A 41-year-old man has developed increasing anxiety over his job performance as a manager of an international corporation. He is Caucasian, holds a master’s of business administration degree, and has a long track record of professional success. Which therapeutic intervention for anxiety is this pa...
,A 41-year-old man has developed increasing anxiety over his job performance
as a manager of an international corporation. He is Caucasian, holds a
master’s of business administration degree, and has a long track record of
professional success. Which therapeutic intervention for anxiety is this patient
particularly suited for?
Cognitive behavioral therapy
A 26-year-old woman has developed generalized anxiety disorder over the
last year, and she has not benefited from cognitive behavioral therapy. At the
time of presentation she is in good physical health and has no psychiatric
comorbidities. You decide to treat her with medication. Which of the following
would be most appropriate?
SSRI or SNRI
A 48-year-old man complains of extreme anxiety whenever he visits his
parents, and over the last several years he has tried to avoid contact with
them. He also fears that he could act in a way that would make his family
disapprove of him. Going on actual visits over the last several years has
provoked extreme anxiety on each occasion. He realizes the fear is irrational
and it impairs his quality of life. He has no history of substance abuse or
mental disorder, and no other medical condition that could explain his
physiologic symptoms of anxiety. Which of the following is the most likely
diagnosis for this patient?
Nongeneralized social anxiety disorder
A 35-year-old man complains of extreme shyness in social situations that go
along with blushing, sweating, and, oftentimes, increased heart rate. He has
started to avoid social contact largely because of this anxiety. He also reports
missing interactions with friends and family. He shows symptoms of
depression and assumes the depression arises from social isolation. Which of
the following is the most likely diagnosis for this patient?
Generalized social anxiety disorder
,A 25-year-old woman who was raped is receiving cognitive behavioral therapy
for symptoms of acute stress disorder. Which of the following medication
classes may be prescribed to further reduce her symptoms and reduce her
risk of developing post-traumatic stress disorder?
SSRI
A 28-year-old woman has experienced a series of episodes of intense anxiety
that were accompanied by trembling, sweating, nausea, and feelings of being
detached from herself. The episodes have been occurring over the last 6
weeks and are always unexpected. The patient had developed a fear that
attacks could occur while she was in the company of other people, and she
has invented various strategies to spend the majority of her time by herself
both at home and at work. Which of the following is the most likely diagnosis
for this patient?
Panic disorder
A patient on methadone maintenance therapy is experiencing acute anxiety
and is being treated with alprazolam. Which potential effect of this drug
combination should be considered?
higher peak methadone levels
A 44-year-old woman has been treated for 4 weeks with diazepam for the
initial management of generalized anxiety disorder. Paroxetine was prescribed
for maintenance treatment and is now taking effect. How should the
termination of benzodiazepine treatment be managed?
taper diazepam over several weeks
A 26-year-old woman presents with generalized anxiety that leaves her
unable to go about her daily activities. Which of the following strategies is the
most promising to quickly control these symptoms?
benzodiazepines in combination with serotonin–norepinephrine reuptake
inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs)
, An 81-year-old woman nursing home resident has developed increased
anxiety, so benzodiazepine treatment is considered. How is the dosing of
benzodiazepines in this patient different from dosing in younger patients?
decreased drug clearance, increased plasma concentrations, increased
sensitivity to benzodiazepine effects
A 23-year-old woman presents with a complaint of not being able to stop
thinking about situations at her job and imagining situations in which she fails.
She says these thoughts are present throughout the day and consume
upward of 2 hours of her day. Because she is constantly fearful, she has
trouble going about her daily routines. As a result, she feels worthless and
also shows marked psychomotor agitation in the form of restless pacing. What
should her diagnosis be?
OCD
A 34-year-old woman has been having episodes during which she consumes
large amounts of food, often sweets and baked goods, in a relatively short
period of time. At presentation, her body mass index is 32 kg/m2. The
episodes usually occur between the time she returns from work and bedtime
and last 3-4 hours and recur 2-3 times per week. She is horrified by the
amount of weight she has gained over the last 5 months since her eating
episodes started. Upon questioning, she admits to inducing vomiting to undo
the eating episode. She feels she has little or no control over the eating
episodes and is deeply ashamed of her eating behavior. What should her
diagnosis be?
bulimia nervosa
A 27-year-old woman has been diagnosed with anorexia nervosa. Which
possible functional changes in the cardiovascular system should you be
aware of in this scenario?
bradycardia, hypotension, arrhythmia
A 27-year-old woman has been diagnosed with anorexia nervosa. Her current
body mass index is 16.5 kg/m2. She is living with her boyfriend and expresses
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