Class 2 Flashcards
Treatment tension headache
advil + caffeine
preventing: amitriptyline, nortriptyline
biofeedback: using a device to give a person feedback about their body function ex: connection person to sp02/ monitoring their pulse while they try to diminish their pulse
relax muscles of neck + scalp
Migraine
Auras, no, spots, photophobia + sounds, pounding, one sided
Trx Migraine
- Triptans. Prev: Mg, b12. Doesn’t work: topiramate, valproate, bbblockers, tricyclic antidepressants
Sx of GAD could cause a headache
Muscle tension in shoulders and neck + sleep deprivation
Selective mutism Ddx
Autism spectrum disorder,
social anxiety
selective mutism
oppositional defiant disorder
Selective mutisme criteria
• The child shows consistent failure to speak in specific social situations in which there is an expectation for speaking (e.g., at school), despite speaking in other situations.
• The disturbance interferes with educational or occupational achievement or with social communication.
• The duration of the disturbance is at least 1 month (not limited to the first month of school).
• The failure to speak is not attributable to a lack of knowledge of, or comfort with, the spoken language required in the social situation.
• The disturbance is not better explained by a communication disorder (e.g., child-onset fluency disorder) and does not occur exclusively during the course of autism spectrum disorder, schizophrenia, or another psychotic disorder.
These behaviors are a method of self-protection during an experience of intense anxiety but may appear deliberately oppositional (Kotrba, 2015).
Individuals with selective mutism may present with social anxiety and social phobia. Symptoms of social anxiety and social phobias may include the following:
• Lack of eye contact
• Clinging to parents
• Hiding
• Running away
• Crying
• Freezing
• Tantruming if asked to speak publicly
• Avoidance of eating in public
• Anxious when having picture or video taken
• Anxious to use public restrooms
In addition to these features of social anxiety, children with selective mutism avoid initiating and participating in conversations. If they are able to express themselves, they may rely on gesturing, nodding, pointing, or whispering. They may have fears of being ignored, ridiculed, or harshly evaluated if they speak.
Treatment of selective mutism
CBT + SSRI if don’t respond after 3-6 months
Autism
Deficits in social emotional reciprocity (impairment in theory of mind), nonverbal communication, stereotyped repetitive movements/ speech, highly restricted, fixated interests (lack of imaginative play), insistence on sameness, routines, rituals, hyper/hypo-reactivity to sensory input. Developmental milestones: language delay. Since childhood.
ODD
Angry/ irritable mood, argumentative/defiant or vindictiveness 6 months
Panic attack like symptoms in schizophrenic ddx
Physical comorbidities Alcohol withdrawal Cocaine intoxication Antipsychotic Rx = akathisia: subjective feeling of restlessness, latuda, abilify. Trx: benzos + propranolol Psychotic Panic attack
What is the co-morbidity between psychotic disorders and anxiety disorders
30%, especially panic
Do ADHD meds increase anxiety
no
What substance do SAD take
cocaine
What substances do anxious people take
ROH, benzos, sedatives, cannabis (short period or if daily: raises a flag for ADHD)
Medical conditions that can look like anx
Pheochromocytoma, hypoglycemia, cardiopulmonary issues: MPOC, infarctus, angina, mitral valve prolapse, gi problems, irritable bowel. Addisons, Cushings, hyperparathyroidism (elevated Ca, kidney stones, abdominal pain, bones, novo).
