PANCE Blueprint Psychiatry - All Smarty PANCE psychiatry
flashcard lesson sets
What is generalized anxiety disorder (GAD)? - (SSRIs) and serotonin-norepinephrine reuptake
Excessive anxiety and worry about a inhibitors (SNRIs) are the first-line drug classes
number of activities or events that is present for generalized anxiety disorder.
more days than not for ≥ 6 months
Second line medications for the treatment of
DSM-5 criteria for GAD?- 1. Severe GAD?- Buspirone and Tricyclic
anxiety/worry about MANY topics, events, tasks antidepressants are second-line medications for
that occur MOST days > 6 months generalized anxiety disorder
2. At least 3 symptoms:
● Muscle tension This class of medications in small to moderate
● Fatigability doses may also be effective, although sustained
● Concentration difficulty use may lead to physical dependence-
● Restlessness Benzodiazepines (anxiolytics) in small to
● Irritability moderate doses may also be effective, although
● Sleep disturbances sustained use may lead to physical dependence.
Mnemonic to remember the symptoms of of Describe panic disorder?- Panic disorder is
GAD?- Mnemonic: Macbeth Frets occurrence of repeated panic attacks typically
Constantly Regarding Illicit Sins accompanied by fears about future attacks or
● Muscle tension changes in behavior to avoid situations that might
● Fatigability predispose to attacks
● Concentration difficulty
● Restlessness DSM V criteria for panic disorder?- 1. > 1
● Irritability panic attack that reoccurs w/o warning and >4
● Sleep disturbances symptoms
2. At least a month or more of worry or avoidant
Norepinephrine is _________ in patients with behavior
generalized anxiety disorder?-
Norepinephrine is increased in patients In order to be classified as panic disorder
with generalized anxiety disorder. patients need to experience the abrupt onset of
at least four of 13 symptoms. What are they? -
GABA and serotonin levels are ___________ in Patients need to experience the abrupt
patients with generalized anxiety disorder.- onset of at least four of the following 13
GABA and serotonin levels are decreased symptoms:
in patients with generalized anxiety disorder. ● pounding heart or fast heart rate
● chest pain or discomfort
What is the psychotherapy of choice for patients ● sweating
with generalized anxiety disorder?- ● trembling
Cognitive behavioral therapy is the ● shortness of breath
psychotherapy of choice for patients with ● nausea
generalized anxiety disorder. ● dizziness
● chills
First line medication for the treatment of GAD?- ● numbness
Selective serotonin reuptake inhibitors ● feelings of choking
,PANCE Blueprint Psychiatry - All Smarty PANCE psychiatry
flashcard lesson sets
● feelings of being detached from oneself If panic disorder is very severe, anti-
● fear of losing control seizure medications may sometimes be
● fear of dying prescribed
To diagnose panic disorder, how long must What are phobias?- Phobias are extreme,
symptoms be present?- To be considered often unreasonable and irrational fears of
panic disorder one must experience: recurrent, something, which could literally be anything
unexpected panic attacks with at least a month
or more of worry or avoidant behavior What are the three main types of phobias?-
There are three main types of phobias:
Patients with a panic disorder can’t predict where 1. Specific phobias
the panic attack will happen next and are likely to 2. Agoraphobia
develop what?- Patients with a panic 3. Social phobia
disorder can’t predict where the panic attack will
happen next, so it’s important to seek treatment Define specific phobic disorders?- Specific
before patients develop avoidance, which is phobic disorders consist of persistent,
when they actively avoid the places where a unreasonable, intense fears (phobias) of specific
panic attack previously occurred. situations, circumstances, or objects
What is it called when a patient experiences
Specific phobia DSM-V criteria?- Persistent
anxiety just thinking about the possibility of
(>6 months) intense fear/anxiety of specific
having a panic attack?- This is called object/situation/place
anticipatory anxiety
A type of specific phobia, is an exaggerated fear
The fear of going into crowded spaces?- of public spaces in which escape may be difficult.
Agoraphobia It is associated with panic disorder.-
Agoraphobia
What are the first-line agents for the
management of panic disorder?- Selective What places must people w/ agoraphobia fear to
serotonin reuptake inhibitors and SNRIs make a formal diagnosis (need 2)?- ●
(venlafaxine) are the first-line agents for the Public transportation
management of panic disorder ● Open spaces
● Enclosed spaces
What can be taken PRN for panic attacks?- ● Lines or crowds
Benzodiazepines and hydroxyzine ● Outside home
What has been an effective type of A type of specific phobia characterized by
psychotherapy for patients with panic disorder?- excessive fear of embarrassment in social
Cognitive-behavioral therapy has been an situations such as public speaking- Social
effective type of psychotherapy for patients with Anxiety Disorder (Social Phobia)
panic disorder
Treatment of specific phobias?- Treatment
If the panic disorder is very severe what class of of specific phobias is with systematic
medications may sometimes be prescribed?- desensitization to the stimulus
, PANCE Blueprint Psychiatry - All Smarty PANCE psychiatry
flashcard lesson sets
Treatment for social anxiety disorder?- In How often to check lithium when it is started?-
social anxiety disorder, patients can take Q2 weeks until @ maintenance (then Q4-8
benzodiazepines or beta-blockers for infrequent weeks)
anxiety-producing occasions.
