Reference no: EM133316608

Assignment: Present a diagnosis , criteria , differential diagnoses and treatment plan for this case (following the dsm5) :

Case Study: 44-year-old male presents in your office having been referred by his primary care physician as needing urgent evaluation. About six days ago he was on a commuter train heading to his work downtown. While they were stopped at an intermediate station, his train was hit from behind by another train which did not get the "slow to a stop" signal on the radio due to an equipment fault. The collision sent a number of persons flying through the air, and the patient was tossed forward

against the top crossbar of the seat in front of him. He felt terrible pain, went to the hospital, and was told he had a simple fracture of one of his lower arm bones. He suffered no other physical

injuries and was fortunate that an orthopedic specialist was in the hospital at the time and he was

casted very quickly. He reports being unable to sleep through the night, with frequent nightmares recalling the accident playing repeatedly in his head. He has been very anxious and fearful, and when he drives he states he's "always on guard" much more than usual. His blood pressure, which has been normal all his life is now borderline hypertensive, and even when he is awake he says "It's like I'm reliving it all over again". The orthopedist has given him permission to return to his

desk job, but with only one car, he would need to take the train. The referring physician gave him a diagnosis of PTSD, and was wondering what you could do to alleviate his stress and symptoms before considering medication. You scheduled an appointment for six days later, which was the earliest you could fit him into your schedule. He showed up on time, was much less anxious, more animated and talking about getting on the train and going back to work soon.