mohamed.ali
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6. A 27-year-old woman comes to the physician because of feelings of anxiety about attending her 10-year high school reunion. She has a 2-year history of profound anxiety, palpitations, and sweating associated with an uneasiness around people; she avoids family gatherings and visiting friends because she is afraid of being embarrassed. She acknowledges that this fear is unreasonable. She does not use illicit drugs but says that alcohol makes her more comfortable around people. Her blood pressure is 130/90 mm Hg, and pulse is 88/min. On physical examination, she appears healthy and well nourished. Occasional wheezing is heard over the left lung field. The remainder of the examination shows no abnormalities. On mental status examination, she appears worried. Her leukocyte count is 9000/mm3 with a normal differential. Which of the following is the most likely diagnosis?
A ) Alcohol abuse
B ) Anxiety disorder due to a general medical condition
C ) Asthma
D ) Generalized anxiety disorder
E ) Panic disorder with agoraphobia
F ) Social phobia
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is it D or F .. I'm confused ..plz reply
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| fandarast
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I would go for F
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| Al Durra
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straighr forward F social phobia
GAD as its name implies , there is no specific reason of the anxiety , so its GENERALIZED .
Panic attaks come OUT OF THE BLUE in no specific place , can come in front of the people and can come when you r alone . When the patient becomes fearful from its coming in front of the people , it is called Panic Attack associated with agrophobia
when the collection of anxiety Sx comes ONLY in front of the people ( social situations ) => social phobia
BTW , the treatment of choice for PANIC disorder is drugs , while the treatment of choice for Phobia is Psychotherapy
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| linaorvos
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f?
there is a specific social event to be afraid of...
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| peter90036
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read the case again: symptoms "associated with an uneasiness around people"
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| sarmich
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answer acc to me is E).. because she presents with the deifinition of Agoraphobia - fear of being in open places aroung people; Agoraphobia needs to be diagnonised as with or without panic. she clearly has s/s of [anic.. namely the palpitations..
its not D) beacuse she dosent report anxiety or panic when she is at home as would be the case with GAD and the reason she dosent want to attend is beacuse she is afraid of being embarassed, which is rather discreet -perfomance type disorder rather than GAD 9think of a lady lying awake in bed worrying about her cat's vaccination on the morrow)
E is more correct than F
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| peter90036
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| r_albayunen
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F for sure.
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| inkspot
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e
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| nyimalay
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F. Social Phobia
Uneasiness around people, avoidance of family gatherings and friends and feeling of embarrassment indicate social phobia.
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| Ivonne
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F for sure, it is specifically around people...
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