Chapter 5 Pt 1

Question 1

what are the signs and symptoms of anxiety

Answer 1

constitutional: fatigue, diaphoresis, shivering
cardiac: chest pain, palpitations, tachycardia, hypertension
pulmonary: SOB, hyperventilation

neurologic/msk: vertigo, lightheadedness, paresthesias, tremors, insomnia, muscle tension

GI: abdominal discomfort, anorexia, nausea, emesis, diarrhea, constipation

Question 2

what medications/substances can cause anxiety

Answer 2

alcohol (intox/withdrawal)
sedatives, hypnotics, or anxiolytics (withdrawal)
cannabis (intox)
hallucinogens (intox)
stimulants (intox/withdrawal)
caffeine (intox)
tobacco (into/withdrawal)
opioids (withdrawal)

Question 3

pathological anxiety occurs when?

Answer 3

symptoms are excessive, irrational, out of proportion to the trigger or are without an identifiable trigger

Question 4

te criteria for most anxiety disorders involve symptoms that

Answer 4

cause clinically significant distress or impairment in social and/or occupational functioning

Question 5

primary anxiety disorders can be diagnosed only after what

Answer 5

determining the signs and symptoms are not caused by physiological effects of substance, medication or medical condition

Question 6

what neurotransmitters are implicated in axiety

Answer 6

norepinephrine
serotonin
GABA

Question 7

what is the most common form of psychopathology

Answer 7

ANXIETY

lifetime prevalence of 30% in women and 19% in men

Question 8

what is treatment for anxiety

Answer 8

psychotherapy for milder presentations

combination treatment with pharmaco therapy for moderate to severe

Question 9

what medical conditions can cause anxiety

Answer 9

neurologic: epilepsy, migraines, brain tumors, multiple sclerosis, Huntingtons disease
endocrine: hyperthyroidism, thyrotoxicosis, hypoglycemia, pheochromocytoma, carcinoid syndrome

metabolicL Vitamin B12 deficiency, lyte abnormalities, porphyria

Resp: asthma, COPD, hypoxia, PE, pneumonia, pneumothorax

Cardiovascular: CHF, angina, arrhythmia, MI

Question 10

what medication used to treat anxiety can make depression worse

Answer 10

benzos

Question 11

what is first line tx for anxiety

Answer 11

SSRI and SNRI

Question 12

what should one do in the short term while waiting the 4-6 weeks for SSRI or SNRI to become effective

Answer 12

bridge with BENZOS

Question 13

what type of anxiety are beta-blockers used for

Answer 13

performance anxiety and panic attacks

Question 14

how long should one provide medication for anxiety

Answer 14

symptomatic relief and continue treatment for at least 6 months before attempting to titrate off

Question 15

what is panic disorder

Answer 15

recurrent, UNEXPECTED panic attacks without an identifiable trigger

one or more of the panic attack followed by ≥1 month of continuous worry about experiencing subsequent attacks or their consequences

not caused by substance, meds, or medical condition

Question 16

who is at greater risk of panic disorder

Answer 16

those with 1st degree relatives wit it

Question 17

what psychosocial factors come into play with panic disorder

Answer 17

increased incidence of stressors (especially loss) prior to onset
history of childhood physical or sexual abuse

Question 18

when a patient presents with a panic attack, one must rule out what

Answer 18

potentially life treating conditions such as: heart attack, thyrotoxicosis, or thromboembolism

Question 19

what is the course of panic disorder

Answer 19

chronic
waxes and wanes
relapses common with discontinuation of medication

Question 20

up to 65% of patinets with panic disorder also have what

Answer 20

MDD

Question 21

what is the best treatment for panic disorder

Answer 21

pharmacotherapy and CBT

SSRI first line