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10 Cards in this Set
- Front
- Back
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How do you break bad news... the dumb mneumonic. Please. |
S - Setup - review notes/Ix, social Hx, etc P - Perception - what do they know? I - Invitation - can I talk about this with you? K - Knowledge - Educate Pt in lay-man English E - Emotion - don't be a dick S - Summary/Strategy - plans, goals |
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How do you empathise like a non-retarded human being when breaking bad news? Mneumonic please. |
N - Name the emotion verbally U - Verbally show understanding of the underlying info/message R - respect and reassure Pt S - Support - how we can help E - Explore further - tell me more |
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Signs of carer compassion fatigue / burnout? |
Deterioration of: Health - sleeping, eating, headaches Emotions - irritable, depressed, guilty Behaviour - flat, pessimistic, callous, suicidal Work - deteriorates, reduced caring Personal - lose connections, withdrawn, dehumanises |
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Risk factors for burnout? |
Empathising too much! Long hours Stressful job No coping strategies Poor training Difficult patients Difficult co-workers Failing own goals |
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Co-morbidities caused by obesity? |
Depression, anxiety CVD Dyslipidaemia Joint problems - arthritis Sleep apnoea Renal pathology HTN Atherosclerosis --> vascular diseases DM Infertility NAFLD GORD |
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Biological causes of obesity? |
Hypothyroidism PCOS Cushings Depression Iatrogenic - GCs, contraception, anti-psychs, anti-epileptics |
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Surgical options for obesity? Some pros and cons for each? |
Gastric band: Pro: quick and easy, gives early satiety and restricts absorption, reversible. Con: high recurrent surgery and complication rate Sleeve gastrectomy: Pro: Short stay, low complications, gd wt loss. Cons: Irreversible, no long-term data, Reflux!, sleeve can expand = wt gain, need vit/min supps Roux-en-Y gastric Bypass: Pro: good wt loss Con: vit/mineral malabsorption, anaemia, major surgery. |
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Important Q's to ask to establish whether someone has substance dependence? From DSM-4 criteria. |
1. Tolerance - do you need larger amounts to get same effect? 2. Withdrawal Sx? 3. Have you taken this drug for longer or in higher doses than planned to? 4. Unable to control use, ie "Have you been able to cut down use at all?" 5. Excessive time spent in substance use related activities. 6. Social, work and recreational activities suffering 7. Continued use despite recognising psychological or physical harms of drug |
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Meds used to help Tx substance abuse? |
Benzo's - wean off using benzodiazepam Disulfuram - makes alcohol into poison Naltrexone - for opiates and alcohol Anti-emetics (metoclopramide/ondansetron) to assist with Sx |
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Mx for a frozen shoulder? |
It is self limiting, so give pain relief and NSAIDs. If Sx persist refer to ortho for ?surgical intervention. Despite Tx, most Pt's won't regain full rotation of shoulder again. |
