usmle6789
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25 yr old woman comes to the physician because of spells characterized by sweating, palpitations, SOB that have awakened her at night several times over the past 3 months. she resigned her job as a sales clerk 6 months ago and now works from home as a telemarketer. She recently began going to grocery store late at night because she feels too nervous with people around. She says that she has been feeling sad lately. She is completely oriented. Diagnosis?
1] Adjustment disorder with anxiety
2] Adjustment disorder with depressed mood
3] Dysthymic disorder
4] Generalized anxiety disorder
5] Major depressive disorder
6] panic disorder with agoraphobia
7] Post traumatic stress disorder
I don’t have clue to this question. Plz explain with answer.
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| ELM
Forum Guru
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Seems 6 to me. But i wander why she get panic attack in her sleep though? She gets dream of being in the closed cituations, may be?
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| lucky
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seems like a generalized anxiety disorder to me, because of her nocturnal symptoms. not very sure though but of the choices listed this seems the closest.
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| tamriko
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6.
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| ELM
Forum Guru
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Doesn't seem GAD to me, because she doesn't have any Sx of anxiety at all, she has no worries. Her Sxs are all related to panic attack.....phychologic plus physiologic changes. :|
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| noelle
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6..
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| lucky
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i agree ,seems more like a panic attack.
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| mdwannabe
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I agree with 6.
Certain people experience symptoms of Panic Dsordr in the middle of sleep. These are either caused by panic disorder or are identified as "night terrors". Most nocturnal panics take place during non-REM sleep, which means they do not tend to come in response to dreams or nightmares. They occur between a half-hour to three and a half hours after falling asleep and are usually not as severe as daytime panics.
Moreover, the last sentence states clearly smx of Agoraphobia.
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| Veer-Zaara
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6.
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