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Psychiatry Year 3 Dundee > Anxiety > Flashcards

Anxiety Flashcards

(63 cards)

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1
Q

What conditions are seen as pathological anxiety in terms of extent and context?

A

Panic
Phobias
OCD
GAD - Generalised Anxiety Disorder

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2
Q

What are the general symptoms of anxiety?

A 
Sweating
Cold Chills
Trembling
Muscle tension 
Dizzy
Dry mouth
Choking
Lump in throat 
Palpitations
Nausea
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3
Q

What are the cognitive symptoms of anxiety?

A 
Fear of loosing control
On edge
Concentrating difficulties 
Hypervigilance
Racing thoughts
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4
Q

What are the behavioural symptoms of anxiety?

A 
Avoidance
Exaggerated responce
Restles
Irritability
Difficulty in getting to sleep
Seeking reassurance
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5
Q

What hormones are involved in the stress response?

A

Catecholamines

Cortisol

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6
Q

Epidemiology of GAD

A

20-40 yrs
1 in 10
2:1
F:M

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7
Q

What is GAD?

A

Generalised and specific anxiety but not specific to a particular environment.

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8
Q

What needs to be investigated in order to diagnose GAD?

A

Hyperthyroidism and Substance abuse need to be ruled out.

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9
Q

In order to have a GAD diagnosis what must the patient present with?

A

Long lasting over 6 moths
Not controllable
Impaired function

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10
Q

What particular symptoms is GAD associated with?

A

Restlessness
Fatigued
Concentrating failure
Sleeplessness

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11
Q

What is first line treatment for GAD?

A

CBT

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12
Q

How long is a person required to undergo CBT in order to assess efficacy?

A

Up to 12 weeks

Less than 4 weeks a response is unlikely

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13
Q

What medication can be used in the treatment of GAD?

A

SSRIs SRNIs
Pregablin
BDZ ( acute short term if very distressed)

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14
Q

Epidemiology of Panic Disorders

A

Adolescence to middle 30’s

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15
Q

What are Panic Disorders?

A

Recurrent and unpredictable attacks of sever anxiety

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16
Q

What are some of the symptoms of Panic disorders?

A

Severe breathlessness
Dying
Depersonalisation
Dizziness

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17
Q

Once they have overcome this episode of Panic how do people with panic disorders usually feel?

A

Normal

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18
Q

What other causes of these symptoms need to be excluded before a diagnosis of Panic disorder is given?

A

Hyperthyroidism
Caffeine
Intoxication
Depression

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19
Q

What are some known triggers of a Anxiety attack?

A

Lactate infusion

Rebreathing CO2

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20
Q

What medications can be used in the treatment of Panic disorders?

A

CBT
SRRI SRNI
Tricyclics

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21
Q

How long does the course of treatment for Panic disorders last?

A

6 months

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22
Q

What is a phobia?

A

A predictable onset of sever anxiety
Fear is recognised and often irrational
Avoidance and anticipatory anxiety are common

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23
Q

What is Agoraphobia?

A

Fear of open spaces, crowds or being outside of ones home.

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24
Q

How do Agoraphobes appear?

A

Due to high prevalence of avoidance they aren’t overly anxious.

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25
What are some signs someone maybe a Agoraphobe?
Others do their shopping for them Drink alcohol before venturing out Go shopping at night Internet shopping
26
What is a Specific phobia?
Marked or persistent fear that is excessive and caused by something specific.
27
How does someone with a specific phobia present?
Immediate onset upon stimulation Insight that response is unreasonable Normal function is often impaired by phobia
28
What is the treatment for phobias?
Exposure behaviour therapy +/- CBT | SSRIs SRNIs
29
What is a Social Anxiety disorder?
Persistent fear of social performance | fear of intimate relations i.e. small group sessions
30
What can proceed a Social Anxiety Disorder?
An embarrassing and humiliating experience
31
Why do Social Anxiety Disorders have such an impact the QOL of a patient?
Poor social, school and poor employment | React to novelty experience by avoidance
32
What is a Social Anxiety disorder?
Persistent fear of social performance | fear of intimate relations i.e. small group sessions
33
What can proceed a Social Anxiety Disorder?
An embarrassing and humiliating experience
34
Why do Social Anxiety Disorders have such an impact the QOL of a patient?
Poor social, school and poor employment | React to novelty experience by avoidance
35
What is OCD?
Recurrent obsessional thoughts and or compulsive acts
36
What are obsessional thoughts?
Ideas, images or impulses entering into the mind in a stereotyped way Recognised as own by patients Unpleasant and resisted
37
What are compulsive acts?
Repeated rituals or behaviours. Not enjoyable Not functional Recognised as pointless
38
What must the patient have in order to have a diagnosis of OCD?
Present most days for at least two weeks | + source of distress
39
What are some common obsessions?
Contaminated with dirt germs viruses etc Fear of harm Excessive concern with order and symmetry
40
What are some common compulsions?
``` Checking Cleaning Repeating acts Hoarding Mental compulsion e.g. special words phrases repeated ```
41
Epidemiology of OCD
No gender bias | Onset at any age but mean is 20 years
42
What are some co-morbid diseases commonly found with OCD?
Schizophrenia Tourettes ED Body dysmorphia
43
What is first line treatment for OCD?
Low intensity psychological help - CBT - individual or group.
44
What is second line for OCD treatment?
Intensive CBT or SSRI | Fluoxetine
45
What is third line treatment for OCD?
SSRI + CBT
46
What is 4th line for treatment of OCD?
Clomipramine - TCA
47
PTSD - mild and 4 weeks post event - Treatment.
Watching and waiting
48
PTSD - Within three months of event - Treatment
CBT (brief) | Hypnotic medication for sleep
49
PTSD - Severe or more than three months post event- Treatment
Trauma focused CBT or EMDR
50
What drugs have limited evidence but can be use for the treatment of PTSD?
Paroxetine and Amitriptyline
51
What is first line for social anxiety?
Individual CBT
52
What is second line for social anxiety?
SSRI review at 12 weeks
53
What SSRI is used in social anxiety?
Setraline
54
What is third line for social anxiety?
SSRI + CBT
55
What is an alternative SSRI which can be used for social anxiety?
Fluvoxamines
56
What SRNI can be used for social anxiety?
Venlafaxine
57
What is 4th line for social anxiety?
Alternative SSRI or SRNI
58
What is 5th line for Social anxiety?
MAOI - Moclobemide
59
What is first line for Panic Disorder?
Self help
60
What is second line for Panic Disorder?
CBT or SSRI
61
What is third line for Panic disorder?
Tricyclics (Clomipramine)
62
How long should treatment for panic disorder last?
6 months
63
What treatments should be avoided in Panic disorder ?
Propanolol BDZ Sedatory 5-HT

Psychiatry Year 3 Dundee (21 decks)

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