Question: provide a differential diagnosis for the patient based on the...
Provide a differential diagnosis for the patient based on the information below with explanation.
Amy is a 29-year-old female who moved back in with her mother about a year ago after her divorce. She has no children. In the last year Amy has been in and out of doctor’s offices due to a number of medical problems including difficulty breathing, heart arrhythmias (fluttering heart), nausea and severe stomach pains, vertigo (dizziness), and paresthesia (tingling, prickling of the skin). Amy has been to the ER on multiple occasions because she was convinced she was having a heart attack because she was experiencing chest pain, her heart was racing, she couldn’t catch her breath, felt like she was choking and thought she might be dying. She has had electrocardiograms (EKGs), numerous blood tests, CT scans, an endoscopy (scope with light and camera to view upper digestive system), and an electronystagmography (ENG) to test for an inner ear problem. All tests have come back normal, which has confused and frustrated Amy because she feels so sick. Amy lost her job about six months ago due to extensive absences from work and because she would often leave work early because she wasn’t feeling well. Because Amy becomes completely incapacitated when she experiences symptoms and because they can occur suddenly and out of the blue, she has become afraid to drive alone for fear that she might get in a car accident. Amy’s mother has been driving her to and from doctor’s appointments. Her mother has also been accompanying her when she goes out in public because she fears experiencing symptoms in public and being embarrassed or unable to get help if she needs it. Amy used to have several close friends but stopped seeing them because hasn’t felt well enough to go out and is embarrassed that she lost her job and is living with her mother while her friends are married with children and appear happy. Amy reports feeling hopeless about her situation.