Generalized Anxiety Disorder

Question 1

Symptoms of anxiety?

Answer 1

Anxious, tense
Chronic fatigue
Irritability
Noise intolerance
Sleep disturbance
Tense muscle
Impaired concentration and memory (can read?)
Startle response
Hyperventilation (hands, feet, mouth paraesthesia)

Question 2

Symptoms of anxiety

Answer 2

Palpitations, sweating
Trembling
Esophageal spasm
Dyspnoea, choking
Dizziness
Detachment: depersonalizations, de realization (observers in reality)
Paraesthesia: hot/cold feelings
Panic sensations
Fear or dying or going crazy

Question 3

DDx of anxiety

Answer 3

Depressive illness (use scale)
Thyrotoxicosis
Alcohol withdrawal
Excessive caffeine (coffee, cola
Hypoglycaemic

Question 4

Rx of anxiety:

Answer 4

Antidepressants for chronic symptoms

Question 5

Rx list for anxiety

Answer 5

Explain
CBT
Relaxation (hypnosis)
Benzos, short-term
Antidepressants
Buspirone 10mg TDS (rarely used/40% of ppl)
Atypical antipsychotics (quitiapine)
Formal psychotherapy for personal vulnerabilities

Question 6

2 types of benzos

Answer 6

Short half life (more addictive)
Long halflife (prolonged cog and emo impairment)

Question 7

Most powerful benzo is?

Answer 7

Alprazolam (Xanax) also most addictive

Question 8

Emergency use of benzos

Answer 8

IM medazolam

Question 9

Treatment of Insomnia

Answer 9

Time of regular WAKING determines their sleep-wake cycle.

Sleep hygiene -weighted blanket
Relaxation technique and sleep apps
Herbal medications: antihistamines? (Valerian, tryptophan)
Melatonin - doesn’t work.

Question 10

Med treatments for insomnia?

Answer 10

Temazepam : 30 min to start, lasts 4-6 hours

Oxazepam: 1 hour to come on, lasts 8 hours

Question 11

Side effects of all hypnotics:

Answer 11

Addiction risk
Rebound insomnia
Nightmares
Amnesia

Question 12

Zolpidem - modern hypnotics SFX?

Answer 12

Automatic actions + amnesia

Question 13

Sedative antidepressants

Answer 13

Agomelatine
Mirtazipine
Meandering
Amityptyline

Question 14

Sedative antipsychotics

Answer 14

Quetiapine
Pericyazine
Chlorpromazine

Question 15

Phobia definition

Answer 15

Unreasonable fear leading to avoidance

Question 16

Most prevalent phobias?

Answer 16

Illness
Storms
Snakes

Question 17

Most treated phobias?

Answer 17

Agoraphobia

Specific phobias

Question 18

Agoraphobia worse in?

Answer 18

Crowded places

Public transport

Question 19

Who gets agoraphobia?

Answer 19

1. Young, usually fragile, unassertive personalities

2. Older: usu. depressive illness

Question 20

Rx of agoraphobia

Answer 20

1. CBT
   Desensitization
   Relaxation/hypnosis
   Flooding (in Vigo or in imagination)
2. SSRIs
3. Anxiolytics of very limited use (no benzos)

Prognosis: 60% cure, 40% chronic or relapsing

Question 21

Specific phobias

Answer 21

Life
Heights
Insects
Snakes

Question 22

Animal phobias who?

Answer 22

Mainly in women and children before puberty

Question 23

OCD is driven by?

Answer 23

Anxiety

Question 24

OCD is what 4 things

Answer 24

1. Recurrent or persistant thought
2. Thought, action (or image)
3. Occurring against the patients will
4. REvolting or ridiculous

Question 25

What are common obsessions? Thoughts?

Answer 25

Sex, violence

Question 26

What are common compulsions?

Answer 26

Checking
Cleaning
Counting
Touching

Question 27

When is OCD worse?

Answer 27

Under stress

obsessional personality

Question 28

DDx for OCD for first time in middle age is?

Answer 28

Depressive illness

Question 29

Onset for OCD?

Answer 29

10-30years

Question 30

Rx of OCD?

Answer 30

CBT
Exposure with response
Flooding or thought stopping
5HT antagonists (clomipramine, SSRI)

Question 31

What neurotransmitter for OCD?

Answer 31

5HT - serotonin pathways

Question 32

Definition of GAD?

Answer 32

Unjustified sense of fear directed towards the future

Self rating: 0-10 (rate chronic, and recent)