Anxiety Disorders Practice Questions

Q: A 25-year-old female presents with a sudden onset of severe headache, palpitations, and a feeling of impending doom. Physical examination reveals no abnormalities. What is the most likely diagnosis?

Panic disorder. ***Panic disorder*** - This presentation describes a classic **panic attack**, which is the hallmark feature of panic disorder, characterized by a sudden onset of intense fear or discomfort that peaks within minutes, accompanied by physical symptoms like **palpitations**, **headache**, and a feeling of **impending doom**. - The lack of specific physical abnormalities on examination further supports a psychological origin rather than an organic cause. - Panic disorder is diagnosed when there are **recurrent unexpected panic attacks** along with persistent concern about additional attacks or their consequences. *Generalized anxiety disorder* - This condition involves **persistent and excessive worry** about various aspects of life for at least 6 months, not typically sudden, acute episodes. - While physical symptoms like headaches can occur, they are generally part of a chronic state of tension and worry, not a sudden, overwhelming attack as described. *Social anxiety disorder* - This disorder is characterized by **intense fear or anxiety regarding social situations** where the individual might be scrutinized or embarrassed. - The symptoms are specifically tied to social interaction and not a generalized, unprovoked attack as described. *Post-traumatic stress disorder* - PTSD involves the development of characteristic symptoms like **re-experiencing traumatic events**, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity, following exposure to a traumatic event. - The patient's presentation does not describe a history of trauma or other PTSD-specific symptoms.

Q: A 40-year-old woman presents with excessive worry about her health, frequently visits doctors, and demands multiple tests despite no significant findings. What is the most likely diagnosis?

Illness anxiety disorder. **Illness anxiety disorder** - This disorder is characterized by **preoccupation with having or acquiring a serious illness**, despite minimal or no somatic symptoms, leading to high levels of anxiety about health. - Individuals frequently **seek medical attention and reassurance**, often demanding multiple tests, despite negative findings. *Panic disorder* - Marked by recurrent, unexpected **panic attacks**, which are sudden episodes of intense fear accompanied by physical symptoms like palpitations and shortness of breath. - While it involves anxiety, the central feature is not a persistent worry about having a specific illness. *Generalized anxiety disorder* - Characterized by **persistent and excessive worry** about various aspects of life, not specifically about having a serious illness. - The worry is often difficult to control and is associated with symptoms like restlessness, fatigue, and difficulty concentrating. *Somatic symptom disorder* - Involves **one or more somatic symptoms that are distressing or result in significant disruption of daily life**, accompanied by excessive thoughts, feelings, or behaviors related to these symptoms. - Unlike illness anxiety disorder, where the focus is on the *fear* of illness, in somatic symptom disorder, the primary concern is the actual physical symptoms themselves.

Q: A 35-year-old man experiences recurrent episodes of intense fear, chest pain, and a feeling of impending doom. What is the most likely diagnosis?

Panic disorder. ***Panic disorder*** - Characterized by **recurrent, unexpected panic attacks** involving sudden, intense fear, physical symptoms like chest pain, and a feeling of impending doom. - The symptoms described (intense fear, chest pain, feeling of impending doom) are classic manifestations of a **panic attack**. *Generalized anxiety disorder* - Involves **persistent and excessive worry** about everyday events, not discrete episodes of intense fear. - While anxiety is present, it does not typically manifest as acute, episodic attacks with such severe physical symptoms. *Post-traumatic stress disorder* - Develops after exposure to a **traumatic event** and is characterized by intrusive memories, avoidance, negative alterations in cognition and mood, and hyperarousal. - The question does not mention any prior trauma, and the symptoms are more acute and episodic than the persistent re-experiencing seen in PTSD. *Social anxiety disorder* - Involves **marked fear or anxiety about social situations** where the individual may be scrutinized by others. - While anxiety occurs in social contexts, it does not typically present as sudden, unprovoked attacks of intense fear and physical symptoms like those described.

Q: A 40-year-old male presents with sudden episodes of intense fear, palpitations, and shortness of breath lasting about 10 minutes. He is afraid of having another attack. What is the diagnosis?

Panic disorder. ***Panic disorder*** - Characterized by recurrent, **unexpected panic attacks** with sudden onset of intense fear and physical symptoms like palpitations and shortness of breath. - The fear of having another attack ("**anticipatory anxiety**") is a key diagnostic criterion for panic disorder. *Generalized anxiety disorder* - Involves **persistent and excessive worry** about various areas of life, not sudden, discrete panic attacks. - Symptoms are more chronic and pervasive, rather than episodic and intense. *Social anxiety disorder* - Marked by intense fear or anxiety about **social situations** where the individual might be scrutinized or judged. - The symptoms are triggered by social performance or interaction, not unexpected attacks. *Specific phobia* - Characterized by an intense, irrational fear of a **specific object or situation** (e.g., heights, spiders). - Panic-like symptoms occur only in response to the specific phobic stimulus, not unexpectedly.

