Anxiety Disorders Practice Questions

Q: What is the most common type of phobia?

Specific phobia. **Explanation:** **Specific Phobia** is the correct answer because it is statistically the most common type of phobia and, in fact, the **most common anxiety disorder** in the general population. It involves an intense, irrational fear of a specific object or situation (e.g., animals, heights, blood-injection-injury). According to epidemiological data, the lifetime prevalence of specific phobias is approximately 10–12%. **Analysis of Incorrect Options:** * **B. Social Phobia (Social Anxiety Disorder):** While very common (lifetime prevalence ~7–12%), it ranks second to specific phobias. It is characterized by a persistent fear of social or performance situations where one might be scrutinized by others. * **C. Agoraphobia:** This involves fear of being in situations where escape might be difficult or help unavailable (e.g., crowds, open spaces). It is less common than specific and social phobias and is frequently associated with Panic Disorder. * **D. Claustrophobia:** This is a fear of enclosed spaces. It is not a separate diagnostic category but is actually a **subtype of Specific Phobia** (Situational type). **High-Yield Clinical Pearls for NEET-PG:** * **Gender Predominance:** Most phobias are more common in **females**, except for Blood-Injection-Injury phobia, which shows a more equal gender distribution. * **Blood-Injection-Injury Phobia:** Unique because it often leads to a **vasovagal response** (bradycardia and hypotension/fainting), whereas other phobias typically cause tachycardia. * **Treatment of Choice:** **Cognitive Behavioral Therapy (CBT)** with **Exposure Therapy** (Systematic Desensitization or Flooding) is the gold standard for specific phobias. Pharmacotherapy (like SSRIs) is more commonly used for Social Phobia and Agoraphobia.

Q: Acrophobia is defined as:

Fear of heights. **Explanation:** **Acrophobia** is a specific phobia characterized by an irrational and extreme fear of **heights**. The term is derived from the Greek word *'akron'*, meaning summit or edge. Patients with acrophobia experience significant anxiety or panic attacks when at an elevation, often leading to the avoidance of stairs, balconies, or high floors. **Analysis of Options:** * **Option A (Fear of being trapped):** This describes **Agoraphobia**. It involves anxiety about being in situations where escape might be difficult or help might not be available in the event of developing panic-like symptoms. * **Option C (Fear of animals):** This is known as **Zoophobia**. Specific animal phobias (e.g., Cynophobia for dogs, Ophidiophobia for snakes) are among the most common specific phobias. * **Option D (Fear of closed spaces):** This is **Claustrophobia**. It is a common specific phobia where individuals fear confinement in small, enclosed areas like elevators or MRI machines. **Clinical Pearls for NEET-PG:** 1. **Treatment of Choice:** For specific phobias like acrophobia, the most effective treatment is **Cognitive Behavioral Therapy (CBT)** with **Systemic Desensitization** or **Exposure Therapy** (specifically *In-vivo* exposure). 2. **Pharmacotherapy:** Benzodiazepines or Beta-blockers (Propranolol) may be used for short-term symptomatic relief of performance-related anxiety but are not first-line for long-term management. 3. **Epidemiology:** Specific phobias are more common in females and usually have an onset in early childhood or adolescence. 4. **Diagnosis:** According to DSM-5, the fear must be out of proportion to the actual danger and persist for **6 months or more**.

Q: A male patient presents with symptoms that mimic heart disease, but has a normal ECG and chest X-ray. What is the most likely diagnosis?

Panic attack. ### Explanation **Correct Answer: B. Panic attack** **1. Why it is correct:** A **Panic Attack** is characterized by a sudden episode of intense fear that triggers severe physical reactions, often mimicking a myocardial infarction (heart attack). Common symptoms include palpitations, chest pain, shortness of breath, and a sense of impending doom. In a clinical setting, if a patient presents with these "cardiac" symptoms but has a **normal ECG and chest X-ray**, a primary cardiac event is ruled out, making a psychiatric etiology like Panic Disorder the most likely diagnosis. The physical symptoms are driven by an acute surge in the sympathetic nervous system. **2. Why other options are incorrect:** * **A. Angina pectoris:** This is caused by reduced blood flow to the heart. While it presents with chest pain, it is usually associated with exertion and would typically show ischemic changes on an ECG or be supported by a history of cardiovascular risk factors. * **C. Autonomic nervous system instability:** This is a broad, non-specific term. While panic attacks involve autonomic arousal, "instability" is not a recognized clinical diagnosis for this specific presentation. * **D. Vasovagal attack:** This typically presents with **bradycardia and hypotension**, leading to syncope (fainting). In contrast, a panic attack usually involves tachycardia and hypertension. **3. High-Yield NEET-PG Pearls:** * **Duration:** Panic attacks usually peak within 10 minutes and last about 20–30 minutes. * **Diagnosis:** According to DSM-5, a Panic Disorder requires recurrent unexpected attacks followed by at least **one month** of persistent concern about future attacks. * **First-line Treatment:** SSRIs (Long-term) and Benzodiazepines (for acute abortive therapy). * **Differential:** Always rule out **Pheochromocytoma** (check urinary VMA) and **Hyperthyroidism** (check TSH) if symptoms are recurrent.

Question 1

Anxiety states can be induced by all of the following except?

Accepted Answer

Cholecystokinin

Answer

Yohimbine

Answer

Sodium Lactate

Answer

Isoproterenol

Question 2

What is the most common type of phobia?

Accepted Answer

Specific phobia

Answer

Social phobia

Answer

Agoraphobia

Answer

Claustrophobia

Question 3

Acrophobia is defined as:

Accepted Answer

Fear of heights

Answer

Fear of being trapped in a place where escape is difficult

Answer

Fear of animals

Answer

Fear of closed spaces

Question 4

A 18-year-old female develops breathlessness with perioral tingling, with two episodes in the past. What is your diagnosis?

Accepted Answer

Panic disorder

Answer

Obsessive-compulsive disorder

Answer

Acute respiratory distress

Answer

Phobic disorders

Question 5

A male patient presents with symptoms that mimic heart disease, but has a normal ECG and chest X-ray. What is the most likely diagnosis?

Accepted Answer

Panic attack

Answer

Angina pectoris

Answer

Autonomic nervous system instability

Answer

Vasovagal attack

Anxiety Disorders — MCQs

Anxiety Disorders — MCQs

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