anxious anxious girls
I'm nervous!
Shakin in my boots
I want to go home
hot girls are anxious
100
the number #1 treatment for this type of anxiety is systematic desensitization or graded exposure
What is a specific phobia?
100
fear of or anxiety about places from which escape might be difficult or fear of developing panic attack symptoms, 6 mons or more
What is agoraphobia?
100
EXCESSIVE anxiety/worry about several events or activities for most days for 6 months or more
What is GAD?
100
A 61-year-old male comes to the office because of uncontrollable feelings of fear and sadness for the past six months. These feelings occur on most days, at home and at work, and have begun to affect his quality of life. He is otherwise in good health and he uses no medications or recreational drugs, including alcohol and tobacco. Examination shows no abnormalities. What is the most likely diagnosis?
Generalized anxiety disorder
100
C
200
In individuals with this anxiety disorder, avoidance is common and patients desire close relationships with others
What is social anxiety disorder?
200
diagnosis of substance-induced anxiety disorder requires that symptoms should start after this amount time using the substance
What is during use or within one month?
200
generalized anxiety disorder is associated with somatic symptoms; in fact, it required 3 somatic symptoms for diagnosis. List those symptoms.
muscle tension, irritability, difficulty sleeping, restlessness. fatigue, concentration difficulties
200
these drugs are infrequently used due to their AEs including: abuse potential, rapid tolerance, dependence, respiratory depression, lethality in OD, inducer of many hepatic enzymes
What are barbiturates?
200
A
300
this is the key differentiating factor between social phobia and agoraphobia
What is nature of the feared object?
300
this is the advantage of using CBT over pharmacotherapy in the treatment of panic disorder
What is a lower rate of relapse following discontinuation of treatment?
300
patients with anxiety disorders are often given benzos, if a patient had been given too much of lorezepam, this is the antidote
What is flumazenil?
300
this anxiolytic is only used on a short-term basis (i.e. for agitation with SCZ and bipolar)
What is dexmedetomidine?
300
A 14-year-old boy comes to the office with a six-month history of anxiety when using public restrooms. He has to go home from school every day at lunch to use the toilet. If he tries to enter a public restroom, he experiences anxiety and is unable to void. He fears someone may walk in, see him urinating, and laugh at him. What is the most likely diagnosis?
Social anxiety disorder
400
abrupt surge in intense fear/discomfort which peaks in minutes
What is a panic attack?
400
the #1 most common feature of this disorder is being embarrassed or humiliated in front of others
What is social anxiety disorder?
400
this onset of activation of this drug is 2-4 wks, it has not sedative or anticonvulsant activity, and is has no risk of dependence
What is buspirone?
400
A 36-year-old man is evaluated for an episode of dizziness while driving. Yesterday, while driving, he suddenly felt dizzy, developed palpitations, started shaking, and had profuse sweating. He briefly felt that he was losing control of his vehicle, which almost made him crash. He stopped driving, and the sensation faded in about an hour. He has no history of similar episodes, takes no daily medication, and has no unusual stressors in his life. Cardiac and neurologic testing are normal. What is the most likely diagnosis?
Panic attack!
*BONUS: Why isn't this panic disorder?
400
A 45-year-old man with a history of depression develops blurry vision, dry mouth, and urinary retention after his physician switched him to a new medication two weeks ago. Which of the following drugs is the most likely cause of these symptoms?
A. amytriptiline
B. bupropion
C. citalopram
D. sertraline
E. venlafaxine
A
*explanation: TCAs have antihistamine and anticholinergic effects
500
these are the criteria necessary for diagnosis of panic disorder
panic attacks with at least one of the attacks followed by 1 month of anxiety about future attacks OR change in behavior
500
A 24-year-old woman comes to the physician because of a 1-year history of intermittent episodes of shortness of breath, chest tightness, palpitation, dizziness, sweaty hands, and a feeling of impending doom. She says her symptoms usually occur within a few blocks of her apartment but she can avoid a “full attack” if she can get home fast enough. Over the past year she has adjusted her life to avoid “attacks” by working from home, having her groceries delivered to her apartment, and having her friends and boyfriend come to her apartment to visit. She says she knows it's excessive, but she has to have her boyfriend accompany her when she leaves the house, otherwise she would be too afraid of being alone outside her home. Within a few hours after each episode, physical examination and laboratory studies have shown no abnormalities. What is the most likely diagnosis?
agoraphobia
**BONUS: Why isn't it panic disorder?
500
these durugs are agonists that are positive allosteric modulators at GABA A receptors if only one a1 subunit is present => this leads to less tolerance, dependence, and withdrawal, but makes for a less effective anxiolytic
What are Z compounds? (zolpidem, zaleplon, etc)
500
Benzos are metabolized by these two mechanisms
What are CYPs (mostly CYP 3A4) and glucuronidation?
500
A 34-year-old woman presents to the emergency department with a migraine headache refractory to sumatriptan. She also takes fluoxetine for depression and omeprazole for gastroesophageal reflux. Soon after being administered meperidine for treatment of her migraine, she develops agitation, diaphoresis, fever, and incoordination. What is the most likely diagnosis?
serotonin syndrome