Confusion, Consent, Crying Man

Question 1

You have been asked to do a punch biopsy in ED. Obtain informed consent.

What are the key issues of informed consent?

Answer 1

Key issues include;

• mental illness does not equal incapacity consent
• Medico legal; MHA exceptions, documentation, who is obtaining it
• Involve family

Question 2

What are key issues re schizophrenia in med/ surge wards?

Answer 2

1. Chronic disease; case manage, medication, last relapse
2. Relapse signature
3. Negative symptoms
4. Metabolic monitoring
5. Reassure (staff)

Question 3

Depression Checklist

Answer 3

1. WIPERC
2. Hx;
   - Demographics
   - Doagnosis; depression
   - Baseline change
   - Risk (suicide/ homicide)
   - Cognition
   - Psych hx
   - meds
   - mx acute issues
   - Supports
3. Mx;
   - Always exclude organic
   - Delay discharge
   - MDT: nurses, hoem team
   - Colateral hisotry
   - consider various rx for depression