Treating Patients with Anxiety Disorders | Evidence-Based
Guidelines | Complete Solutions | Pass Guaranteed - A+
Graded
Getting Started: Assessment & Differential Diagnosis of Anxiety
Disorders
9 Questions
Q1: A 34-year-old woman presents to the clinic complaining that she has been "worrying
about everything" for the past 8 months. She reports difficulty controlling her worry
about work performance, finances, her children's safety, and her health. She notes
restlessness, muscle tension in her shoulders, difficulty falling asleep, and trouble
concentrating at work. Her physical exam is unremarkable, and TSH is within normal
limits. Based on DSM-5 criteria, which diagnosis is most appropriate?
A. Panic disorder with agoraphobia
B. Generalized anxiety disorder [CORRECT]
C. Social anxiety disorder
D. Adjustment disorder with anxiety
Correct Answer: B
Rationale: This patient meets DSM-5 criteria for GAD: excessive anxiety and worry
occurring more days than not for at least 6 months, difficulty controlling worry, and three
,or more associated symptoms (restlessness, muscle tension, sleep disturbance,
difficulty concentrating). Option A requires recurrent unexpected panic attacks, which
are not described. Option C requires fear of social scrutiny, not present here. Option D
requires identification of a specific stressor within 3 months of onset, and symptoms
typically resolve within 6 months of stressor removal.
Q2: A 28-year-old man reports three episodes in the past month where he suddenly felt
his heart racing, chest tightness, shortness of breath, and dizziness, accompanied by an
intense fear that he was dying or losing control. He has been avoiding crowded places
because he fears having another episode. He has no medical conditions and his EKG is
normal. Which diagnosis best fits this presentation?
A. Generalized anxiety disorder
B. Social anxiety disorder
C. Panic disorder with agoraphobia [CORRECT]
D. Specific phobia
Correct Answer: C
Rationale: This patient has recurrent unexpected panic attacks with persistent worry
about future attacks and maladaptive avoidance behavior (agoraphobia), meeting
criteria for panic disorder with agoraphobia. Option A lacks the discrete panic attack
pattern. Option B involves social evaluation fears, not panic symptoms. Option D
requires a specific phobic object or situation, not panic attacks.
Q3: A 42-year-old man is referred by his primary care provider for evaluation of anxiety.
He reports avoiding business meetings, refusing promotions that require public
speaking, and declining social invitations because he fears being judged or humiliated.
When forced into social situations, he experiences blushing, trembling, and nausea.
, These symptoms have been present since adolescence. Which screening tool would be
most appropriate to quantify the severity of his symptoms?
A. GAD-7
B. Panic Disorder Severity Scale (PDSS)
C. Liebowitz Social Anxiety Scale (LSAS) [CORRECT]
D. Beck Anxiety Inventory (BAI)
Correct Answer: C
Rationale: The LSAS is specifically designed to assess fear and avoidance in social
situations, making it the ideal tool for social anxiety disorder. Option A screens for
generalized anxiety. Option B assesses panic disorder severity. Option D is a general
anxiety measure but lacks the social-specific domains needed here.
Q4: A 38-year-old woman presents with anxiety, palpitations, heat intolerance, and a
10-pound weight loss over 2 months. Her TSH is 0.2 mIU/L (low) and free T4 is
elevated. She has been drinking 4–5 cups of coffee daily. Which of the following is the
most appropriate initial management before considering a primary anxiety disorder
diagnosis?
A. Start sertraline 50 mg daily for presumed GAD
B. Treat the hyperthyroidism and reduce caffeine intake, then reassess anxiety
symptoms [CORRECT]
C. Prescribe lorazepam 1 mg twice daily for immediate relief
D. Order a 24-hour urine catecholamine collection
Correct Answer: B
Rationale: Anxiety due to another medical condition (hyperthyroidism) and
substance-induced anxiety (caffeine) must be ruled out before diagnosing a primary
anxiety disorder. Treating the underlying cause (Option B) is essential. Option A would