14th February 2025

A 68-year-old woman has been feeling anxious, dazed and confused ever since seeing her dog get run over by a bus a few hours prior.

A 68-year-old woman has been feeling anxious, dazed and confused ever since seeing her dog get run over by a bus a few hours prior.

She has a background of obstructive sleep apnoea, obesity and hypertension. She has been having yearly CT scans of her chest to monitor an enlarged pulmonary lymph node. She takes felodipine and uses CPAP at night.

In her early twenties, she suffered with bulimia nervosa whilst at university, but this resolved with CBT and the cessation of her exams.

She attends A&E, and obs are: HR 112, BP 142/78, RR 24, SpO2 99% on RA, temperature 36.6.

She is seen by an SHO who, after normal blood tests and a CT scan of her head, feels that her presentation is not due to an acute organic process.

Which of the following is true regarding the underlying pathology?

Select the SINGLE most appropriate option from the list below. Select ONE option only.