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60ish female s/p recent AICD for a cardiomyopathy is gettin"shocked" more frequently and she has noticed most of these symptoms happened when she is entering basement. She now experienecs palpitations, dizziness, sweats and feeling of getting shocked again, everytime she even slightly opens the basement door. She has no other symptoms and has normal physical exam. what is most likely diagnosis?





5)Panic attack

And Why?


There is definit object which makes her fear.


Pt here experiencing symptoms....makes any difference?

mfw116688 wrote:
There is definit object which makes her fear.


she presented some symptoms analogous with Panic attack,i approve 5


4. phobia.




5 is right per uworld.


Agree...I thought this was a sure case of phobia, but was surprised with the answer

BlackRoSe wrote:
Panic attacks have no definite trigger. There is a trigger in this case. The symptoms of panic/anxiety are the same as the symptoms of fear. I conclude UW is wrong sticking out tongue.


This sounds like the anticipatory anxiety of a panic attack. Panic attacks can be situational and lead to agoraphobia. Only in panic disorder is the panic attack by definition "out of the blue"


i thought it was panic attack because to me phobia is just being scared and not wanting to put yourself in that particular situation. i mean if she had phobia then she will refrain from opening the basement door in the first place. btw whats AICD ? lol


simply put... since its asking "diagnosis"..

phobia (specific) is the right one.

as someone mentioned panic attack is a sx of phobia.

If they had put panic disorder as a choice.. then it would become a topic of real interest which would probably conclude with "poor question and lets leave at that". UW has known to be incorrect in several questions but overall they're great.

AICD = Automatic Implantable Cardioverter Defibrillator


lol i cant believe i asked whats AICD this was before internal medicine and sx rotation offcourse grin


Panic attack is a symptom of various anxiety disorder. Its not a DSM IV diagnosis so answer is phobia

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