CAM 3 Psychiatry
What is the 1st line tx option for seasonal affective disorder? - ANS SSRIs
What med has a specific indication for seasonal affective disorder? - ANS Bupropion (Wellbutrin)
True/False
20-25% of the population will experience anxiety disorders. - ANS true - super common!
What is the median age of onset for anxiety disorders? - ANS 12 y/o
How long must a pt have sx to be diagnosed w generalized anxiety disorder? - ANS 6 months
What questionnaire/scale is most commonly used in primary care for generalized anxiety disorder? -
ANS GAD-7
What is the 1st line tx for generalized anxiety disorder? - ANS SSRIs --> Escitalopram, citalopram,
Sertraline, Paroxetine
&
SNRIs
**almost always going w an SSRI**
Which antidepressant should be avoided in the tx of generalized anxiety disorder & why? - ANS
Bupropion bc it is very stimulating & can worsen anxiety
,What med can be added on to SSRIs short term while waiting on the effects to kick in for pts w
generalized anxiety disorder? - ANS benzos --> given for 1-2 weeks just to get em going
What anxiolytic drug can be given to pts w generalized anxiety disorder as monotherapy or adjunct
therapy? - ANS Buspirone (Buspar)
True/False
Benzodiazepines can be used long term for generalized anxiety disorder bc it is the most effect tx option.
- ANS false - only for short term use!
35-year-old female with a complaint of worry which she cannot control for the last year. She tells you
that her symptoms daily consisting of sleep disturbances, difficulty concentrating, and irritability. She
reports her symptoms started around age 17 but have worsened. What is your most likely dx & 1st line
tx option? - ANS generalized anxiety disorder
SSRI or SNRI
Which of the following symptoms is generally not characteristic of GAD?
A - awakening with apprehension and unrealistic concern about future misfortune
B - worry out of proportion to the likelihood or impact of feared events
C - a 6-month or longer course of anxiety and associated symptoms
D - association of the anxiety with depression
E - anxiety exclusively focused on health concerns - ANS E - anxiety exclusively focused on health
concerns
What is the psychotherapy of choice for this GAD?
A - cognitive-behavioral therapy (CBT)
B - hypnosis
,C - supportive psychotherapy
D - psychoanalytic psychotherapy
E - none of the above - ANS A - cognitive-behavioral therapy (CBT)
Which of the following pharmacologic agents is not recommended in the treatment of GAD?
A - venlafaxine
B - buspirone
C - benzodiazepines
D - selective serotonin reuptake inhibitors (SSRIs)
E - clozapine - ANS E - clozapine
When is the average age of onset for panic disorder? - ANS 22 y/o
How long do sx of worry following a panic attack have to persist to be diagnosed w panic disorder? - ANS
1 month
What is the DSM 5 criteria for diagnosing panic disorder? - ANS 1 month of worry after 1+ panic attack(s)
+
4 related sx --> SOB, palpiations, chest discomfort, GI upset, sweating, chills, dizziness, & more
What is considered first line in the long term treatment of panic disorder
A - Benzodiazepines
B - TCAs
C - SSRIs
D - Wellbutrin - ANS C - SSRIs
, 30-year-old male who arrives at your ED in distress stating that he had " a heart attack." The event
started suddenly and was associated with diaphoresis, chest pain, tachycardia, and tachypnea.
Troponins and ECG are within normal limits. Upon further questioning, he reports some numbing
around his lips and that he has such episodes every few days for the past three months. The attacks
have become so severe that he has been missing work and didn't go to last week's Christmas party. He
denies recreational or illicit drug use. He further shares that he recently divorced and has had no social
support. Recent lab results have all been normal or within standard limits, including TSH and vitamin
B12. What is your pt's most likely dx? - ANS panic disorder
___________ is fear or anxiety regarding places from which escape may be difficult. - ANS agoraphobia
What is the most disabling phobia bc it commonly interferes w life & work? - ANS agoraphobia
How long must sx persist to be dx w agoraphobia? - ANS 6+ months
How long must sx persist for any type of phobia to be diagnosed according to DSM 5? - ANS 6+ months
__________ is fear of social situations or situations involving scrutiny or involvement w strangers. - ANS
social anxiety disorder (social phobia)
How long must sx persist to make a dx of social anxiety disorder? - ANS 6+ months
21 y/o female presents to your office stating she is going to drop out of college. Pt states that for the last
8 months, she has been experiencing such crippling anxiety about going to class due to the fear of being
scrutinized by classmates & professors. It has become so bad that she avoids going to class so she does
not have to feel that degree of anxiety. What disorder does your pt most likely have? - ANS social
anxiety disorder
What is the 1st line tx for panic disorder? - ANS SSRIs
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