Question:easy
An MBBS student presents with choking, dyspnea, chest tightness, anxiety and an impending sense of doom. On examination all systemic findings are normal, and she is referred to psychiatry. What is the probable diagnosis?
An MBBS student presents with choking, dyspnea, chest tightness, anxiety and an impending sense of doom. On examination all systemic findings are normal, and she is referred to psychiatry. What is the probable diagnosis?
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A sudden storm of fear with a sense of doom and a completely normal physical exam is the giveaway.
Updated On: Jun 23, 2026
- Panic disorder
- Depression
- Epilepsy
- Asthma
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The Correct Option is A
Solution and Explanation
Clinical pearl: the phrase impending sense of doom plus choking and palpitations, with a normal physical workup, is the textbook description of a panic attack.
Eliminate the rest. Asthma is removed first because the respiratory examination is normal, with no wheeze or distress on auscultation. Epilepsy does not fit, as there is no seizure activity, aura, or post-ictal state, just acute anxiety. Depression is a sustained disorder of mood and anhedonia over weeks, the opposite of a brief explosive episode of fear.
The remaining answer, panic disorder, captures the recurrent, abrupt episodes of overwhelming anxiety with prominent autonomic symptoms (chest tightness, breathlessness, palpitations) and the dread of doom, all in someone whose organic evaluation is unremarkable.
Ref: Arvind Arora Review of Psychiatry.
Eliminate the rest. Asthma is removed first because the respiratory examination is normal, with no wheeze or distress on auscultation. Epilepsy does not fit, as there is no seizure activity, aura, or post-ictal state, just acute anxiety. Depression is a sustained disorder of mood and anhedonia over weeks, the opposite of a brief explosive episode of fear.
The remaining answer, panic disorder, captures the recurrent, abrupt episodes of overwhelming anxiety with prominent autonomic symptoms (chest tightness, breathlessness, palpitations) and the dread of doom, all in someone whose organic evaluation is unremarkable.
Ref: Arvind Arora Review of Psychiatry.
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