1A 23 y/o woman arrives at the ED complaining that out of the blue she had been seized by an overwhelming fear, associated w/ SOB & racing heart. The symptoms lasted 20 minutes. During that time she thought she was dying. She had 4 similar episodes in the last month & she's worried it will happen again. What is the probable dx?
Panic Disorder
2What is a core fear in pts w/ social anxiety disorder?
Revealing self-flaws and appearing socially incompetent
3What is one factor that improves exposure therapy outcomes when treating specific phobias?
Involvement of the therapist vs self-directed attempts
4How should the therapist approach exposure therapy for treatment of a specific phobia?
Gradually vs flooding
5What type of therapy is more beneficial for treating specific phobia?
Exposure therapy. However, CBT can be useful to help w/ catastrophic thoughts.
6Is pharmacotherapy first line treatment for a specific phobia?
No, psychotherapy is best but pharacotherapy can adjunct PRN.
7What neurotransmitter is released when fear is heightened and causes peripheral manifestations?
ACTH: transmits to nerves in the muscles to initiate movement
8How should benzodiazepines be prescribed for anxiety?
Short term (2-4 weeks) for pts w/ severe anxiety & unacceptable distress
For infrequent use, to permit exposure to situations evoking severe anxiety (flying)
In the initial weeks of SSRI/SNRI initiation to quickly reduce anxiety before the onst of SSRI/SNRI anxiolytic effects
NEVER for PRN for ongoing treatment of chronic mild-to-moderate anxiety
9A 22 y/o woman presents to her provider w/ the chief complaint that she is anxious about the way she looks. She notes that for "as long as she can remember" she has been obsessed about the fact that something must be wrong with her face. Her eyes are too far apart and her nose is mis-shapen. She spends her time isolated from others so they cannot see her face. The PMHNP does not notice anything unusual about her face and she cannot be consoled by this statement. What is the most likely dx?
Body dysmorphic disorder
10A 28 y/o taxi driver is chronically consumed by fears of having accidently run over a pedestrian. Although he tries to convince himself that his worries are silly, his anxiety continues to mount until he drives back to the scene of the "accident" and proves to himself that nobody lies hurt in hte street. This behavior best exemplifies what?
A compulsion secondary to an obsession
11A 34 y/o administrative assistant climbs 12 flights of stairs every day to reach her office because she is terrified by the thought of being trapped in an elevator. She has never had any traumatic event occur in an elevator; yet, she has been terrified of them since childhood. What is the dx?
Specific phobia
12What is an appropriate pharmacology treatment for a talented 21 y/o musician whose career may be in jeopary because of acute anxity whenever he plays in front of an audience?
Beta blocker
13What underlying pathophysiology is thought to be present in several anxiety disorders?
Impaired prefrontal function & hyper-responsive amygdala
14What is a component of CBT used for anxiety disorders?
Cognitive restructuring
15What conditions are highly comorbid with anxiety disorders?
schizophrenia
major depression
substance use disorder
**not associated w/ antisocial personality disorder
16What is the most appropriate pharmacological treatment for a woman who washes her hands hundreds of times a day out of fear of contaminations. She cannot stop herself, although her hands are raw and chafed.
SSRI
17What drugs or drug classes may elicit the acute effects of anxiety?
Cocaine, Albuterol, Amphetamines