MGRADES EXAMS
NURS 5461 Anxiety UPDATED ACTUAL
Exam Questions and CORRECT Answers
ANXIETY DISORDERS - CORRECT ANSWER - Excessive—overestimate the danger •
Persistent, most develop in childhood—need to assess and treat in childhood • More in females
than males [2:1] • Need to ask or they may not report
WHAT ARE THE ANXIETY DISORDERS? - CORRECT ANSWER - • Anxiety—
Separation Anxiety; Panic Disorder, Agoraphobia, Social Anxiety Disorder, Generalized Anxiety
Disorder [GAD] • OCD and Related Disorders— OCD, Trichotillomania, Hoarding, Excoriation
Disorder • Trauma Disorders—PTSD, ASD, Adjustment Disorder • They are the most common
psychiatric disorders across the lifespan
GERIATRIC LATE LIFE ANXIETY DISORDERS - CORRECT ANSWER - • Difficult to
diagnose due to somatic symptoms and multiple medical issues • 2x more prevalent than
dementia; 4-8x more prevalent than MDD • GAD in 50%, 30% will have a specific phobia (e.g.
agoraphobia), 10% will have OCD, PD, or PTSD • Cognitive—hypervigilance to threat, seeing
oneself as vulnerable, and perceiving demands of life greater than resources, impact QOL,
morbidity/mortality-*must avoid benzos
frailty puts them at risk, also recent loss contribtes to anxiety risk
NEUROBIOLOGICAL BASIS OF ANXIETY - CORRECT ANSWER - • Frontal Lobes •
Higher psychological processes • Planning, decision making, impulse control, language,
memory, and others. • Neuronal circuitry in the frontal lobes is shaped and fine tuned during
adolescence • Experience plays a prominent role in these changes.
AMYGDALA - CORRECT ANSWER - • Role in emotional aspects of memory • Stored if
highly emotional consequences • Volume may vary based on genetics, traumatic experiences,
disorders • Enlarged amygdala volume & anxiety using MRI
depressed person smaller amygdala
*M w autism have fewer memory cells in amygdala
, MGRADES EXAMS
HIPPOCAMPUS - CORRECT ANSWER - • Essential to the formation of memory • Smaller
hippocampal volume in anxiety disorders • Smaller hippocampal volumes in pts with sexual
abuse.
depressed B hippoc. volume reduction
AMYGDALA AND STRESS—THE ANXIETY AND FEAR CIRCUITRY - CORRECT
ANSWER - Stress (traumatic event)→ senses → thalamus, where the stress is triaged →
prefrontal cortex to assess the level of danger (slow process) → amygdala • Prefrontal cortex
supposed to help process (impairment may be genetic) -->straight to amygdala• Severe
trauma/stress leads to un erasable fear response • Wired based on genetics (e.g. panic disorder)
AMYGDALA & TRAUMA - CORRECT ANSWER - Thalamus →Amygdala &
Hippocampus • Emotional valence to the experience causing motor responses & reflexes (startle,
facial expression) • Hypothalamus then causes neuroendocrine & autonomic responses (CRH
released) • Overactive amygdala → hyperarousal symptoms • Startle, Irritability, Angry
outbursts, Rage, Hypervigilance →reexperiencing symptoms
low cortisol=inc. risk for PTDS
CORTISOL & KINDLING—BRAIN SENSITIZATION TO STRESS - CORRECT
ANSWER - • Cortisol is our primary stress hormone • Exposure over time to high cortisol ↑
sensitivity of thalamus to stimuli of psychologically threatening nature • This is kindling! •
Stronger response to lower levels of stimuli • ↑ cortisol reactivity • Highly reactive to
environmental stimuli • Intrusive memories of trauma from cortisol effects in forming neural
networks of memory
PTSD - CORRECT ANSWER -
GLUTAMATE AND THE ADRENAL GLAND—HAVE MAJOR ROLES - CORRECT
ANSWER - Can cause secretion by the hippocampus and prefrontal cortex during the stress
[or trauma] • Creates strong & vivid memories by prolonging excitation of cells as it solidifies
the trauma memories-->Recurrent dreams & Intrusive thoughts • Causes excitotoxicity from
oxidative stress & cell destruction-->Avoidance and numbing symptoms • Amnesia from
dissociation
NURS 5461 Anxiety UPDATED ACTUAL
Exam Questions and CORRECT Answers
ANXIETY DISORDERS - CORRECT ANSWER - Excessive—overestimate the danger •
Persistent, most develop in childhood—need to assess and treat in childhood • More in females
than males [2:1] • Need to ask or they may not report
WHAT ARE THE ANXIETY DISORDERS? - CORRECT ANSWER - • Anxiety—
Separation Anxiety; Panic Disorder, Agoraphobia, Social Anxiety Disorder, Generalized Anxiety
Disorder [GAD] • OCD and Related Disorders— OCD, Trichotillomania, Hoarding, Excoriation
Disorder • Trauma Disorders—PTSD, ASD, Adjustment Disorder • They are the most common
psychiatric disorders across the lifespan
GERIATRIC LATE LIFE ANXIETY DISORDERS - CORRECT ANSWER - • Difficult to
diagnose due to somatic symptoms and multiple medical issues • 2x more prevalent than
dementia; 4-8x more prevalent than MDD • GAD in 50%, 30% will have a specific phobia (e.g.
