Anxiety disorders: hyperventilation: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Anxiety disorders: hyperventilation

Sample item

A young woman in a panic attack presents with tingling around the mouth, carpopedal spasm and light-headedness with rapid breathing. The most appropriate immediate step is

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Reassurance and slow, controlled breathing

Hyperventilation causes respiratory alkalosis, which lowers ionised calcium and produces perioral paraesthesia and carpopedal spasm. Reassurance and breathing retraining correct it. Rebreathing from a bag is no longer recommended because of hypoxia risk.

Option by option

  • A. Reassurance and slow, controlled breathing (correct)

    Correct. Calming and slowing the breathing reverses alkalosis.

  • B. IV haloperidol

    Haloperidol is not indicated for a panic attack.

  • C. Intubation

    Intubation is unwarranted in hyperventilation.

  • D. IV calcium gluconate

    Total calcium is normal, and the ionised fall is due to alkalosis, so calcium is not required.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Reassurance and slow, controlled breathing. Hyperventilation causes respiratory alkalosis, which lowers ionised calcium and produces perioral paraesthesia and carpopedal spasm.

Why is "IV haloperidol" not the answer?

Haloperidol is not indicated for a panic attack.

Why is "Intubation" not the answer?

Intubation is unwarranted in hyperventilation.

Why is "IV calcium gluconate" not the answer?

Total calcium is normal, and the ionised fall is due to alkalosis, so calcium is not required.

What concept does this question test?

It tests Anxiety disorders: hyperventilation in Psychiatry. Reassurance and breathing retraining correct it. Rebreathing from a bag is no longer recommended because of hypoxia risk.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Anxiety disorders: hyperventilation?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.