Anxiety Disorders; Trauma and Stress Related Disorders

Question 1

Patient will present as → a 35-year-old female with a complaint of worry which she cannot control for the last year. She tells you that her symptoms daily consisting of sleep disturbances, difficulty concentrating, and irritability.

Answer 1

Generalized anxiety disorder

Question 2

Excessive anxiety and worry occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance)

Answer 2

Generalized anxiety disorder

Question 3

SSRIs: Paroxetine and escitalopram
SNRIs: Venlafaxine
Buspirone is also effective
Benzodiazepines (short-term use)
 beta blockers
Psychotherapy

Answer 3

tx for GAD

Question 4

Patient will present as → a 26-year-old first-year PA student with a medical history significant for GERD comes to your office because of frequent episodes of palpitations. The palpitations are sudden in onset and are accompanied by sweating and a sense that she is going to “pass out.” The episodes typically last no more than 10 minutes, and although the patient feels as if she may pass out, she never has.

Answer 4

panic disorder

Question 5

An occurrence of three … (sudden unexpected periods of intense fear or discomfort) episodes in three weeks

Answer 5

panic attacks.

Panic disorder

Question 6

SSRIs: Paroxetine, Sertraline, Fluoxetine
Benzodiazepines: for acute attacks (watch for abuse)
CBT (relaxation, desensitization, examining behavior consequences)

Answer 6

panic disorder tx

Question 7

Excessive and persistent fear of a specific object, situation or activity that is generally not harmful.

Lasts for 6 months or more.
Patients know their fear is excessive, but they can’t overcome it.

Answer 7

specific phobia

Question 8

exposure therapy (first line), teach to relax and try to understand/overcome the fear

SSRI + CBT
Benzodiazepines (before doing event)

Answer 8

specific phobia tx

Question 9

SSRIs are first-line
Cognitive Behavioral Therapy (CBT)
Prazosin for nightmares
Benzodiazepines, if used, should not be continued more than 2 weeks after a traumatic event

Answer 9

tx for PTSD

Question 10

The disproportionate response to a stressor that would normally be expected (ex. job loss, physical illness) which begin within 3 months of the stressor and end within 6 months after stressor resolved

Answer 10

adjustment disorder

Question 11

tx is psychotherapy

Answer 11

adjustment disorder tx