CT 1 - The Patient With Anxiety Flashcards
Outline some facts about the epidemiology of anxiety
Affects at least 1 in every 10 people
F > M
What is anxiety
Normal response to danger which causes an increase in adrenaline, NA, cortisol, activation of the sympathetic system, increase in serotonin.
Is normal because it helps us to perform better but when it impacts someone’s daily functioning this is when it becomes a problem.
What are the physical symptoms of anxiety
Muscle tension, headaches, pain and fatigue
Hyperventilation which can lead to dizziness and tingling of toes and fingers
Sympathetic over activity (increased HR, BP, ectopic beats, dry mouth, frequent urination and loose stools)
What are psychological symptoms of anxiety
Poor concentration, memory, sleep disturbance
Fear, panic, worry or feeling on edge
Thoughts about future danger, fear of dying or worrying about worry
What are some physical investigations that should be carried out in a person who is exhibiting symtoms of anxiety
Blood tests: check for thyroid function
Glucose tests for hypoglycaemia
Urine drug screen
ECGs?
GAD-7 questionnaire
What treatments are offered for anxiety
Psycho-education on sleep, exercise and relaxation
CBT
SSRIs
Benzos
Beta blockers
What is a phobia
Extreme or irrational fear of a particular object or situation which leads to avoidance of that thing. This anxiety interferes significantly with everyday living
What are specific phobias
Phobia of specific objects or situations such as animals, heights, needles
What is social phobia
Phobia of a social situation like eating, speaking or performing
What is agoraphobia
Phobia of being outside or in a public place
How are phobias treated
Graded exposure
CBT
What is generalised anxiety disorder
Anxiety which is not triggered by a specific stimulus but is continuous and generalised/free floating
What organic causes may mimic anxiety disorder
Hypo/hyperthyroid
Substance misuse such as amphetamines, alcohol withdrawal, excess caffeine
Thyrotoxicosis
Hypoglycaemia
Pheochromocytoma
Psych causes: depression, dementia, avoidant personality disorder and schizophrenia
What is the treatment for GAD
1) mindfulness and CBT
2) SSRIs
What is panic disorder
Recurrent, unexpected panic attacks occur with no obvious triggers. May progress to agoraphobia
Peak age of onset is 15-19 years old
Have features of anxiety but panic symptoms like difficulty breathing, choking, chest tightness, depersonalisation, derealisation, dizziness and fainting
