Anxiety Disorders Flashcards

1
Q

What are 3 potential symptoms of anxiety?

A

palpitations

sweating

dry mouth

difficulty breathing

chest pain

nausea / butterflies in stomach

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2
Q

What are 2 potential types of anxiety disorders?

A
  • generalised anxiety disorder
    • (persistent anxiety about a variety of things)
  • social phobia
  • specific phobias
    • (e.g. arachnophobia)
  • panic disorder
    • (discrete episodes of panic)
  • obsessive compulsive disorder (OCD)
  • post traumatic stress disorder (PTSD)
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3
Q

Are GABA levels increased or decreased in the cortex of patients with anxiety disorder?

A

decreased GABA levels

GABA is an inhibitory neurotransmitter

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4
Q

Why should benzodiazepines not be used long term for anxiety disorder?

A

dangerous in overdose

risk of addiction or tolerance

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5
Q

Which 3 key structures form the limbic system?

A

Hippocampus

Hypothalamus

Amygdala

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6
Q

What is the function of the hippocampus?

A

involved in the formation of memories and suppression of the HPA axis

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7
Q

What is the function of the amygdala?

A

play a key role in the processsing of emotions (especially fear)

major outputs to the cortex and hypothalamus

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8
Q

How can anxiety lead to excess cortisol in the body?

A

simulation of the limbic-hypothalamo-pituitary-adrenal axis

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9
Q

Whare are the two common treatment options for anxiety disorders?

A

Selective Serotonin Re-uptake Inhibitors
(SSRIs potentially increase the sensitivity of glucocorticoid receptors in the hippocampus to suppress the HPA axis)

Cognitive Behavioural Therapy

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10
Q

What is an obsession in the context of psychiatry?

A

thought that persists and dominates and individuals thinking, despite awareness that the thought is without purpse and has persisted beyond the point of usefulness

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11
Q

What is a compulsion in the context of psychiatry?

A

obsessional motor act resulting from an obsessional impulse, or mediated by an obsessional mental image

e.g. I will need to turn the light switch on and off x10 or my wife will die

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12
Q

What is the diagnostic criteria for OCD according to ICD-10?

A

obsessions ± compulsions present on most days for at least 2/52

obsessions and compulsios have the following features:

  • originate in the mind of the patient
  • repetetive and unpleasant
  • acknowledged as excessive / unreasonable (INSIGHT)
  • patient tries to reist but one is unsucessfully resisted

obsessions ± compulsions must cause distress or interfere with social functioning

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13
Q

By what age have most patients (75%) developed symptoms of OCD and which gender are more greatly affected?

A

by 30 years of age

male = female

(more common in boys in childhood)

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14
Q

What are 3 suggested theories of the pathophysiology underlying OCD?

A

Re-entry Circuits in the Basal Ganglia

Reduced Serotonin

PANDAS

(neurospychiatric disorder associated with streptococcal infection)

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15
Q

How is a re-entry circuit in the basal ganglia believed to be related to obsessive compulsive disorder?

A

a circuit exists between the output and and processing centres of the brain, that does not allow the individual to acknowledge that a ‘hidden danger’ has been addressed and acted upon

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16
Q

What talking therapy can be used to help patients with OCD?

A

cognitive behavioural therapy

17
Q

What will be the effect of deep brain stimulation of the subthalamic nucleus in patients with treatment resistant OCD?

A

stimulation of the STN causes increased activity of GPi / SNr

this causes increased inhibition of thalamus

leading to less stimulation of the cortex

18
Q

What is post traumatic stress disorder PTSD?

A

repetetive, intrusive recollection or re-enactment of a traumatic event of exceptional severity, in memories, daytime imagery or dreams

19
Q

What is the underlying pathophysiology in PTSD?

A

hyperactivity of the amygdala, causing exaggerated response to perceived threat

20
Q

How can PTSD be treated?

A

Cognitive Behavioural Therapy

Eye Movement Desensitisation Reprocessing (EMDR)

(recall distressing images while receiving one of several types of bilateral sensory input)