Clozapine
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The parents of a critically ill 6 y/o patient tell you that when the child became ill, his 14 y/o brother started to behave badly in the school and at home. As the younger child`s doc, you should
a. refer the teenager to an adolescent psychologist
b. speak to the teenager ASAP
c. speak to the teenager when the younger child is out of danger
d. tell the parents that the patient is the younger child, not the teenager
e. tell the parents to concentrate on the younger child
pls explain ur answer.
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| me007
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a.
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| Clozapine
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could you pls explain the answer me007?
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| Ancylostoma
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A I guess i would have to Go with A too. The child looks like hes acting out and not able to cope with the news that he will soon lose his brother. I'm weary of this answer becuase Kaplan always say never refer a patient. I suppose the brother isnt a patient. I dont like the last three choices and even if you talked to the child are you qualified to asses his mental state ? I dont know but A seems like the best answer. Tell me If I'm wrong.
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| unique1
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I am afraid I will disagree with A because as Kaplan says , how can we refer the boy to another doc even without talking to him ?
I choose B . Please correct me with explanation of correct answer if I am wrong .
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| Ancylostoma
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I interpreted it as terminally ill not Critically ill. I think you may be right. Did anyone notice that the kaplan Qbank was full of ethics questions but didnt have enough Doctor patient relationship questions?
Edited by Ancylostoma on 01/23/07 - 09:05 PM
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| Luckyall
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i'd go with B
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| Luckyall
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mmmmm how can one possibly reffer the teenager to an adolescent psychologist when is not your pt ?
All you can do is just to try to see if you can solve it ... right?
Then is the ethical duty to help out as much as you can thi family issues !
Can you type the exaplanation, please ?
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| me007
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ok.
You are physician and teenager is not your patient and he has not illness.
But you supposed to help.
if you pick b or c - what are you going to tell him? Will it make any difference to his bad behavior? physician is not psychologist.
c - yes, it's true, but it is not the answer
d - does not make any difference to situation
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| Luckyall
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Yes, you have the duty to talk to him, try to understand his fears.
Is like your pt is a minor, he is smoking and hios parents ask you.... what should we do, you have to kindly, invite the parents OUT of the room and talk to the kid in private
I guess i read it somewhere on one of Kaplan ethical cases
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| Clozapine
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Thanks guys !! The answer IS B.
I was confused too, coz kaplan says, 'know who your patient is', but 'you shouldn`t refer a patient' is kinda rule of thumb.
The explanation is, the underlying cause of the teen-ager`s behavior is possibly anxiety/fear/concern for younger sibling /lack of attention/changed behavior of his parents, and the parents brought this to your attention so you should talk to the teen ager to relieve his fears.
Adolescents often "Act-out" when fearful or depressed. It`s the doctor`s role to deal with problems in the patient`s support system and thus help in recovery.There`s usually no need to refer family members to mental health professionals. Waiting until the younger child is out of danger will needlesssly prolong the teenager`s problem and further stress the family.
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| Ancylostoma
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Well that makes sense. we should all post more of these doctor patient relationship questions . Ive seen a couple of people say that there were so many of them on their test.
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