I am going to answer the sample USMLE Step 2 CK Questions with Explanation. These questions are available at USMLE.org
A 21-year-old man comes to student health services because of a 6-month history of increasingly frequent episodes of moderate chest pain. The first episode occurred while he was sitting in traffic and feeling stressed because he was late for a college class. At that time, he had the sudden onset of moderate chest pain, a rapid heartbeat, sweating, and nausea. He says he felt as though he were going to die. The episode lasted approximately 10 minutes. He had a similar episode 1 month later while on a date; the symptoms were so severe that he abruptly ended the date. During the past 3 weeks, he has experienced two to three episodes weekly. He says he fears having an episode while in public or on a date, so he has decreased his participation in social activities and the amount of time he spends outside of his apartment. He has no history of serious illness and takes no medications. He does not drink alcohol or use other substances. Vital signs are within normal limits. Physical examination discloses no abnormalities. On mental status examination, he has an anxious mood and full range of affect.
Which of the following is the most likely diagnosis?
(B) Generalized anxiety disorder
(C) Illness anxiety disorder (hypochondriasis)
(D) Social anxiety disorder (social phobia)
(E) Somatic symptom disorder
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Agoraphobia is characterized by anxiety about being in situations or places from which escape might be difficult or embarrassing or where help may not be available in the event of a panic attack or other incapacitating symptoms. The individual typically avoids these situations, leading to significant impairment in social or occupational functioning. The described symptoms, including chest pain, rapid heartbeat, sweating, nausea, and fear of having an episode in public, are consistent with panic attacks, which commonly occur in agoraphobia. Additionally, the avoidance of social activities and spending less time outside his apartment further supports this diagnosis.
The correct answer is A