Panic Disorder
Self-Study Examination
Instructions: After studying the text answer the following true/false or multiple choice questions. Remember, there's only one answer to each question.
a) The diagnosis of panic disorder requires the presence of at least four of the thirteen symptoms that develop abruptly and reach a crescendo within 10 minutes, typically lasting 10 minutes or so. b) Besides a detailed clinical assessment of the presenting complaints and history, the diagnosis of panic disorder requires positive laboratory tests. c) Panic attacks may also occur during sleep. d) To satisfy the diagnostic criteria for panic disorder, at least some of the panic attacks must occur spontaneously.
a) True b) False
a) tricyclic antidepressants b) MAO inhibitors c) benzodiazepines
a) tricyclics b) MAO inhibitors c) benzodiazepines
a) More than half of patients with mental illness in the United States are treated exclusively within the general medical care system rather than in the mental health system. b) One-third to one-half of psychiatric illnesses are not accurately diagnosed by their physicians. c) Many patients suffering from a mental illness present with somatic complaints to avoid the stigma of mental illness. d) Antianxiety medications are among the most frequently prescribed medications in the United States. e) none of the above
a) He would go only if accompanied by his spouse or a friend. b) He would forgo the movie if he could not find anyone to go with. c) He would go because he does not want to miss a good movie. d) He would occupy an isle seat in the last row or near an exit.
a) soldier's heart b) neurasthenia c) cardiac neurosis d) hypocondria e) effort phobia
a) Recent studies have estimated that as many as 2-3% of the population may have panic disorder. b) Three times as many women are affected by panic disorder as men. c) The onset of panic disorder is generally after the age of thirty. d) Panic disorder tends to be a relapsing, remitting illness.
a) Most patients with panic disorder are able to link their disorder to stressful life events. b) Panic disorder is a familial disease. c) Panic disorder generally begins in the context of stressful life events. d) Patients with panic disorder often grew up as children with uncommon fears and were more anxious than other children.
a) cardiac symptoms b) gastrointestinal symptoms c) neurologic symptoms d) anxiety and depression symptoms
a) Most patients who meet the criteria for somatization disorder are also likely to meet the criteria for panic disorder. b) Patients who satisfy both the criteria for somatization and panic disorder should be diagnosed with panic disorder and treated pharmacologically. c) According to DSM-ffl, diagnosis of somatization disorder requires identification of thirteen symptoms from a list of 35. d) Several studies have shown that patients with chest pain are four times as likely to have panic disorder as those without chest pains. e) Patients with chest pain and panic disorder have a high likelihood of suffering myocardial infarction.
a) An overwhelming majority of patients with somatization disorder also meet criteria for panic disorder. b) Symptoms such as chest pain, palpitations, shortness ofbreath, and dizziness are common symptoms for both disorders. c) Somatization disorder is a chronic, severe condition with no known specific treatment whereas panic disorder is highly treatable. d) all of the above e) none of the above
a) frequent episodes of major depression b) frequent intoxication or withdrawal symptoms c) recurrent use of the substance despite adverse consequences to health, vocation, family and social life d) a great deal of time spent in acquiring the substance, using it, or recovering from its effects e) increased tolerance for the substance
a) unrealistic or excessive worry about one or more life circumstances for six months or longer during which the patient is bothered more days than not by these concerns. b) presence of at least six of eighteen symptoms from three categories c) anxiety or worry about having a panic attack d) all of the above
a) cerebral cortex b) locus ceruleus c) amygdala d) thyroid gland
a) treat panic disorder separately or concurrently with the medical condition. b) focus on any chronic medical illness that could precipitate anxiety. c) review all drugs that the patient is taking that could cause anxiety. d) b and c above. e) all of the above
a) hyperthyroidism b) hypoglycemia c) acute familial and financial crises d) cocaine e) coronary artery disease
a) altered state of consciousness b) progression into other types of epilepsy c) flushing, hyperventilation and tachycardia d) hallucinations e) psychic behavior with episodes of deja vu or jamais vu
a) explain the biologic research on panic disorder b) explain the effectiveness of medications c) help patient understand that panic attacks can occur even when no apparent stress is present, because of the dysfunction of the autonomic nervous system d) project an image of confidence in the diagnosis e) discourage the patient from becoming dependent
a) advise the patient that he or she may have side effects from the medications b) see the patient at least once a week and be available by telephone to answer questions about side effects c) limit the medication dosage so as not to build resistance to the drug d) give the patient books or articles to read about panic attacks
a) block spontaneous panic attacks b) eliminate avoidance behavior and social phobias
a) trazodone b) imipramine c) desipramine d) nortriptyline e) amitriptyline
a) increase the dosage to 150 mg of imipramine or desipramine b) change to a less noradrenergic drug, such as 25 mg of nortriptyline c) temporarily add a low dose ofalprazolam d) switch to a monoamine oxidase inhibitor or benzodiazepine
a) dry mouth b) constipation c) memory dysfunction d) increase in blood pressure e) weight gain
a) Patients with panic disorder have a concurrent maj or depression and benzodiazepines are not effective antide¬pressants. b) Some patients may abuse benzodiazepines. c) serious side-effects d) Benzodiazepines are more difficult to taper than are tricyclic antidepressants or MAOIs.
a) patients with a history of polydrug or alcohol abuse b) patients with personality disorders and chronic benign pain conditions c) patients with concurrent major depression d) all of the above e) a and b
a) sedation b) orthostatic hypotension c) psychomotor impairment d) slurred speech and amnesia
a) beer and wine b) coffee, tea and other caffeine-containing beverages c) cheese d) beef or chicken liver e) smoked or pickled fish, especially herring
a) sedation b) hypertensive reactions c) insomnia d) orthostatic hypertension
a) tricyclic antidepressant b) MAOI c) benzodiazepine
a) Another six-to-twelve month course of medication is prescribed before a second attempt to taper medication is instituted. b) augment medication with psychotherapy c) increase the dosage of medication to just above the level at which relapse occurred d) all of the above e) a and c
a) decrease social and psychologic distress b) improve self-esteem c) reduce or eliminate maladaptive mechanisms such as avoidance, wishful thinking and passivity d) take place of psychopharmacologic treatment
a) in vivo exposure to frightening situations b) hyperventilation exposure and breathing training c) group therapy and interaction with other patients of panic disorder d) desensitization to the patient's own somatic symptoms
a) patients who tend to deny or minimize stressful life events and anxiety b) patients who are unable to tolerate side effects of psychopharmacological medications c) patients concurrently suffering from major depression with suicidal tendencies d) patients who have serious medical illness, such as heart disease, diabetes, or chronic obstructive lung disease e) patients with financial and marital problems