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  #1  
Old 09-25-2012
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Default explain each and every option

An 18-year-old woman is brought to the emergency
department by her sister after she was
found lying asleep in bed, next to an empty
bottle of acetaminophen. The sister thinks that
“something is up” with the patient’s boyfriend
because she had returned home the previous
night horribly upset and in tears. When asked
how many acetaminophen pills were in the
bottle, the sister notes that the bottle was nearly
empty, and the patient could not have taken
any more than six pills. Which of the following
questions is the most helpful to ask the patient
during this interview?

(A) “Do you ever hear voices or see things that
other people can’t see?”
(B) “Have you ever been hospitalized for psychiatric
reasons before?”
(C) “Tell me more about your relationship
with your boyfriend”
(D) There is no reason to elicit more information;
every suicidal patient should be hospitalized
(E) “What recreational drugs do you use?”
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  #2  
Old 09-25-2012
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This seems so tough ,I wish I could choose all the options
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  #3  
Old 09-25-2012
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Quote:
Originally Posted by K06100 View Post
An 18-year-old woman is brought to the emergency
department by her sister after she was
found lying asleep in bed, next to an empty
bottle of acetaminophen. The sister thinks that
“something is up” with the patient’s boyfriend
because she had returned home the previous
night horribly upset and in tears. When asked
how many acetaminophen pills were in the
bottle, the sister notes that the bottle was nearly
empty, and the patient could not have taken
any more than six pills. Which of the following
questions is the most helpful to ask the patient
during this interview?

(A) “Do you ever hear voices or see things that
other people can’t see?”
(B) “Have you ever been hospitalized for psychiatric
reasons before?”
(C) “Tell me more about your relationship
with your boyfriend”
(D) There is no reason to elicit more information;
every suicidal patient should be hospitalized
(E) “What recreational drugs do you use?”
I am confused between C and D.

(D) There is no reason to elicit more information;
every suicidal patient should be hospitalized
If she have significant LFT changes then without knowing reason we have to stabilize patient.

C. This can also be the possibility to manage cause of suicide attempt properly.

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Old 09-26-2012
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Quote:
Originally Posted by K06100 View Post
An 18-year-old woman is brought to the emergency
department by her sister after she was
found lying asleep in bed, next to an empty
bottle of acetaminophen. The sister thinks that
“something is up” with the patient’s boyfriend
because she had returned home the previous
night horribly upset and in tears. When asked
how many acetaminophen pills were in the
bottle, the sister notes that the bottle was nearly
empty, and the patient could not have taken
any more than six pills. Which of the following
questions is the most helpful to ask the patient
during this interview?

(A) “Do you ever hear voices or see things that
other people can’t see?”
(B) “Have you ever been hospitalized for psychiatric
reasons before?”
(C) “Tell me more about your relationship
with your boyfriend”
(D) There is no reason to elicit more information;
every suicidal patient should be hospitalized
(E) “What recreational drugs do you use?”

Tough one If i am th doctor i would opt the question..

(C) “Tell me more about your relationship
with your boyfriend”
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  #5  
Old 09-26-2012
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(C) Open ended question to :
1 - build rapport
2 - begin a discussion
3 - figure out if the sister is right, and dig deeper to address the concern.

also, (D) is worth mentioning and although hospitalization is ESSENTIAL for all pts with suicidal ideations, It is important to figure out and address the underlying cause (Emotional, schizophrenia, work-related, self-image)

All the others imply something and THAT is not the way you want to begin a conversation with any patient, let alone the suicide attempts...
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  #6  
Old 09-26-2012
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The correct answer is C. One of the most important
things to remember when interviewing
a suicidal patient is that patients may tend to
minimize their own symptoms, expressing a denial
of what they were really hoping to accomplish.
However, all aspects of the patient’s suicide
attempt, any previous suicide attempts,
and the meaning behind the current crisis
must all be explored. This question will enable
the interviewer to learn more about the patient,
her feelings, and what is currently happening
in her life that led to this event.
Answer A is incorrect. If the patient is psychotic,
then appropriate medications should
be initiated; however, the details of her suicide
attempt must be elicited fi rst.
Answer B is incorrect. Although obtaining a
good psychiatric history is important, in the
acute setting it is more important to address
the sincerity of the patient’s suicide attempt,
and evaluate whether she is still a danger to
herself.
Answer D is incorrect. Any patient who is a
danger to herself should be hospitalized, but to
do so without an understanding of her actions
would not be appropriate.
Answer E is incorrect. Although it is important
to address substance abuse as a contributor to
any suicide attempt, the details of the suicide
and plan are more important in the acute setting.
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