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42 Cards in this Set
- Front
- Back
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What is the definition of anxiety disorders?
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group of mental disorders characterized by the subjective and physiologic manifestations of fear
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What are physical manfestations of anxiety?
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• Dizziness
• GI disturbance (diarrhea) • Mydriasis (pupil dilation) • Palpitations • Sweating • Shakiness • Syncope • Tingling in the extremities • Tachycardia • Tremor • Urinary urgency and frequency |
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What are medical conditions associated with anxiety?
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• Cardiac arrhythmias
• Excessive caffeine intake • Hypothyroidism and Hyperthyroidism • Hypoglycemia • Mitral valve prolapse • Pheochromocytoma • Substance abuse • Vitamin B12 deficiency |
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What are the 5 major classifications of anxiety disorders?
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• Generalized Anxiety Disorder
• Obsessive-Compulsive Disorder • Panic Disorder • Phobias • Post-Traumatic Stress Disorder (PTSD) |
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What are characteristics of anxiety symptoms?
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• Period of anxiety symptoms that have a sudden onset and increase in intensity over an approximately 10-minute period
• Occur about twice weekly and last @ 30 minutes • Between attacks the patient fears having another attack |
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What is the medical condition most resembling panic disorder?
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myocardial infarction
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What psychological conditions are most closely associated with panic disorders?
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• Depression
• Factitious disorder • Generalized anxiety disorder • Hypochondriasis • Malingering • Social or specific phobia |
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How can you induce a panic attack for diagnostic purposes?
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• IV Sodium Lactate
• Inhalation of CO2 (breathing in & out of a bag) |
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Anxiety disorder is more common in which gender?
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females
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What first line treatment for anxiety disorders?
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1st line treatment is antidepressants
• SSRI: Prozac or Paxil 20mg/day • Tricyclics: Tofranil 150 – 300mg/day titrated slowly • MAOI: Nardil 30 – 75 mg/day |
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What is the most useful benzodiazepine to treat panic disorder?
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Alprazolam (Xanax) 2-6 mg/day
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What is the most useful adjunct to pharmacotherapy in treating panic disorder?
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cognitive therapy
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What is the definition of specific phobia?
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an irrational fear of certain specific things (ex. animals, heights, or needles)
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What is the definition of social phobia?
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an exaggerated fear of social or environmental situations (ex. public speaking or using a public restroom)
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What are differential diagnosis of specific phobia?
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• Hypochrondriasis
• OCD • Paranoid personality disorder • Panic disorder |
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What are differential diagnosis of social phobia?
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• major depressive disorder
• normal shyness • Schizoid personality disorder |
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What is the treatment options for specific phobias?
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• Systematic desensitization is most effective
• Hypnosis • Family therapy • Psychotherapy |
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What are treatment options for social phobias?
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• MAOIs (ex. Phenelzine/Nardil)
• Beta blockers (ex. propanolol, atenolol) |
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What are characteristics of obsessive-compulsive disorder?
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• Recurrent thoughts, feelings, and images (obsessions) or repetitive actions (compulsions)
• Most patients know that these thoughts and behaviors are irrational |
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What are the most common compulsions?
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• hand washing
• door locking • checking gas jets |
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What are other conditions that resemble OCD?
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• Schizophrenia
• Tourette disorder • temporal lobe epilepsy |
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What are medical treatment options for OCD?
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• Clomipramine [Anafronil] 150 – 250 mg/day
• Fluoxetine [Prozac] 40 – 80 mg/day • Fluvoxamine [Luvox] 100 – 300 mg/day * Behavioral therapy and supportive psychotherapy is also useful |
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What are symptoms of generalized anxiety disorder?
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• Persistent symptoms of anxiety including hyperarousal
• Symptoms must last at least 6 months • Anxiety symptoms may not be related to a specific person or situation (free–floating anxiety) |
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When does generalized anxiety disorder most commonly start?
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3rd decade of life
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What are treatment options for generalized anxiety disorder?
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• Cognitive & behavioral therapy
• Pharmacologic treatment - Benzodiazepines (1st line drug treatment) - Buspirone (Buspar) |
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Which benzodiazepines are short-acting?
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• Lorazepam (Ativan)
• Oxazepam (Serax) • Triazolam (Halcion) |
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Which benzodiazepines are intermediate-acting?
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• Alprazolam (Xanax)
• Temazepam (Restoril) |
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Which benzodiazepines are long-acting?
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• Chlordiazepoxide (Librium)
• Clonazepam (Klonopin) • Diazepam (Valium) • Flurazepam (Dalmane) |
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Which benzo is used for psychotic agitation?
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Lorazepam (Ativan)
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Which benzos are used for alcohol withdrawal?
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• Oxazepam (Serax): short-acting
• Chlordiazepoxide (Librium): long-acting |
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Which benzos are used for insomnia?
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• Triazolam (Halcion): short-acting
• Temazepam (Restoril): intermediate-acting • Flurazepam (Dalmane): long-acting |
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Which benzo is used as an antidepressant and to treat panic disorder and social phobia?
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Alprazolam (Xanax)
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Which benzo is used for seizures, mania, social phobia, and panic disorder?
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clonazepam (Klonopin)
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Which benzo is used for muscle relaxation, analgesia, and as an anticonvulsant?
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Diazepam (Valium)
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Which anti-anxiety agent is used for intolerance to benzodiazepines?
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Meprobamate (Miltown)
* classification: Carbamate |
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Which antianxiety agent is used to treat anxiety in the elderly, has low abuse potential, and no sedative effects?
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Buspirone (Buspar)
* classification: Azapirone |
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What class of medication are used primarily for the autonomic symptoms of anxiety?
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beta blockers (propranolol 80-160 mg)
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What is the distinguishing features between other anxiety disorders and PTSD?
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presence of a catastrophic traumatic event
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What are symptoms of PTSD?
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• anxiety
• dissociative symptoms • flashbacks • numbing of affective response • recurrent nightmares • social withdrawal • survivor's guilt |
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How long must symptoms last to have PTSD?
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• symptoms must last for more than 1 month
• symptoms can last for years (in chronic form) • if symptoms last 2 days-4 weeks, it is diagnosed as acute stress disorder |
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What is the most helpful treatment for PTSD?
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psychotherapy, support groups, & group therapy
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There are no good pharmacologic treatments for PTSD. What are some drugs that have been tried with some success?
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• Imipramine (Tofranil)
• SSRIs • Carbmazepine (used particularly for flashbacks and nightmares) |
