achilles
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Topics: 87
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E.
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| srf
Forum Guru
Topics: 73
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d
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| babli
Forum Guru
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correct ans is E.
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| srf
Forum Guru
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babali ,would you please explain why e is right & d wrong.does not e avoid pt q & concern ? is it not without empathy? would pt like that? what we want to convey to pt by e? pt has already told his complains so many times to various doctors.what diffrence will it make if he says them again?
do you think that others might have missed some thing in history taking?
please explain.
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| chemamr
Moderator and PGY2
Topics: 703
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E
the patient is concerned about his stomachaches, so i think we should listen the story from him right away, taking a clinical history, then a physical examination. And then at the end, you can check the files to check for some lab tests and what other physicians have told about the patient and other stuff.
I mean, you need both things: listen the patientīs history and read the files. But 1st thing to do should be to TALK with the patient about his problem(s). Thatīs my opinion, thatīs what iīd do.
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| achilles
Forum Guru
Topics: 87
Posts: 1,208
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agree totally with chemamr and it is also the reason why i choose E as the answer.
srf, yu sound a bit offended. i think it would be nice to be a bit more polite to babli who took out time from her busy schedule to post this question and initiate a discussion from which all of us benefit and she would surely be very happy to answer any doubts that any of us have.
chemamr, could yu pls look up the post on hypothyroidism by determine in the int med forum. how was the match for you this yr ?
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" it's not whether you get knocked down, it's whether you get up"
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| babli
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Topics: 40
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It is important to to take control of the patient.gentle redirection back to the problem is most appropriate course of action @ this point.although old medical record r always helpful,a patient who brings in a thick stack of records & demands u to read them should cause psychiatry flag to b raised in the back of your mind.going too quickly to a psychiatric slant may offend the patient,however,& prevent u from building trust & gaining confidence of the patient.going along the patient's wishes may lead to further demands(which r quite likely to b inappropriate also).
srf this is the explanation given.hope it helps.
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| srf
Forum Guru
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Thanks for explanation babali. Now I got it.For me psychiatric q are a bit more difficult to understand. I need explanation to understand it. I hope you will not mind it.
thanks again
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| babli
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hi srf i don't mind @ all.we all r in phase of learning & understanding..i also don't understand psychiatry quite well.i've made same kind of questions wrong again & again that's y i posted.
achilles & chemamr thanks to both of u for taking time to explain.
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| srf
Forum Guru
Topics: 73
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glad to hear that from you
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| Dr.D
Forum Senior
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answer is E
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| Kamsi
Forum Guru
Topics: 103
Posts: 347
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E
This patient most likely has hypochondriasis, has been doctor shopping . They are usually concerned and want treatment started early .A sympathetic approach is ideal The best thing is to hear his story to create a rapport and once established u sceen for other conditions like depression,anxiety,OCD and regular follow up.U may go through the life later to see what the other doctors have done .
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| dermatology
Forum Elite
Topics: 30
Posts: 293
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E
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