Separation anxiety disorder US Medical PG Practice Questions and MCQs
Practice US Medical PG questions for Separation anxiety disorder. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Separation anxiety disorder US Medical PG Question 1: A 34-year-old female presents to a counselor at the urging of her parents because they are concerned that she might be depressed. After recently breaking up with her long-term boyfriend, she moved back in with her parents because she could not handle making decisions alone. Soon after their breakup, she started going on 5–7 dates a week. She has been unemployed for 3 years, as her boyfriend took care of all the bills. In the past year, she thought of looking for a job but never felt confident enough to start the process. Her mom arranges her doctor's appointments and handles her car maintenance. She describes feeling uneasy when she is alone. She has hypothyroidism treated with levothyroxine. She does not smoke or drink alcohol. Vital signs are normal. Mental status exam shows a neutral affect. Neurologic examination shows no focal findings. Which of the following is the most likely diagnosis?
- A. Avoidant personality disorder
- B. Histrionic personality disorder
- C. Borderline personality disorder
- D. Separation anxiety disorder
- E. Dependent personality disorder (Correct Answer)
Separation anxiety disorder Explanation: ***Dependent personality disorder***
- The patient exhibits a pervasive and excessive need to be cared for, leading to **submissive and clinging behavior** and fears of separation, as evidenced by her inability to make decisions, reliance on parents, and discomfort when alone.
- Her history of unemployment and reliance on her boyfriend, followed by moving back with parents and having her mom handle appointments and car maintenance, strongly supports an inability to function independently and an excessive need for reassurance and support, characteristic of **dependent personality disorder**.
*Avoidant personality disorder*
- This disorder is characterized by a pervasive pattern of **social inhibition**, feelings of inadequacy, and hypersensitivity to negative evaluation, which are not the primary features here.
- While she may lack confidence in looking for a job, her constant search for new relationships (5-7 dates a week) and reliance on others for decision-making point away from the **social avoidance** central to this diagnosis.
*Histrionic personality disorder*
- This disorder is marked by **excessive emotionality** and **attention-seeking behavior**, often through seductive or provocative means.
- Although she is actively dating, the core issue appears to be her need for care and support rather than a desire to be the center of attention or dramatize her emotions.
*Borderline personality disorder*
- Characterized by a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity, such as **frantic efforts to avoid abandonment** or **recurrent suicidal behavior**.
- While she might fear abandonment (expressed as uneasiness when alone), the overall clinical picture lacks the impulsivity, mood swings, self-harm, or intense anger typically seen in borderline personality disorder.
*Separation anxiety disorder*
- This disorder typically manifests with excessive fear or anxiety concerning separation from attachment figures, often seen in childhood, but can occur in adults.
- While she expresses **uneasiness when alone**, the pervasive pattern of **submissive behavior**, difficulty making decisions, and chronic dependency on others for all aspects of life points more towards a personality disorder rather than an anxiety disorder primarily focused on separation.
Separation anxiety disorder US Medical PG Question 2: A 45-year-old woman presents to her primary care physician with complaints of muscle pains, poor sleep, and daytime fatigue. When asked about stressors she states that she "panics" about her job, marriage, children, and finances. When asked to clarify what the "panics" entail, she states that it involves severe worrying. She has had these symptoms since she last saw you one year ago. What is the most likely diagnosis?
- A. Generalized anxiety disorder (Correct Answer)
- B. Social phobia
- C. Adjustment disorder
- D. Obsessive-compulsive disorder
- E. Panic disorder
Separation anxiety disorder Explanation: ***Generalized anxiety disorder***
- This patient presents with **chronic, excessive, and uncontrollable worry** about multiple life circumstances (job, marriage, children, finances), fulfilling the core diagnostic criterion for GAD.
- The associated symptoms of **muscle pains**, **poor sleep**, and **daytime fatigue** are common physical manifestations of GAD, and the duration of symptoms for over a year supports the diagnosis.
*Social phobia*
- **Social phobia**, or social anxiety disorder, involves intense fear and anxiety in **social situations** where one might be scrutinized or judged.
- The patient's reported worries are broad and not limited to social interactions, making social phobia less likely.
*Adjustment disorder*
- **Adjustment disorder** is characterized by emotional or behavioral symptoms developing within **three months of an identifiable stressor**, not diffuse chronic worry.
