Anxiety, Obsessions And Reactions To Stress

Question 1

Define agoraphobia

Answer 1

Fear of busy, hectic and crowded places (+/- panic attacks). Unable to escape.

Question 2

What is social phobia?

Answer 2

Avoidance of situations where they are exposed to scrutiny of others. They are ok in an anonymous crowd but not at an intimate dinner party.
Alcohol and drugs perpetuate the problem

Question 3

Which specific phobias can lead to physical symptoms?

Answer 3

Blood, needle or injury phobias can lead to low blood pressure and bradycardia

Question 4

What is the treatment for phobias?

Answer 4

Exposure therapy, either gradual (desensitisation) or flooding. It causes habituation

Question 5

What is panic disorder?

Answer 5

Episodic paroxysmal anxiety (lasts about 10mins) ‘out of the blue presentation’. Feel
Ike they might die or collapse or lose control.
Associated with anticipatory anxiety and avoidance.
Noradrenaline action.

Question 6

Why do you get pins and needles in panic disorders?

Answer 6

Hyperventilating, less co2, high ph, low calcium. This affects nerve conduction and therefore results in pins and needles.

Question 7

‘Free floating anxiety’ refers to which anxiety disorder?

Answer 7

Generalised anxiety disorder

There is no specific stimulus as a trigger. Symptoms present for at least 6months.

Question 8

Usual Treatment for anxiety disorders?

Answer 8

CBT + SSRI

Question 9

Is the dose of antidepressant higher for treating depression or anxiety?

Answer 9

Anxiety

Question 10

Which anxiety disorders is in beneficial to use beta-blockers?

Answer 10

Ones with a specific trigger e.g. Performing or presenting. Beta blockers (propanalol)can be used PRN.

Question 11

What symptoms are associated with obsessive compulsive disorder?

Answer 11

Repetition
Numbers
These thoughts are intrusive and can not be ignored leading to ritualistic behaviours.
Over 2weeks in duration.

Question 12

OCD is associated with which type of personality disorder?

Answer 12

Anankastic (rigidity, orderliness)

Question 13

Which specific type of CBT is used for OCD?

Answer 13

ERP, exposure response prevention

The person has to refraining from ritualising

Question 14

Which symptoms are associated with acute stress reaction? And after what length of time is this normal?

Answer 14

Anxious ‘dream world’
Amnesia
Depersonalisation and derealisation.
Disoriented and agitated

Should resolve within 1-3days/ 2 weeks

Question 15

What is adjustment disorder?

Answer 15

Stress response continuing for over normal amount of time (1month).Depression and anxiety

Question 16

What are the usual triggers for PTSD?

Answer 16

Threatened death, serious injury, torture or rape.

Question 17

What’s the aetiology in PTSD?

Answer 17

The memory formation during the traumatic event is incomplete and instead of ‘remembering’ they end up ‘reliving’ the event. The amygdala (emotions) is hyperactive and the hippocampus (memory) is atrophied.

Question 18

What are th features of PTSD?

Answer 18

Nightmares
Flashbacks - vivid
Intrusive memories 
Avoidance 
Hyoervigilance
Exaggerated startle (unable to relax)

Question 19

What anxiety disorder is EMDR used? (eye movement desensitisation and reprocessing)

Answer 19

PTSD.

Said to help process those traumatic memories.

Question 20

What are problems like IBS and chronic pain, sometimes referred to as?

Answer 20

Somatoform disorders. They are mediated by the autonomic nervous system.
Can we treated with any antidepressant at a low dose e.g. Amitrypiline 10mg

Question 21

What is dissociative (conversion) disorder?

Answer 21

When psychological symptoms manifest as physical symptoms.
Eg blindness without any pathology. Or non-epileptic seizures. Patients rarely hurt themselves.

Rx: psychodynamic therapy.

Question 22

Why should you try not to give benzodiazepines?

Answer 22

Addiction

Discontinuation syndrome

Question 23

How long can an adjustment disorder last for?

Answer 23

Up to 6months

Must occur in the 3months from the trigger