Q: A 25-year-old woman experiences persistent, excessive worrying about multiple events or activities for the past 8 months. What is the most appropriate diagnosis?

Generalized anxiety disorder. ***Generalized anxiety disorder*** - This condition is characterized by **persistent, excessive worry** about various events or activities for at least **six months**, which aligns with the patient's presentation of 8 months of worry. - The worry is often difficult to control and is associated with symptoms like **restlessness**, **fatigue**, difficulty concentrating, irritability, muscle tension, and sleep disturbance. *Panic disorder* - This disorder involves recurrent, unexpected **panic attacks**, which are sudden episodes of intense fear accompanied by physical symptoms such as palpitations, shortness of breath, and dizziness. - It does not primarily involve persistent, generalized worrying about multiple life domains, but rather fear of future panic attacks. *Obsessive-compulsive disorder* - This condition is characterized by the presence of **obsessions** (recurrent, intrusive thoughts or urges) and/or **compulsions** (repetitive behaviors or mental acts performed to reduce anxiety). - While it involves anxiety, the nature of the anxiety is distinct from the free-floating worry seen in the patient, being tied to specific intrusive thoughts and rituals. *Social anxiety disorder* - This disorder involves intense fear or anxiety about social situations where the individual might be scrutinized or judged by others. - The patient's symptoms describe **generalized worry** about multiple events, not specifically fear related to social performance or interaction.

Q: Generalized anxiety disorder is diagnosed when anxiety and worry continue for at least?

6 months. ***6 months*** - This duration is a key diagnostic criterion for **Generalized Anxiety Disorder (GAD)**, as defined by the **DSM-5**. - It signifies that the **excessive anxiety and worry** about various events or activities are chronic and persistent, indicating a pervasive condition rather than a transient reaction to stress. *2 months* - This duration is **too short** to meet the diagnostic criteria for GAD according to the DSM-5. - A shorter period of anxiety might be indicative of an **acute stress disorder** or a specific phobia, but not generalized anxiety. *4 months* - While a significant duration, **4 months** does not meet the minimum diagnostic timeframe for GAD. - The persistence of symptoms beyond this point, specifically up to 6 months, is crucial for diagnosis. *8 months* - While 8 months of symptoms certainly qualifies for GAD, the **minimum duration** for diagnosis is 6 months. - This option incorrectly suggests a longer minimum period than is actually required by diagnostic manuals.

Q: What is the term for an extreme or irrational fear of darkness?

Fear of darkness. ***Fear of darkness*** - **Nyctophobia** is the specific and persistent **irrational fear of darkness** or night. - This phobia can cause significant distress and impairment in daily life, often leading to avoidance of dark environments. *Fear of confined spaces* - This describes **claustrophobia**, which is the fear of being in **tight or enclosed spaces**. - While it can be exacerbated in dark confined spaces, the primary fear is of the confinement itself, not the darkness. *Fear of strangers or foreigners* - This is known as **xenophobia**, an intense or irrational dislike or fear of people from other countries or cultures. - This is unrelated to the fear of darkness, as it pertains to social and cultural anxieties. *Fear of germs or dirt* - This condition is called **mysophobia**, characterized by an **irrational fear of contamination** by germs, dirt, or disease. - It often manifests as excessive handwashing or avoidance of public places, and is distinct from nyctophobia.

Q: A student unable to deliver speech before an audience is suffering from?

Social anxiety disorder. ***Social anxiety disorder*** - This condition involves an intense, persistent fear of social situations, particularly those where one might be scrutinized or judged by others. - Public speaking is a classic scenario that can trigger significant distress and avoidance in individuals with **social anxiety disorder**. *Fear of open spaces* - This symptom describes **agoraphobia**, which is an anxiety disorder characterized by fear and avoidance of situations or places that might cause panic, helplessness, or embarrassment, often due to a perceived inability to escape. - While it can sometimes involve fear of public gatherings, its core is about escape/safety from open, unfamiliar, or overwhelming spaces, not specifically about performance. *Fear of enclosed spaces* - This refers to **claustrophobia**, which is an anxiety disorder characterized by an irrational fear of confined spaces. - It does not involve the fear of speaking or performance before an audience. *Obsessive Compulsive Disorder* - **OCD** is characterized by recurrent and persistent thoughts (obsessions) and/or repetitive behaviors or mental acts (compulsions) performed to reduce anxiety. - It does not typically manifest as an inability to deliver a speech before an audience unless the obsessions or compulsions directly interfere with such an activity, which is not the primary mechanism of this symptom.

