Anxiety

Question 1

Anxiety Disorders

Answer 1

• Specific phobia
• Social Anxiety Disorder
• Panic Disorder
• Agoraphobia
• GAD (Generalized Anxiety Disorder)

Question 2

Specific Phobia

Answer 2

• Anxiety

- Avoidance of specific object/situation

Question 3

Social Anxiety Disorder

Answer 3

• Anxiety

- Avoidance of social situations

Question 4

Panic Disorder

Answer 4

• Repeated unexpected panic attacks

- Concern/avoidance

Question 5

Agoraphobia

Answer 5

• Anxiety

- Avoidance of crowded/enclosed/open situations

Question 6

GAD

Answer 6

• Worry anxiety

- Somatic/cognitive/irritability symptoms

Question 7

Obsessive Compulsive/Related Disorders

Answer 7

• OCD
• Body Dysmorphic Disorder
• Hoarding Disorder
• Trichotillomania
• Excoriation Disorder

Question 8

OCD

Answer 8

• Obsessive Compulsive Disorder
• Obsessions/compulsions
• Impairment

Question 9

Body Dysmorphic Disorder

Answer 9

• Preoccupation with perceived bodily flaws

- Repetitive behavior

Question 10

Hoarding Disorder

Answer 10

• Difficulty discarding possessions due to distress

- Accumulation

Question 11

Trichotillamania

Answer 11

• Repeated pulling out of hair

- Difficulty stopping

Question 12

Excoriation Disorder

Answer 12

• Recurrent skin picking

- Difficulty stopping

Question 13

Trauma/Stressor-Related Disorders

Answer 13

• Acute Stress Disorder
• Post-traumatic Stress Disorder
• Adjustment Disorders

Question 14

Acute Stress Disorder

Answer 14

• Trauma
• Some PTSD symptoms
• < 1 month

Question 15

PTSD

Answer 15

• Trauma
• Intrusion
• Avoidance
• Mood disturbance
• Hyperarousal
• > 1 mo

Question 16

Adjustment Disorder

Answer 16

• Stress
• Significant emotional/behavioral symptoms
• Other disorders not present

Question 17

Neurophysiology + Anxiety

Answer 17

• Heightened “bottom up”: apprehension, fear and related memory functioning
• Lowered “top down”: cognitive and emotional regulation control of apprehension/fear

Question 18

Screening Tests

Answer 18

• GAD-7 for anxiety disorders (differing sensitivity/specificity)
• PC-PTSD-5: PTSD

Question 19

Anxiety Disorder NonPharm

Answer 19

• Cognitive behavioral therapy
• Exposure therapy
• Psychodynamic psychotherapy
• Somatic therapies: exercise, deep brain stimulation

Question 20

Anxiety Disorder Pharm

Answer 20

• SSRI
• SNRI
• 5HT2 antagonist
• 5HT1A partial agonist
• Multimodal serotonergic agents
• TCA
• MAOI
• Benzos

-CAM: Kava

Question 21

Serotonin Syndrome

Answer 21

• Difficult to study
• Precipitated by single or multiple serotonergic medications
• D/C med
• Use benzo
• Hypertensive, mydriasis, diarrhea, tremor, agitation

Question 22

Serotonin Withdrawal Syndrome

Answer 22

• D/C syndrome
• Malaise HA, imbalance, tremors, sleep disturbances, GI disturbances, anxiety
• Reassure or start fluoxetine and taper (less likely to cause)

Question 23

Pregnancy + Antidepressants

Answer 23

• Spontaneous abortion
• Preterm birth
• Neonatal withdrawal syndrome
• Cardiac malfunctions
• Sertraline and paroxetine minimally excreted in breast milk

Question 24

Benzos + Pregnancy

Answer 24

• CI
• Excreted in breast milk
• Hypoglycemia, respiratory suppression, neonatal withdrawal, “floppy” infant

Question 25

No Anti-Panic Property Drugs

Answer 25

- Buspirone - Propranolol - Hydroxyzine

Question 26

Panic Disorder Treatments

Answer 26

- Psychotherapy - SSRI or SNRI - Imipramine - Benzo

Question 27

Social Anxiety Disorder Treatment

Answer 27

- Psychotherapy - SSRI or SNRI - Gabapentin - Benzo - MAOI

Question 28

Acute Stress Treatments

Answer 28

- CHT - Cognitive Processing Therapy - Prolonged Exposure Therapy -Possibly: morphine, hydrocortisone, imipramine

Question 29

Ineffective for Acute Stress

Answer 29

- SSRI - Propranolol - Benzo

Question 30

PTSD Treatments

Answer 30

- Acute: psychotherapy or medication - Relapse: Medication - DON'T USE BENZOS

Question 31

PTSD Drug Options

Answer 31

- SSRI or SNRI - Prazosin augmentation - TCA - Quetiapine - Antipsychotic augmentation?

Question 32

OCD Treatment

Answer 32

- Medications/therapy for acute - Medications for relapse - SSRI or SNRI - Clomipramine - Augmentation with SDA

Question 33

Weight Gain Drugs

Answer 33

- Gabapentin - Amitriptyline - Mirtazapine - Olanzapine - Risperidone - Quetiapine - Divalproex

Question 34

Weight Loss Drugs

Answer 34

- Topiramate - Bupropion - Fluoxetine