AANP Family Nurse Practitioner (FNP) Certification ExamAssessmentHard
A 32-year-old female presents with recurrent episodes of palpitations, sweating, tremors, and a feeling of impending doom over the past 3 months. These episodes are sudden, peak within 10 minutes, and resolve spontaneously. She reports avoiding situations where these attacks have occurred, such as crowded places and driving on highways. Physical exam and routine lab work (CBC, TSH, electrolytes) are unremarkable. What is the most likely diagnosis?
- ASpecific Phobia
- BSocial Anxiety Disorder
- CPanic Disorder with Agoraphobia
- DGeneralized Anxiety Disorder
Show answer & explanationAnswer & explanation
Correct answer: C. Panic Disorder with Agoraphobia
The patient's presentation of recurrent, unexpected panic attacks (palpitations, sweating, tremors, feeling of doom) followed by persistent worry about additional attacks and maladaptive behavior to avoid them (avoiding crowded places, highways) is consistent with Panic Disorder with Agoraphobia.
Why the other options are wrong
- A. Specific Phobia involves intense fear of a particular object or situation (e.g., spiders, heights), not unexpected panic attacks leading to widespread avoidance.
- B. Social Anxiety Disorder involves intense fear of social situations due to fear of negative evaluation, not sudden panic attacks and broad avoidance of places.
- D. Generalized Anxiety Disorder involves persistent, excessive worry about multiple events/activities, not discrete panic attacks and associated avoidance.
Panic Disorder with Agoraphobia
Characterized by recurrent unexpected panic attacks and persistent worry about future attacks, often leading to agoraphobia (avoidance of situations where escape might be difficult or help unavailable).
- Recurrent, unexpected panic attacks.
- Fear of future attacks.
- Agoraphobia: avoidance of places/situations due to fear of panic attacks.
Memory trick: Anxiety's Branches: Worry, Panic, Social, Specific