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Psychiatry Week 2 2018/19 > 1: Anxiety - generalised anxiety, panics and phobias > Flashcards

1: Anxiety - generalised anxiety, panics and phobias Flashcards

1
Q

What are some physical symptoms of anxiety?

A

Sweating; hot flushes; cold chills

Tremor

Sesnory disturbance e.g pararesthesia

Feeling faint

Dry mouth

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2
Q

What are some cognitive symptoms of anxiety?

A

Fear of losing control

Feeling on edge

Difficulty concentrating

Hypervigilance

Meta-worry (worrying about worry)

Preference for order and routine

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3
Q

What is derealisation?

A

A feeling that you’re not real

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4
Q

What is hypervigilance?

A

Paying extreme attention to internal (e.g your heartbeat) or external (other people) factors

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5
Q

What type of lifestyle do people with an anxiety disorder prefer?

A

Ordered

Routine

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6
Q

What are some behavioural symptoms of anxiety?

A

Avoidance of certain situations

Exaggerated startle

Insomnia due to worrying

Excessive use of substances

Restlessness; inability to relax

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7
Q

Which structure initially determines if a sensory stimulus requires a stress response?

A

Amygdala

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8
Q

Which hormone regulates the stress response?

Which gland releases it?

A

Cortisol

Adrenal gland

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9
Q

When is anxiety pathological?

A

Extreme symptoms

Context: anxiety is disproportionate to situation

Impairment of daily activities

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10
Q

Which type of anxiety disorder has ever-present, non-specific symptoms?

What are some of these symptoms?

A

Generalised anxiety disorder

Sweating, tremor, feeling faint

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11
Q

What are the symptoms of generalised anxiety disorder?

A

Nervousness

Tremor

Aches and pains

Sweating

Dizziness

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12
Q

Generalised anxiety disorder presents as ___ worrying over no particular situation.

A

persistent

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13
Q

What is an endocrine disease which causes anxiety?

A

Hyperthyroidism

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14
Q

What are the criteria for diagnosing generalised anxiety disorder?

A

Long-lasting (most days for > 6 months)

Uncontrollable anxiety

Significant distress / impairment of function

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15
Q

What percentage of the population will have generalised anxiety disorder?

A

10%

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16
Q

Generalised anxiety disorder is more common in (men / women).

A

women

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17
Q

Generalised anxiety disorder often presents with medically ___ symptoms.

A

medically unexplained symptoms

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18
Q

90% of patients with GAD have other ___ disorders.

A

psychiatric

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19
Q

How is GAD managed in the long term?

A

Cognitive behavioural therapy

SSRIs / SNRIs

Pregabalin

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20
Q

Which class of drug can be used to control anxiety in the short term management of GAD?

A

Benzodiazepines

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21
Q

What is panic?

A

Acute presentation of severe anxiety

22
Q

What is a panic disorder?

A

Recurrent, unpredictable episodes of panic

23
Q

Panic disorder is (predictable / unpredictable).

A

unpredictable

24
Q

What are some symptoms of panic disorder?

A

Palpitations

Chest pain

Derealisation

Dizziness

25
Q

What is agoraphobia?

A

Fear of going outside or similar - social situations, crowds etc.

26
Q

GAD and panic disorder can be caused by drugs or medical conditions like hyperthyroidism - true or false?

A

False

Unrelated to physiological effects of drugs / diseases

27
Q

Panic disorder can only be diagnosed when symptoms aren’t explained by an underlying disorder.

What is an example of an underlying psychiatric disorder which may present as panic?

A

Depression

Bipolar disorder

28
Q

What is the typical course of GAD and panic disorder?

A

Chronic, fluctuating

29
Q

What are

a) psychological
b) pharmacological methods of managing panic disorder?

A

a) CBT

b) SSRIs / SNRIs/ TCAs or benzodiazepines for acute episodes

30
Q

What is a phobia?

A

Irrational fear of something; avoidance behaviour and anxiety

31
Q

What is the most common phobia?

A

Agoraphobia

fear of going outside, travelling alone, crowds etc.

32
Q

Why do patients with agoraphobia tend to experience very little anxiety?

A

Because they don’t leave the house

33
Q

Agoraphobia may be a primary disorder or secondary to other disorders such as?

A

Depression

Panic disorder

34
Q

Patients with agoraphobia may misuse ___ to reduce their anxiety.

A

drugs

35
Q

In specific phobias, exposure to the phobic stimulus causes ___.

A

anxiety

36
Q

What are some examples of specific phobias?

A

Flying

Heights

Injections

Animals

37
Q

Which animals do some patients have phobias for?

A

Dogs

Spiders

38
Q

What psychological therapy is often recommended for phobias?

A

Behavioural therapy

systematic desensitisation to phobic stimulus

39
Q

Which anxiety disorder presents as a fear of scrutiny by others and aversion to being embarrassed or humiliated?

A

Social anxiety disorder

40
Q

What are the common symptoms of social anxiety disorder?

A

Blushing

Fear of vomiting

Fear of micturition; defaecation

41
Q

Who tends to present with social anxiety disorder?

A

School-aged children

42
Q

How do patients with social anxiety disorder react to new situations?

A

Avoidance

Withdrawal

43
Q

What are the two components of obsessive compulsive disorder?

A

Obsessive thoughts

Compulsive acts

44
Q

Obsessive thoughts are often described as ego-dystonic.

What does this mean?

A

Unpleasant, doesn’t match with ideal view of self or situation

Can see why this is horrible when patient cannot shift them

45
Q

What is a compulsive act?

A

Repeated ritual or stereotypical behaviour

46
Q

In obsessive compulsive disorder, patients often realse that their thoughts are ___ and their behaviours are ___.

A

thoughts - irrational

behaviours - non-functional

47
Q

What is the difference between obssessive acts (seen in OCD) and obsessive traits?

A

Obsessive acts - non-functional, not enjoyable, recognised as pointless by the patient

Obsessive traits - e.g enjoying things being tidy, perfect; behaviour brings satisfaction (and are often recognised as ‘competent’ or ‘professional’ by others)

48
Q

What are the criteria for diagnosing OCD?

A

Symptoms present for > 2 weeks

Interfering with patient’s life and daily activities

Obsessions are patient’s own thoughts

Compulsive acts aren’t enjoyable

49
Q

OCD often exists co-morbidly with other ___ disorders.

A

psychiatric

50
Q

What is the main psychological treatment for OCD?

A

CBT

response prevention, encourage patient to do/not do something to show them that thoughts or acts are irrational

51
Q

Which receptor do benzodiazepines act on?

What general effect does this cause?

A

Enhance action of GABA (inhibitory neurotransmitter)

Inhibition

effective anxiolytic

52
Q

What are some side effects of benzodiazepines?

A

Sedation

Addictive drug

Psychiatry Week 2 2018/19 (8 decks)

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