- The symptoms in adjustment disorder typically resolve within **six months** after the stressor or its consequences have ended, whereas this patient's symptoms are chronic and pervasive.
*Obsessive-compulsive disorder*
- **Obsessive-compulsive disorder (OCD)** involves recurrent, intrusive **obsessions** (thoughts, urges, images) and/or **compulsions** (repetitive behaviors or mental acts) performed to reduce anxiety.
- While the patient experiences severe worrying, there's no mention of specific obsessions or compulsive behaviors aimed at neutralizing those anxieties.
*Panic disorder*
- **Panic disorder** is characterized by recurrent, unexpected **panic attacks**—sudden surges of intense fear or discomfort accompanied by physical and cognitive symptoms.
- While the patient uses the term "panics," she clarifies it involves "severe worrying," not discrete, intense, and short-lived panic attacks.
Separation anxiety disorder US Medical PG Question 3: An 8-year-old girl is brought to the physician by her parents because of difficulty sleeping. One to two times per week for the past 2 months, she has woken up frightened in the middle of the night, yelling and crying. She has not seemed confused after waking up, and she is consolable and able to fall back asleep in her parents' bed. The following day, she seems more tired than usual at school. She recalls that she had a bad dream and looks for ways to delay bedtime in the evenings. She has met all her developmental milestones to date. Physical examination shows no abnormalities. Which of the following is the most likely diagnosis?
- A. Normal development
- B. Sleep terror disorder
- C. Nightmare disorder (Correct Answer)
- D. Post-traumatic stress disorder
- E. Separation anxiety disorder
Separation anxiety disorder Explanation: ***Nightmare disorder***
- The key features supporting **nightmare disorder** are vivid, frightening dreams that lead to waking up, the ability to recall the dream content, being easily consolable, and attempts to avoid bedtime.
- Sleep disturbances, daytime fatigue, and negative emotional responses centered around sleep are characteristic of this disorder.
*Normal development*
- While occasional bad dreams are part of normal development, a frequency of one to two times per week over 2 months, leading to daytime tiredness and bedtime avoidance, suggests a **clinical disorder** exceeding typical developmental experiences.
- The distress caused and impact on daily functioning (tiredness at school) differentiate it from normal, transient nightmares.
*Sleep terror disorder*
- **Sleep terrors** typically involve abrupt awakening with intense fear, screaming, and autonomic arousal, but the individual is usually disoriented, inconsolable, and has no recall of the event upon waking or the next day.
- In this case, the child is consolable and *recalls* having a bad dream, distinguishing it from sleep terrors.
*Post-traumatic stress disorder*
- **PTSD** requires exposure to a traumatic event, which is not mentioned in the vignette.
- While nightmares can be a symptom of PTSD, they are usually accompanied by other symptoms like flashbacks, avoidance behavior, negative alterations in cognition/mood, and hypervigilance related to the trauma.
*Separation anxiety disorder*
- **Separation anxiety disorder** is characterized by excessive fear or anxiety concerning separation from attachment figures.
- Although the child sleeps in her parents' bed, the primary issue is frightening dreams and difficulty sleeping, not anxiety specifically related to separation from her parents.
Separation anxiety disorder US Medical PG Question 4: A 14-year-old girl presents to the pediatrician for behavior issues. The girl has been having difficulty in school as a result. Every time the girl enters her classroom, she feels the urge to touch every wall before heading to her seat. When asked why she does this, she responds, "I'm not really sure. I just can't stop thinking about it until I have touched each wall." The parents have noticed this behavior occasionally at home but were not concerned. The girl is otherwise healthy, has many friends, eats a balanced diet, does not smoke, and is not sexually active. Her temperature is 98.2°F (36.8°C), blood pressure is 117/74 mmHg, pulse is 80/min, respirations are 15/min, and oxygen saturation is 98% on room air. Physical exam is notable for a healthy young girl. Neurologic exam is unremarkable. There is no observed abnormalities in behavior while the girl is in the office. Which of the following is the most appropriate initial step in management for this patient?
- A. Cognitive behavioral therapy (Correct Answer)
- B. Lorazepam
- C. Risperidone
- D. Clomipramine
- E. Fluoxetine
Separation anxiety disorder Explanation: ***Cognitive behavioral therapy***
- This patient exhibits classic symptoms of **obsessive-compulsive disorder (OCD)**, characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) performed to alleviate anxiety.
