A 35-year-old man presents to the psychiatry OPD with an intense fear of spiders (arachnophobia) that significantly interferes with his daily activities. He reports avoiding certain areas of his house and experiencing panic attacks when encountering spiders. What is the most appropriate first-line treatment for this patient?
ABenzodiazepines
BAntidepressants
CCognitive behavioral therapy
DBeta-blockers
EAnxiolytics
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?
AGeneralized anxiety disorder
BSocial phobia
CAdjustment disorder
DObsessive-compulsive disorder
EPanic disorder
A 42-year-old man comes to the emergency department complaining of chest pain. He states that he was at the grocery store when he developed severe, burning chest pain along with palpitations and nausea. He screamed for someone to call an ambulance. He says this has happened before, including at least 4 episodes in the past month that were all in different locations including once at home. He is worried that it could happen at work and affect his employment status. He has no significant past medical history, and reports that he does not like taking medications. He has had trouble in the past with compliance due to side effects. The patient’s temperature is 98.9°F (37.2°C), blood pressure is 133/74 mmHg, pulse is 110/min, and respirations are 20/min with an oxygen saturation of 99% on room air. On physical examination, the patient is tremulous and diaphoretic. He continually asks to be put on oxygen and something for his pain. An electrocardiogram is obtained that shows tachycardia. Initial troponin level is negative. A urine drug screen is negative. Thyroid stimulating hormone and free T4 levels are normal. Which of the following is first line therapy for the patient for long-term management?
ACognitive behavioral therapy
BAlprazolam
CImipramine
DFluoxetine
EBuspirone
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