Panic disorder — MCCQE Part 1 MCQ

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ModerateAnxietyPanic disorderMCCQE Part 1

A 27-year-old woman has recurrent sudden episodes of palpitations, chest tightness, trembling and fear of dying that peak within 10 minutes; cardiac work-up is normal. Which of the following is the most likely diagnosis?

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Correct answer: D — Panic disorder

Panic disorder is the single best answer because the age, timing, examination findings and investigations in the vignette fit Panic disorder better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian anxiety guidelines, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian anxiety guidelines