Fast Five Quiz: Generalized Anxiety Disorder

Stephen Soreff, MD

Disclosures

September 20, 2018

Hyperthyroidism is one of the most common medical causes for anxiety related to a medical condition. Serum thyroid-stimulating hormone and T4 levels should be considered for excluding a primary thyroid abnormality.

Electrolyte analysis is unnecessary, although several abnormalities may be present in the setting of hyperventilation. Serum phosphorus and ionized calcium may be diminished in patients with hyperventilation and carpopedal spasm, Chvostek sign, or Trousseau sign. The serum calcium level may be within the reference range.

Functional MRI and PET scans have shown increases in blood flow and metabolic activity in the orbitofrontal cortex, limbic structures, caudate, and thalamus, with a trend toward right-sided predominance, in patients with obsessive-compulsive disorder. However, these imaging modalities are of value for research, and not indicated for normal workups.

For more on the workup of GAD, read here.

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