AANP Family Nurse Practitioner (FNP) Certification ExamDiagnosisHard
A 30-year-old female presents with recurrent episodes of sudden, intense anxiety, accompanied by palpitations, sweating, trembling, shortness of breath, and a fear of losing control or dying. These episodes peak within minutes and last for about 15-30 minutes. She has started avoiding crowded places and public transportation due to fear of having another attack. Her physical exam and lab work are normal. What is the most likely diagnosis?
- ASpecific Phobia
- BPanic Disorder with Agoraphobia
- CGeneralized Anxiety Disorder
- DSocial Anxiety Disorder
Show answer & explanationAnswer & explanation
Correct answer: B. Panic Disorder with Agoraphobia
The patient's recurrent, unexpected panic attacks with associated physical symptoms and fear of recurrence, leading to avoidance behaviors (agoraphobia), are characteristic of Panic Disorder with Agoraphobia.
Why the other options are wrong
- A. Specific Phobia involves intense fear of a particular object or situation (e.g., heights, spiders), not spontaneous panic attacks or generalized avoidance of public spaces.
- C. Generalized Anxiety Disorder involves persistent and excessive worry about multiple areas of life, not discrete panic attacks or agoraphobia.
- D. Social Anxiety Disorder (social phobia) is characterized by fear of social situations where one might be scrutinized or embarrassed, not spontaneous panic attacks or broad avoidance of public places.
Panic Disorder with Agoraphobia
Panic disorder is characterized by recurrent unexpected panic attacks. Agoraphobia is an anxiety disorder characterized by fear and avoidance of situations where escape might be difficult or help unavailable during a panic-like symptom.
- Panic attacks involve sudden, intense fear and physical symptoms (palpitations, dyspnea, dizziness).
- Fear of future attacks leads to significant behavioral changes, including avoidance.
- Agoraphobia often develops as a complication, leading to avoidance of public places.
Memory trick: PANIC: Palpitations, Anxiety, Nausea, Intense fear, Chest pain.