QBDOTW: A 45-year-old Anxious Female referred by Physician
Welcome to MedSmarter’s USMLE Style Question Break Down of the Week. For those preparing for the USMLE Step 1, this week we break down a high-yield Psychiatry question. As always you want to begin with reading the last sentence of the vignette first to get an understanding of what the question is asking for.
Question Break Down of the Week:
A 45-year-old woman presents to a psychiatrist after a referral from her physician due to the fact that she feels anxious all of the time. Her primary care physician diagnosed her with generalized anxiety disorder and prescribed buspirone; however, the patient does not report feeling any better. She works as an accountant and spends most of her day in a single, private cubicle. She has no close friends and lives by herself. She says that occasionally people from work invite her out at night, but she never goes, even though she would like to. She is not dating currently and is worried that people don’t like her. Which of the following personality disorders best describes this patient?
A) Avoidant
B) Dependent
C) Histrionic
D) Narcissistic
E) Schizoid
F) Schizotypal
The correct answer choice is A: Cluster C is called the anxious, fearful cluster. Cluster C personality disorders include avoidant, obsessive-compulsive, and dependent; patients with these disorders are characterized as anxious or worried and have abnormal fears about relationships, separation, and control. There is a genetic association with anxiety disorders. Patients with avoidant personality disorder are sensitive to rejection, socially inhibited, and timid, with overwhelming feelings of inadequacy.
Did you think the answer was different?
Did you think that the correct answer choice was other than A? You can view this video for a deeper discussion of why B, C, D, E and F were not the correct answer choices.
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