Friday 7 December 2012

Usmle Step 1 MCQ’s # 29

Title: Usmle Step 1 MCQ’s # 29
Subject: Behavioral Science

Q NO 29: A 34-year-old woman is brought to the physician by her husband, who says that her “disabling disorder” is ruining their lives. She is terrified of being “stuck” in a crowd, “trapped” on a bridge, or “locked” in a train or bus. She is “deathly afraid” of leaving the house alone, but she will occasionally go out on the weekends with her husband. She says that this condition began sometime in her 20’s, but cannot recall any event that triggered this behavior. She is very embarrassed about being “house bound.” Which of the following is the most likely diagnosis?

A. Agoraphobia
B. Arachnophobia
C. Avoidant personality disorder
D. Generalized anxiety disorder
E. Social phobia

Explanation:
The correct answer is A. This patient has agoraphobia, which is the intense tear of situations or places where it may be difficult to escape. It is often a disabling condition that causes the individual to have a tear of leaving home. These individuals are embarrassed about their behavior and may feel more comfortable going places with a companion. It can occur with or without panic disorder. Exposure therapy may be effective in these patients.
Arachnophobia (choice B) is an intense fear of spiders that can be triggered by seeing a spider, picturing a spider, or entering a situation where a spider may be encountered.
Individuals with avoidant personality disorder (choice C) are socially withdrawn however they desire relationships and dislike their isolation. They are hypersensitive and tear rejection. The patient in this case is scared of feeling “trapped” or being in a situation where she cannot escape, she is not socially isolated because she is shy or fears criticism.
Generalized anxiety disorder (choice D) is characterized by persistent worry about virtually every aspect of an individual’s life. The anxiety and worry must cause functional impairment, last at least 6 months, and be associated with at least 3 of the following: restlessness, fatigability, irritability, muscle tension, sleep disorders, and difficulty concentrating. The patient in this case is anxious about situations from which escape might be difficult she is not worried about all other aspects of her life.
Individuals with social phobia (choice E) are fearful of situations with unfamiliar people or when they maybe scrutinized by others. This tear must impair everyday activities and relationships. An example of a common social phobia is fear of giving a speech. The woman in this case is not tearful of the scrutiny of others she is scared of being unable to escape a situation or place.

Source: http://usmleworldwide.com/blog/?p=452

2 comments:

  1. Hi Pal! I wish to say that this post is awesome, nice written and include almost all important info’s. I’d like to see more posts like this.

    ReplyDelete
  2. Very interesting blog. A lot of blogs I see these days don't really provide anything that attract others, but I'm most definitely interested in this one. Just thought that I would post and let you know.

    ReplyDelete