Psychosocial Encounter

Question 1

Depression mneumonic

Answer 1

SIG E CAPS

• Sleep change
• Interests decreased
• Guilt
• Energy decreased
• Concentration decreased
• Appetite/weight disturbance
• Psychomotor changes
• Suicide thoughts

Question 2

Test for depression

Answer 2

PHQ=9

9 questions; scales rage from 0 -3

Question 3

most important questions in PHQ-9

Answer 3

9. Thought that you would be better off dead or of hurting yourself
10. Summary question: If you checked of any problems, how difficult have these problems made it for you to do your work, take care of things at home or get along with other people?

Question 4

is someone is currently suicidal, what do you asks?

Answer 4

1. Have you ever thought of hurting or killing yourself?
2. Do you have a plan to harm yourself? What is it?

Question 5

how to assess suicidal risk

Answer 5

1. currently suicidal, intent, plan?
2. previous attempts?
3. ID risks and protective factors: what keeps you from killing yourself

Question 6

RF for suicide

Answer 6

1. past hx of suicide attampt or ideation
2. Male
3. Physician

Question 7

Protective factor for suicide

Answer 7

1. suportive relationships

2. Religious/cultural beliefs AGAINST suicide

Question 8

what is the Audit-C

Answer 8

3 Q (5 choices per question, valued at 0 –4 points) screening tool to identify unhealthy alcohol use including hazardous drinkers or active alcohol use disorders

• • test => hazardous drinking
• • Men = 4 or more
    
    • Women = 3 or more

Question 9

Question in AUDIT-C

Answer 9

1. How often do you have a alcoholic drink ?
2. How many standard alcoholic drinks do you have on a typical day?
3. How often do you have 6 or more drinks on one occasion?

Question 10

CAGE questionnaire

Answer 10

1. Cut down
2. Annoyed (ppl annoyed you by critisizing drinking)
3. Guilt (guilty about drikning)
4. Eye-opener (have you ever had a drink 1st thing in morning to steady nerves/get rid of hangover)

Question 11

Threshold for CAGE

Answer 11

2 or more on CAGE question is POSTIIVE

W = 7 drinks/week

M = 14 drinks/week

Question 12

if pt has dyspnea, consider what DDx

Answer 12

1. Panic disorder
2. Asthma
3. Pneumothorax
4. PE
5. HF
6. Hypoxia

Question 13

if you suspect pt is experiencing spousal abuse, what should you do?

Answer 13

ask direct questions!

1. Is your partner or someone close to you threatening you, or otherwise making you feel afraid?
2. Have you ever been hit, kicked, punched, strangled, or otherwise hurt by your partner or spouse?
3. Are you safe at home? Or Do you feel safe at home? (NOTis your home safe?)

Question 14

PE for a psychosocial encounter?

Answer 14

1. Basic: heart, lungs, OSE
2. Exam is driven by assx symptoms or ROS

Question 15

in psychosocial encounter, if ot has palpitations, what do you do extra for PE

Answer 15

1. Extensive CV exam
   
   1. palpate thrill or PMI
   2. listen in different positions or with bell
   3. Palpate thyroid
   4. DTR

Question 16

in psychosocial encounter, if ot has HA, what do you do extra for PE

Answer 16

1. CN 2-12
2. Gait
3. Rhomberg

Question 17

in psychosocial encounter, if ot has chronic pain, what do you do extra for PE

Answer 17

1. Assess area of concentration
   
   1. ROM
   2. Strength
   3. Neurovacular
   4. Special tests

Question 18

what should you say in : general” for SOAP note

Answer 18

1. hygeine and dress
2. affect
3. eye contact
4. NRG level
5. Engagement and interactions

Question 19

Instead of: Fidgeting constantly, say what?

Answer 19

unable to sit still, tapping heels throughout exam

Question 20

Be objective—avoid making a diagnosis without objective data

•Instead of: the patient is obviously intoxicated, say what

Answer 20

pts words are slurred and odor of alcohol. let blood alcohol levels prove diagnosis