Target level of lithium?- The target level of
Treatment for agoraphobia?- Cognitive lithium is 0.6 - 1.4 mEq/L
behavioral therapy and selective serotonin
reuptake inhibitors Toxic level of lithium?- > 2 mEq/L
What is bipolar disorder?- Bipolar disorder Second-line medical treatment for Bipolar II?-
is a mood disorder that is characterized by Antipsychotics (e.g. olanzapine,
episodes of mania, hypomania, and major risperidone, quetiapine)
depression. The subtypes of bipolar disorder
include bipolar I and bipolar II Other mood stabilizers used for bipolar disorder?
- Lamotrigine, carbamazepine, and valproic
More manic with some depression?- acid
Bipolar I
Valproic acid can cause what SEs?- ●
Hypomania with more (profound) depression?- Encephalopathy
Bipolar II (remember that bipolar II is ● Increased ammonia
depression > mania because depression is twice ● Thrombocytopenia
as big a word as mania) ● Hepatitis
● Pancreatitis
A milder form of bipolar disorder that lasts at ● Sedation
least two years and presents with fluctuating mild ● Weight gain
depressive and hypomanic symptoms-
Cyclothymic disorder is a milder form of SE of carbamazepine (Tegretol)?- Aplastic
bipolar disorder that lasts at least two years and anemia and SIADH (hyponatremia)
presents with fluctuating mild depressive and
hypomanic symptoms. Class of medication you never give to Bipolar I?-
SSRIs - They may worsen mania
How long does bipolar 1 have to last to be
considered a disorder?- At least 7 days + at Lamotrigine SE?- Steven Johnson
least 3 symptoms Syndrome (stop when you see a rash)
First-Line medical treatment for Bipolar I and
Lab to monitor for patients on lithium- TSH
Bipolar II?- Lithium (thyroid stimulating hormone)
Side effects of lithium?- ● Cognitive Manic episodes are a feature of this type of
impairment bipolar disorder?- Manic episodes are a
● Hypothyroid- HyperPTHism (so high Ca++) feature of type I bipolar disorder
● Edema
● Nephrogenic DI
flashcard lesson sets
What is generalized anxiety disorder (GAD)? - (SSRIs) and serotonin-norepinephrine reuptake
Excessive anxiety and worry about a inhibitors (SNRIs) are the first-line drug classes
number of activities or events that is present for generalized anxiety disorder.
more days than not for ≥ 6 months
Second line medications for the treatment of
DSM-5 criteria for GAD?- 1. Severe GAD?- Buspirone and Tricyclic
anxiety/worry about MANY topics, events, tasks antidepressants are second-line medications for
that occur MOST days > 6 months generalized anxiety disorder
2. At least 3 symptoms:
● Muscle tension This class of medications in small to moderate
● Fatigability doses may also be effective, although sustained
● Concentration difficulty use may lead to physical dependence-
● Restlessness Benzodiazepines (anxiolytics) in small to
● Irritability moderate doses may also be effective, although
● Sleep disturbances sustained use may lead to physical dependence.
Mnemonic to remember the symptoms of of Describe panic disorder?- Panic disorder is
GAD?- Mnemonic: Macbeth Frets occurrence of repeated panic attacks typically
Constantly Regarding Illicit Sins accompanied by fears about future attacks or
● Muscle tension changes in behavior to avoid situations that might
● Fatigability predispose to attacks
● Concentration difficulty
● Restlessness DSM V criteria for panic disorder?- 1. > 1
● Irritability panic attack that reoccurs w/o warning and >4
● Sleep disturbances symptoms
2. At least a month or more of worry or avoidant
Norepinephrine is _________ in patients with behavior
generalized anxiety disorder?-
Norepinephrine is increased in patients In order to be classified as panic disorder
with generalized anxiety disorder. patients need to experience the abrupt onset of
at least four of 13 symptoms. What are they? -
GABA and serotonin levels are ___________ in Patients need to experience the abrupt
patients with generalized anxiety disorder.- onset of at least four of the following 13
GABA and serotonin levels are decreased symptoms:
in patients with generalized anxiety disorder. ● pounding heart or fast heart rate
● chest pain or discomfort
What is the psychotherapy of choice for patients ● sweating
with generalized anxiety disorder?- ● trembling
Cognitive behavioral therapy is the ● shortness of breath
psychotherapy of choice for patients with ● nausea
generalized anxiety disorder. ● dizziness
● chills
First line medication for the treatment of GAD?- ● numbness
Selective serotonin reuptake inhibitors ● feelings of choking
,PANCE Blueprint Psychiatry - All Smarty PANCE psychiatry
flashcard lesson sets
● feelings of being detached from oneself If panic disorder is very severe, anti-
● fear of losing control seizure medications may sometimes be
● fear of dying prescribed
To diagnose panic disorder, how long must What are phobias?- Phobias are extreme,
symptoms be present?- To be considered often unreasonable and irrational fears of
panic disorder one must experience: recurrent, something, which could literally be anything
unexpected panic attacks with at least a month
or more of worry or avoidant behavior What are the three main types of phobias?-
There are three main types of phobias:
Patients with a panic disorder can’t predict where 1. Specific phobias
the panic attack will happen next and are likely to 2. Agoraphobia
develop what?- Patients with a panic 3. Social phobia
disorder can’t predict where the panic attack will
happen next, so it’s important to seek treatment Define specific phobic disorders?- Specific
before patients develop avoidance, which is phobic disorders consist of persistent,
when they actively avoid the places where a unreasonable, intense fears (phobias) of specific
panic attack previously occurred. situations, circumstances, or objects
What is it called when a patient experiences
Specific phobia DSM-V criteria?- Persistent
anxiety just thinking about the possibility of
(>6 months) intense fear/anxiety of specific
having a panic attack?- This is called object/situation/place
anticipatory anxiety
A type of specific phobia, is an exaggerated fear
The fear of going into crowded spaces?- of public spaces in which escape may be difficult.
