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16 Cards in this Set
- Front
- Back
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48. Tx of OCD?
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a. SSRIs are the first line of tx, but the higher-than-normal doses may be required to be effective.
b. TCAs such as Clomipramine (Anafranil) are also effective. c. Behavioural tx- is considered as effective as pharmacotherapy, but best outcomes are often achieved when both are used simultaneously. d. Exposure and response prevention (ERP) is often used. e. ECT or surgery (cingulotomy) can be used as a last resort. |
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49. PTSD dx?
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a. Pt has experienced or witnessed a traumatic event
b. The event was potentially harmful or fatal, and the initial reaction was intense fear or horror. c. Persistent re-experiencing of the even (dreams, flashbacks, etc) d. Avoidance of stimuli associated w/the trauma (eg avoiding a location that will remind him or her of the event or having difficulty recalling details of the event. e. Numbing of responsiveness (limited range of affect, feelings of detachment or estrangement from others, etc). f. Persistent sx of ↑ arousal (eg, difficulty sleeping, outbursts of anger, hypervigilence, exaggerated startle response, or difficulty concentrating. |
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50. How long must sx persist for in PTSD?
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a. At least 1 month.
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51. Comorbidities associated w/PTSD?
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a. Pts have a high incidence of associated substance abuse and depression.
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52. Prognosis for PTSD?
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a. ½ of pts remain sx free after 3 months of tx.
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53. Tx of PTSD?
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a. Antidepressants: SSRIs, TCAs (imipramine, doxepin), MAOIs.
b. Anticonvulsants (for flashbacks and nightmares. c. CBT, relaxation training, support groups, family therapy. d. Eye movement desensitization and reprocessing (EMDR). |
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54. Cognitive processing therapy?
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a. Is a modified form of CBT in which thoughts, feelings, and meanings of events are revisited and questioned.
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55. PTSD vs. acute Stress disorder?
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a. PTSD: Event occurred at any time in past and symptoms last > 1 month.
b. Acute Stress Disorder: Symptoms last < 1 month and event occurred < 1 month ago. |
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56. Use of Benzos in pts w/PTSD?
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a. BZDs should be avoided in tx of PTSD bc of the high rate of substance abuse in these pts.
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57. Diagnosis of Acute Stress Disorder (ASD)?
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a. The diagnosis of ASD is reserved for pts who experience a major traumatic event but have anxiety sx for only a short duration.
b. To qualify for this diagnosis, the sx must occur w/in 1 month of the trauma and last for a maximum of 1 month. |
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58. Note if a pt is exhibiting anxiety and dysfunction 2 wks after a traumatic event, he could qualify for acute stress disorder, but not PTSD until the sx have lasted >1 month.
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58. Note if a pt is exhibiting anxiety and dysfunction 2 wks after a traumatic event, he could qualify for acute stress disorder, but not PTSD until the sx have lasted >1 month.
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59. Diagnosis of Generalized Anxiety Disorder?
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a. Requires at least 6 months of 3 out of 6 symptoms.
b. Excessive anxiety and worry about daily events and activities (that is difficult to control) for at least 6 months. c. Must be associated w/at least 3 of the following: 1. Restlessness 2. Fatigue 3. Difficulty concentrating 4. Irritability 5. Muscle tension 6. Sleep disturbance. |
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60. Note: When diagnosing GAD, make sure to rule out medical conditions that produce anxiety, such as hyperthyroidism. Ask about caffeine intake.
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60. Note: When diagnosing GAD, make sure to rule out medical conditions that produce anxiety, such as hyperthyroidism. Ask about caffeine intake.
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61. Tx of GAD?
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a. The most effective tx approach is a combination of psychotherapy (CBT) and pharmacotherapy.
b. SSRIs, Buspirone, and venlafaxine. c. If benzos are used (clonazepam, diazepam [Valium]), they should be tapered off when possible bc of risk of tolerance and dependence. |
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62. Note: In GAD, the anxiety is free-floating as opposed to being fixed on a specific person, event, or activity.
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62. Note: In GAD, the anxiety is free-floating as opposed to being fixed on a specific person, event, or activity.
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63. Complete
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63. Complete
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