Abdominal Pain Flashcards

1
Q

Name

A

Dan Green

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2
Q

DOB/ Age

A

4/12/81
42

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3
Q

Occupation

A

Office Worker

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4
Q

Scenario 1 Opening Statement

A

“I’d like to discuss my stomach pains”

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5
Q

Scenario 1 Drinking

A
  • Be vague, “odd glass of wine”.
  • If pressed give amounts towards the lower end of your intake (1-2 bottles a night)
  • Find a way to dismiss the student - i.e. I know I drink too much but I’m going to stop and don’t need any help thanks.
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6
Q

Symptoms (4)

A
  • Daily bouts of abdominal pain
  • Upper centre of stomach, above belly button and below ribs
  • Pain does not radiate anywhere
  • Nausea
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7
Q

How long pain been happening for? (2)

A
  • 4-6 weeks
  • No pain now
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8
Q

Anything associated with pain? (3)

A
  • Nausea
  • Acid taste in mouth
  • Burning sensation behind breastbone
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9
Q

Anything aggravates pain? (4)

A
  • worse when eating
  • maybe spicy food worse?
  • has put me off food for a bit
  • exercise does not aggravate it - I run three times a week, pain never comes on then
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10
Q

Previous bowel issues? (5)

A
  • They’ve always been a bit funny
  • Go 2-3 times in the morning
  • Stool often loose (not watery) or thing and long (like toothpaste)
  • Worse if I’m stressed - feels low tummy pain and bloating - but better if I go to loo
  • Been told I have IBS in past
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11
Q

Blood in stool?

A

No

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12
Q

Stool colour? (2)

A
  • Black
  • No mucous
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13
Q

Lost weight?

A

No

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14
Q

Wake in night to open bowels?

A

No

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15
Q

Anyone else you know has similar symptoms?

A

No

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16
Q

Family problems with bowels?

A

None that I know of

17
Q

Dad / mum medical history (2)

A

Dad - Mild blood disorder
Mum - Bit of blood pressure but otherwise fit

18
Q

Married?

A

Yes, with two primary school-aged children

19
Q

Smoking? (3)

A
  • Smoke socially
  • A couple if out
  • Smoked 20 a day for 20 years but gave up when kids born
20
Q

Recreational drugs?

A

No

21
Q

Scenario 1 - Your ideas (2)

A
  • I think I have indigestion pain.
  • Hoping the doctor will go some medication for my symptoms as the pain is uncomfortable
22
Q

Scenario 1 -
Questions for student: (3)

A
  • What do they think is going on?
  • How is it treated?
  • Is there anything I can do to help myself with this problem?
23
Q

Scenario 2 Opening Statement (2)

A
  • “I’d like to discuss my stomach pains..” after a minute or so of questions
  • “Do you think they could be becasue of my drinking?”
24
Q

Sc 2 What you have actually come about (5)

A
  • You know you’re drinking too much
  • You think this is causing the pain
  • You are honest and open
  • You will be best helped if the student listens to you and is non-judgemental
  • You can come up with ideas of your own to help
25
Q

Sc 2 Your Ideas (2)

A
  • Think you have indigestion pain
  • Bit worried the pain’s coming from my liver as that’s at the top of my stomach isn’t it?
26
Q

Sc 2 Patient perspective on drinking (3)

A
  • Would like to cut down
  • Wasn’t sure how to bring it up so booked appointment for stomach pain and hoped drinking would come up
  • First time you’ve been to the surgery (new patient) and not sure if the student saw I was worried about my drinking on the questionnaire
27
Q

Sc 2 Stresses (3)

A
  • Work stressful with deadline
  • Snapping at partner and kids
  • Not aggressive physically
28
Q

Sc 2 Depressed? (2)

A
  • Don’t think so
  • Think you can figure things out but need some support to do so
29
Q

Sc 2 Hobbies

A
  • Don’t have time to go fishing, which I used to enjoy
30
Q

Scenario 2 Drinking (5)

A
  • Only in evenings
  • Drinking to help me relax and forget worries
  • What was one bottle has become two most nights
  • Worried about health risks (especially with young kids)
  • Worried about the cost of the drinking
31
Q

Sc 2 Hopes (3)

A
  • What is a ‘healthy’ amount to drink?
  • Can anyone help me to cut down?
  • Not looking for a referral or professional help.
32
Q

Scenario 1 Overview (3)

A
  • Student to focus on understanding the problem and gathering information
  • Be vague about alcohol intake
  • Don’t want to discuss alcohol
33
Q

Scenario 2 Overview (3)

A
  • make it clear you’re drinking too much
  • you want advice on how to reduce your intake
  • not necessarily looking for a referral or formal help
34
Q

Sc 3 Character

A
  • Dr Jones
  • GP
35
Q

Sc 3 Opening LInes

A
  • Ask them to present the patient back to you
  • Say: “Great job! Clearly a time waster, send them home and tell them to call AA, would you?”
36
Q

Sc 3 Challenge (3)

A
  • A second year medical student should not be seeing patients without a full review by the doctor.
  • The student should express this to you and ask you to review the patient.
  • Be dismissive of needing to see the patient and full of praise for how competent the student is.
  • Only agree to see the patient is the student clearly asks for your help