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EOR: Behavioral Health > Anxiety Disorders, Trauma, and Stress Related Disorders > Flashcards

Anxiety Disorders, Trauma, and Stress Related Disorders Flashcards

1
Q

types of anxiety disorder

A

generalized anxiety disorder
panic disorder
phobic disorders

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2
Q

types of phobic disorders

A

specific phobia
social phobia

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3
Q

what do you think when you see a pt with uncontrollable worry x 1 year - she has daily sx consisting of sleep disturbance, difficulty concentrating, and irritability

A

generalized anxiety disorder

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4
Q

excessive anxiety and worry ocurring more days than not - for at least 6 mo - about a number of events or activities

A

gad

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5
Q

dsm 5 for gad

A

-6 months of worry that is difficult to control
-causes significant distress/impairment
-no other cause/mental disorder
-anxiety is associated w. 3 or more of the following:
-restlessness
-easily fatigued
-difficulty concentrating
-irritability
-muscle tension
-sleep disturbance

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6
Q

tx for gad (5)

A

SSRIs
SNRIs
buspirone
benzos
bb
psychotherapy

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7
Q

which 2 SSRIs are used for gad

A

paroxetine
escitalopram

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8
Q

what SNRI is used for gad

A

venlaxafine

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9
Q

how long does buspirone take to be effective

A

2 weeks

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10
Q

tx for acute gad

A

benzos
bb

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11
Q

what do you think when you see a pt who presents w. sudden, frequent episodes of palpitations accompanied by sweating and a feeling that she is going to pass out (but she never has) - these began when she started PA school and she is afraid to go to school for fear of having an “attack”

A

panic disorder

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12
Q

dsm 5 definition of panic attack

A

sudden, unexpected period of intense fear or discomfort

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13
Q

dsm 5 for panic d.o

A

-3 panic attacks in 3 weeks
-at least one attack must be followed by one month or more of one or both:
-persistent worry about additional panic attack
-significant maladaptive change in behavior related to attacks

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14
Q

tx for panic d.o

A

SSRI’s
benzos
CBT

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15
Q

what SSRI’s are used for panic disorder (3)

A

paroxetine
sertraline
fluoxetine
venlafaxine

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16
Q

tx for acute panic attacks

A

benzos

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17
Q

dsm 5 for social phobia (aka social anxiety d.o)

A
  • > 6 mo of marked and persistent far of social or performance situations in which one is exposed to unfamiliar people or possible scrutiny by others
  • fear of acting in a humiliating/embarrassing way - public speaking, initiating conversation, dating, eating in public
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18
Q

social phobia (social anxiety d.o) may coexist w. what other disorder

A

avoidant personality disorder

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19
Q

dsm 5 for specific phobias

A

-exessive and persistent fear of a specific object, situation, or activity that is generally not harmful
-lasts for 6 mo or more
-pt knows fear is irrational but they can’t overcome it
-distress causes pt to go to extreme lengths to avoid fear

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20
Q

first line tx for specific phobias

A

exposure therapy - relax and try to understand/overcome fear

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21
Q

pharm for specific phobias

A

SSRI + CBT
benzos for acute

22
Q

tx for agoraphobia

A

SSRI + CBT

23
Q

% of pt’s w. gad have at least one other similar psychiatric d.o at some time in their life

A

80%

24
Q

what type of therapy used for gad challenges the distortions in a patients thinking that trigger and heighten anxiety

A

cbt

25
Q

t/f: combining cbt w. other behavioral techniques is more effective than cbt alone for gad

A

t!

26
Q

what other behavioral techniques are useful to combine w. cbt for gad

A

-relaxation training: deep breathing/progressive muscle relaxation
-biofeedback and imagery

27
Q

list benzos in order of shortest to longest half life

A
  1. alprazolam (xanax)
  2. clonazepam (klonopin)
  3. diazepam (valium), clorazepate (tranzene), chlordiazepoxide
28
Q

what tx may be useful for specific phobia when exposure to feared object or situation can not be avoided

A

benzo - lorazepam
bb - propranolol

29
Q

when should prophylactic tx for specific phobia be given when fear can not be avoided

A

1-2 hr before exposure

30
Q

a phobia is an excessive fear of an object or place that leads to or can be preceded by

A

panic attack

31
Q

mc psychiatric d.o in the US

A

specific phobia

32
Q

types of phobias (4)

A

animals
natural environment
situational
injury

33
Q

what do you think when you see a pt who has experienced a traumatic event that causes an acute stress reaction with symptoms that persist past 1 month

A

ptsd

34
Q

tx for ptsd (4)

A

ssri’s + CBT - 1st line
prazosin
benzos

35
Q

what is prazosin used for in ptsd

A

nightmares

36
Q

if benzos are used for ptsd, they should not be used longer than

A

2 weeks

37
Q

disproportionate reponse to a stressor (job loss, physical illness) that impairs ADLs

A

adjustment disorder

38
Q

adjustment disorder begins w.in _ months of the stressor and end w.in _ months after stressor has resolved

A

begin: 3 months
end: 6 months

39
Q

stressors for adjustment disorder include (6)

A

marital conflict
financial conclift
family conflict/parental separation
school problems/changing schools
sexuality issues
death/family illness

40
Q

tx for adjustment disorder

A

psychotherapy

41
Q

what do you think when you see a pt w. a 3 month hx of feeling depressed and extremely distressed at work after accepting a managerial position and experiencing interpersonal conflict w. 2 employees

A

adjustment disorder

42
Q

common precipitant of adjustment disorder in young adults

A

leaving home and going to college

43
Q

adjustment disorder is characterized by _ behavior
and _ symptoms

A

maladaptive behavior
emotional symptoms

44
Q

typical presentation of adjustment disorder (3)

A

tearful
depressed
reckless behavior

45
Q

hallmark features of ptsd (8)

A

intrusive recollections
uncontrolled thoughts
flashbacks
emotional numbing
avoidance
difficulty sleeping
severe anxiety
feelings of danger, helplessness, horror

46
Q

t/f: MAOIs, TCAs, clonidinem propranolol, lithium, and buspirone have all shown efficacy with ptsd

A

t!

47
Q

why do you have to be especially careful when using benzos for ptsd

A

high rates of substance abuse disorders in this pt pop

48
Q

only 2 FDA approved meds for ptsd

A

sertraline
paroxetine

49
Q

what therapy is effective for decreasing symptoms of reexperiencing and hyperarousal in ptsd (4)

A

relaxation training
systematic desensitization
flooding
cognitive reframing

50
Q

what type of therapy is effective for processing traumatic memories in ptsd

A

emdr (eye movement desensitization and reprocessing)

51
Q

what class of drug is prazosin

A

alpha 1 antagonist

effective for nightmares and insomnia in ptsd

EOR: Behavioral Health (13 decks)

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