Q: Which of the following is NOT a characteristic feature of somatization disorder?

Rejection of the sick role. ***Rejection of the sick role*** - Patients with somatization disorder (now classified under **somatic symptom disorder** in DSM-5) characteristically **embrace the sick role**, not reject it - They actively seek medical attention, present with multiple chronic physical symptoms, express significant distress, and often become preoccupied with their perceived illnesses - This adoption of the sick role is a key behavioral pattern distinguishing somatization disorder from malingering or factitious disorder *Absence of pseudo-neurological symptoms* - This is incorrect because **pseudo-neurological (conversion) symptoms** are characteristic features of somatization disorder - Examples include paralysis, blindness, seizures, sensory loss, aphonia, and loss of coordination - These symptoms resemble neurological conditions but lack organic pathology *Absence of pain symptoms* - This is incorrect because **pain symptoms** are among the most common presentations in somatization disorder - Patients typically report pain in multiple sites: headaches, back pain, joint pain, chest pain, abdominal pain - Pain complaints are often one of the primary reasons these patients seek medical care *Lack of sexual symptoms* - This is incorrect because **sexual and reproductive symptoms** are frequently reported in somatization disorder - Examples include sexual indifference, erectile dysfunction, dyspareunia, irregular menses, excessive menstrual bleeding, and vomiting throughout pregnancy - These contribute to the widespread and varied somatic complaints characteristic of the disorder

Question 1

A 25-year-old female presents with a sudden onset of severe headache, palpitations, and a feeling of impending doom. Physical examination reveals no abnormalities. What is the most likely diagnosis?

Accepted Answer

Panic disorder

Answer

Generalized anxiety disorder

Answer

Social anxiety disorder

Answer

Post-traumatic stress disorder

Question 2

A 40-year-old woman presents with excessive worry about her health, frequently visits doctors, and demands multiple tests despite no significant findings. What is the most likely diagnosis?

Accepted Answer

Illness anxiety disorder

Answer

Panic disorder

Answer

Generalized anxiety disorder

Answer

Somatic symptom disorder

Question 3

A 35-year-old man experiences recurrent episodes of intense fear, chest pain, and a feeling of impending doom. What is the most likely diagnosis?

Accepted Answer

Panic disorder

Answer

Generalized anxiety disorder

Answer

Post-traumatic stress disorder

Answer

Social anxiety disorder

Question 4

A 40-year-old male presents with sudden episodes of intense fear, palpitations, and shortness of breath lasting about 10 minutes. He is afraid of having another attack. What is the diagnosis?

Accepted Answer

Panic disorder

Answer

Generalized anxiety disorder

Answer

Social anxiety disorder

Answer

Specific phobia

Question 5

What are the key differences between generalized anxiety disorder and panic disorder?

Accepted Answer

GAD involves persistent worry, while Panic Disorder involves recurrent panic attacks.

Answer

GAD does not primarily involve panic attacks, which are a hallmark of Panic Disorder.

Answer

GAD is characterized by chronic anxiety symptoms, while Panic Disorder presents with episodic intense fear reactions.

Answer

GAD involves fear of specific situations, while Panic Disorder involves generalized worry about daily activities.

Question 6

A 25-year-old woman experiences persistent, excessive worrying about multiple events or activities for the past 8 months. What is the most appropriate diagnosis?

Accepted Answer

Generalized anxiety disorder

Answer

Panic disorder

Answer

Obsessive-compulsive disorder

Answer

Social anxiety disorder

Question 7

Generalized anxiety disorder is diagnosed when anxiety and worry continue for at least?

Accepted Answer

6 months

Answer

2 months

Answer

4 months

Answer

8 months

Question 8

What is the term for an extreme or irrational fear of darkness?

Accepted Answer

Fear of darkness

Answer

Fear of confined spaces

Answer

Fear of strangers or foreigners

Answer

Fear of germs or dirt

Question 9

A student unable to deliver speech before an audience is suffering from?

Accepted Answer

Social anxiety disorder

Answer

Fear of open spaces

Answer

Fear of enclosed spaces

Answer

Obsessive Compulsive Disorder

Question 10

Which of the following is NOT a characteristic feature of somatization disorder?

Accepted Answer

Rejection of the sick role

Answer

Absence of pseudo neurological symptoms

Answer

Absence of pain symptoms

Answer

Lack of sexual symptoms

Anxiety Disorders — MCQs

Anxiety Disorders — MCQs

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