Neuro 2 - Ryan - Anxiety Disorders

Front 1

Function of stress?

Back 1

Warning of internal or external threat = brains alarm system
Normal anxiety is short-lived

Front 2

What are the manifestations of anxiety?

Back 2

Emotional = fear
Cognitive = apprehension/worry
Behavioral = Hypervigilence, Avoidance

Front 3

Whats the Yerkes-Dodson Law?

Back 3

The performance-stress curve

Front 4

Define anxiety disorder

Back 4

Extremes of normal anxiety - no real danger exists or emotional reaction is excessive/disproportionate to actual danger

Disorders tend to be chronic or recurrent and impair social or occupational function

Front 5

T/F: most pts with one anxiety disorder will have features of the other disorders

Back 5

TRUE

Front 6

T/F: many anxiety disorders respond to similar tx

Back 6

Yeppers

Front 7

Do different anxiety disorders stem from different brain regions?

Back 7

No

Front 8

Whats the most common anxiety disorder?

Back 8

Specific phobia

Front 9

List the anxiety diroders

Back 9

Panic disorder (w or w/o agorophobia), Agorophobia (w/o hx of panic), Generalized anxiety disorder, Specific phobia, social phobia (social anxiety disorder), OCD, PTSD, Acute stress disorder, anxiety associated with a general medical condition, substance-induced anxiety disorder

Front 10

What are the causes of anxiety disorders?

Back 10

Genetic

Environmental

Front 11

Dif. Dx for anxiety disorders?

Back 11

Medical disorders like hyperthyroidism, hypoglycemia

Substance abuse like amphetamines

Other psychiatric conditions - depression etc

Front 12

Pt has episodic panic attacks with fear and physical symptoms of pushing a cart in the grocery store. She had a panic attack one day followed by a month of concern about having to do it again, worrying about the implications of pushing the cart, and had a significant change in behavior b/c of it in that she doesn't get groceries any more. Dx?

Back 12

Panic Disorder

Front 13

Criteria for panic disorder?

Back 13

1 panic attack followed by one of the following:

Persistent concern about future attacks
Worrying about implications of consequences of attacks (going crazy, having MI, etc)
Significant change in behavior related to attacks

Front 14

We need at least 4 of WHAT symptoms to qualify as a panic attack?

Back 14

palpitations or heart pounding, sweating, trembling/shaking, shortness of breath/sense of smothering, choking, chest pain/discomfort, N, Abd distress, dizzy/lightheaded/faint, losing control or going crazy, chills/hot flashes, Numb/tingling, unreality (depersonalization), fear of dying

Front 15

Define Panic disorder with Agorophobia

Back 15

Panic disorder where pt has a fear of being in places or situations where escape may be difficult

Front 16

Pt has a fear of riding in rides in Disney Land (Looking at you Natasha...) She feels like she won't be able to gt help if needed, and this leads her to avoid a variety of situations. (shes never panicked, though) Dx?

Back 16

Agorophobia

Front 17

T/F: Agorophobia is as high as 60% in cardiology clinics

Back 17

Truf

Front 18

Generalized anxiety disorder key feature?

Back 18

chronic uncontrollable worry about numerous events of every day life

Front 19

Grandma Meme constantly worries about everything and won't let you wear multi-colored clothes to school. She especially hates it when you wear that puffy cat-lion shirt and fashion your hair into a lion's mane. Dx?

Back 19

Generalized Anxiety disorder

Front 20

Criteria for Generalized anxiety disorder

Back 20

Excessive anxiety/worry occuring more days than not for at least 6 months

Difficulty controlling the worry

3 or more: Restlessness, feeling keyed up, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance

Front 21

How long do generalized anxiety disorder symptoms have to persist to call it that?

Back 21

6 months

Front 22

Pt is afraid of hershey bars and avoids them and the state of PA where they're made at all costs. Dx?

Back 22

Specific phobia

unreasonable fear

Front 23

Fear of heights?

Back 23

Acrophobia

Front 24

Pt has a fear of blood injections. Dx

Back 24

Specific phobia

Front 25

Typical onset of specific phobias?

Back 25

Childhood

Front 26

Generalized Anxiety disorder onset?

Back 26

early adulthood

Front 27

Pt has exaggerated fear of embarrassing herself in front of people like public speaking, talking with her teacher (authority figure) or eating in public. Symptoms have lasted 6 months. Dx?

Back 27

Social anxiety disorder

Front 28

What are the 2 types of social anxiety disorder?

Back 28

generalized type (most social situations) and non-generalized (performance) type

Front 29

What is often co-morbid with social anxiety disorder?

Back 29

depression, phobias, panic attacks, substance abuse

Front 30

How do we treat this pt? Pt has exaggerated fear of embarrassing herself in front of people like public speaking, talking with her teacher (authority figure) or eating in public. Symptoms have lasted 6 months.

Back 30

Social anxiety disorder: SSRI, Benzo, Buspirone, MAOI, B-blocker, cognitive behavioral therapy

Front 31

Pt has fear of dark, so has to turn lights on and off 15 times before entering every room to ensure they work. Dx?

Back 31

OCD

Front 32

Whats the obsession and whats the compulsion: Pt has fear of dark, so has to turn lights on and off 15 times before entering every room to ensure they work.

Back 32

Obsession = fear of dark

Compulsion = lights on and off

Front 33

Presence of intrusive thoughts (obsessions) which cause anxiety and bring about behaviors (compulsions) to relieve the anxiety. Dx?

Back 33

OCD

Front 34

List some Obsessions and compulsions seen in adults

Back 34

Obsessions = contamination, pathological doubt, somatic, need for symmetry, aggressiveness, sexual acts, multiple obsessions

Compulsions = checking, washing, counting, need to ask or confess, symmetry/precision, hoarding, multiple compulsions

Front 35

When does OCD usually come about?

Back 35

teens or early adulthood 20s

Front 36

OCD has a high occurrence with what other disorder?

Back 36

Tourette's

Front 37

How do we tx OCD?

Back 37

SSRI, blah other drugs, cognitive behavioral therapy, ECT = electroconvulsive therapy, Psychosurgery

Front 38

How does PTSD differ from Acute stress disorder?

Back 38

Acute stress disorder is one month or less, then turns into PTSD if it lasts longer than a month

Front 39

Pt has had recurrent nightmares for 1.5 months about the time she went to Chuckie Cheese drunk and jumped over the guard rail only to find out the mechanical Chuckie on stage was just that: NOT REAL. (true story) Dx?

Back 39

PTSD (since its over 1 month)

Front 40

Criteria for PTSD and Acute Stress Disorder?

Back 40

After threatening event that causes fear, helplessness, or horror

Traumatic event is re-experienced

Persistent avoidance of stimuli associated with arousal

Front 41

How do we manage this unfortunate pt? Pt has had recurrent nightmares for 1.5 months of the time she went to Chuckie Cheese drunk and jumped over the guard rail only to find out the mechanical Chuckie on stage was just that: NOT REAL.

Back 41

PTSD management:

Anti-depressants = SSRIs, mood stabilizers, clonidine, B-blockers, cognitive behavioral therapy, EMDR, stress management, exposure therapy

For Acute stress disorder = benzos

For both ASD and PTSD: crisis intervention: support, education, development of coping mechanisms, ventilation, relaxation etc.