QUESTIONS AND SOLUTIONS
◉ Depression with psychotic features. Answer: Mood disturbances
w/ delusions or hallucinations.
Varied sleep patterns.
Fluctuation in appetite
Severely impaired energy
Auditory/visual hallucinations or delusions.
Tx: SSRI/atypicals eg Sertraline with olanzapine.
◉ Dexamethasone suppression test. Answer: blood analysis for
cortisol levels after administration of synthetic glucocorticoid. Used
to evaluate cortisol levels in Cushings disease which is highly
comorbid with psych disorders.
◉ Generalized Anxiety Disorder (GAD). Answer: A disorder
characterized by chronic excessive worry accompanied by three or
more of the following symptoms: restlessness, fatigue, concentration
problems, irritability, muscle tension, and sleep disturbance.
Onset: Gradual
,Triggers: None
◉ Panic Disorder. Answer: An anxiety disorder marked by
unpredictable minutes-long (15-30min) episodes of intense dread in
which a person experiences terror and accompanying chest pain,
choking, or other frightening sensations, sweating, shaking, SOB.
Fear of death.
Onset: Sudden
Triggers: May be without trigger/or triggers that caused previous
attacks.
◉ Social Anxiety Disorder. Answer: an anxiety disorder involving the
extreme and irrational fear of being embarrassed, judged, or
scrutinized by others in social situations
◉ Tx for anxiety disorders. Answer: SSRI First line
SNRI (Venlafaxine)
Buspirone
TCA
Benzos fro short course
Remeron
, Antipsychotics/anticonvulsants (tx resistant) (quetiapine second
line GAD).
Beta blockers (SAD)
Hydroxyzine
◉ Neurobiology of Anxiety. Answer: Amygdala (perihinal cortex,
ventrolateral prefrontal cortex anterior insula)
Hippocampus
SAD- Medial temporal lobe: Amygdala hyper response
◉ Neurotransmitters associated with Anxiety Disorders. Answer:
Norepiniphrine High
Serotonin low
Dopamine low
GABA low
◉ Schizoaffective Disorder. Answer: Psychotic disorder featuring
symptoms of both schizophrenia and major mood disorder.
Onset: Late teens/early adulthood. May be later if mood dominant.
2-week period of psychotic symptoms without mood symptoms.