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UWM Patho II Exam 4
Anxiety Disorder
| Question | Answer |
|---|---|
| How is anxiety correlated with fear? | Fear is a normal reaction to a known, environmental source of danger In anxiety, the individual experiences apprehension, but the source of the danger is unknown or unrecognized. |
| What are the physical manifestations of anxiety and fear? | They are similar to those of fear including restlessness, palpitations, mydriasis, syncope, tingling, etc. |
| What are the classifications of anxiety disorders? | 1.Panic disorder 2.Phobias 3.Obsessive-compulsive disorder 4.Post-traumatic stress disorder 5.Generalized anxiety disorder |
| What neurotransmitters are associated with anxiety? | The major neurotransmitters associated with anxiety are: 1.GABA(↓ activity) 2.NE (↑ activity) 3.serotonin (↓ activity) |
| What areas of the brain are involved in anxiety disorders? | 1.Locus ceruleus 2.Raphe nuclei *The limbic system, which receives information from these areas of the brain, has benzodiazepine receptor-binding sites. |
| What are organic causes of symptoms of anxiety? | 1.Vitamin B12 deficiency 2.Hypo- or hyperthyroidism 3.Cardiac arrhythmia 4.Hypoparathyroidism *rule these out before diagnosing as anxiety |
| What is the definition of a panic disorder? | 1.Episodic periods of intense anxiety that occur suddenly and usually last about 30 min, without clear circumscribed stimulus. 2.Three attacks in 3-week period 3.abrupt onset of symptoms 4.peak within 10 minutes |
| What is the epidemiology of panic disorders? | 1. The mean age of onset is 25 years 2. 1.5% of population has disorder 3. 70% to 80% are women 4. 10% to 14% of cardiology patients have panic attacks |
| What are the clinical manifestations of panic disorder? | 1.great apprehension and fear 2.Palpitations 3.trembling 4.sweating 5.Fear of dying or going crazy 6.Hyperventilation 7.“air hunger” 8.Sense of unreality |
| Which panicogens can induce panic attacks? | 1.hyperventilation 2.carbon dioxide 3.yohimbine 4.sodium lactate 5.epinephrine |
| What is the treatment for panic attacks? | 1.Benzodiazepines: a.Alprazolam (a short-acting drug) b.Clonazepam (simulating the action of GABA) 2.Tricyclic antidepressants a.imipramine 3.SSRI,s a.sertraline b.fluoxetine 3.Carbon dioxide (for hyperventilation) |
| What is the prognosis for panic disorder? | 1.Panic disorder has a chronic course, with many recurrent episodes. 2.As many as 90% of patients experience a relapse when medication is discontinued. |
| What are phobias? | 1.Persistent or irrational fears of objects 2.avoidance of social or environmental situations because of the fear a.Public speaking (Glossophobia or speech anxiety) is the #1 phobia. |
| What are specific kinds of phobias? | Fear of specific objects: a.spiders, snakes, needle, heights b.Anxiety when faced with identifiable object c.Phobic object avoided d.Fear must be persistent and disabling |
| What is Agoraphobia? | Fear of open spaces with a sense of helplessness or humiliation, which manifests anxiety and panic-like symptoms. Travel restricted Often occurs with panic disorder |
| Gamophobia: | Fear of marriage (gam=gamete) |
| Algophobia: | An abnormal fear of pain (alg=pain) |
| Acrophobia: | Fear of heights (acro=height) |
| Trypanophobia: | The extreme and irrational fear of medical procedures involving injections or hypodermic needles |
| Hydrophobia: | Fear of water (such as liquids to drink) *a symptom of rabies |
| Osmophobia: | Hypersensitivity to smells causing aversion to odors. |
| How is stage fright treated medicinally? | 1.Beta blockers: a.atenolol b.propranolol 2.SSRI's: a.paroxetine *most common phobia |
| How is generalized social anxiety treated? | 1.MAO inhibitors: a. phenelzine 2.SSRI's: a. paroxetine |
| What is OCD? | Characterized by obsession and compulsions 1.Obsession: focusing on one thought, usually to avoid another 2.Compulsion: repetitive action shields person from thoughts, action "fixes" bad thought (out of control) |
| What is the epidemiology of OCD? | 1. 1.5% have disorder 2. 3% lifetime prevalence 3. 50% remain unmarried 4. Males = females 5. Major depression among 2/3rds over lifetime |
| What is the etiology of OCD? | 1.(EEG) abnormalities 2.(↓ REM sleep latency) 3.neuroendocrine abnormalities (similar to those seen in patients with depression) 4.serotonin is a closely associated NT 5.In 60% of cases symptoms of OCD first appear after a stressful life experience |
| What are s/s of OCD? | 1.Increased frontal lobe metabolism 2.Increased activity in the caudate nucleus The most common obsessions and compulsions include Contamination (e.g., cleaning after touching common objects) Checking Counting Putting things in order, etc |
| What is the treatment for OCD? | 1.SSRI's a.fluoxetine b.fluvoxamine 2.Tricyclic antidepressants a.clomipramine 3.Psychotherapy |
| What is the prognosis for OCD? | 1/3 of patients, symptoms improve significantly with treatment 1/3 of patients, symptoms improve moderately with treatment 1/3 symptoms do not improve or progressive deterioration in function occurs |
| What is generalized anxiety disorder? | persistent anxiety lasting at least 6 months with: 1.tension 2.sympathetic symptoms 3.parasympathetic symptoms 4.insomnia |
| What is the etiology of generalized anxiety disorder? | 1.more women(55%~60%) 2.men (40%~45%) 3.starts during 3rd decade of life 4.In 50% of patients, onset occurs during childhood and adolescence. 5.anxiety is unrelated to specific things 6.closely associated with major depressive disorder and dysthymia |
| What are the symptoms of generalized anxiety disorder? | 1.Fidgety & jumpy 2.Autonomic hyperactivity (heart pounding, sweating, chest pains) 3.Hyperventilation 4.fear, worry, rumination 5.difficulty concentrating 6.Vigilance and scanning (impatient, hyperactive,distracted) 7.Fatigue, insomnia & restlessnes |
| What is the treatment for generalized anxiety disorder? | 1.Relaxation therapy 2.desensitization 3.Anti-anxiety agents: A.Benzodiazepines: 1.Diazepam (GABA A receptor stimulator) B.Serotonin receptor agonists: 1.Buspirone |
| What is the Prognosis of generalized anxiety disorder? | 1.50% patients with GAD have chronic symptoms which wax and wane 2.The remaining patients become asymptomatic within a few years. *A major complication of long-term treatment is addiction to benzodiazepine anti-anxiety agents |
| What is post traumatic stress disorder? | 1.People who have had a severe physiological or psychological trauma are at risk for post-traumatic stress disorder 2.Symptoms must be exhibited for more than 1 month *if less, diagnose as acute stress disorder |
| What are the Manifestations of Post traumatic Stress Disorder (PTSD)? | 1.Flashbacks 2.Avoidance of associated stimuli 3.Diminished responsiveness to external world 4.Sleep disruption 5.Excess Irritability 6.Loss of control 7.Impulsivity 8.Headaches 9.Inability to concentrate 10.Repetition compulsion |
| What is the treatment for post traumatic stress disorder? | 1.Short-term psychotherapy 2.TCA's 3.MAO inhibitors |
| What is the prognosis of post traumatic stress disorder? | 1. 1/2 of patients with PTSD recover completely within 3 months 2. Many others have symptoms for a year or longer |
Created by:
czenecke
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