stress, anxiety, Flashcards
what is the acute stress reaction
normal response - lasts about 2 days
what is acute stress disorder
occurs after traumatic event and lasts 4 weeks
symptoms acute stress disorder
intrusive thought (eg flashback, nightmare) // dissociative // low mood // avoid event, talking about it, people involved // hypervigilant, sleep disturbance
mx acute stress disorder
1 = trama CBT // 2 = benzo
mx acute stress disorder
1 = trama CBT // 2 = benzo
what is adjustment disorder
failure to readjust to new life after traumatic event
how long do symptoms have to last for PTSD
1 month (4+ weeks)
symptoms PTSD
re-experiencing: flashback, nightmare // avoidance: people, situation, talking // hyperarousal: of threat, easily startles, irritable, sleep deprived // emotionally numb
non-drug mx PTSD
trauma CBT or eye movement if severe
drug mx PTSD
not routine // SSRI (sertraline) or venlaxafine // severe = risperidone
what medications can trigger GAD
salbutamol, theophylline, steroids, antidepressants, coffee
non-pharma mx GAD
1 = education + monitoring // 2 = low intensity psychological intervention // 3 = high intensity
stepwise drug mx GAD
1 = sertraline (SSRI) // 2 = alternative SSRI or SNRI (duloxetine, venlafaxine) // 3 = pregabalin
mx physical symptoms anxiety
beta blockers
what is panic disorder
panic attacks, not always provoked
1st mx panic disorder
CBD or SSRI first line
2nd mx panic disorder
if no response after 12 weeks –> imipramine or clomipramine (TCA)
mx of acute, severe panic attack
benzo
mx to specific phobias
graded exposure + CBT –> SSRI eg fluoxetine
diagnosing anorexia
restriction of food –> very low body weight (<17.5 or <15% expected) // intense fear of gaining weight // dysmorphia, denial of body weight
anorexia physical findings
low BMI, bradycardia, hypotensive, large salivary glands, dry skin, lanugo hair, alopecia
endocrine disturbance anorexia
low FSH, LH, oestrogen // raised cortisol + GH // low T3
metabolic findings anorexia
hypoK, impaired glucose, raised cholesterol
most common cause of death anorexia
arrhythmia, prolonged QT
mx adult with anorexia
one of: individual eating CBT // maudsley treatment // specialist support
mx young people anorexia
1 = anorexia family therapy // 2 = CBT
criteria bulimia
episodes of binging + lack of control // vomiting, exercise, laxatives, diuretics // once a week for 3 months // body dysmorphia
signs of vomiting bulimia
bad teeth // russell sign = callus on knuckles or hands from vomiting
non-pharma mx bulimia
refer // self help –> ED CBT or family CBT if child
drug mx bulimia
high dose fluoxtine
what is AFRID
Avoidant restrictive food intake disorder (ARFID) - common in autism