- **Exposure and response prevention (ERP)**, a component of cognitive behavioral therapy, is the first-line psychosocial treatment for OCD and has strong evidence for its efficacy in both children and adults.
*Lorazepam*
- **Lorazepam** is a benzodiazepine used for acute anxiety or panic attacks, providing short-term relief.
- It is not a primary treatment for OCD and does not address the underlying obsessive-compulsive cycle; long-term use can lead to dependence.
*Risperidone*
- **Risperidone** is an atypical antipsychotic, primarily used for conditions like schizophrenia, bipolar disorder, or severe behavioral disturbances.
- While sometimes used as an augmentation strategy in refractory OCD, it is not a first-line treatment, especially without prior trials of CBT or SSRIs.
*Clomipramine*
- **Clomipramine** is a tricyclic antidepressant (TCA) with potent serotonin reuptake inhibition, making it effective for OCD.
- However, due to its less favorable side effect profile compared to selective serotonin reuptake inhibitors (SSRIs), it is typically reserved for cases where SSRIs are ineffective.
*Fluoxetine*
- **Fluoxetine** is an SSRI, a first-line pharmacologic treatment for OCD.
- While effective, current guidelines recommend starting with **CBT (specifically ERP)** as the initial treatment for mild to moderate OCD, or combining it with medication for more severe cases.
Separation anxiety disorder US Medical PG Question 5: A 28-year-old woman is brought to a counselor by her father after he found out that she is being physically abused by her husband. The father reports that she refuses to end the relationship with her husband despite the physical abuse. She says that she feels uneasy when her husband is not around. She adds, “I'm worried that if I leave him, my life will only get worse.” She has never been employed since they got married because she is convinced that nobody would hire her. Her husband takes care of most household errands and pays all of the bills. Physical examination shows several bruises on the thighs and back. Which of the following is the most likely diagnosis?
- A. Schizoid personality disorder
- B. Separation anxiety disorder
- C. Avoidant personality disorder
- D. Dependent personality disorder (Correct Answer)
- E. Borderline personality disorder
Separation anxiety disorder Explanation: ***Dependent personality disorder***
- This patient exhibits a pervasive and excessive need to be taken care of, leading to **submissive and clinging behavior, and fears of separation**. Key features include difficulties making decisions, avoiding disagreement due to fear of loss of support, and preoccupation with fears of being left to care for herself.
- Her comments about her life getting worse if she leaves her husband, her inability to seek employment, and her husband managing all household affairs are consistent with her **reluctance to leave an abusive relationship** because of an exaggerated fear of being alone or unable to care for herself.
*Schizoid personality disorder*
- Characterized by a pervasive pattern of **detachment from social relationships** and a restricted range of emotional expression.
- Individuals with this disorder typically show **little interest in forming close relationships**, in contrast to the patient's clinging behavior.
*Separation anxiety disorder*
- Primarily marked by **excessive anxiety concerning separation from home or from those to whom the individual is attached**, often seen in childhood, but can occur in adults.
- While there is some anxiety about separation, the patient's broader pattern of submissive behavior, difficulty with independent functioning, and belief she cannot care for herself points more strongly to a **personality disorder** rather than an anxiety disorder focused solely on separation.
*Avoidant personality disorder*
- Involves extreme social inhibition, feelings of inadequacy, and **hypersensitivity to negative evaluation**.
- These individuals **desire social connection but avoid it due to fear of rejection**, which contrasts with the patient's clinging and submissive efforts to maintain a relationship.
*Borderline personality disorder*
- Characterized by significant **instability in moods, interpersonal relationships, self-image, and behaviors**.
- While there can be fear of abandonment, this disorder typically involves **impulsivity, intense anger, and frantic efforts to avoid abandonment**, which are not the primary features described in this patient.
Separation anxiety disorder US Medical PG Question 6: A 35-year-old man comes to the Veterans Affairs hospital because of a 2-month history of anxiety. He recently returned from his third deployment to Iraq, where he served as a combat medic. He has had difficulty readjusting to civilian life. He works as a taxi driver but had to take a leave of absence because of difficulties with driving. Last week, he hit a stop sign because he swerved out of the way of a grocery bag that was in the street. He has difficulty sleeping because of nightmares about the deaths of some of the other soldiers in his unit and states, “it's my fault, I could have saved them. Please help me.” Mental status examination shows a depressed mood and a restricted affect. There is no evidence of suicidal ideation. Which of the following is the most appropriate initial step in treatment?
