GAD

Question 1

for GAD, symptoms have to be impacting life and present most days for how long ?

Answer 1

6 months

Question 2

what is the treatment of GAD

Answer 2

CBT
SSRI/SNRI
PREGABLIN

Question 3

can benzos be given?

Answer 3

in the short term only

Question 4

what is agoraphobia?

Answer 4

avoiding places or situations where you might feel panicked, trapped, embarrassed or hopeless

Question 5

does panic disorder have to occur with agoraphobia?

Answer 5

no, can be separate

Question 6

what can panic disorder be the direct result of ?

Answer 6

the physiological effects of a drug or general medical condition e.g. hyperthyroid, caffeine intoxication

Question 7

Can generalised anxiety disorder be caused by substance misuse or another medical condition ?

Answer 7

no

Question 8

typical onset of panic disorder?

Answer 8

adolescence and 30s

Question 9

@ 10 year follow up - rule of 1/3ds?

Answer 9

with panic disorder, at 10 year follow up - 1/3 will be better, 1/3 the same and 1/3 worse

Question 10

why can panic attacks be triggered by re breathing air/

Answer 10

increased CO2

Question 11

panic atacks can be triggered in susceptible individuals by infusions of?

Answer 11

lactate

Question 12

treatment of panic disorders?

Answer 12

Cognitive Behavioural Therapy

SSRIs / SNRIs / Tricyclics

Question 13

The three types of phobia

Answer 13

agoraphobia
social phobia
specific phobia

Question 14

when do phobias present?

Answer 14

usually early onset in life

Question 15

A fairly well-defined cluster of phobias embracing fears of leaving home, entering shops, crowds and public places, or travelling alone in trains, buses or planes. Avoidance of the phobic situation is often prominent, and some people with agoraphobia experience little anxiety because they are able to avoid their phobic situations

Answer 15

agoraphobia

Question 16

agoraphobia is usually 2y to another disorder such as ?

Answer 16

panic disorder or depression

Question 17

someone who goes shopping to 24 hour store at night when quiet?

Answer 17

agoraphobia

Question 18

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

Answer 18

specific phobia

Question 19

phobia of spiders would be which type of phobia ?

Answer 19

specific

Question 20

treatment of phobia ?

Answer 20

behavioural therapy -Graded exposure / systematic desensitisation
Add in CBT if necessary

SSRIs / SNRIs if required

Question 21

the individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating?

Answer 21

social phobia/ social anxiety disorder

Question 22

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

Answer 22

social phobia

Question 23

tx of social phobia?

Answer 23

Cognitive Behavioural Therapy
SSRIs / SNRIs

Benzodiazepines (short term only)

Question 24

what is OCD?

Answer 24

Recurrent obsessional thoughts and/or compulsive acts

Question 25

what kind of obsessional thoughts?

Answer 25

Ideas, images or impulses entering the mind in a stereotyped way

Question 26

Compulsive Acts examples?

Answer 26

Repeated rituals or stereotyped behaviours | Not enjoyable

Question 27

Obsessional symptoms or compulsive acts must be present most days for at least?

Answer 27

2 weeks, and be a source of distress

Question 28

treatment of OCD?

Answer 28

cognitive behaviour therapy and SSRI

Question 29

what do benzos enhace the effect of

Answer 29

GABA

Question 30

There is a benzodiazepine binding receptor on which receptor ?

Answer 30

GABA A receptor (a for anxiety)

Question 31

what other substances act on the GABA - A receptor?

Answer 31

alcohol and barbiturates

Question 32

agonists at the BZD site produce what effect? and antagonists produce what effect?

Answer 32

agoinsts produce relaxation and anti convulsant effects | antagonists cause anxiety and are pro-convulsant

Question 33

Benzodiazepines - are they well tolerated?

Answer 33

yes

Question 34

Problems with BZD if used over 2 weeks?

Answer 34

``` sedation and psychomotor impairment withdrawal problems dependancy and abuse alcohol interaction can worsen co morbid depression ```

Question 35

treatment of anxiety conditions is generally ?

Answer 35

CBT or behavioural therapy and/or SSRIs.

Question 36

important differentials for anxiety (medical)

Answer 36

hyperthyroid, cardiac disease and medication induced

Question 37

medications that cause anxiety?

Answer 37

caffeine, salbutamol, theophylline, corticosteroids, antidepressants

Question 38

first line SSRI?

Answer 38

sertraline (certainty)

Question 39

what do you need to warn young patients about when starting them on sertraline?

Answer 39

increased risk of suicidal thinking and self harm

Question 40

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

Answer 40

amygdala