A 34-Year-Old Woman Comes to the Office Accompanied by Her

A 34-year-old woman comes to the office accompanied by her husband for an employment physical examination.  The patient says, "I'd rather not be here, but my job requires labs every 2 years."  While getting blood drawn, she starts to feel anxious, nauseated, and short of breath, and says, "I feel like the room is spinning."  The patient's husband explains that she has had similar episodes since childhood, which began following a bike accident during which she cut her knee and bled profusely.  Medical history is significant for asthma and type 2 diabetes mellitus.  Temperature is 36.7 C (98.1 F) , blood pressure is 140/90 mm Hg, pulse is 104/min, and respirations are 20/min.  BMI is 36 kg/m².  Physical examination is significant for anxious demeanor but is otherwise unremarkable.  Which of the following is the most likely diagnosis?

A) Anxiety due to a medical condition
B) Illness anxiety disorder
C) Panic disorder
D) Posttraumatic stress disorder
E) Specific phobia

Correct Answer:

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