- A. Dialectical behavioral therapy
- B. Venlafaxine therapy
- C. Cognitive behavioral therapy (Correct Answer)
- D. Motivational interviewing
- E. Prazosin therapy
Separation anxiety disorder Explanation: ***Cognitive behavioral therapy***
- **Cognitive Behavioral Therapy (CBT)** is considered a first-line psychological treatment for **Post-Traumatic Stress Disorder (PTSD)**, which the patient's symptoms (deployments, intrusive thoughts, nightmares, avoidance, guilt) strongly suggest.
- CBT helps individuals identify and challenge **maladaptive thought patterns** and behaviors related to the trauma, fostering new coping mechanisms.
*Dialectical behavioral therapy*
- **Dialectical Behavioral Therapy (DBT)** is primarily used for individuals with **Borderline Personality Disorder** or severe emotional dysregulation.
- While it can help with emotional regulation, it is not the **first-line therapy** specifically targeting trauma-related cognitive distortions and avoidance behaviors seen in PTSD.
*Venlafaxine therapy*
- **Venlafaxine**, an SNRI, is an antidepressant that can be effective for PTSD symptoms. However, current guidelines recommend **psychotherapy (like CBT)** as the initial step, especially when feasible.
- While pharmacotherapy can be used, it's typically considered **adjunctive** or for cases where psychotherapy alone is insufficient or not preferred.
*Motivational interviewing*
- **Motivational interviewing** is a patient-centered counseling style used to address ambivalence and enhance a person's **intrinsic motivation** for change.
- It is often utilized in substance abuse treatment or when patients are resistant to treatment, but it is not a primary, standalone treatment for the core symptoms of PTSD.
*Prazosin therapy*
- **Prazosin** is an alpha-1 antagonist used off-label to treat **PTSD-related nightmares** and sleep disturbances.
- While it can be helpful for a specific symptom, it does not address the broader spectrum of PTSD symptoms, such as intrusive thoughts, avoidance, or negative cognitions.
Separation anxiety disorder US Medical PG Question 7: A 15-year-old boy is referred to a child psychologist because of worsening behavior and constant disruption in class. He has received multiple reprimands in the past 6 months for not doing the homework his teacher assigned, and he refuses to listen to the classroom instructions. Additionally, his teachers say he is very argumentative and blames other children for not letting him do his work. He was previously well behaved and one of the top students in his class. He denies any recent major life events or changes at home. His past medical history is noncontributory. His vital signs are all within normal limits. Which of the following is the most likely diagnosis?
- A. Attention deficit hyperactivity disorder
- B. Antisocial personality disorder
- C. Conduct disorder
- D. Oppositional defiant disorder (Correct Answer)
- E. Major depressive disorder
Separation anxiety disorder Explanation: ***Oppositional defiant disorder***
- This patient's symptoms of **argumentativeness**, **defiance**, and **blaming others**, combined with his previous good behavior and denial of major life events, are classic signs of **oppositional defiant disorder (ODD)**.
- ODD involves a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months, clearly distinguishing it from a temporary behavioral issue.
*Attention deficit hyperactivity disorder*
- While **ADHD** can cause inattention and difficulty following instructions, it typically presents earlier in childhood and is characterized by **hyperactivity**, **impulsivity**, and **inattention** that would have likely been prominent before recently.
- The patient's primary symptoms here are an argumentative and defiant attitude rather than core symptoms of inattention or hyperactivity that began recently.
*Antisocial personality disorder*
- This disorder is typically diagnosed in **adulthood (18 years or older)**, although symptoms of **conduct disorder** must be present before age 15. The patient is currently 15.
- **Antisocial personality disorder** involves a pervasive pattern of disregard for and violation of the rights of others, which is more severe than the defiance seen in this case.
*Conduct disorder*
- **Conduct disorder** involves a more severe pattern of behavior, including aggression towards people or animals, destruction of property, deceitfulness or theft, and serious violations of rules, which is not described in this patient.
