Approach to anxiety disorders Quiz: Ace Your Exams
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A 19-year-old woman comes to the primary care clinic for a 6-month history of severe anxiety. She has no significant past medical, surgical, or psychiatric history. Her anxiety occurs suddenly without anything specific setting it off, and she experiences sweating, chest tightness, palpitations, and numbness around her lips. She often must leave the room she is in during an anxiety episode. She continues to work and participate in social gatherings though she has refused some invitations from friends lately because of worry about future attacks. For the past two months, she has been fearful and worried that these episodes could start while working or during class. She does not exhibit other fears or intrusive thoughts. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 15/min, and blood pressure is 135/85 mmHg. Cardiopulmonary examination is normal. Physical exam reveals an anxious-appearing woman who appears her stated age and uses a soft tone of voice. She is reactive and attenuates to noises outside the examination room. Neurological examination is normal. Which of the following is the most likely diagnosis?
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