Anxiety Disorders

Question	Answer
77. A patient presents to your office with a complaint of intense fear of going to social functions at her child’s school. On further examination you note that she has fears that she will act in a way that will be humiliating or embarrassing. She is also made anxious by having to meet new people that she does not know. Your differential diagnosis of this patient should include which one of the following Axis II disorders? A. Borderline personality disorder B. Obsessive–compulsive personality disorder C. Narcissistic personality disorder D. Avoidant personality disorder E. Dependent personality disorder	D. Avoidant personality disorder
119. Which one of the following conditions has the highest prevalence? A. Depressive disorders B. Anxiety disorders C. Schizophrenia D. Dementia E. Substance abuse	B. Anxiety disorders
A young woman presents to the emergency room with complaints of palpitations, sweating, shortness of breath, chest pain, and nausea. She thinks that she is having a heart attack. Electrocardiogram (ECG) reveals normal sinus rhythm with no ischemic changes. Cardiac enzymes are not elevated. Given her symptoms, an alternative diagnosis would be: A. Manic episode B. Myxedema madness C. Mad Hatter syndrome D. Psychotic disorder not otherwise specified (NOS) E. Panic attack	E. Panic attack
A patient describes feeling anxious about being in places or situations from which escape may be difficult or in which help may not be available should the patient begin to panic. The patient avoids various situations because of these fears. The term that best describes this patient’s symptoms is: A. Agonothete B. Agoniada C. Agoraphobia D. Agora E. Agouara	C. Agoraphobia
A construction worker is brought to the emergency room immediately after an accident on a job site. He was standing very near a three-story scaffold that fell and missed crushing him by inches. He reports feeling anxiety, a sense of numbing, detachment, and difficulty remembering the accident and states that he feels like he is in a daze. The most likely diagnosis is: A. Generalized anxiety disorder B. Major depression C. Delirium D. Dissociative amnesia E. Acute stress disorder	E. Acute stress disorder
What is the difference between posttraumatic stress disorder and acute stress disorder? A. The nature of the trauma B. The symptoms that follow the trauma C. The impairment resulting from the symptoms D. The duration of the symptoms E. The age of the patient	D. The duration of the symptoms
A physician examines a female patient in the emergency room who has recently been diagnosed with a social phobia. Which one of the following answer choices would most likely be the greatest fear for this patient? A. Having to take responsibility for planning a dinner with her husband B. Being in a relationship with a new boyfriend C. Going to a state fair and being around thousands of people D. Being scrutinized by others E. Competing for a new position that just opened up in her company	D. Being scrutinized by others
Which one of the following medical conditions should not be considered when evaluating patients with anxiety disorders? A. Carcinoid syndrome B. Hyperventilation syndrome C. Hypoglycemia D. Hyperthyroidism E. Central serous chorioretinopathy	E. Central serous chorioretinopathy
What is the most important step in treating separation-anxiety disorder in an 11-year-old? A. Give methylphenidate B. Give risperidone C. Rapidly send the child back to school D. Thorough psychoanalysis of the mother E. High-dose benzodiazepine treatment	C. Rapidly send the child back to school
A patient comes to you 3weeks after witnessing a child hit by a car. Since then she has been having feelings of detachment and feels “in a daze.” She has recurrent thoughts and dreams about the event. She describes depersonalization. She has avoided discussing the event with friends and family and her sleep has been poor. What is the most appropriate diagnosis? A. Posttraumatic stress disorder B. Major depressive disorder C. Acute stress disorder D. Panic disorder E. Primary insomnia	C. Acute stress disorder
Which of the following anxiety disorders has equal rates in both males and females? A. Panic disorder B. Generalized anxiety disorder C. Social phobia D. Obsessive–compulsive disorder E. Specific phobia	D. Obsessive–compulsive disorder
Which of the following is the most significant risk factor for posttraumatic stress disorder and the best predictor of symptom development following exposure to trauma? A. A family history of anxiety or depression B. The availability of psychiatric care immediately following the trauma C. Low socioeconomic status D. Being single, divorced, or widowed E. The nature, severity, and duration of exposure to the trauma	E. The nature, severity, and duration of exposure to the trauma
Which of the following anxiety disorders is most common? A. Panic disorder B. Obsessive–compulsive disorder C. Posttraumatic stress disorder D. Specific phobia E. Generalized anxiety disorder	D. Specific phobia
Which one of the following is an appropriate Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM 5), specifier used for substance-induced anxiety disorder? A. With generalized anxiety B. With panic attacks C. With obsessive–compulsive symptoms D. With onset during withdrawal E. With delayed onset	D. With onset during withdrawal
A 25-year-old female comes to the psychiatrist complaining of irritability, poor concentration, and poor sleep. Which one of the following should not be included in the differential diagnosis? A. Generalized anxiety disorder B. Major depressive disorder C. Premenstrual dysphoric disorder D. Posttraumatic stress disorder E. Social anxiety disorder	D. Posttraumatic stress disorder
