides short term releif, ur gunna end up going back in the circle

high dose SSRI> may need to wait 3 months to see the response

we dont use Clomipramine first line>> bc it has unpleasant SE

-deep brain stimulation

 Biological

SSRIs +/- antipsychotics

Deep brain stimulation? 

Psychological

CBT and variety of other interventions 

Social

Family support

Groups etc.

25
Q

Deep brain stimulation

A

STN stimulated

26
Q

Post Traumatic Stress Disorder (PTSD) features

When must it occur?

A

memory of a past traumatic event cause recurrent mental and physical distress!

  • Can occur within 6 months following an exceptionally severe traumatic event (e.g. rape, battlefield trauma)
  • Causes repetitive, intrusive recollection or re-enactment of the event in memories, daytime imagery, or dreams
  • There is conspicuous emotional detachment, numbing of feeling, and avoidance of stimuli that might arouse recollection of the trauma
27
Q

Pathophysiology of PTSD

A
28
Q

Treatment of PTSD

A

 Biological

  • SSRIs
  • Maybe short term benzodiazepines

Psychological

• CBT

Eye movement desensitization reprocessing therapy 

Social

Charities are particularly active, such as ‘Help for Heroes’

29
Q

mechanism of action of benzodiazepine reduce her anxiety symptoms?

A

Neuropsyciatry (21 decks)

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