Chapter·PsychiatryAnxiety

Neurobiological basis of anxietyDownloads

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1

A 52-year-old woman presents to her primary care physician for her annual checkup. She lost her job 6 months ago and since then she has been feeling worthless because nobody wants to hire her. She also says that she is finding it difficult to concentrate, which is exacerbated by the fact that she has lost interest in activities that she used to love such as doing puzzles and working in the garden. She says that she is sleeping over 10 hours every day because she says it is difficult to find the energy to get up in the morning. She denies having any thoughts about suicide. Which of the following neurotransmitter profiles would most likely be seen in this patient?

AIncreased dopamine

BDecreased serotonin and norepinephrine

CIncreased norepinephrine

DDecreased acetylcholine

EDecreased gamma-aminobutyric acid

2

A 52-year-man is brought to the physician because of a 2-week history of memory loss. Three weeks ago, he had a cardiac arrest that required cardiopulmonary resuscitation and intravenous epinephrine. On mental status examination, he cannot recall objects shown to him 20 minutes earlier but vividly recalls memories from before the incident. The remainder of the examination shows no abnormalities. Which of the following structures of the brain is most likely affected?

AInternal pyramidal layer of the amygdala

BMicroglial cells of dorsal midbrain

CPurkinje cells of the cerebellum

DPyramidal cells of the hippocampus

EAstroglial cells of the putamen

3

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

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