Anxiety

Question 1

Is anxiety normal?

Answer 1

Yes

It is a normal response to threat or danger

Question 2

Which gender is more affected with GAG

Answer 2

Females

Question 3

Aetiology of anxiety

Answer 3

Genetic predisposition
Stress (work, noise, hostile, home)
Events (losing or gaining a spouse, moving job, moving home)
Ect..

Question 4

GI symptoms anxiety

Answer 4

Dry mouth 
Swallowing difficulties 
Lump in throat 
Dyspepsia 
Nausea
Flatulence 
Frequent loose bowels 
Butterflies in tummy

Question 5

Resp. symptoms anxiety

Answer 5

Tight chest
Hyperventilating
Difficulty inhaling

Question 6

CVS symptoms anxiety

Answer 6

Palpitations
Missed beats
Chest pain

Question 7

Genitourinary symptoms of anxiety

Answer 7

Frequency/urgency of micturition
Amenorrhoea
Dysmenorrhoea
Erectile failure

Question 8

CNS symptoms of anxiety

Answer 8

Dizziness

Sweating

Question 9

Muscle symptoms of anxiety

Answer 9

Muscle tension
Tremor
Headache
Muscle pain

Question 10

Sleep symptoms of anxiety

Answer 10

Sleep disturbance 
Initial insomnia 
Frequent waking 
Nightmares 
Night terrors

Question 11

Ddx psychiatric conditions for GAD

Answer 11

Depression
Schizophrenia
Dementia
Substance misuse

Question 12

DDx physical conditions for GAD

Answer 12

Thyrotoxicosis 
Phaechromoytoma 
Hypoglycaemia 
Asthma 
Arrhytmias

Question 13

What is the main risk with prescribing sedatives

Answer 13

They ave a high risk of dependency

Question 14

Rx of GAD

Answer 14

Clear plan for management
Explanation and education
Advice re caffeine, alcohol, exercise

Relaxation training
CBT
Hypnosis
SSRI

(rarely sedatives)

Question 15

What is agoraphobia

Answer 15

Cluster of phobias 
Fear of crowds 
Fear of travel 
Fear of events away from home 
Fear of no easy way to escape or get help

Question 16

What is a social phobia

Answer 16

Inappropriate anxiety in situation where person feels observed or could be criticised

Question 17

Examples of where someone with social phobia could face anxiety

Answer 17

Restaurants
Shops or queues
Public speaking

Question 18

What is a specific phobia

Answer 18

When the persons anxiety is Restricted to a specific situation

Question 19

Give examples of specific phobias

Answer 19

Odontophobia (dentists)
Arachnophobia (spiders)
Coulrophobia (clowns)

Question 20

Symptoms of social phobia

Answer 20

When in social places or places where they could be observes/criticsed

Anxiety symptoms 
Nausea 
Blushing 
Toilet urgency 
Tremor

Question 21

Rx for panic attacks

Answer 21

Try CBT

Question 22

Rx for social phobia

Answer 22

CBT

Education and advice

Question 23

Medication Rx for anxiety

Answer 23

SSRI
or
TCA

Question 24

What is PTSD

Answer 24

Delated or protracted reaction to a stressor of exceptional severit

Question 25

Examples of events which could cause PTSD

Answer 25

``` Combat Natural or human cause disaster Rape Torture Witnessing any of the above ```

Question 26

Who is at greater risk of developing PTSD

Answer 26

``` Women = 20% Men = 8% ```

Question 27

Vulnerability factors of PTSD

Answer 27

``` Mood disorder Previous trauma (esp. as child) Lack of social support Female Partly genetic ```

Question 28

Protective factors of PTSD

Answer 28

Higher education and social group | Good paternal relationship

Question 29

What are the 3 key elements to PTSD

Answer 29

Hyperarousal Re-experiencing phenomena Avoidance

Question 30

Describe hyperarousal in PTSD

Answer 30

Persistent anxiety Irritability Insomnia Poor concentration

Question 31

Describe re-experiencing phenomena in PTSD

Answer 31

Intense intrusive images Flashbacks when awake Nightmares during sleep Often with increased BP, increased pulse and sweating

Question 32

Describe avoidance in PTSD

Answer 32

``` Emotional numbness Cue avoidance Recall difficulties Diminished interests Drug/alcohol misuse Poor concentration ```

Question 33

According to NICE guideline when should survivors be screened for PTSD?

Answer 33

1/12

Question 34

Rx for mild symptoms of PTSD

Answer 34

Watchful waiting | Review in further month

Question 35

Rx for more severe PTSD

Answer 35

Trauma focused CBT Eye movement desensitisation and reprocessing (EMDR)

Question 36

Medication Rx for PTSD

Answer 36

SSRIs TCAS Risk of dependance with sedatives

Question 37

What is the prognosis for PTSD

Answer 37

Usually 50% recover in 1yr