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15 Cards in this Set
- Front
- Back
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What is the major source of adrenergic innervation (and NE neurons) that also plays a large role in anxiety disorders?
- What other systems play a part too? |
Locus coeruleus
- GABA from limbic - 5HT and neuropeptides |
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Characterize a "panic attack"
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Discrete episodes of intense anxiety
Sudden onset Peak within 10 minutes Associated with at least 4 of the 13 other somatic or cognitive symptoms of autonomic arousal |
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Characterize a "panic disorder."
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recurrent, unexpected panic attacks (at least 4 in one month)
attacks are followed for at least one month with concern about having another attack, worry about implications of the attack, or behavioral changes as a result of the attack. |
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Gender prevalence in panic disorder? Likely age of onset?
What tx are appropiate? |
2:1 F:M; late teens thru 3rd decade
SSRI = 1st line TCA and MAOI are also used. - sedative/hypno's in the short term |
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A patient presents suffering from severe worry that seems out of proportion to situational factors. They report that it occurs "on most days of the week" and that it has been going on for at least 6m. Their significant other describes them as a "worrier."
Top of the diff? - how many additional sx would you need to confirm? Tx? |
Generalized Anxiety Disorder (GAD)
- 3 out of 6 (Muscle tension, restlessness, insomnia, problems concentrating, easy fatiguability, irritability, persistent anxiety) antiD, Benzo's, buspirone |
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What 4 categories exist of PTSD sx?
How long must a pt have examples of all of them to get the dx? Groups with the highest prevalence of PTSD? Tx? |
- re-experiencing sx
- avoidance sx - emotional numbing - hyperarousal sx (insomnia, irritabiliy, hypervigilance, exaggerated startle response) >1m combat veterans and women who are the victims of sexual trauma. Exposure based cog. behav tx; psychotherapy aimed at various aspects - SSRI's are 1st line - atypical antipsychotics are increasingly being used. |
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How would you characterize "social phobia?"
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- Distinction: anxiety only occurs when the patient is subject to the scrutiny of others (public speaking, oral exam, eating in the cafeteria)
- Phobic stimulus is avoided or endured with intense anxiety - Fear and avoidant behaviors interfere with person’s normal routine or cause marked distress |
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How would you tx social phobia?
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- SSRI's and MAOI
- high potency benzo's - low doses of B-blockers are helpful for public speaking (if only an occasional event) - psychotherapy |
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What is the typical age of onset of situational phobias? Phobias of animals, natural environments, blood, and injections?
True Tx? Acute Tx? |
bimodal = childhood and mid-twenties
Childhood flooding = exposing the person to the feared stimulus in a gradual, desensitizing way - Benzo's and B-blockers are useful acutely. |
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Characterize the 'obsessions' and 'compulsions' of OCD.
What are the sx of OCD needed to dx? |
- Obsessions: recurrent, intrusive, unwanted thoughts (i.e. fear of contamination)
- Compulsions: behaviors or rituals aimed at reducing distress or preventing a dreaded event (i.e. compulsive handwashing) recurrent obsess/compul that consume >1hr a day - person recognizes that this is excessive and unreasonable |
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Are OCD sx ego-dystonic or ego-syntonic?
Mean age of OCD onset? Is it typically developed after 35y? |
ego-dystonic = the ego doesn't enjoy it.
mid-twenties, tho' men can get it earlier. - no |
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What is the preferred tx of OCD?
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- Serotoning reuptake inhibitors
- clomipramine (serotoneric trycyclic antiD) - psychotherapy: exposure and response prevention. |
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How is OCD diff from OCPD?
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Obsessive-Compulsive Disorder is different from obsessive compulsive personality disorder (OCPD)
OCPD: a pervasive pattern of preoccupation with orderliness, perfectionism and control that begins by early adulthood |
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What is the site of noradrenergic neurons in the CNS? Serotonergic?
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locus ceruleus; raphe nucleus
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What is a pheochromocytoma? What can it cause?
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adrenal medullary tumor - can cause sx of anxiety.
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