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YEAR 3 PSYCH > Anxiety > Flashcards

Anxiety Flashcards

1
Q

what acts as the emotional filter of the brain for assessing whether sensory material via the thalamus requires a stress or fear response

A

amygdala

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2
Q

acute stress leads to dose-dependent increase in what

A

catecholamines and cortisol

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3
Q

_____ acts to mediate and shut down the stress response

A

cortisol

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4
Q

through negative feedback, cortisol acts on what

A

pituitary
hypothalamus
hippocampus
amygdala

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5
Q

acute stress _____ cortisol levels

A

increases

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6
Q

what is an automatic though

A

thought that pops into your head throughout the day

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7
Q

what is a schema

A

a deep rooted unconditional belief that stems from childhood experience. they shape assumptions and automatic thoughts

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8
Q

what is GAD

A

anxiety that is not restricted to, or strongly predominating in any particular environment - free floating

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9
Q

what makes anxiety qualify as GAD

A 
long lasting (most days for 6 months)
not controllable 
causing significant distress/impairment in function
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10
Q

what is the typical age of onset of GAD

A

20-40

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11
Q

what is the course of GAD

A

chronic and fluctuating

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12
Q

is GAD more common in women or men

A

women

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13
Q

__% are co-morbid with other psychiatric disorders

A

90

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14
Q

what is the first line treatment of GAD

A

CBT

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15
Q

what pharmacological methods can be used to treat GAD

A

SSRI - sertraline
SNRI - venlafaxine
pregabalin
Benzodiazepines (ST only)

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16
Q

what investigations would be done for GAD

A

ECG
PFTs
TFTs
FBC

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17
Q

when do problems with benzos arise

A

if used over 2 weeks

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18
Q

what kind of problems arise with benzos

A

sedation and psychomotor impairment
withdrawal problems
can worsen depression
nausea and headache

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19
Q

how do you treat an overdose of benzodiazepines

A

flumazenil

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20
Q

what kind of withdrawal symptoms are seen with benzos

A

rebound anxiety
insomnia
irritability
delirium

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21
Q

how do benzos work

A

enhance the effect of GABA –> sedation, muscle relaxation, anticonvulsant effects, reduced anxiety

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22
Q

GABA channels allow __ influx

A

Cl-

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23
Q

what is panic disorder

A

recurrent attacks of severe anxiety which are not restricted to any particular situation or set of circumstances and so attacks are unpredictable

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24
Q

what are s/s of panic disorder

A

sudden onset of palpitations, chest pain, choking sensation, dizziness, unreality

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25
Q

when does a panic attack peak

A

10 minutes, lasts up to 45 mins

26
Q

most patients with PD also have

A

agoraphobia

27
Q

what is agoraphobia

A

fear and avoidance of places and situations that might cause you to panic and make you feel trapped, helpless or embarrassed e.g. big crowds, public transport

28
Q

what is the typical age onset of PD

A

late adolescence to mid 30s

29
Q

what is the typical course of PD

A

waxing and waning

chronic

30
Q

PD is often comorbid with

A

other anxiety disorders, depression, drug and alcohol misuse

31
Q

what is the first line treatment in PD

A

CBT (+ graded exposure of agoraphobia)

32
Q

what are some pharmacological options for treating PD

A

SSRI
SNRI - venlafaxine
TCA - imipramine, clomipramine
benzo - short term only - acute

33
Q

what are the 3 types of phobia

A

agoraphobia
social phobia
specific phobia

34
Q

phobias are typically late/early onset

A

early

35
Q

with phobias, is the fear recognised as irrational?

A

yes

36
Q

phobias are typified by

A

avoidance and anticipatory anxiety

37
Q

what does agoraphobia entail

A

fears of leaving home, entering shops, crowds, public places, travelling alone
- avoidance is prominent

38
Q

agoraphobia may be second to conditions such as

A

panic disorder

depression

39
Q

people with agoraphobia often use ___ to get over anxiety

A

alcohol

40
Q

what is specific phobia

A

marked and persistent fear that is excessive or unreasonable cued by the presence or anticipation of a specific object or situation

41
Q

what is the treatment of specific phobia

A

behavioural therapy - graded exposure
CBT if necessary
SSRI/SNRI if required

42
Q

what is social phobia

A

persistent fear of one or more social or performance situation in which the person is exposed to unfamiliar people or possible scrutiny by others

43
Q

social phobia tends to occur in ____ social situations

A

small

44
Q

what is the treatment of social phobia

A

CBT
SSRI/SNRI
benzo

45
Q

what is OCD

A

recurrent obsessional thoughts and/or compulsive acts

46
Q

in anxiety there is increased bilateral activation and increased CBF of the

A

amygdala

47
Q

what are obsessional thoughts

A

ideas images or impulses entering the mind in stereotyped way

48
Q

how would you describe the nature of the obsessional thoughts in OCD

A

unpleasant, resisted and ego-dystonic

49
Q

what are compulsive acts in OCD

A

repeated rituals or stereotyped behaviours that are not enjoyable or functional - pointless

50
Q

carrying out the compulsive act is assoc with

A

reduced anxiety

neutralising behaviour

51
Q

what is needed for diagnosis of OCD

A

obsessional thoughts or compulsive acts must be present most days for at least 2 weeks and be a source of distress and interference with activities

  • obsessions must be the persons own thoughts
  • resistance must be present
  • rituals are not pleasant
  • must be repetitive
52
Q

what are some common obsessions

A

fear of germs
fear of harm
obsession with order/symmetry
obsession with body

53
Q

what are some common compulsions

A

checking
cleaning / washing
repeating words
collecting

54
Q

what is the mean onset of OCD

A

20

55
Q

what is the peak onset of OCD for males

A

13-15

56
Q

what is the peak onset of OCD for females

A

24-25

57
Q

60-90% of OCD experience one ________ episode

A

major depressive

58
Q

OCD has significant co-morbidity with

A 
schizophrenia
tourettes/tic disorders
body dysmorphic disorder
eating disorders
trichotillomania
59
Q

what is trichotillomania

A

compulsive desire to pull out hair

60
Q

what is the treatment of OCD

A

CBT - including response prevention
SSRI
clomipramine

YEAR 3 PSYCH (14 decks)

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