Anxiety Disorders

Question 1

what is a panic attack?

Answer 1

episode of intense fear or discomfort

develops suddenly

peaks within 10 minutes and lasts less than 60 min

Question 2

symptoms of panic attacks

Answer 2

1. dizziness
2. choking
3. trembling
4. parasthesias
5. sweating/hot flashes
6. SOB/CHest pain
7. fear of losing control or dying
8. nausea/abdominal distress
9. depersonalization

Question 3

management of panic attack

Answer 3

BENXOS

I.e. lorazepam, alprazolam

Question 4

panic disorder

Answer 4

recurrent, unexpected panic attacks at least 2

AND one of:

1. attacks are often followed by concern about future attacks
2. worry about implication of attacks
3. significant change of behavior related to attacks

Question 5

agoraphobia

Answer 5

anxiety about being in places or situations from which escape may be difficult

this is not panic disorder

Question 6

management of panic disorder

Answer 6

chronic: SSRIS and CBT
acute: Benzes

Question 7

GAD

Answer 7

excessive anxiety or worry majority of days

> 6 months

about various aspects

Question 8

anxiety associated symptoms (8)

must have 3 of them!

Answer 8

fatigue
restlessness
difficulty concentrating 
muscle tension 
sleep disturbance 
irritability 
shakiness 
HA

Question 9

management of anxiety

Answer 9

1. antipressants (SSRI)
2. Buspar - no cause of sedation
3. Benzos
4. psychotherapy

Question 10

social anxiety disorder

Answer 10

persistent, intense fear of social or performance situations in which the person is exposed to the scrutiny of others for fear of embarrassment

these situations almost always provoke anxiety and often panic attacks

Question 11

management of social anxiety

Answer 11

1. SSRIs
2. Beta blockers
3. benzos
4. psychotherapy

Question 12

specific phobia

Answer 12

persistent, intense fear or anxety of a specific situation, object, or place

out of proportion to any real danger

object is actively avoidedd

everyday activities impaired y distress or avoidance

Question 13

management of specific phobia

Answer 13

exposure/desensitization therapy

Question 14

PTSD MC seen in?

Answer 14

young adults
combat experience or urban violence
rape or assault

Question 15

PTSD general criteria

Answer 15

1. exposure to actual or threatened death, serious injury, or sexual violence
2. presence of intrusion symptoms

Question 16

PTSD exposure mechanisms

Answer 16

1. direct experience of traumatic event
2. witnessing the event in person
3. learning the event happened to a close friend
4. experience extreme or repeated exposure to details of traumatic event

Question 17

intrusion symptoms

Answer 17

1. re-experiencing (>1 month as repetitive recollections and dissociative reactions
2. avoidance of stimuli
3. negative alterations in cognition and mood - inability to remember, exaggerated beliefs, horror, guilty, anger
4. arousal reactivity

Question 18

management of PTSD

Answer 18

SSRIs

Trazadone for insomnia

CBT

Question 19

acute stress disorder

Answer 19

similar to PTSD but symptoms are < 1 month

Question 20

treatment of acute stress disorder

Answer 20

counseling/psychotherapy

treat as PTSD if persistent

Question 21

adjustment disorders

Answer 21

emotional or behavioral reaction to an identical stressor/event that causes a disproportionate response

typically within 3 months and resolves 6 months after

Question 22

clinical manifestations of adjustment disorders

Answer 22

marked distress out of proportion to severity

significant impairment in areas of functioning

Question 23

management of adjustment disorder

Answer 23

1. psychotherapy
2. medications in selected cases, not preferred treatment
3. pts may self medicate