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17 Cards in this Set
- Front
- Back
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Explain the MOA of the anxiolytic benzodiazepine
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Binds to an accessory/regulatory site on GABAa, acting allosterically to increase GABA affinity at the receptor.
This potentiates the opening of the channel for lower levels of GABA. It is NOT a GABA agonist Results in Cl influx into cell > hyperpolarisation > harder to reach AP threshold. |
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Describe 3 types of phobias
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1) Agoraphobia: fear of suffering a panic attack in a place where likely embarassment or lack of help is perceived
2) Specific phobia: excessive, unreasonable fear cued by a specific object or situation 3) Social phobia: excessive concern over negative evaluations and scrutiny by others |
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What is an obsession and compulsion
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Obsession: recurring and persistent intrusive thoughts or impulses that are intrusive and inappropriate
Compulsion: A repetitive behaviour whose goal is to reduce anxiety or distress |
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A patient is worried most days of the week, is often tired, has difficulty sleeping and concentrating. What is the likely diagnosis
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If symptoms > 6 months then GAD.
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A person is a workaholic, obsessed with detail. What would make this a disorder
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Only an obsession causes marked distress, occurs for more than one hour each day or causes social or occupational dysfunction.
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What is anxiety
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A sense of apprehension, vigilence and heigtened autonomic arousal accompanied by unpleasant sensations
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A patient is admitted and you suspect amphetamine intoxication. What signs do you monitor
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Think mania + anxiety + psychosis:
Euphoria Hyperarousal Talkative Insomnia Agitation, anxiety, panic Hallucinations Paranoia hypertensive crisis and heart failure Sweating |
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What is the psychoanalytic theory of anxiety
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Unresolved conflict between id, ego and superego. Defence mechanisms become activated such as denial, repression, suppression, acting out etc
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Define generalised anxiety disorder (DSM)
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Persistent, excessive, difficult to control anxiety > 6 months severe enough to cause psychosocial impairment + 3 or more symptoms/signs:Restlessness or feeling keyed up or on edge
Fatigue Concentration loss Irritability Muscle tension Sleep disturbances (difficulty falling or staying asleep) Worry |
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What are the psychiatric differentials for GAD
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Panic disorder (sudden, severe, no buildup, > 1 month)
OCD (presence of compulsions and obsessiveness) PTSD Adjustment disorder (began < 30, 4 different sites of pain, sexual dysfunction, neurological (pseudo) complaint) Somatisization ( Agoraphobia (fear of panic in open spaces or inescapable situations) Social phobia (anxiety when under scrutiny, perceived negative judgement) |
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What are 3 different medications commonly used and dosages for anxiety disorders
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1) escitalopram (10mg initially -> 20mg)
2) sertraline (25mg -> 100mg) 3) buspirone in pregnancy (not if preeclampsia - renal impairment) (15mg tds to 20mg tds) |
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What are the non-psychiatric differentials for GAD
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1) Substances: alcohol withdrawal, cocaine, amphetamines, caffeine
2) Metabolic: hypo/hyperthyroidism, cushings, phaeochromocytoma 3) Delerium 4) Other: respiratory, cardiac, neurological diseases |
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What are the risks of PTSD
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1) Substance abuse
2) Other psych disorders: depression, anxiety disorders, somatoform disorders 3) Suicide |
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What are the diagnostic criteria for PTSD
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1) Reexperiencing an extreme traumatic event >1 month after incident (otherwise may be adjustment disorder if lacking flashbacks and avoidance. If dissociation then it is acute stress disorder)
2) Avoidance of trauma related cues, regression and dissociation 3) Hyperarousal, sleep disturbance (nightmares) |
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What are the differentials for PTSD
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ASD (must have dissociation and < 1 month)
Adjustment disorder (< 6 months of GAD symptoms and functional impairment) |
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What non drug therapies are available for PTSD
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Trauma focussed CBT
Eye movement desensitization |
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What are the risk factors associated with PRSD
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Suicide: 20% attempt, 6x risk ratio
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