Acute Stress disorder and PTSD

Question 1

when to screen for PTSD?

Answer 1

new onset insomnia, anxiety, fear, interpersonal conflicts, or escalating substance use.

Question 2

how to screen for PTSD

Answer 2

intrusive recollections of traumatic events (memories, nightmares, flashbacks), assessing for symptoms of hyperarousal (sleep disturbance, hypervigilance, irritability), negative mood (anger decreased interested and emotional detachment) and avoidance (ppl or situations that are reminders)

Question 3

clinical features of acute stress disorder:

Answer 3

duration >3 days and <1 month
exposure to actual or threatened trauma
symptoms in following categories;
avoidance of internal memories or external reminders
intrusion: (nightmares and flashbacks)
dissociation (amnesia of event or derealization)
arousal (insomnia, hypervigilance, startle)
negative mood

Question 4

Acute stress disorder

Answer 4

is like the acute disorder associated with a traumatic event. Long term becomes PTSD

Can treat if impairment is severe regardless of duration

Question 5

Management of Acute stress disorder:

Answer 5

trauma focused brief cognitive behavioral therapy
consider medication for insomnia, intense anxiety
monitor for PTSD (symptom duration >1 month)

Question 6

acute stress disorder develops during which time frame?

Answer 6

within 4 weeks of traumatic event

Question 7

characteristic qualities of acute stress disorder

Answer 7

intrusive re-experience (distressing memories, nightmares, flashbacks)
avoid reminders of event
arousal symptoms (sleep disturbance, irritability, impaired concentration, hypervigilance and exaggerated startle response

Question 8

exposure to life threatening trauma
avoidance of reminders and dissociation
nightmares, flashbacks and intrusive memories
emotional detachment, negative mood, decreased interest in activities
sleep disturbance or hyper vigilance, irritability
Duration >1 month

Answer 8

PTSD clinical features

Question 9

depersonalization and derealization can be a part of PTSD

Answer 9

not diagnosed as a separate disorder when PTSD criteria are met.

Question 10

1st line treatment of PTSD is

Answer 10

trauma focused cognitive behavioral psychotherapy and SSRI like sertraline.

can use prazosin - alpha adrenergic receptor blocker has been helpful for decreasing nightmares and improve sleep in pts who have PTSD and used as an adjunct to SSRI or SNR I

Question 11

medical treatment of specifically nightmares and sleep disturbances

Answer 11

alpha 1 adrengeric blocker

prazosin can help

Question 12

do beta blockers and topiramate help with hyperarousal or mood stabilizing with PTSD?

Answer 12

no.

do not pick them. insufficient evidence or largely negative studies.