stress, anxiety,

Question 1

what is the acute stress reaction

Answer 1

normal response - lasts about 2 days

Question 2

what is acute stress disorder

Answer 2

occurs after traumatic event and lasts 4 weeks

Question 3

symptoms acute stress disorder

Answer 3

intrusive thought (eg flashback, nightmare) // dissociative // low mood // avoid event, talking about it, people involved // hypervigilant, sleep disturbance

Question 4

mx acute stress disorder

Answer 4

1 = trama CBT // 2 = benzo

Question 5

mx acute stress disorder

Answer 5

1 = trama CBT // 2 = benzo

Question 6

what is adjustment disorder

Answer 6

failure to readjust to new life after traumatic event

Question 7

how long do symptoms have to last for PTSD

Answer 7

1 month (4+ weeks)

Question 8

symptoms PTSD

Answer 8

re-experiencing: flashback, nightmare // avoidance: people, situation, talking // hyperarousal: of threat, easily startles, irritable, sleep deprived // emotionally numb

Question 9

non-drug mx PTSD

Answer 9

trauma CBT or eye movement if severe

Question 10

drug mx PTSD

Answer 10

not routine // SSRI (sertraline) or venlaxafine // severe = risperidone

Question 11

what medications can trigger GAD

Answer 11

salbutamol, theophylline, steroids, antidepressants, coffee

Question 12

non-pharma mx GAD

Answer 12

1 = education + monitoring // 2 = low intensity psychological intervention // 3 = high intensity

Question 13

stepwise drug mx GAD

Answer 13

1 = sertraline (SSRI) // 2 = alternative SSRI or SNRI (duloxetine, venlafaxine) // 3 = pregabalin

Question 14

mx physical symptoms anxiety

Answer 14

beta blockers

Question 15

what is panic disorder

Answer 15

panic attacks, not always provoked

Question 16

1st mx panic disorder

Answer 16

CBD or SSRI first line

Question 17

2nd mx panic disorder

Answer 17

if no response after 12 weeks –> imipramine or clomipramine (TCA)

Question 18

mx of acute, severe panic attack

Answer 18

benzo

Question 19

mx to specific phobias

Answer 19

graded exposure + CBT –> SSRI eg fluoxetine

Question 20

diagnosing anorexia

Answer 20

restriction of food –> very low body weight (<17.5 or <15% expected) // intense fear of gaining weight // dysmorphia, denial of body weight

Question 21

anorexia physical findings

Answer 21

low BMI, bradycardia, hypotensive, large salivary glands, dry skin, lanugo hair, alopecia

Question 22

endocrine disturbance anorexia

Answer 22

low FSH, LH, oestrogen // raised cortisol + GH // low T3

Question 23

metabolic findings anorexia

Answer 23

hypoK, impaired glucose, raised cholesterol

Question 24

most common cause of death anorexia

Answer 24

arrhythmia, prolonged QT

Question 25

mx adult with anorexia

Answer 25

one of: individual eating CBT // maudsley treatment // specialist support

Question 26

mx young people anorexia

Answer 26

1 = anorexia family therapy // 2 = CBT

Question 27

criteria bulimia

Answer 27

episodes of binging + lack of control // vomiting, exercise, laxatives, diuretics // once a week for 3 months // body dysmorphia

Question 28

signs of vomiting bulimia

Answer 28

bad teeth // russell sign = callus on knuckles or hands from vomiting

Question 29

non-pharma mx bulimia

Answer 29

refer // self help –> ED CBT or family CBT if child

Question 30

drug mx bulimia

Answer 30

high dose fluoxtine

Question 31

what is AFRID

Answer 31

Avoidant restrictive food intake disorder (ARFID) - common in autism