Review Note
Last Update: 04/01/2024 02:31 AM
Current Deck: Neurology::Prior Rite Questions
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Text
A 30-year-old woman presents with a history of several episodes of extreme anxiety, sweating, and palpitations. Some of these episodes occurred while riding in a car, while others occurred while at home. Due to these episodes, she has developed a dislike for being in cars, which has limited her ability to work and socialize. What is the most likely diagnosis?
- Specific phobia
- Claustrophobia
- Generalized anxiety disorder
- Panic disorder
- Social phobia
Answer: {{c1::Panic disorder}}
Notes
Explanation of the Correct Answer:
- Recurrent unexpected panic attacks: The patient experiences sudden episodes of intense fear, characterized by anxiety, sweating, and palpitations.
- Variety of settings: The attacks occur in different situations (in a car and at home), which is a key feature of panic disorder.
- Behavioral changes due to attacks: The patient's aversion to riding in cars due to fear of these episodes indicates a significant change in behavior, a common consequence of panic disorder.
- Absence of specific triggers: Unlike specific phobias, panic disorder does not require a specific trigger for the onset of symptoms.
Analysis of Incorrect Answers:
- Specific Phobia:
- Characterized by an intense, irrational fear of specific situations, objects, or activities.
- The patient's symptoms are not limited to a specific situation or object.
- Claustrophobia:
- A type of specific phobia involving a fear of enclosed spaces.
- The patient's episodes also occur in non-enclosed spaces (like at home), making this diagnosis less likely.
- Generalized Anxiety Disorder:
- Involves persistent and excessive worry about various domains of life.
- The patient's symptoms are acute episodes of intense fear rather than chronic, generalized worry.
- Social Phobia:
- Fear of social situations where one is exposed to possible scrutiny by others.
- The patient's symptoms do not specifically involve social situations or fear of judgment.
Pathophysiology Outline:
- Panic Disorder:
- Etiology: Involves a combination of genetic, environmental, and psychological factors.
- Mechanism: Abnormal regulation of neurotransmitters, especially serotonin, and an overactive sympathetic nervous system.
- Progression: Characterized by recurrent panic attacks leading to persistent worry about additional attacks and changes in behavior to avoid them.
Use of Analogies:
- Think of panic disorder as an over-sensitive car alarm that goes off unpredictably, even in the absence of a real threat, causing significant distress and leading to behavioral changes (like avoiding parking the car in certain areas) to prevent the alarm from triggering. This analogy illustrates the unexpected and often unprovoked nature of panic attacks in panic disorder, along with the subsequent changes in behavior to avoid these distressing episodes.
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