agoraphobia), 10% will have OCD, PD, or PTSD • Cognitive—hypervigilance to threat, seeing
oneself as vulnerable, and perceiving demands of life greater than resources, impact QOL,
morbidity/mortality-*must avoid benzos
frailty puts them at risk, also recent loss contribtes to anxiety risk
NEUROBIOLOGICAL BASIS OF ANXIETY - CORRECT ANSWER - • Frontal Lobes •
Higher psychological processes • Planning, decision making, impulse control, language,
memory, and others. • Neuronal circuitry in the frontal lobes is shaped and fine tuned during
adolescence • Experience plays a prominent role in these changes.
AMYGDALA - CORRECT ANSWER - • Role in emotional aspects of memory • Stored if
highly emotional consequences • Volume may vary based on genetics, traumatic experiences,
disorders • Enlarged amygdala volume & anxiety using MRI
depressed person smaller amygdala
*M w autism have fewer memory cells in amygdala
, MGRADES EXAMS
HIPPOCAMPUS - CORRECT ANSWER - • Essential to the formation of memory • Smaller
hippocampal volume in anxiety disorders • Smaller hippocampal volumes in pts with sexual
abuse.
depressed B hippoc. volume reduction
AMYGDALA AND STRESS—THE ANXIETY AND FEAR CIRCUITRY - CORRECT
ANSWER - Stress (traumatic event)→ senses → thalamus, where the stress is triaged →
prefrontal cortex to assess the level of danger (slow process) → amygdala • Prefrontal cortex
supposed to help process (impairment may be genetic) -->straight to amygdala• Severe
trauma/stress leads to un erasable fear response • Wired based on genetics (e.g. panic disorder)
AMYGDALA & TRAUMA - CORRECT ANSWER - Thalamus →Amygdala &
Hippocampus • Emotional valence to the experience causing motor responses & reflexes (startle,
facial expression) • Hypothalamus then causes neuroendocrine & autonomic responses (CRH
released) • Overactive amygdala → hyperarousal symptoms • Startle, Irritability, Angry
outbursts, Rage, Hypervigilance →reexperiencing symptoms
low cortisol=inc. risk for PTDS
CORTISOL & KINDLING—BRAIN SENSITIZATION TO STRESS - CORRECT
ANSWER - • Cortisol is our primary stress hormone • Exposure over time to high cortisol ↑
sensitivity of thalamus to stimuli of psychologically threatening nature • This is kindling! •
Stronger response to lower levels of stimuli • ↑ cortisol reactivity • Highly reactive to
environmental stimuli • Intrusive memories of trauma from cortisol effects in forming neural
networks of memory
PTSD - CORRECT ANSWER -
GLUTAMATE AND THE ADRENAL GLAND—HAVE MAJOR ROLES - CORRECT
ANSWER - Can cause secretion by the hippocampus and prefrontal cortex during the stress
[or trauma] • Creates strong & vivid memories by prolonging excitation of cells as it solidifies
the trauma memories-->Recurrent dreams & Intrusive thoughts • Causes excitotoxicity from
oxidative stress & cell destruction-->Avoidance and numbing symptoms • Amnesia from
dissociation