Agoraphobia It is associated with panic disorder.-
Agoraphobia
What are the first-line agents for the
management of panic disorder?- Selective What places must people w/ agoraphobia fear to
serotonin reuptake inhibitors and SNRIs make a formal diagnosis (need 2)?- ●
(venlafaxine) are the first-line agents for the Public transportation
management of panic disorder ● Open spaces
● Enclosed spaces
What can be taken PRN for panic attacks?- ● Lines or crowds
Benzodiazepines and hydroxyzine ● Outside home
What has been an effective type of A type of specific phobia characterized by
psychotherapy for patients with panic disorder?- excessive fear of embarrassment in social
Cognitive-behavioral therapy has been an situations such as public speaking- Social
effective type of psychotherapy for patients with Anxiety Disorder (Social Phobia)
panic disorder
Treatment of specific phobias?- Treatment
If the panic disorder is very severe what class of of specific phobias is with systematic
medications may sometimes be prescribed?- desensitization to the stimulus
, PANCE Blueprint Psychiatry - All Smarty PANCE psychiatry
flashcard lesson sets
Treatment for social anxiety disorder?- In How often to check lithium when it is started?-
social anxiety disorder, patients can take Q2 weeks until @ maintenance (then Q4-8
benzodiazepines or beta-blockers for infrequent weeks)
anxiety-producing occasions.
Target level of lithium?- The target level of
Treatment for agoraphobia?- Cognitive lithium is 0.6 - 1.4 mEq/L
behavioral therapy and selective serotonin
reuptake inhibitors Toxic level of lithium?- > 2 mEq/L
What is bipolar disorder?- Bipolar disorder Second-line medical treatment for Bipolar II?-
is a mood disorder that is characterized by Antipsychotics (e.g. olanzapine,
episodes of mania, hypomania, and major risperidone, quetiapine)
depression. The subtypes of bipolar disorder
include bipolar I and bipolar II Other mood stabilizers used for bipolar disorder?
- Lamotrigine, carbamazepine, and valproic
More manic with some depression?- acid
Bipolar I
Valproic acid can cause what SEs?- ●
Hypomania with more (profound) depression?- Encephalopathy
Bipolar II (remember that bipolar II is ● Increased ammonia
depression > mania because depression is twice ● Thrombocytopenia
as big a word as mania) ● Hepatitis
● Pancreatitis
A milder form of bipolar disorder that lasts at ● Sedation
least two years and presents with fluctuating mild ● Weight gain
depressive and hypomanic symptoms-
Cyclothymic disorder is a milder form of SE of carbamazepine (Tegretol)?- Aplastic
bipolar disorder that lasts at least two years and anemia and SIADH (hyponatremia)
presents with fluctuating mild depressive and
hypomanic symptoms. Class of medication you never give to Bipolar I?-
SSRIs - They may worsen mania
How long does bipolar 1 have to last to be
considered a disorder?- At least 7 days + at Lamotrigine SE?- Steven Johnson
least 3 symptoms Syndrome (stop when you see a rash)
First-Line medical treatment for Bipolar I and
Lab to monitor for patients on lithium- TSH
Bipolar II?- Lithium (thyroid stimulating hormone)
Side effects of lithium?- ● Cognitive Manic episodes are a feature of this type of
impairment bipolar disorder?- Manic episodes are a
● Hypothyroid- HyperPTHism (so high Ca++) feature of type I bipolar disorder
● Edema
● Nephrogenic DI
