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Psychiatry SOH > Anxiety disorders > Flashcards

Anxiety disorders Flashcards

1
Q

Anxiety is a normal reaction, normal emotion that people experience. True or false?

A

True

- but it is important to identify when it becomes pathological

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2
Q

What are the 3 groups of symptoms we assess in anxiety (normal) ?

A

Biological (physical) symptoms
Cognitive symptoms
Behavioural symptoms

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3
Q

Normal anxiety - physical symptoms

A 
Sweating 
Cold chills 
Trembling / shaking 
Muscle tension / aches 
Numbness / tingling 
Feeling dizzy / unsteady / faint 
Dry mouth 
Difficulty swallowing 
Sensation of a lump in throat
Difficulty breathing 
Palpitations
Chest pain 
Nausea
Abdominal distress
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4
Q

Normal anxiety - cognitive symptoms

A 
Fear of losing control 
Feeling on edge / tense
Difficulty concentrating 
Feeling that objects are un-real (derealisation)
Feeling that you are distant or "not really here" (depersonalisation) 
Hyper-vigilance 
Racing thoughts 
Meta worry
Health anxiety
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5
Q

Normal anxiety - behavioural symptoms

A 
Avoidance of certain situations
Exaggerated response to minor surprises 
Difficulty in getting to sleep
Excessive use of alcohol/drugs
Restlessnesss
Irritability
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6
Q

Acute stress leads to increase in ____ and ____

A

Cortisol and cateholamines

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7
Q

What is the function of cortisol in the stress response?

A

Acts as to mediate and shut down the stress response

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8
Q

In acute stress, cortisol levels are INCREASED/DECREASED?

A

Increased

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9
Q

When does normal anxiety become an anxiety disorder?

A

When anxiety becomes pathological and impairs day to day function.

Anxiety is more extreme than normal.

Anxiety is present in situations that are not normally anxiety provoking

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10
Q

Amygdala centred circuit is involved with FEAR/WORRY?

A

Fear

- panic, phobias

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11
Q

Name 4 anxiety disorders

A

Generalised anxiety disorder
Panic disorder
Phobias
OCD

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12
Q

Patient with anxiety that is not restricted to any particular environmental circumstance and is present most of the time. What is the likely diagnosis?

A

Generalised anxiety disorder

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13
Q

Generalised anxiety disorder - definition

A

Generalised and persistent anxiety
Not restricted or fixed on one particular thing
Present all/most of the time

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14
Q

Generalised anxiety disorder - cause

A

Unknown

Not due to substance misuse or any other medical condition

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15
Q

Generalised anxiety disorder - typical age of onset?

A

between 20-40

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16
Q

Generalised anxiety disorder is more common in which sex?

A

Females

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17
Q

Generalised anxiety disorder - clinical features

A 
Earlier discussed +
Persistent nervousness 
Fears (e.g. that family member will have a RTA) 
Sleep disturbance 
- restless unsatisfied sleep
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18
Q

In GAD, the patient often acknowledges that they don’t need to be anxious about all of these things but they can’t help it. True or false?

A

True

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19
Q

Generalised anxiety disorder - diagnosis

A

Must be severe enough to be:

  • long lasting (most days for at least 6 months)
  • non controllable
  • causing significant distress
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20
Q

Generalised anxiety disorder - management

A
  1. High intensity CBT OR Drug treatment (SSRI)
  2. SNRI
  3. Pregablin
  4. Combo of CBT + drug
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21
Q

Generalised anxiety disorder - for how many months do you continue treatment for?

A

18 months

22
Q

Panic disorder - definition

A

Recurrent attacks of severe anxiety
There is a reason/trigger for anxiety
Intermittent
Unpredictable

23
Q

Panic disorder is intermittent. True or false?

A

True

24
Q

Panic disorder - age of onset

A

Adolesence - mid 30s

25
Q

Panic disorder can be triggered in some people by causing a build up of which substance?

A

Lactate

26
Q

Panic disorder - which imaging investigation may be useful?

A

PET scan

27
Q

Panic disorder - management

A
  1. CBT
  2. Anti-depressant (SSRI)
  3. TCA
28
Q

Panic disorder - how long do you continue treatment for?

A

6 months

29
Q

Phobia - definition

A

Irrational fear of something that is relatively quite normal
Fear in a particular situation that is excessive or unreasonable

30
Q

What are the 3 types of phobia?

A

Agoraphobia
Social phobia
Specific phobia

31
Q

Fear of leaving home, entering shops, crowds and other public places is called?

A

Agoraphobia

32
Q

Agoraphobia - who gets it?

A

Adolescence -> 30s

33
Q

Agoraphobia is more often a PRIMARY/SECONDARY disorder?

A

Secondary

34
Q

Agoraphobia - clinical features

A

Avoidance of the phobic situation

35
Q

Specific phobia - definition

A

Cued by the presence or anticipation of a specific object or situation
- e.g. fear of flying

36
Q

Specific phobia - who gets it?

A

Early onset

- early adolescence -> 20s

37
Q

Specific phobia - clinical features

A

Exposure to the phobic stimulus provokes an immediate anxiety response.
Normal functioning is impaired by the avoidance, anxious anticipation or distress in the feared situations

38
Q

Social phobia - definition

A

Persistent fear of social scrutiny

Fear of embarrassing themselves in public

39
Q

Social phobia usually occurs in large social settings. True or false?

A

False

- small social settings

40
Q

Social phobia - clinical features

A

Exposure to feared situation provokes anxiety, which may take the form of a situationally bound panic attack
Poor school/employment history

41
Q

OCD - definition

A

Recurrent obsessional thoughts and/or compulsive acts

42
Q

OCD - more likely to occur earlier in males/females?

A

Males

43
Q

OCD - obsessional thoughts

A

Ideas, images or impulses entering the mind
Recognised as the patients own thoughts
But they are unpleasant

eg a woman that is distressed about harming her children

44
Q

OCD - compulsive acts

A

Repeated rituals

Recognised as pointless

45
Q

OCD - common obsessions

A 
Contamination 
Sexual thoughts (being a paedophile)
Fear of harm (door locks are not safe)
46
Q

OCD - common compulsions

A

Cleaning, washing
Repeating acts
Order
Hoarding

47
Q

OCD - obsessions must always be the individuals own thoughts. true or false?

A

True

48
Q

OCD - Obsessional symptoms / compulsive acts must be present most days for at least _____ before a diagnosis can be made

A

2 weeks

49
Q

OCD - management

A
  1. CBT
  2. SSRI
  3. SSRI + CBT
  4. TCA
50
Q

Which drugs are used to treat anxiety

A 
Benzodiazepines
Anti-depressants 
Buspirone 
Pregablin 
Beta blocker
51
Q

Which beta blocker is used to treat anxiety?

A

Propranolol

Psychiatry SOH (19 decks)

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