Anxiety Disorders

Question 1

What are the 3 models of Stress?

Answer 1

• Biomechanical “engineering”
• Medicophysiologicals
• Psychological / Transactional

Question 2

What are the 2 main focuses of coping?

Answer 2

• Problem Focused

- Emotion Focused

Question 3

What is problem focused coping?

Answer 3

Efforts are directed towards modifying the stressor.

i.e. preparation or interview practice for med school application

Question 4

What is emotion focused coping?

Answer 4

Modification of the emotional reaction.

This one relates to “defence mechanisms”

and sedative drug problems.

Question 5

What are the symptom groups of anxiety? “flight or fight responses”
(5)

Answer 5

1) Physiological Arousal
2) Autonomic Arousal
3) Muscle Tension
4) Hyperventilation
5) Sleep Disturbance

Question 6

What constitutes to physiological arousal reactions to stress? (5)

Answer 6

• Fearful Anticipation
• Irritability
• Sensitivity to noise
• Poor concentration
• Worrying thoughts

Question 7

What constitutes to autonomic arousal reaction to stress? (5)

Answer 7

• GI (N+V)
• Resp (tight chest)
• Cardio (MI symptoms)
• Genitourinary (micturation)
• CNS (dizziness)

Question 8

Give examples of muscle tension symptoms of anxiety. (3)

Answer 8

Tremor
Headache
Muscle Pain

Question 9

Give side effects of the hyperventilation symptoms of anxiety. (3)

Answer 9

Hypocapneoa (CO2 deficit)
Breathlessness
Tingling in extremities

Question 10

What constitutes as symptoms relating to sleep disturbance? (3)

Answer 10

Initial insomnia
Frequent waking
Nightmares / terrors

Question 11

Name the 3 most common phobias.

Answer 11

Agoraphobia

Social Phobia

Specific (isolated) Phobias

Question 12

What is Generalised Anxiety Disorder? (GAD)

Answer 12

Perisitent symptoms for several months, with no direct trigger.

Question 13

What are some psychiatric differentials to anxiety? (4)

Answer 13

• Depression
• Schizophrenia
• Demantia
• Substance misuse

Question 14

What are some medical differentials to anxiety? (5)

Answer 14

• Thyrotoxicosis
• Phaeochromocytoma
• Hypoglycaemia
• Asthma
• Arrythmia

Question 15

What gender is most likely to be affected by anxiety?

Answer 15

Females

Question 16

How do we manage GAD?

Answer 16

CBT

Question 17

What is social phobia?

Answer 17

Inappropriate anxiety in situations where a person feels observed or criticised.

Question 18

How do we manage social phobia?

Answer 18

CBT

Education and Advice

SSRI

Question 19

What is OCD?

Answer 19

Obsessional thoughts.

Occurring repeatedly and not willed.

Question 20

What is the aetiology of OCD? (3)

Answer 20

• M=F
• 2% prevalence
• 5HT function abnormalities (genetic)

Question 21

How do we manage OCD? (5)

Answer 21

• Treat depression
• General Measures
• Serotonic drugs ( i.e. fluoxetine or clomipramine)
• CBT
• Psychosurgery ?

Question 22

What is PTSD? (medical definition)

Answer 22

Delayed and or protracted reaction to a stressor of exceptional severity.

Question 23

What are the key symptoms to the reaction in PTSD? (3)

Answer 23

1) Hyperarousal
2) Re-experience phenomena
3) Avoidance of reminders

Question 24

What is hyperarousal? (4)

Answer 24

Persistent Anxiety
Irritability
Insomnia
Poor concentration

Question 25

What is Re-exeprience phenomena? (2)

Answer 25

Intrusive images:

1) Flashbacks when awake
2) Nightmares during sleep

Question 26

What are some signs of avoidance? (4)

Answer 26

1) Emotional Numbness
2) Cue Avoidance
3) Recall Difficulties
4) Anhedonia

Question 27

What gender is most likely to suffer from PTSD?

Answer 27

Women

2:1 ratio

Question 28

How do we manage PTSD? (6)

Answer 28

• Follow NICE guidelines
• Screening of disaster survivors
• “watchful waiting”
• Trauma focused CBT
• Eye movement desensitisation and reprocessing
• NO SEDATIVES (risk of high dependency). Try SSRIs or TCAs