Psychiatry interview notes

Conducting interview. Background information.

  1. How old are you?
  2. Where do you live?
  3. What is your marital status?
  4. How do you support yourself?
  5. Where do you receive your mental health treatment?
  6. How long have you been on the inpatient unit?

How did you get admitted: voluntary or involuntary

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CASC FLASH CARDS NOTES 2011
Conducting interview. Stock phrases.
1. Introduction; good morning sir/madam-----my name is Dr ­ and your name is..?
2. I may need to interrupt you from time to time to get important information and it is not
meant to be disrespectful in any way.
Conducting interview. Background information.
1. How old are you?
2. Where do you live?
3. What is your marital status?
4. How do you support yourself?
5. Where do you receive your mental health treatment?
6. How long have you been on the inpatient unit?
7. How did you get admitted: voluntary or involuntary?
Conducting interview. History of the present illness.
1. What led you to being hospitalised?
2. What is the reason for your receiving psychiatric care as an outpatient?
3. Would it be appropriate then for me to say that this.....is the reason for your being
admitted/receiving treatment?
4. I am not sure that I understand, would you kindly clarify?
Q1. ALCOHOL. Patient with alcohol problem was admitted to orthopaedic ward after fall.
A. Take history and Mental state examination
B. Talk to nurse and discuss management plan.
Answer
A. Substance misuse history.
1. Onset and progression.
2. Typical daily drug use
3. Withdrawal symptoms
4. Poly substance use

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Previous treatment
6. Complications: physical, psychological, social and family, occupation, finance, insight and
motivation.
Q2. ALCOHOL. Assess motivation to change
Answer
1. Empathy
2. Avoid confrontation
3. Intention to change
4. Disadvantages of status quo.
5. Advantages of status quo
6. Advantages of change
7. Conclusion.
Q3. ALCOHOL. Perform physical examination.
1.Use hand gel before and after entering station.
2.Introduce yourself and state reason for the assessment/appointment (History).
3.Consent.
4.Ask for Chaperone.
5. Enquire about pain.…read more

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Eye movement: elicit nystagmus, lateral gaze.
g. cerebellar signs: Finger-nose test, Dysdiadochokinesia- heel shin test.
h. Reflexes in upper and lower limbs.
i. Gait.
j. sensory: Light touch, vibration and proprioception.
k. cardiovascular exam.
l. Respiratory exam.
THANK THE PATIENT
Q4. ANXIETY DISORDERS
Assess patient for anxiety disorder
Answer:
1. Communication
2. Presenting complaint and history
3. Background information
4. Diagnostic consideration
5.…read more

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Explain diagnosis and management to Carer.
Answer.
1. Communication skills: Respond to carers questions.
2. Diagnosis.
3. Management.
4. Prognosis.
Management: Include the following- MDT approach;options;psychoeducation;
pharmacological treatment; CBT; Psychiatric disorder treatment; role of carer in
treatment plan; graded exposure with relaxation...
Q6. ANXIETY DISORDERS. AGORAPHOBIA. Explore psychopathology.
1.Do you avoid places or situations from which escape might be difficult or embarrassing or in which
help may not be available in the event of having a panic attack or panic-like symptoms?
2.…read more

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Tell me more about it.
3. Do they bother you or cause any distress?
4. Do they affect your life in anyway?
5. Tell me more about it.
Q10. ANXIETY DISORDERS. Explore anxiety and Panic attacks.
Anxiety:
1.Would you describe yourself as an anxious person?
2. Tell me more about it.
Panic attack:
1.Do you have periods of intense apprehension, fearfulness, or terror that occur out of the blue?
2. Is it often associated with feelings of impending doom?
3.…read more

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Tell me more about it.
3. Do you avoid such situations?
Q14. ADHD
Take history from patient's parent.
Answer.
1. History triad: Inattentive and short attention span; hyperactive at least 6 months for both;
impulsive.
2. Associated behaviour problems.
3. Lifelong nature of symptoms.
4. Pervasiveness of symptoms in all environments.
5. Effect on function; family; peers; academic.
6. Co-morbidity: reading delay.
Q15. ADHD
Discuss management of ADHD to Parent.
Answer.
1. Acknowledge and address father's concerns.
2. Explore what father already knows.
3.…read more

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Social play: spontaneity; reciprocity.
4. Peer relationship.
5. Communication.
6. Stereotypes and routines.
7. Areas of interest.
8. Abuse and bullying.
9. Behavioural issues.
Q17. BEHAVIOURAL DISTURBANCE.
An 80 year old woman had a recent fall. She became hostile to staff.
Task: A. Elicit psychotic symptoms and basic cognitive assessment.
B. Discuss diagnosis and management plan.
Answer.
A. Outline as follows.
1. Communication.
2. Circumstance of head injury.
3. Premorbid function.
4. Current difficulties: Risk; self-care; mood irritable; forgetful; apathy and social.
5.…read more

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Management of head injury.
8. Need more information.
Q18. BEREAVEMENT.
Assess for grief and depression.
Answer:
1. Communication and sensitivity.
2. Chronology.
3. Grief.
4. Sadness and depression symptoms.
5. Guilt.
6. Hopelessness and helplessness.
7. Self-esteem.
8. Retardation.
9. Psychotic symptoms.
10. Family and social support.
11. Suicide risk.
12. Conclusion.
Q19. BLINDNESS.
TASK: Perform assessment to arrive at diagnosis and co-morbidity and perform physical
examination.
Answer
Assessment:
1. Present complaint.
2. History of present complaint.
3. Temporal relation with stressors.
4. Medical complaints.…read more

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Offending history.
8. Illicit and legal drug use.
9. Effect on others.
10. Risks.
Diagnosis and comorbidity.
Conversion disorder; hypochondriasis; somatoform disorder; anxiety; depression; personality;
substance misuse; etc.
Aetiology:
Predisposing, precipitating; perpetuating factors and secondary gain.
Physical exam:
Chaperone; consent; visual acuity; visual fields; eye movements and reflexes; fundoscopy.
Q20. BODY DYSMORPHIC DISORDER.
Task: Take history and nature of symptoms and perform mental state exam.
Answer:
1. Acknowledge his feeling about referral.
2. Sequential history of symptoms.
3. Assess nature of symptoms: overvalued idea; delusions.…read more

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Use simple language and avoid jargons.
5. Professional approach.
6. Relatives concerns; respond appropriately.
7. Explain result of CT Brain and need for further investigation to clarify diagnosis.
8. Avoid giving false hope.
9. Control of interview.
Q22. CRANIAL NERVES EXAMINATION.
Remember the following five steps for all physical examination stations.
1.Use hand gel before and after entering station.
2.Introduce yourself and state reason for the assessment/appointment (History).
3.Consent.
4.Ask for Chaperone.
5. Enquire about pain.
CN1: Abnormal smell.…read more

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