A 27-Year-Old Man Comes to the Emergency Department with Palpitations

question 414

Multiple Choice

A 27-year-old man comes to the emergency department with palpitations, sweating, and shortness of breath that began 10 minutes ago. He says, "Please help me, I don't want to die." He has experienced several similar episodes over the past 2 months, which occurred without warning in situations including open spaces or crowds and resolved gradually after 10 to 20 minutes. He has no history of serious illness and takes no medications. He drinks 2 bottles of beer daily. He appears anxious and has a flushed face. Physical examination, ECG, and laboratory evaluation are normal.  The patient is diagnosed with panic disorder.  After discussion of treatment options, he decides to pursue cognitive-behavioral therapy and start a short-term anxiolytic medication that also has muscle-relaxant and anticonvulsant properties.  Which of the following best describes the mechanism of action of this medication?

• A)Antagonism at GABA A benzodiazepine receptor sites
• B)Increased duration of chloride channel opening
• C)Increased frequency of chloride channel opening
• D)Inhibition of serotonin and norepinephrine reuptake
• E)Inhibition of serotonin reuptake

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Definitions:

IQ / Achievement Discrepancy

The difference between a person's measured intelligence quotient (IQ) and their actual performance or achievements, often used in diagnosing learning disabilities.

Learning Disability

A condition that affects a person's ability to learn, process, or understand information, differing from intellectual disabilities in specific competencies.

Performance Anxiety

A state of nervousness that can occur when people perform sexually that can negatively affect their performance, because they are too busy worrying about and monitoring their own performance and their partners’ responses.

Learning Disorder

A neurological condition that affects a person's ability to receive, process, or communicate information.