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30 Cards in this Set

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  • Back
1. Cardiac and pulmonary sx of anxiety?
a. Cardiac: Palpitations, tachycardia, HTN
b. Pulm: SOB, choking sensation
2. Neurologic sx of anxiety?
a. Dizziness, light-headedness
b. Hyperreflexia
c. Mydriasis (pupil dilation)
d. Tremors
e. Tingling in peripheral extremities.
3. Psychological sx of anxiety?
a. Restlessness (pacing)
b. Butterflies in the stomach.
4. Other sx of anxiety?
a. Sweating, GI, urinary urgency and frequency.
5. Anxiety?
a. The subjective experience of fear and its physical manifestations.
b. It is a common, normal response to a perceived threat.
6. Pathological anxiety?
a. Is inappropriate (there is no real source of fear or the source is not sufficient to account for the severity of the sx).
b. In people w/anxiety disorders, the SYMPTOMS INTERFERE W/DAILY FUNCTIONING and interpersonal relationships.
7. Neurotransmitter imbalances associated w/anxiety?
a. ↑ activity of Norepinephrine
b. ↓ activity of GABA and 5-HT.
8. Medical causes of anxiety?
a. Hyperthyroidism
b. B12 deficiency
c. Hypoxia
d. Neurological disorders (epilepsy, brain tumours, MS, cerebrovascular disease, etc).
e. Cardiovascular disease
f. Anaemia
g. Pheochromocytoma
h. Hypoglycemia.
9. Substance-induced anxiety disorders?
a. Caffeine intake and withdrawal and Theophylline.
b. Amphetamines
c. ETOH and sedative withdrawal
d. Other illicit drugs
e. Mercury or arsenic tox.
f. Organophosphate or benzene tox
g. PCN
h. Sulfonamides
i. Sympathomimetics
j. Antidepressants.
10. In whom does anxiety develop most commonly?
a. Prevalence in FM: 30%. In men: 19%.
b. More frequently in higher socioeconomic groups.
11. Panic attacks?
a. Panic attacks are discrete periods of heightened anxiety and fear that classically occur in pts w/panic disorder, but can also be seen w/other anxiety disorders (phobic disorders, PTSD).
b. They peak w/in 10 minutes and usually last <25 minutes.
c. They may be provoked by triggers or come on spontaneously.
12. To diagnose a panic attack, a pt must have at least 4 sx:
1. Palpitations
2. Sweating
3. Shaking
4. SOB
5. Choking sensation
6. Chest pain
7. Nausea or abdominal distress
8. Light-headedness
9. Depersonalization (feeling detached from oneself) or derealization (feeling out of reality)
10. Fear of losing control or going crazy
11. Fear of dying
12. Numbness or tingling
13. Chills or hot flashes.
13. With what conditions are panic attacks associated?
a. Mitral valve prolapse
b. Asthma
c. Pulmonary embolus
d. Angina
e. Anaphylaxis.
14. Panic disorder?
a. Characterized by spontaneous recurrent panic attacks w/no obvious precipitant.
b. Pts w/panic disorder suffer from panic attacks on average 2x/wk but may range from several times per day to a few times per year.
c. They usually last between 20-30 minutes
d. Anticipatory anxiety about having another attack is common between episodes.
15. Diagnosis of panic disorder?
a. At least one of the attacks must be followed by a minimum of 1 month of the following:
i. Persistent concern about having additional attacks.
ii. Worry about the implications of the attack
iii. A significant change in behaviour related to the attacks (avoidance of situations that may provoke them).
16. What should always be specified w/panic disorder?
a. Whether it is w/agoraphobia or not.
17. How to titrate SSRIs for use in panic disorder?
a. Always start SSRIs at low dose and ↑ slowly in panic disorder bc some SSRIs can have side effects that may initially worsen anxiety.
18. Characteristic situations avoided in agoraphobia?
a. Bridges
b. Crowds
c. Buses
d. Trains
e. Any open areas outside the home.
19. Changes in neurotransmitters in panic disorder?
a. ↑ NE
b. ↓ 5-HT and GABA.
20. Panic attacks may be induced by?
a. Caffeine
b. Nicotine
c. Hyperventilation.
21. Tx of panic disorder?
a. Best long-term tx is SSRIs, esp. Paroxetine (Paxil, Aropax, Paxeva) and sertraline (Zoloft).
b. Typically takes 2-4 wks to become effective, and HIGHER DOSES are required than for depression.
c. Other antidepressants (clomipramine [Anafranil] and imipramine [Tofranil]) may also be used.
d. BZDs are effective immediately but are best used temporarily bc of their risk of causing tolerance and dependency.
e. Tx should continue for at least 8-12 months, as relapse is common after discontinuation of therapy.
22. Nonpharmacologic tx of panic disorder?
a. Relaxation training, biofeedback, CBT, insight-oriented psychotherapy.
23. Agoraphobia?
a. Fear of being alone in public places.
b. The anxiety-> the avoidance of being in places or situations from which or help might be difficult.
c. It can diagnosed alone or as panic disorder w/agoraphobia (50-75% have coexisting panic disorder).
d. When a coexisting panic disorder is treated, agoraphobia usually resolves.
e. When agoraphobia is not associated w/panic disorder, it is usually chronic and debilitating.
24. Social phobia vs. shyness?
a. To be social phobia, the provoked anxiety ahs to interfere w/their daily functioning.
25. Specific phobia?
a. A specific phobia is a strong, exaggerated fear of a specific object or situation.
26. Social phobia?
a. Also called Social Anxiety Disorder
b. Fear of social situations in which embarrassment can occur.
27. Diagnostic criteria for specific phobias?
1. Persistent excessive fear brought on by a specific situation or object.
2. Exposure to the situation brings about an immediate anxiety response.
3. Pt recognizes that the fear is excessive.
4. The situation is avoided when possible or tolerated w/intense anxiety.
5. If person is under age 18, duration must be at least 6 months.
b. The diagnosis of social phobia has the same criteria as above except that the feared situation is related to social settings in which the pt might be embarrassed or humiliated.
28. Most common mental disorders in the US?
a. Phobias.
b. Affect 5-10% of the population.
c. Specific phobia is more common than social phobia.
29. What is performance anxiety often treated w/?
a. Beta blockers.
30. What disorders are often comorbid in phobic pts?
a. Substance disorders, esp alcohol dependence.
b. Up to 1/3 of phobic pts also have associated Major depression.