T10.1: Physician Patient Relationship

Question 1

What is the single best predictor of postcussional syndrome? (MG)

A. Number of prior concussions
B. Older age
C. Premorbid psychiatric symptoms
D. Litigation

Answer 1

D. Litigation

This was from the DLA

Question 2

You enter the room of a pediatric oncology patient for the first time. The patient is covered in skin lesions- especially over her face. You didn’t read the chart before entering, and react visibly on your face (gap-mouthed, wide eyes, etc.). The patient watches your reaction and immediately hides under the blankets. You cannot get her to come out, answer questions, or allow you to examine her. Her mother says people often react like you did in public, and the little girl is aware of it. Describe what is going on here (MG)

A. Denial
B. Transference
C. Projection
D. Counterfransference

Answer 2

B. Transference

Outside of the hospital, people react how you did and it upsets her. Inside of the hospital so far, the staff have been sensitive to the issue and not reacted. However, when you reacted you caused her to transfer her need to hide in public to the hospital setting. It will be very difficult for any medical personnel to work with her now.

Question 3

Delivering bad news to a patient? Use SPIKES. What does it stand for? (MG)

Answer 3

Setting up the interview
Perception of the patient
Invitation
Knowledge
Emotions and empathy
Strategy and summary