A 34-year-old man reports frequent episodes of chest pain, s

Discussion in 'USMLE Step 2 CK' started by Guest, Jul 22, 2009.

  1. Guest

    Guest Guest

    A 34-year-old man reports frequent episodes of chest pain, shortness of breath, and diaphoresis associated with feelings of high anxiety during a visit to his family physician. The patient says that he is veteran of the Gulf War and has been increasingly troubled by memories of and nightmares about his combat experiences ever since attending a reunion with fellow veterans in June of 2001; symptoms intensified after the events of September 11, 2001. He experiences anxiety whenever he hears news about the war in Afghanistan and has canceled his newspaper subscription and discarded his television as a result. He does not understand why he is only recently troubled by memories from 10 years ago and wonders if there is something physically wrong with him. A detailed evaluation, including a cardiac work-up, reveals no evidence of any medical illness. Which of the following diagnoses is most likely?

    1. Normal reaction to trauma
    2. Acute stress disorder
    3. Adjustment disorder with anxiety
    4. PTSD, acute
    5. PTSD, delayed onset
  2. Guest

    Guest Guest

    5-PTSD delayed onset > 6 mon for onset

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