A patient with severe panic disorder comes to you for help. Which of the following is the most effective treatment you can offer her? A. Psychodynamic psychotherapy B. An SSRI C. Cognitive behavioral therapy D. A TCA E. Cognitive behavioral therapy plus an SSRI	E. Cognitive behavioral therapy plus an SSRI
Which of the following is not a common comorbidity associated with social phobia? A. Drug abuse B. Conversion disorder C. Alcohol abuse D. Other anxiety disorders E. Major depressive disorder	B. Conversion disorder
You start a patient in your practice on an SSRI for treatment of panic disorder. Which of the following medications can you add that will be effective, is FDA-approved for panic disorder, and will lead to a more rapid response? A. Buspirone B. Gabapentin C. Propranolol D. Topiramate E. Clonazepam	E. Clonazepam
A patient has a panic attack and then worries significantly about having more attacks. How long must the patient worry to meet DSM criteria for panic disorder? A. 1 week B. 2 weeks C. 1 month D. 3 months E. 6 months	C. 1 month
How long must a 42-year-old man have excessive anxiety to meet DSM 5 criteria for generalized anxiety disorder? A. 6 weeks B. 2 weeks C. 6 months D. 2 months E. 5 days	C. 6 months
Giving a patient cognitive behavioral therapy (CBT) plus an SSRI for social anxiety disorder will most likely result in which of the following? A. Better results than an SSRI alone B. Better results than CBT alone C. Poor results for refractory cases D. No initial benefit over monotherapy with either an SSRI or CBT in most cases E. Poorer response than psychodynamic psychotherapy alone	D. No initial benefit over monotherapy with either an SSRI or CBT in most cases
Which of the following could be expected for a patient with social phobia compared to the general population? A. Increased number of friendships B. Higher level of education C. Lower rates of suicide D. Poorer marital function E. Increased success in career advancement	D. Poorer marital function
Vignette Ten Lisa is a 22-year-old barista at a local coffee shop who comes to your office seeking help after feeling that she did not get any better with her primary care physician. She gives a long history of anxiety around other people dating back to childhood. At one point, while in high school, her mother pressured her to become a camp counselor to “overcome shyness.” Lisa was able to force herself to do it for a few weeks but then became overwhelmed by the anxiety and quit. She also went through a period of time during her school years when she wouldn’t use public restrooms or would use them only if they were completely empty. She got into trouble for leaving class to go to the restroom all of the time. When the restroom was empty during classes she felt the most comfortable using it. Now she reports being very anxious at work and at parties. She snuck out of the holiday party for her job because she was so uncomfortable. She worries that other people are judging her and won’t like her. She says that she feels stupid interacting with others, especially at work. She had quit a p	Vignette Ten questions /Answers - next 10 questions
1. Which of the following should be included in Lisa’s differential diagnosis? (Choose three of four) A. Panic disorder B. Schizoaffective disorder C. Social phobia D. Generalized anxiety disorder	A. Panic disorder C. Social phobia D. Generalized anxiety disorder
2. Given Lisa’s medication history, which other medications may be worth trying? (Choose three of four) A. Paroxetine B. Clonazepam C. Citalopram D. Bupropion	A. Paroxetine B. Clonazepam C. Citalopram
3. Which of the following has the best evidence to support its use for Lisa’s condition? A. Cognitive behavioral therapy B. Supportive psychotherapy C. Motivational interviewing D. Psychodynamic psychotherapy	A. Cognitive behavioral therapy
4. Lisa is most likely to be misdiagnosed with which of the following? (Choose two of four) A. Schizoid personality disorder B. Avoidant personality disorder C. Schizotypal personality disorder D. Dependent personality disorder	A. Schizoid personality disorder B. Avoidant personality disorder
5. Which diagnosis best explains Lisa’s avoidance of public restrooms during her school years? A. Specific phobia B. Panic disorder C. Social phobia D. Agoraphobia	C. Social phobia
6. The performance-only subtype of social phobia is most successfully treated by which one of the following? A. Benztropine B. Olanzapine C. Propranolol D. Lorazepam	C. Propranolol
7. The major concern of patients with social phobia is which one of the following? A. Avoidance of relationships B. The need for someone to be with them in stressful situations C. Fear of rejection D. Fear of embarrassment	D. Fear of embarrassment
8. How long does Lisa need to have symptoms to meet DSM criteria for social phobia? A. 2 weeks B. 2 months C. 6 weeks D. 6 months	D. 6 months
9. Which of the following are common side effects of Lisa’s condition? (Choose three of four) A. Blushing B. Dry mouth C. Sweating D. Fear of dying	A. Blushing B. Dry mouth C. Sweating
10. As many as one-third of patients with Lisa’s condition also meet criteria for which one of the following disorders? A. Major depressive disorder B. Agoraphobia C. Cocaine abuse D. Body dysmorphic disorder	A. Major depressive disorder
Video Vignette 6 - couldn't find in the textbook.	End of Anxiety Disorders Flashcards

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