RL CCE

Question 1

Sexual Hx - 5 Ps

Answer 1

1. Partners - men, women, both
2. Practice - vaginal, anal, oral
3. Prevention - condoms, contraception
4. PHx STIs + screening
5. Pregnancy +/- periods

Question 2

Adolescent Hx - C:HEADS

Answer 2

Confidentiality
Home
Education + employment
Eating + exercise
Activities
Drugs + EtOH + smoking
Sexuality + gender
Suicide + depression + DSH
Safety

Question 3

Psych - depression PHQ2

Answer 3

Over the last 2 weeks:
?little interest or pleasure in activities
?feeling down or hopeless

Question 4

Psych - anxiety GAD2

Answer 4

Over the last 2 weeks:
?feeling nervous or on edge
?unable to stop or control worries

Question 5

Psych - eating disorder SCOFF

Answer 5

S – Do you make yourself Sick because you feel full?
C – Do you worry or lose Control over how much you eat?
O – LoW >One stone (6.35kg) in 3m?
F – Do you think you’re Fat (when others don’t)?
F – does Food dominate your life?

Question 6

Trauma - CAVES

Answer 6

Connect + stay involved
Arousal - soothe
Validate
Empower + collaborate
Safety (Emergency numbers, important documents, place to go)

Question 7

EtOH - AUDIT C

Answer 7

1. How often do you have EtOH?
2. How many drinks containing EtOH do you have on a typical day if drinking?
3. How often do you have 6+ drinks on one occasion?

Question 8

EtOH - CAGE

Answer 8

C – Cutting Down
A – Annoyed by Criticism
G – Guilty Feeling
E – Eye-openers

Question 9

Smoking - 5As

Answer 9

ASK about smoking and document
ASSESS amount smoked, dependence, readiness to change
ADVISE/AGREE use motivational interviewing and set a quit date
ASSIST with a quit plan, offer pharmacotherapy if >10/day
ARRANGE Quitline referral and follow up visits at 1w and 1m

Question 10

Smoking - how to assess nicotine dependence

Answer 10

Number of minutes between waking and first cigarette
Number of cigarettes per day
Type of craving or withdrawal Sx experienced

Question 11

Suicide safety plan - PIECES

Answer 11

Protective factors / reasons to live
Internal coping strategies
Environment (make it safe)
Crisis (#, services)
Early warning signs
Support (people, place)

Question 12

Pain Hx - 5As

Answer 12

ACTIVITY - ADLs
ANALGESIA - average + worst pain, relief from medications
ADVERSE EFFECTS - constipation, nausea, drowsiness
ABERRANT BEHAVIOURS
AFFECT - mood

Question 13

ROS - CRANIUMM

Answer 13

Cardio - chest pain or palpitations
Resp - cough or SOB
Abdo - pain, N&V, changes to bowels
Neuro - headaches, dizziness, vision or hearing changes
Infection - fevers or rash
Urogenital - dysuria, discharge, changes to urine
MSK - joint pain or muscle aches, weakness
Malignancy - weight loss, fevers or night sweats

Question 14

Non-pharm Mx - SNAPPIE CC

Answer 14

S - Smoking
N - Nutrition (don’t forget salt!)
A - Alcohol
P - Physical activity
P - Programs (cardiac/pulm rehab, mums/bubs, mens shed, MyAgedCare, meals on wheels etc)
I - Immunisations
E - Education (websites, support groups)

C - Car (Fitness to Drive)
C - Court (ACD, PoA, MDO, mandatory reporting)

Question 15

7 Mx steps

Answer 15

1. GP vs ED?
2. Education
3. Non-pharm (SNAPPIE-CC)
4. Pharmacological
5. Referrals (specialist/AH)
6. Paperwork (certificates/legal/notify)
7. Follow up/safety net/recalls

Question 16

Elderly Hx - DAMN FIASCOS

Answer 16

Driving
Alarm/alert
Medications (+imms)
Nutrition

Falls
Incontinence (bowel/bladder)
Advance care directive
Services
Cognition
Osteoporosis
Sensory (hearing/vision)

Question 17

Palliative Care - PAIND DOCTORS

Answer 17

P - Pain
A - Anorexia/Oral Intake
I - Insomnia
N - Nausea
D - Dyspnoea

D - Documentation (ACD, EPOA, Wills, etc)
O - Oral hygiene/Mouth Care
C - Constipation
T - Tiredness
O - Oedema
R - Restlessness/Agitation
S - Spiritual, Social and pSychological