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Mrs. Sylvia Contesta is a 62-year-old Hispanic female with the complaint of “sometimes I hear people talking about me and they stare.” The patient is accompanied by her oldest daughter to the visit. For the past 2 months, the patient has been up all night cleaning because she cannot sleep. Currently on Lisinopril/Hydrochlorothiazide 20 mg/25 mg 1tablet PO daily, Tamoxifen 20 mg 1 tab PO daily, Multivitamin PO daily. Current Therapy: None. Has anxiety/fear/avoidance present for 6 months. Denies being depressed, not apathetic, slightly agitated and irritable when talking about her frustrations, denies euphoria, crying spells often, presence of significant stressors, and difficulty getting up in the mornings. Denies feeling fatigued and reports that she always had “high energy” even when she was the sickest and going through chemo and radiation.

List the three most likely differential diagnoses based on the chief complaint, with cited rationale (use DSM5 criteria to rule in/out). What is the etiology/pathophysiology associated with each diagnosis? What is the prevalence of each of these diagnoses?
A: Choose one of your differentials as a primary diagnosis.
P: Develop a plan of care for your chosen diagnoses, including the following: 
Diagnostic testing
Pharmacologic interventions, including dosage, route, and frequency
Nonpharmacologic interventions, including modality and frequency
Education, including health promotion, maintenance, and psychosocial needs
Safety plan
Referrals required
Follow-up, including return to clinic (RTC) in what time frame and reason, including any labs needed for next visit
SCIENCE
HEALTH SCIENCE
NURSING
NURSING NU643

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