A 33-Year-Old Woman Comes to the Office Due to Poor

question 213

Multiple Choice

A 33-year-old woman comes to the office due to poor sleep for the past 2 months.  The patient says, "Most nights, I wake up around 2 AM in a state of panic-my heart is racing and it's hard to fall back asleep.  I can barely stay awake at work, and it takes me twice as long to finish assignments because I need to reread everything."  The patient lives alone and works as a computer programmer.  She filed for divorce 3 months ago due to her husband's substance use and violent behavior toward her.  The patient drinks a glass of wine at bedtime to help her fall asleep and does not use illicit drugs.  Vital signs are within normal limits.  Physical examination and laboratory evaluation are unremarkable.  On mental status examination, she appears tired and her mood is depressed and anxious.  The patient jumps when a nearby door slams closed.  At one point, she appears to stare into space and does not respond to her name for a few moments.  Which of the following is the most likely diagnosis in this patient?

• A)Adjustment disorder
• B)Depersonalization/derealization disorder
• C)Generalized anxiety disorder
• D)Major depressive disorder
• E)Panic disorder
• F)Posttraumatic stress disorder

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Definitions:

Social Demands

The expected norms and behaviors that society imposes on individuals or organizations.

Ego Involvement

The degree to which a person identifies personally with a task or issue, affecting their attitudes and behaviors.

Problem-Solving Team

Is set up to deal with a specific problem or opportunity.

Artificial Boundaries

Man-made limits or divisions that may hinder processes or categorization, often without a natural basis.