anxietypanic disorder - julyananxietypanic障碍-朱利安

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1、PsychiatryFinalsPage20of20OSCEsStructure·5minutesateachstation·Readtheinstructions·Thecluesareinthescenario·Stationsmaybehistory,examiningorprocedure–historyishardest·Who’satthestation?·Introduceyourself·Explaintothepatientwhatyou’vebeenaskedtodo·Markedbystructuredsheet,1pointperitemattempted·E

2、xtramarksforoverallexcellence·Howyouaregraded–thereisadegreeofpeerreferencingforborderlinescoresWhyanOSCE?·Seewww.kcl.ac.uk/depsta/medicine/gppc/osce.htm·Validityvsreliability–OSCEsarereliable·Testsbreadthratherthandepth·Testcompetenceratherthenexcellence·Any1stationislessimportantthanallstatio

3、nsputtogether–don’tbeputoffifonegoesbadly·Legalconsiderations–candidateswhofailcansueifprocessnotequitableandtransparentTips·You’retheretoscorePOINTS,nottakeaperfecthistory/doaperfectexam·It’smoreimportantthateverythingisDONEthandonewell·Trytoappearconfidentbutnotarrogant·It’sfairerthanlongcase

4、sandshortcases!Page20of20PsychiatricassessmentIngeneral,rememberthatpsychiatricassessmentisnodifferentthangeneralmedical/surgicalassessment.Management=assessment+interventionAssessment=history,examination+investigations1.Personaldetails2.Reasonforreferral3.Historyofpresentingproblem4.Pastpsychi

5、atrichistory5.Pastmedicalhistory6.Drughistory7.Familyhistory8.Personalhistory9.Socialhistory10.Forensichistory11.Premorbidpersonality12.Mentalstateexamination13.Physicalexamination14.InvestigationsPage20of20PsychiatricassessmentPersonaldetailsReasonforreferralPresentingproblem·Patient’sownwords

6、·Symptomclusters·Psychosis·Mood·Anxiety·OCD·Substancemisuse,riskPastpsychiatric·Diagnoses,admissions,detentions,self-harm,who’sinvolvedPastmedical·Headinjuries·SeizuresDrug·Prescribed·OTC+homeopathic·Smoking·Illicit·AlcoholFamilyPersonalSocialForensic·ChargespastandpendingPremorbidpersonality·F

7、romotherswherepossibleMentalstate·UsepsychiatricterminologyPhysicalInvestigationsPage20of20MentalstateexaminationAppearance·Build,distinguishingfeatures,clothing,hygieneBehaviour·Agitated/retarded/overactive,eyecontact,rapport,app