Anxiety Disorders

Question 1

what is the difference between physiological and pathological anxiety

Answer 1

pathological anxiety occurs when the anxiety is so marked that it has an impact on a patients life or occurs in situations that typically do not cause anxiety

Question 2

list the physical symptoms of anxiety

Answer 2

sweating 
shaking 
muscle tension 
numbness and tingling 
feeling dizzy 
dry mouth 
feeling of lump in the throat 
difficulty breathing 
palpitations 
chest pain 
nausea

Question 3

list the cognitive symptoms of anxiety

Answer 3

fear of losing control 
mentally tense 
difficulty in concentrating 
depersonalisation 
meta-worry 
preference for order and routine

Question 4

list the behavioural symptoms of anxiety

Answer 4

avoidance in certain situations 
exaggerated response to minor surprises 
difficulty in getting to sleep 
excessive use of drugs and alcohol 
persistent irritability 
checking behaviours

Question 5

acute stress causes what hormone to rise

Answer 5

cortisol

Question 6

list the main types of anxiety disorders

Answer 6

generalised anxiety disorder 
panic disorder 
agoraphobia 
social phobia 
specific phobia 
obsessive compulsive disorder

Question 7

in what situations does generalised anxiety occur and what are the predominating symptoms

Answer 7

generalised and persistent - not restricted to any particular circumstances
main symptoms are nervousness, muscle tensions, sweating, palpitations and dizziness

Question 8

what is a typical fear in GAD

Answer 8

feeling that the patient or someone close to them will become unwell or have an accident

Question 9

for diagnosis of GAD, what needs to be present

Answer 9

symptoms for most days a week for at least 6 months

not controllable and causing functional impairment

Question 10

what is the age of onset for GAD

Answer 10

between 20-40 years

Question 11

list some typical co-morbid disorders with GAD

Answer 11

depression

substance abuse

Question 12

what is the management of GAD

Answer 12

CBT to identify thoughts and behaviours that perpetuate anxiety
SSRI/SNRI
pregabalin
benzodiazepines short term

Question 13

what is panic disorder

Answer 13

an anxiety disorder characterised by recurrent attacks of severe anxiety not in any particular situation - intense bursts of anxiety that are not due to any other cause

Question 14

describe the symptoms of panic disorder

Answer 14

sweating, chest and epigastric pain, nervousness, muscle tensions, palpitations
secondary fear of dying/losing control

Question 15

what is the age of onset for anxiety disorder

Answer 15

adolescence - mid 30s

Question 16

outline the management for panic disorder

Answer 16

CBT
SSRI/SNRI
benzodiazepines

Question 17

what is agoraphobia

Answer 17

cluster of phobias associated with fear of leaving their home, entering public places such as shops and crowds. also fear of travelling alone

Question 18

is agoraphobia most commonly a primary or secondary disorder

Answer 18

secondary - associated with depression or panic disorder

Question 19

list the 3 types of phobias seen

Answer 19

agoraphobia
specific phobia
social phobia

Question 20

people with a phobia recognise their fear as irrational true/false

Answer 20

true

phobias are typified by anxiety and avoidance

Question 21

what are specific phobias

Answer 21

marked and persistent fears that are excessive and unreasonable, typically flying, heights, animals and receiving an injection

Question 22

what is the management of phobias

Answer 22

behavioural therapy with exposure and systematic desensitisation
CBT
SSRI/SNRI

Question 23

what is a social phobias

Answer 23

persistent fear of social or performance situations, individual fears they will act in a way that is embarrassing

Question 24

list the common symptoms seen in social anxiety

Answer 24

blushing or shaking
fear of vomiting
urgency or fear or micturition and defaecation

Question 25

describe some obsessive thoughts seen in OCD

Answer 25

ideas entering the mind in a stereotyped way
recognised as the patients own thoughts
but thoughts are unpleasant, resistant and ego-dystonic

Question 26

describe some compulsive acts seen in OCD

Answer 26

repeated rituals/stereotypes behaviours
not enjoyable
not functional
often viewed as neutralising

Question 27

how long must symptoms be present for diagnosis of OCD

Answer 27

present most days for at least 2 weeks and are a source of distress and interfere with activities

Question 28

list co-morbidities for OCD

Answer 28

eating disorder
schizophrenia
tics
body dysmorphic disorder