A 44-Year-Old Woman Comes to the Office Due to Worsening

question 264

Multiple Choice

A 44-year-old woman comes to the office due to worsening anxiety.  Prior to starting her new job 3 months ago, the patient had not suffered from anxiety or any other psychiatric condition.  She experiences the demands of her new job as overwhelming and disproportionate to the support and resources she has available at work.  Around the same time that she started her new job, the patient began to suffer sudden episodes of palpitations, sweating, pounding headache, and panicky feelings that have recurred every few days for no apparent reason.  The patient was also recently diagnosed with hypertension that has only slightly improved with antihypertensive medication.  Temperature is 37.2 C (99 F) , blood pressure is 184/86 mm Hg, pulse is 91/min, and respirations are 14/min.  BMI is 23 kg/m².  The patient appears anxious, mildly tremulous, and diaphoretic on examination.  Laboratory results are as follows: Which of the following is the most likely explanation for this patient's symptoms?

• A)Acute intermittent porphyria
• B)Carcinoid syndrome
• C)Generalized anxiety disorder
• D)Hyperthyroidism
• E)Insulinoma
• F)Panic disorder
• G)Pheochromocytoma

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Definitions:

Confidence Level

The percentage that expresses the degree of certainty in the reliability of a confidence interval.

Confidence Interval

A chain of values, emanating from statistical investigations of samples, which is believed likely to enclose the value of a mysterious population parameter.

Regression Line

A line of best fit through a scatter plot of data points that shows the relationship between two variables.

API Gravity Degrees

A measure of how heavy or light a petroleum liquid is compared to water.