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Psychiatry > Anxiety disorders > Flashcards

Anxiety disorders Flashcards

1
Q

what does an individuals reaction to stress depend on?

A

an individuals reaction to stress depends on a balance between their cognitive processing of any perceived threat and their perceived ability to cope

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2
Q

what are the 2 coping mechanisms?

A

problem focused i.e. revising for exams

emotion focussed i.e. relaxation therapy, sedatives

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3
Q

what are the psychological symptoms of anxiety?

A 
fearful anticipation
irritability
sensitivity to noise 
poor concentration
worrying thoughts
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4
Q

what are the autonomic symptoms of anxiety?

A

GI:

  • dry mouth
  • difficulty swallowing
  • dyspepsia, nausea, wind
  • frequent loose motions

respiratory;

  • difficulty breathing
  • hyperventillation
  • tight chest

CV;

  • palpitations
  • chest pain

Genitourinary;

  • increased frequency/ urgency of micturition
  • amenorrhoea/ dysmenorrhoea
  • erectile dysfunction

CNS;

  • sweating
  • dizziness

muscle tension;

  • muscle pain
  • tremor
  • headache

hyperventillation;

  • tingling in peripheries
  • carpopedal spams (decrease in Ca)
  • breathlessness

sleep disturbance;

  • insomnia
  • frequent wakening
  • nightmares and terrors
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5
Q

what are the different anxiety disorders?

A

generalised anxiety disorder
phobia anxiety disorder
OCD
PTSD

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6
Q

what are differential diagnoses of an anxiety disorder?

A

depression
schizophrenia
substance misuse
dementia

thyrotoxicosis 
phaeochromocytoma 
hypoglycaemia
asthma
arrhythmia
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7
Q

how can you differentiate generalised anxiety disorder from phobic anxiety disorder?

A

GAD is persistant several months of anxiety symptoms not confined to a specific situation or object

phobic anxiety is only in specific circumstances or there is a perceived threat of encountering that feared object

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8
Q

what are the core symptoms of social phobia?

A

tremor

blushing

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9
Q

what is social phobia?

A

inapproate anxiety in a situation when you feel you are being observed or criticised

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10
Q

how is social phobia managed?

A

education and advice
CBT
medication i.e. SSRI

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11
Q

what are the management options for generalised anxiety disorder?

A

education and advice
relaxation training
CBT
medication - SSRI, benzodiazepine

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12
Q

what are the core features in CBT for generalised anxiety disorder?

A

identifying errors, reprocessing and reassessing responsibility

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13
Q

in what sex is GAD more common?

A

F > M

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14
Q

in what sex is PTSD more common?

A

F > M

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15
Q

what is the mechanism behind the aetiology of GAD?

A

GAD is caused by a stressor acting on a personality predisposed by a combination of genetic factors and environmental influences in childhood

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16
Q

what is OCD?

A

recurrent obsessional thoughts or compulsive acts

17
Q

what is the genetic influence in the aetiology of OCD?

A

5 HT functional abnormalities

18
Q

what are the management options for OCD?

A

antidepressants i.e. SSRI or clomipramine
CBT
psychosurgery

19
Q

what are the features of obsessional thoughts in OCD?

A 
ideas, images, impulses
occurring repeatedly, unwilled 
unpleasant and distressing 
the individuals own thoughts
anxiety arises because of the distress of the thought or attempts to resist it
20
Q

what are the features of the compulsive acts or ritual associated with OCD?

A

behaviours repeated again and again
not a helpful act
not enjoyable
often viewed by the sufferers as preventing them from harm of self or from others
anxiety symptoms occur if they try and resist compulsions

21
Q

what is PTSD?

A

prolonged or delayed response to a stressor of significant severity

22
Q

what are the key elements to the reaction to a stressor of exceptional severity?

A

hyperarousal
re-experiencing phenomena
avoidance of reminders

23
Q

what are the features of PTSD with regards to the key elements to the reaction of a stressor of significant severity?

A

hyperarousal;

  • irritability
  • persistant anxiety
  • insomnia
  • poor concentration

re-experiencing phenomena

  • intense intrusive images
  • flashbacks when awake
  • nightmares

avoidance of reminders

  • emotional numbness
  • cue avoidance
  • recall difficulties
  • diminishes interests
24
Q

what factors make some individuals more vulnerable to PTSD than others?

A

mood disorder
female
previous history of trauma esp child
lack of social support

25
Q

what are the protective factors against PTSD?

A

higher education and social status

good paternal relationship

26
Q

what is the management for mild PTSD?

A

watchful waiting and review in 1 month

27
Q

what is the management for severe PTSD?

A

trauma focussed CBT
eye movement desensitisation and reprocessing
sedatives
SSRI

28
Q

when are survivors of a disaster screened for PTSD?

A

after 1 month following disaster

Psychiatry (13 decks)

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