Chapter 40. Generalized Anxiety Disorder, Panic Disorder, and Social Anxiety Disorder

Question 1

1. Which of the following statements regarding panic disorder is true?
   A. Panic attacks are expected and have an identifiable trigger
   B. Panic attacks usually peak in intensity in about 1 hour.
   C. Agoraphobia is always present.
   D. It is more common in men.
   E. Panic symptoms are self-limiting in duration.

Answer 1

E. Panic symptoms are self-limiting in duration.

Question 2

2. Which of the following substances/medications would not be expected to contribute to panic anxiety?
   A. Albuterol
   B. Olanzapine
   C. Cannabis
   D. Phenylephrine
   E. Caffeine

Answer 2

B. Olanzapine

Question 3

3. Pregabalin is a preferred treatment for a patient with GAD and a history of which of the following?
   A. Comorbid depression
   B. Alcohol dependence
   C. Did not tolerate SSRIs
   D. Renal impairment
   E. Nonadherence

Answer 3

C. Did not tolerate SSRIs

Question 4

4. The following treatment would be preferred for a 12-year-old with SAD.
   A. Alprazolam
   B. Fluoxetine
   C. Pregabalin
   D. Cognitive-behavioral therapy (CBT)
   E. Individual supportive psychotherapy

Answer 4

D. Cognitive-behavioral therapy (CBT)

Question 5

5. Which of the following statements is true regarding quetiapine in the treatment of anxiety disorders?
   A. Is effective for treatment of panic disorder
   B. Is associated with weight gain, sedation, and fatigue
   C. Is effective in doses above 300 mg/day
   D. Superior efficacy to SSRIs
   E. Similar efficacy to CBT

Answer 5

B. Is associated with weight gain, sedation, and fatigue

Question 6

6. Which of the following medications is not appropriate initial treatment for a 23-year-old woman with GAD and no other comorbidities?
   A. Pregabalin
   B. Quetiapine
   C. Sertraline
   D. Venlafaxine
   E. Fluoxetine

Answer 6

B. Quetiapine

Question 7

7. Which of the following is true of CBT in the treatment of anxiety?
   A. Only effective when delivered face to face
   B. Is inferior to antidepressants in acute treatment of panic disorder
   C. Is associated with more sustainable benefits than antidepressants
   D. Is not effective for children with anxiety disorders
   E. Is less expensive than medications

Answer 7

C. Is associated with more sustainable benefits than antidepressants

Question 8

8. A 23-year-old otherwise healthy woman with GAD has no past history of drug or alcohol abuse and no family history of substance abuse. She is started on lorazepam 0.5 mg three times daily. Which of the following side effects will you warn her about?
   a. Risk of withdrawal symptoms upon discontinuation b. Sedation
   c. Anterograde amnesia
   d. Slowed reaction time
   e. All of the above

Answer 8

e. All of the above

Question 9

9. Which initial antidepressant regimen is likely to be the best tolerated by a patient with panic disorder?
   A. Duloxetine 60 mg daily
   B. Bupropion 300 mg XL daily
   C. Imipramine 50 mg three times daily
   D. Paroxetine 10 mg daily
   E. Buspirone 15 mg three times daily

Answer 9

D. Paroxetine 10 mg daily

Question 10

10. A 22-year-old woman with SAD has significant improvement in anxiety after 14 weeks of treatment with sertraline. How long should she remain on sertraline?
    A. Discontinue now
    B. Additional 3 months
    C. Additional 6 months
    D. Additional 1–2 years
    E. Lifetime therapy

Answer 10

C. Additional 6 months

Question 11

11. A 26-year-old African American man with SAD has been stable on sertraline 100 mg/day for the past year. He reports to the clinic today with complaints of increased anxiety, agitation, and nausea. Upon further examination, you notice he last filled his sertraline Rx (90-day supply) 4 months ago. Medications: Ibuprofen 400 mg as needed for joint pain. He reports taking sertraline most days but ran out 4 days ago. What is most likely going on with AS?
    A. Serotonin syndrome
    B. Serotonin withdrawal
    C. Neuroleptic malignant syndrome
    D. Relapse of SAD
    E. Rebound anxiety

Answer 11

B. Serotonin withdrawal

Question 12

12. A 78-year-old black woman has HTN, DJD, osteoporosis, and GAD. Which of the following medications is the best choice for management of her GAD?
    A. Pregabalin
    B. Trazodone
    C. Quetiapine
    D. Escitalopram
    E. Mirtazapine

Answer 12

D. Escitalopram

Question 13

13. What is the best initial treatment for a 39-year-old man with comorbid panic disorder and alcohol use disorder?
    A. Sertraline
    B. Quetiapine
    C. Pregabalin
    D. Bupropion
    E. Alprazolam

Answer 13

A. Sertraline

Question 14

14. What monitoring parameters should be followed in a 10-year-old initiated on fluoxetine for SAD?
    A. Suicidal Ideation
    B. School performance
    C. Anxiety Symptoms
    D. Nausea, headache, stomach ache
    E. All of the above

Answer 14

E. All of the above

Question 15

15. Which of the following GAD patients is most likely to be a CYP 2C19 poor metabolizer and will have an exaggerated response to diazepam 5 mg three times daily with increased
    sedation and CNS and cognitive side effects?
    A. 25-year-old white woman
    B. 25-year-old black woman
    C. 45-year-old black man
    D. 45-year-old Asian man
    E. 45-year-old white man

Answer 15

D. 45-year-old Asian man