- The behaviors in this patient (argumentativeness, defiance) are less severe than the behaviors associated with conduct disorder.
*Major depressive disorder*
- Although behavioral changes can occur in **depression**, this patient does not exhibit other common symptoms such as **anhedonia**, changes in sleep or appetite, or persistent sadness, which would be expected with **major depressive disorder**.
- His behaviors are primarily externalizing and defiant rather than indicating an internal state of sadness or loss of interest.
Separation anxiety disorder US Medical PG Question 8: A 28-year-old male presents to his primary care physician with complaints of intermittent abdominal pain and alternating bouts of constipation and diarrhea. His medical chart is not significant for any past medical problems or prior surgeries. He is not prescribed any current medications. Which of the following questions would be the most useful next question in eliciting further history from this patient?
- A. "Does the diarrhea typically precede the constipation, or vice-versa?"
- B. "Is the diarrhea foul-smelling?"
- C. "Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life"
- D. "Are the symptoms worse in the morning or at night?"
- E. "Can you tell me more about the symptoms you have been experiencing?" (Correct Answer)
Separation anxiety disorder Explanation: ***Can you tell me more about the symptoms you have been experiencing?***
- This **open-ended question** encourages the patient to provide a **comprehensive narrative** of their symptoms, including details about onset, frequency, duration, alleviating/aggravating factors, and associated symptoms, which is crucial for diagnosis.
- In a patient presenting with vague, intermittent symptoms like alternating constipation and diarrhea, allowing them to elaborate freely can reveal important clues that might not be captured by more targeted questions.
*Does the diarrhea typically precede the constipation, or vice-versa?*
- While knowing the sequence of symptoms can be helpful in understanding the **pattern of bowel dysfunction**, it is a very specific question that might overlook other important aspects of the patient's experience.
- It prematurely narrows the focus without first obtaining a broad understanding of the patient's overall symptomatic picture.
*Is the diarrhea foul-smelling?*
- Foul-smelling diarrhea can indicate **malabsorption** or **bacterial overgrowth**, which are important to consider in some gastrointestinal conditions.
- However, this is a **specific symptom inquiry** that should follow a more general exploration of the patient's symptoms, as it may not be relevant if other crucial details are missed.
*Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life*
- Quantifying pain intensity is useful for assessing the **severity of discomfort** and monitoring changes over time.
- However, for a patient with intermittent rather than acute, severe pain, understanding the **character, location, and triggers** of the pain is often more diagnostically valuable than just a numerical rating initially.
*Are the symptoms worse in the morning or at night?*
- Diurnal variation can be relevant in certain conditions, such as inflammatory bowel diseases where nocturnal symptoms might be more concerning, or functional disorders whose symptoms might be stress-related.
- This is another **specific question** that should come after gathering a more complete initial picture of the patient's symptoms to ensure no key information is overlooked.
Separation anxiety disorder US Medical PG Question 9: A 26-year-old woman presents to the office complaining of bloating and consistent fatigue. Past medical notes on her record show that she has seen several doctors at the clinic in the past year for the same concerns. During the discussion, she admits that coming to the doctor intensifies her anxiety and she does not enjoy it. However, she came because she fears that she has colon cancer and says, “There’s gotta be something wrong with me, I can feel it.” Past medical history is significant for obsessive-compulsive disorder (OCD). She sees a therapist a few times a month. Her grandfather died of colon cancer at 75. Today, her blood pressure is 120/80 mm Hg, heart rate is 90/min, respiratory rate is 18/min, and temperature is 37.0°C (98.6°F). Physical examination reveals a well-nourished, well-developed woman who appears anxious and tired. Her heart has a regular rhythm and her lungs are clear to auscultation bilaterally. Her abdomen is soft, non-tender, and non-distended. No masses are palpated, and a digital rectal examination is unremarkable. Laboratory results are as follows:
Serum chemistry
Hemoglobin 13 g/dL
Hematocrit
38%
MCV 90 fl
TSH
4.1 μU/mL
Fecal occult blood test negative
Which of the following is the most likely diagnosis?
- A. Malingering
- B. Somatic symptom disorder
- C. Generalized anxiety disorder
- D. Body dysmorphic disorder
- E. Illness anxiety disorder (Correct Answer)
Separation anxiety disorder Explanation: ***Illness anxiety disorder***
- This patient exhibits **preoccupation with having or acquiring a serious illness**, despite minimal somatic symptoms and negative diagnostic findings. Her fear of colon cancer, despite an unremarkable physical exam and negative fecal occult blood test, is a key indicator.
