Anxiety Disorders and Eating Disorders

Question 1

Sudden onset of intense fear

-Often occur with no trigger

Answer 1

Panic Attack

Question 2

Is brief and only lasts minutes to an hour

Answer 2

Panic Attack

Question 3

Items in room look foggy or unreal. Patient feels like they are in a foreign place despite being at home

-Hallmark of panic attack

Answer 3

Derealization

Question 4

Classified as an “out of body experience.”

• Detached, looking at self from above
• Also a hallmark of panic attack

Answer 4

Depersonalization

Question 5

Recurrent, unexpected panic attacks

• Not post-traumatic
• Not responsive to phobia

Answer 5

Panic Disorder

Question 6

Attacks followed by 1 month or more of persistent concern or worry about panic attacks

Answer 6

Panic Disorder

Question 7

Median age of onset for panic disorder is

Answer 7

24 years old

Question 8

If you have a first degree relative with panic disorder, you are at

Answer 8

Increased risk

Question 9

Chronic, persistent anxiety. Lasts longer than 6 months

Answer 9

Generalized Anxiety Disorder

Question 10

Fear of a specific object or situation

-Leads to avoidance behavior

Answer 10

Specific Phobias

Question 11

Specific phobia of social settings with an excessive fear of embarrassment

Answer 11

Social anxiety disorder

Question 12

Fear of leaving a safe place for a public setting

-Fear of needing to flea with no help available

Answer 12

Agoraphobia

Question 13

Is NOT fear of scrutiny and embarrassment

Answer 13

Agoraphobia

Question 14

Imagining exposure to feared stimulus

-Relaxation

Answer 14

Systematic Desensitization

Question 15

Recurrent, persistent thoughts, urges, or images

-Intrusive and unwanted

Answer 15

Obsessions

Question 16

Patient attempts to ignore or suppress causes distress

Answer 16

Obsessions

Question 17

Repetitive behaviors or mental acts

-Done to relieve obsessions

Answer 17

Compulsions

Question 18

Commonly occurs with schizophrenia or schizoaffective disorder, bipolar disorder, and eating disorders

Answer 18

Obsessive Compulsive Disorder

Question 19

What are two pharmacological treatments to obsessive compulsive disorder?

Answer 19

SSRIs and Clomipramine (TCA)

Question 20

What are three forms of treatment for PTSD?

Answer 20

CBT, SSRIs, Prazosin

Question 21

Alpha-1 blocker that reduces nightmares and improves sleep

-May cause orthostatic hypertension

Answer 21

Prazosin

Question 22

Exposure to threatened death, injury, or sexual assault can cause

Answer 22

Acute Stress Disorder

Question 23

Characterized by recurrent, intrusive memories and lasts less than one month

Answer 23

Acute stress disorder

Question 24

Abnormal eating patterns that disrupt or psychosocial functioning

Answer 24

Eating Disorder

Question 25

Excessive diet and exercise that leads to low body weight -BMI of less than 18.5 kg/m^2

Answer 25

Anorexia Nervosa

Question 26

Have an intense fear of gaining weight and increased mortality from malnutrition

Answer 26

Anorexia Nervosa

Question 27

What are the endocrine effects of Anorexia Nervosa?

Answer 27

Decreased GnRH and decreased LH/FSH, and amenorrhea

Question 28

The type of amenorrhea seen with anorexia Nervosa is

Answer 28

Functional hypothalamic amenorrhea

Question 29

Anorexic patients have a inability to concentrate urine and have characteristic free water loss and accompanying

Answer 29

Hyponatremia

Question 30

What is a major physiological sign of anorexia Nervosa?

Answer 30

Decreased creatinine and this decreased muscle mass

Question 31

Anorexic patients have decreased bone density due to

Answer 31

Low estrogen and high cortisol

Question 32

We often see bone marrow suppression, anemia, leukopenia, and thrombocytopenia with

Answer 32

Anorexia Nervosa

Question 33

On physical exam, why will we see in a patient with anorexia Nervosa?

Answer 33

Bradycardia, hypotension, lanugo hair growth

Question 34

The hallmark of re-feeding syndrome is

Answer 34

Hypophosphatemia

Question 35

Most fatalities from re-feeding syndrome are

Answer 35

Cardiac

Question 36

Have poor contractility and low stroke volume due to cardiac and respiratory failure from loss of ATP

Answer 36

Re-feeding syndrome

Question 37

Binge eating followed by vomiting or the use of laxatives to compensate and avoid weight gain

Answer 37

Bulimia Nervosa

Question 38

Occurs at least once a week for three months

Answer 38

Bulimia Nervosa

Question 39

Contrasts with anorexia Nervosa in that these patients have normal weight

Answer 39

Bulimia Nervosa

Question 40

What are three complications that wee see as a result of purging from bulimia Nervosa?

Answer 40

Contraction alkalosis, loss of K+, and low urinary chloride

Question 41

A useful test to perform when we have a metabolic acidosis with an unknown cause

Answer 41

Urinary chloride

Question 42

Urinary chloride is low (Less than 10-20) in

Answer 42

Vomiting -Due to loss of Cl- in gastric secretions

Question 43

A young woman with an unexplained metabolic alkalosis and low urinary chloride is likely to have

Answer 43

Bulimia Nervosa

Question 44

Two other purging complications in bulimia Nervosa are

Answer 44

PArotid swelling and erosion of dental enamel

Question 45

Scars on knuckles from induced-vomiting

Answer 45

Russel’s Sign

Question 46

Compulsive overeating of excessively large amounts of food

Answer 46

Binge eating

Question 47

Occurs at least once a week for three months

Answer 47

Binge eating disorder

Question 48

Binge eating disorder often occurs with other disorders such as anxiety and depression. The first line of treatment is

Answer 48

Psychotherapy (CBT)

Question 49

An ADHD stimulant used to treat Binge eating disorder

Answer 49

Lisdexamfetamine

Question 50

A seizure medication used to treat binge eating disorder

Answer 50

Topiramate

Question 51

Clinical trials of lisdexamfetamine and topiramate show increased abstinence from binge episodes. This leads to

Answer 51

Reduced weight

Question 52

In anorexia Nervosa, we give inpatient treatment to individuals below

Answer 52

75-80% of ideal body weight