BM - Anxiety Disorders Flashcards

1
Q

Define anxiety

A

Apprehension, tension, or uneasiness from anticipation of danger/threat

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2
Q

What is the adaptive function of anxiety

A

anxieties help us be safe

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3
Q

Define pathological anxiety

A

When anxiety interferes with effectiveness in living, achievement of desired goals or satisfaction, or reasonable emotional comfort

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4
Q

What are the physical symptoms of anxiety

A

Chest pressure/pain, choking, dyspnea, tachycardia, palpitations, sweating, twitching/tremor, G/I distress, difficulty swallowing, dizziness, paresthesia, difficulty concentrating

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5
Q

What should be considered when diagnosing anxiety

A

History, mental status exam, physical exam, laboratory tests, psychological evaluations

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6
Q

What is panic disorder

A

The presence of recurrent, unexpected panic attacks followed by at least 1 month of one of the needed symptoms

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7
Q

What are the symptoms that patients must have at least one of to meet criteria for panic disorder

A
  1. Persistent concern about having additional attacks
  2. Worry about the implications or consequences of the attacks
  3. A significant change in behavior related to the attacks
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8
Q

What is a panic attack

A

A discrete period of intense apprehension, fearfulness, or terror, often associated with a feeling of impending doom all in the absence of any real danger

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9
Q

What are the symptoms of a panic attack (need at least 4)

A

Palpitations, sweating, trembling, SOB, chest pain, feeling of choking, nausea, dizziness/lightheaded, paresthesia; All develop abruptly and peak within 10 minutes

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10
Q

What is the average age of onset for panic disorder

A

adolescence through mid 30s

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11
Q

What is panic disorder often comorbid with

A

Mood and substance disorders

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12
Q

What is the etiology of panic disorder

A

Neurotransmitters, genetics, psychological factors (stressors, triggers)

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13
Q

What is the criteria for specific phobia

A

Marked and persistent fear provoked by presence or anticipation of a specific object or situation (animals, heights, planes, blood); recognizes that the fear is excessive or unreasonable (with the exception of children)

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14
Q

What is the criteria for social anxiety disorder

A

Marked and persistent fear of social or performance situations where there are unfamiliar people or potential scrutiny by others; fear that they will act in a way (or have anxiety sx) that are humiliating/embarrassing; also aware that the fear is excessive or unreasonable

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15
Q

What is the criteria for obsessive-compulsive disorder

A

Presence of obsessions or compulsions; recognition that obsessions/compulsions are excessive/unreasonable; the obsessions/compulsions cause marked distress, are time consuming (>1 hour/day), or significantly interfere with normal routine, functioning, relationships

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16
Q

Define obsession

A

Anxiety provoking thought

17
Q

Define compulsioin

A

Repetitive behavior that patient performs to reduce obsession/thoughts

18
Q

What are common symptom patterns with OCD

A

Contamination/germs, performing compulsions a set number of times, symmetry, not stepping on cracks, pathological doubt

19
Q

What is the onset and trend of OCD

A

Male and female have equal rate; onset in adolescence/young adulthood

20
Q

What are the symptoms of Post traumatic stress disorder

A
  1. Exposure to actual or threatened death/injury, or sexual violence
  2. Intrusion symptoms (memories, dreams, dissociative reactions/flashbacks)
  3. Persistent avoidance of stimuli associated with the trauma
  4. Negative alterations in cognition/mood
  5. Alterations in arousal
  6. Duration of symptoms is greater than 1 month
  7. Clinically significant impairment/distress in social, occupational, other functioning
21
Q

Give examples of the negative alterations in cognition/mood

A
  1. Inability to recall important aspect of trauma
  2. Negative belief/emotional state; unable to experience positive emotions
  3. Diminished interest/participation in significant activities
  4. Feeling detached/estranged from others
22
Q

Give examples of alterations in arousal

A
  1. Irritability, angry outbursts
  2. Reckless/self-destructive behavior
  3. Hypervigilance
  4. Exaggerated startle response
  5. Can’t concentrate
  6. Sleep disturbance
23
Q

What are the risk factors of PTSD

A

occupation with high risk of traumatic experiences such as first responders and military

24
Q

What is the criteria for generalized anxiety disorder

A

Excessive anxiety and worry about a number of events or activities occurring more days than not for at least 6 months; Difficult to control the worry; Need at least 3 symptoms (1 in children)

25
What are the symptoms of which 3 are needed for GAD
Restlessness, fatigue/sleep disturbances, difficulty concentrating, irritability, muscle tension*, sleep disturbances
26
What is other information about GAD
1. Most worries are unlikely to happen 2. Many bodily representations of anxiety 3. Lifelong disorder
27
What are some anxiety disorders that are caused by a medical condition
Asthma, allergies, PE, angina, arrythmias, CHF, alterations in BP, hyperthyroid, hypoglycemia, electrolyte disturbances, seizures, PMS
28
Substance/medication-induced anxiety disorder
Stimulants, anticholinergics, drug withdrawal, hallucinogens, indomethacin
29
What is good to establish to begin treatment with anxiety patient
Good rapport with patient and empathetic response to the patient's story
30
What are some treatments for anxiety
Psychotherapy should be the first treatment method; Pharmacotherapy w/ SSRI's and SNRI's
31
What is the role of prescribing benzodiazepines for anxiety
prescribe short-term while waiting for SSRI's or SNRI's to begin working or as PRN for panic attacks; they are very addicting but can be very helpful, ex) Xanax, valium
32
How to treat social phobia
Inderal - blood pressure medication that controls physical symptoms of anxiety; may need to be on SSRI or SNRI if more severe
33
How to treat specific phobia
take small steps to overcome phobia with coping techniques and possibly benzos
34
What are other ways to treat all anxieties
Adequate sleep, decrease caffeine, exercise