Kmsd-A Pd Questions

Front 1

How can u break down Panic Attack Sx?

Back 1

Somatic and Cognitive
palpitations, sweating, trembling or shaking, sensations of shortness of breath or smothering, feeling of choking, chest pain or discomfort, nausea or abdominal distress, dizziness or lightheadedness, paresthesias, and chills or hot flushes.

derealization or depersonalization, fear of losing control or "going crazy," fear of dying,

Front 2

how is panic attack anxiety different than GAD anxiety?

Back 2

discrete, almost paroxysmal, nature and its typically greater severity

Front 3

What are panic attacks called with less than 4 sx?

Back 3

limited-symptom attacks

Front 4

3 types of panic attacks?

Back 4

unexpected (uncued), situationally bound (cued), and situationally predisposed

Front 5

Difference between situationally bound versus situationally predisposed panic attacks?

Back 5

Situationally bound (cued) Panic Attacks are defined as those that almost invariably occur immediately on exposure to, or in anticipation of, the situational cue or trigger (e.g., a person with Social Phobia having a Panic Attack upon entering into or thinking about a public speaking engagement). Situationally predisposed Panic Attacks are similar to situationally bound Panic Attacks but are not invariably associated with the cue and do not necessarily occur immediately after the exposure (e.g., attacks are more likely to occur while driving, but there are times when the individual drives and does not have a Panic Attack or times when the Panic Attack occurs after driving for a half hour).

Front 6

unexpected Panic Attacks is required for a diagnosis of

Back 6

Panic Disorder

Front 7

situationally bound Panic Attacks are experienced by a majority of individuals with

Back 7

Social Phobia (e.g., the person experiences a Panic Attack each and every time she must speak in public) and Specific Phobias (e.g., the person with a Specific Phobia of dogs experiences a Panic Attack each and every time he encounters a barking dog)

Front 8

situationally predisposed Panic Attacks most typically occur in

Back 8

Generalized Anxiety Disorder (e.g., after watching television news programs that warn of an economic slowdown, the person becomes overwhelmed with worries about his finances and escalates into a Panic Attack) and
Posttraumatic Stress Disorder (e.g., a rape victim sometimes experiences Panic Attacks when faced with reminders of the traumatic event, such as seeing a man who reminds her of the assailant).

Front 9

How can you differentiate panic attacks and associated disorder?

Back 9

careful consideration of the focus of anxiety associated with the Panic Attacks

To illustrate, consider a woman who has a Panic Attack prior to a public speaking engagement. If this woman indicates that the focus of her anxiety was that she might die from an impending heart attack, then assuming other diagnostic criteria are met, she may have Panic Disorder. If on the other hand, this woman identifies the focus of anxiety as not the Panic Attack itself, but of being embarrassed and humiliated, then she may be more likely to have Social Phobia.

Front 10

Agoraphobia: what situations are often avoided?

Back 10

being alone outside the home or being home alone; being in a crowd of people; traveling in an automobile, bus, or airplane; or being on a bridge or in an elevator.

Front 11

Panic Disorder: minimum number of panic attacks?

Back 11

At least two unexpected Panic Attacks are required for the diagnosis

Front 12

Give the order of frequency of panic attack types in panic disorder

Back 12

1. Uncued PA's
no clear trigger

2. Situationally predisposed
situation usually triggers
those more likely to occur on, but not invariably associated with, exposure to a situational trigger

3. Situationally bound attacks
situation almost always triggers
those that occur almost invariably and immediately on exposure to a situational trigger

Front 13

Panic Disorder and comorbidity with depression
What percent of time does depression precede PD?

Back 13

Reported rates for comorbid Major Depressive Disorder vary widely, ranging from 10% to 65% in individuals with Panic Disorder. In approximately one-third of individuals with both disorders, the depression precedes the onset of Panic Disorder. In the remaining two-thirds, depression occurs coincident with or following the onset of Panic Disorder.

Front 14

Panic Ds comorbidity with other Anxiety Disorders?

Back 14

Comorbidity with other Anxiety Disorders is also common, especially in clinical settings and in individuals with more severe Agoraphobia. Social Phobia and Generalized Anxiety Disorder have been reported in 15%-30% of individuals with Panic Disorder, Specific Phobia in 2%-20%, and Obsessive-Compulsive Disorder in up to 10%. Although the literature suggests that Posttraumatic Stress Disorder has been reported in 2%-10% of those with Panic Disorder, some evidence suggests that rates may be much higher when posttraumatic symptoms are systematically queried. Separation Anxiety Disorder in childhood has been associated with this disorder. Comorbidity and symptom overlap with Hypochondriasis are common

Front 15

What are Panic Ds Lab findings?

