Psychiatry EOR: Anxiety Disorders; Trauma and Stress Related Disorders (Pearls) Flashcards
Patient will present as → a 35-year-old female with a complaint of worry which she cannot control for the last year. She tells you that her symptoms daily consisting of sleep disturbances, difficulty concentrating, and irritability. She reports her symptoms started around age 17 but have worsened.
What does this Pt most likely have?
GAD
GAD is excessive anxiety and worry occurring ______ days for at least _______ months, about a number of events or activities (such as work or school performance)
Most and 6
In GAD the anxiety needs to be associated with ______ (or more) of the six symptoms. What are the 6 symptoms?
3
Restlessness easily fatigued difficulty concentrating irritability muscle tension sleep disturbance
What are the SSRI treatments for GAD
Paroxetine and escitalopram
What SNRI is used for GAD?
Venlafaxine
Is buspirone effective in treating GAD?
yes starting dose is 5mg PO bid or TID however it can take 2 weeks before working
Are benzos used short term or long term for GAD?
Short term
a 26-year-old first-year PA student with a medical history significant for GERD comes to your office because of frequent episodes of palpitations. The palpitations are sudden in onset and are accompanied by sweating and a sense that she is going to “pass out.” The episodes typically last no more than 10 minutes, and although the patient feels as if she may pass out, she never has. The episodes first appeared when she started PA school and have increased in frequency to the point where she is afraid to attend lectures out of fear of having an “attack.”
What does this patient have?
Panic disorder
An occurrence of ______ panic attack (sudden unexpected periods of intense fear or discomfort) episodes in _______ weeks
three and three, this is panic disorder
For GAD at least one of the panic attacks needs to be followed by how many and how long of the following?
Persistent concern or worry about additional panic attacks or their consequences
A significant maladaptive change in behavior related to the attacks
one or both and for one month
What SSRIs are used for panic attacks?
Paroxetine, Sertraline, Fluoxetine
What medication can you use for abortive therapy with panic attacks
Benzodiazepams
Of course the answer for Tx of panic attacks on a test is?
CBT
What can coexist with avoidant personality disorder?
Social phobia
How long does someone symptoms of social phobia need to last to be diagnosed?
greater than 6 months
