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Generalized anxiety disorder — USMLE Step 2 CK MCQ

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ModeratePsychiatryGeneralized anxiety disorderUSMLE Step 2 CK

A 57-year-old Asian American man comes to the clinic because of changes in mood, behavior, or thinking. History and focused examination are notable for excessive worry for more than six months with muscle tension and insomnia. Temperature is 101.5°F (38.6°C), blood pressure is 82/48 mmHg, pulse is 132/min, respirations are 28/min, and oxygen saturation is 90% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. There is no evidence of intoxication, delirium, or a primary neurologic disorder unless described in the vignette. Which of the following is the most appropriate next step in management?

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Correct answer: D — Cognitive behavioral therapy or SSRI therapy

The vignette describes Generalized anxiety disorder, supported by excessive worry for more than six months with muscle tension and insomnia. Cognitive behavioral therapy or SSRI therapy is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: APA Anxiety Disorder Guideline