Back 15

Some individuals with Panic Disorder show signs of compensated respiratory alkalosis (i.e., decreased carbon dioxide and decreased bicarbonate levels with an almost normal pH)

Panic Attacks in response to panic provocation procedures such as sodium lactate infusion or carbon dioxide inhalation are more common in individuals with Panic Disorder than in control subjects or individuals with Generalized Anxiety Disorder.

Front 16

What are Panic Ds Associated physical examination findings and general medical conditions.

Back 16

Transient tachycardia and moderate elevation of systolic blood pressure may occur during some Panic Attacks. Studies have identified significant comorbidity between Panic Disorder and numerous general medical symptoms and conditions, including, but not limited to, dizziness, cardiac arrhythmias, hyperthyroidism, asthma, chronic obstructive pulmonary disease, and irritable bowel syndrome. However, the nature of the association (e.g., cause-and-effect) between Panic Disorder and these conditions remains unclear. Although studies have suggested that both mitral valve prolapse and thyroid disease are more common among individuals with Panic Disorder than in the general population, others have found no differences in prevalence.

Front 17

Panic Ds > in men or women?
How many times with and without agoraphobia

Back 17

Panic Disorder Without Agoraphobia is diagnosed twice as often and Panic Disorder With Agoraphobia three times as often in women as in men.

Front 18

Panic Ds Prevalence Rates lifetime and one year

Back 18

Although lifetime prevalence rates of Panic Disorder (With or Without Agoraphobia) in community samples have been reported to be as high as 3.5%, most studies have found rates between 1% and 2%. One-year prevalence rates are between 0.5% and 1.5%

TWO PERCENT
PANIC DISORDER

Front 19

Prevelance of Panic Ds in clinical population for mental health referrals?

Back 19

For example, Panic Disorder is diagnosed in approximately 10% of individuals referred for mental health consultation. In general medical settings, prevalence rates vary from 10% to 30% in vestibular, respiratory, and neurology clinics to as high as 60% in cardiology clinics.

Front 20

Age at onset for Panic Disorder

Back 20

varies considerably, but is most typically between late adolescence and the mid-30s

Front 21

Panic Disorder distribution age wise?

Back 21

There may be a bimodal distribution, with one peak in late adolescence and a second smaller peak in the mid-30s. A small number of cases begin in childhood, and onset after age 45 years is unusual but can occur.

Front 22

In Panic Ds, when is onset of Agoraphobia?

Back 22

Although Agoraphobia may develop at any point, its onset is usually within the first year of occurrence of recurrent Panic Attacks

Front 23

How do individuals do treated in tertiary care settings?

Back 23

Naturalistic follow-up studies of individuals treated in tertiary care settings (which may select for a poor-prognosis group) suggest that, at 6-10 years posttreatment, about 30% of individuals are well, 40%-50% are improved but symptomatic, and the remaining 20%-30% have symptoms that are the same or slightly worse.

Front 24

First-degree biological relatives of individuals with Panic Disorder are up to XXXXXXXX? times more likely to develop Panic Disorder.

Back 24

8

Front 25

If the age at onset of the Panic Disorder is before 20, first-degree relatives have been found to be up to XXXXXXXX times more likely to have Panic Disorder.

Back 25

20

Front 26

What features of panic attacks might alert you that a GMC is causing Panic Attack Symptoms

Back 26

Features such as onset after age 45 years or the presence of atypical symptoms during a Panic Attack (e.g., vertigo, loss of consciousness, loss of bladder or bowel control, headaches, slurred spech, or amnesia) suggest the possibility that a general medical condition or a substance may be causing the Panic Attack symptoms

Front 27

How do you differentiate Panic Ds from other disorders associated with avoidanct behaviours?

Back 27

The focus of the anxiety also helps to differentiate Panic Disorder With Agoraphobia from other disorders characterized by avoidant behaviors. Agoraphobic avoidance is associated with anxiety about the possibility of having a Panic Attack or panic-like sensations, whereas avoidance in other disorders is associated with concern about the negative or harmful consequences arising from the feared object or situation (e.g., scrutiny, humiliation, and embarrassment in Social Phobia; falling from a high place in Specific Phobia of heights; separation from parents in Separation Anxiety Disorder; persecution in Delusional Disorder)

Front 28

Differentiation of Specific Phobia, Situational Type, from Panic Disorder With Agoraphobia may be particularly difficult because both disorders may include Panic Attacks and avoidance of similar types of situations (e.g., driving, flying, public transportation, enclosed places). So how do u differentiate?

Back 28

Prototypically, Panic Disorder With Agoraphobia is characterized by the initial onset of unexpected Panic Attacks and the subsequent avoidance of multiple situations thought to be likely triggers of the Panic Attacks. Prototypically, Specific Phobia, Situational Type, is characterized by situational avoidance in the absence of recurrent unexpected Panic Attacks.

Front 29

What key factors allow differentiating panic attack associated dx?

Back 29

the focus of anxiety,
the type and number of Panic Attacks,

the number of situations avoided, and

the level of intercurrent anxiety.