Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Review Question - QID 220750

In scope icon N/A
QID 220750 (Type "220750" in App Search)
A 22-year-old man presents to the student health department at his university with a 6-month history of anxiety. He previously presented to the emergency department with sudden-onset palpitations when he first started graduate school. He had a negative cardiac workup, and he was discharged with a 24-hour Holter monitor, which was also negative. He has no history of any medical or psychiatric illnesses. Since his initial ED visit, he has had several episodes of unprovoked palpitations associated with feelings of dread and lightheadedness, though he cannot identify a particular trigger. He has begun sitting towards the back of the lecture halls so that he can “quickly escape and not make a scene” in case he has an episode in class. His temperature is 98.6°F (37°C), blood pressure is 135/82 mmHg, pulse is 83/min, and respirations are 12/min. Physical exam is unrevealing. An ECG is obtained, and the result is shown in Figure A. This patient's disorder is most associated with the development of which of the following conditions?
  • A

Anorexia

0%

0/0

Borderline personality disorder

0%

0/0

Major depressive disorder

0%

0/0

Post-traumatic stress disorder

0%

0/0

Schizotypal personality disorder

0%

0/0

  • A

Select Answer to see Preferred Response

This patient is having recurrent panic attacks with no clearly associated stimulus for a period greater than 1 month, which is consistent with a diagnosis of panic disorder. This condition is associated with the development of major depressive disorder.

Panic attacks are characterized by palpitations, chest pain, abdominal pain, paresthesias, fear of death, and choking among others. Sometimes, these symptoms may be clinically difficult to distinguish from an organic cause. Agoraphobia is associated with panic disorder and can take place in several settings, including auditoriums, trains, bridges, and even traffic. Panic disorder is also associated with major depression, anxiety, schizophrenia, obsessive-compulsive disorder, substance use disorders, phobias, and cluster C personality disorders such as avoidant, dependent, and obsessive-compulsive personality disorders. Treatment is cognitive behavioral therapy and selective serotonin reuptake inhibitors. Acute episodes of panic can be treated with benzodiazepines; however, this is not an appropriate chronic therapy, as this will lead to dependence.

Kunas et al. studied the effect of depressive comorbidities on patients with panic disorder. They found that cognitive-behavioral therapy is effective in improving depressive symptoms in patients with panic disorder as well. They recommend using cognitive-behavioral therapy to improve outcomes in patients with mental health disorders.

Figure/Illustration A is an ECG that demonstrates normal sinus rhythm without abnormalities (red circle). Patients with panic disorder will not have cardiac changes when they are at rest.

Incorrect Answers:
Answer 1: Anorexia is an eating disorder characterized by extreme weight loss (with a BMI < 17.5) and aversion to eating. It is associated with major depressive disorder, suicidality, obsessive-compulsive disorder, and other eating disorders. Patients often suffer from major electrolyte derangements.

Answer 2: Borderline personality disorder is a cluster B personality disorder characterized by splitting and unstable interpersonal relationships. It is associated with major depressive disorder, bipolar disorder, and substance use disorder.

Answer 4: Post-traumatic stress disorder is caused by a traumatic event and presents with flashbacks, nightmares, and anxiety. Unlike panic disorder, patients have specific previous events that trigger episodes. It is associated with other mood disorders such as major depressive disorder and bipolar disorder.

Answer 5: Schizotypal personality disorder is a cluster A personality disorder characterized by strange or magical thinking that is not frankly psychotic. Patients have stable but strange beliefs, such as healing crystals. It is associated with schizophrenia.

Bullet Summary:
Panic disorder is associated with major depressive disorder, agoraphobia, substance abuse, and bipolar disorder.

ILLUSTRATIONS:
REFERENCES (1)
Authors
Rating
Please Rate Question Quality

0.0

  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon

(0)