Question 3
35 year old female salesperson comes to the ER with dypsnoea and palpitations. She is sure that this an asthmatic attack and she is going to die. These symptoms began while a bus ride to work. She has had similar symptoms earlier twice in last 2 weeks, and this is her third visit to ER for such a cause. She gives no history of chest pain. She says that there is a lot of stress at work due to the new management. She has no history of asthma or any other medical illnesses in the past. She is sexually active with a male partner and is taking OCPs to prevent pregnancy. Her physical examination is normal except for an increased pulse rate which is regular. What is the best possible diagnosis?
A) Hypochondriasis
B) Hyperthyroidism
C) Panic Attack
D) Pulmonary embolism
E) Generalised anxiety disorder
F) Acute Stress disorder
G) Pneumonia
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1 comments:
Answer: C) Panic Attack
The vignette most likely point out to the diagnosis of Panic disorder. Typically, the scenario would describe a female patient with dyspnea, sweating, palpitations, fainting, etc., and the patient feels like she would die soon. It is treated emergently with a benzodiazepene for quicker relief, and on a long term basis the patient may require an antidepressant, such as a SSRI along with behavioral therapy.
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