- Her history of seeking care from multiple doctors, admitting anxiety about visits, and stating "There's gotta be something wrong with me, I can feel it," aligns with the **excessive health-related behaviors** (or maladaptive avoidance) and **high anxiety about health** central to illness anxiety disorder.
*Somatic symptom disorder*
- This disorder is characterized by **one or more somatic symptoms that are distressing or result in significant disruption of daily life**, accompanied by excessive thoughts, feelings, or behaviors related to these symptoms.
- In this case, the patient's symptoms (bloating, fatigue) are minimal, and her primary concern is the *fear of having* a serious illness, rather than the distress caused by the physical symptoms themselves.
*Generalized anxiety disorder*
- This involves **excessive anxiety and worry about a number of events or activities** that is difficult to control and present for at least 6 months.
- While the patient experiences anxiety, it is specifically focused on her health, not generalized concerns about various aspects of her life.
*Malingering*
- This involves the **intentional production of false or grossly exaggerated physical or psychological symptoms**, motivated by external incentives such as avoiding work or obtaining financial compensation.
- The patient genuinely believes she has a serious illness and is distressed by this belief, rather than faking symptoms for an external gain.
*Body dysmorphic disorder*
- This disorder is characterized by **preoccupation with one or more perceived defects or flaws in physical appearance** that are not observable or appear slight to others.
- The patient's concerns are about an internal illness (colon cancer), not specific physical appearance flaws.
Separation anxiety disorder US Medical PG Question 10: A 37-year-old man comes to the emergency department with his wife because of a 3-day history of severe pain in his right arm. He also reports that he cannot move his right arm. The symptoms began after the patient woke up one morning, having slept on his side. He is otherwise healthy. He works as a waiter and says that he feels exhausted from working several night shifts per week. He adds that he “can barely keep his eyes open” when looking after their daughter the next day. Since the onset of the pain, he has been unable to work and is fully dependent on his wife, who took an extra shift to make enough money to pay their monthly bills. The patient appears relaxed but only allows himself to be examined after his wife convinces him. His vital signs are within normal limits. Examination shows 1/5 muscle strength in the right arm. Reflexes are normal. He has no sensation to light touch over the entire right arm and forearm. When a pin prick test is conducted, the patient rapidly withdraws the right arm. Which of the following is the most likely diagnosis?
- A. Malingering (Correct Answer)
- B. Factitious disorder
- C. Radial nerve palsy
- D. Illness anxiety disorder
- E. Brachial neuritis
Separation anxiety disorder Explanation: ***Malingering***
- The patient's presentation with **selective symptoms** (no sensation but rapid withdrawal from pinprick) and the **secondary gain** (avoiding work, dependence on wife for bills) are classic signs of malingering.
- The patient appears *relaxed* despite "severe pain" and only allows examination after persuasion, suggesting a **conscious fabrication of symptoms** for an external incentive.
*Factitious disorder*
- Involves the **deceptive production of symptoms** in oneself or others, but the primary motivation is to assume the **sick role**, without obvious external rewards.
- The patient in this scenario clearly benefits from avoiding work, which points away from factitious disorder.
*Radial nerve palsy*
- Would present with a specific **motor and sensory deficit pattern** corresponding to the radial nerve distribution, typically **wrist drop** and sensory loss over the dorsum of the hand.
- The patient's reported "entire right arm and forearm" sensory loss and paradoxical withdrawal to pinprick are inconsistent with a true neurological lesion.
*Illness anxiety disorder*
- Involves **preoccupations with having or acquiring a serious illness** despite minimal or no somatic symptoms, and is characterized by high levels of anxiety about health.
- This patient's presentation is more about symptom production for an external gain rather than anxiety about disease or actual illness.
*Brachial neuritis*
- Typically causes **severe pain** followed by **weakness and muscle atrophy** in the muscles innervated by the brachial plexus, but the sensory loss typically follows a dermatomal or nerve distribution.
- The reported global sensory loss in the entire arm and forearm, with preserved reflexes and paradoxical withdrawal to pinprick, is inconsistent with a specific nerve inflammation or damage.
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