Abdominal Pain Flashcards
(36 cards)
1
Q
Name
A
Dan Green
2
Q
DOB/ Age
A
4/12/81
42
3
Q
Occupation
A
Office Worker
4
Q
Scenario 1 Opening Statement
A
“I’d like to discuss my stomach pains”
5
Q
Scenario 1 Drinking
A
- Be vague, “odd glass of wine”.
- If pressed give amounts towards the lower end of your intake (1-2 bottles a night)
- Find a way to dismiss the student - i.e. I know I drink too much but I’m going to stop and don’t need any help thanks.
6
Q
Symptoms (4)
A
- Daily bouts of abdominal pain
- Upper centre of stomach, above belly button and below ribs
- Pain does not radiate anywhere
- Nausea
7
Q
How long pain been happening for? (2)
A
- 4-6 weeks
- No pain now
8
Q
Anything associated with pain? (3)
A
- Nausea
- Acid taste in mouth
- Burning sensation behind breastbone
9
Q
Anything aggravates pain? (4)
A
- worse when eating
- maybe spicy food worse?
- has put me off food for a bit
- exercise does not aggravate it - I run three times a week, pain never comes on then
10
Q
Previous bowel issues? (5)
A
- They’ve always been a bit funny
- Go 2-3 times in the morning
- Stool often loose (not watery) or thing and long (like toothpaste)
- Worse if I’m stressed - feels low tummy pain and bloating - but better if I go to loo
- Been told I have IBS in past
11
Q
Blood in stool?
A
No
12
Q
Stool colour? (2)
A
- Black
- No mucous
13
Q
Lost weight?
A
No
14
Q
Wake in night to open bowels?
A
No
15
Q
Anyone else you know has similar symptoms?
A
No
16
Q
Family problems with bowels?
A
None that I know of
17
Q
Dad / mum medical history (2)
A
Dad - Mild blood disorder
Mum - Bit of blood pressure but otherwise fit
18
Q
Married?
A
Yes, with two primary school-aged children
19
Q
Smoking? (3)
A
- Smoke socially
- A couple if out
- Smoked 20 a day for 20 years but gave up when kids born
20
Q
Recreational drugs?
A
No
21
Q
Scenario 1 - Your ideas (2)
A
- I think I have indigestion pain.
- Hoping the doctor will go some medication for my symptoms as the pain is uncomfortable
22
Q
Scenario 1 -
Questions for student: (3)
A
- What do they think is going on?
- How is it treated?
- Is there anything I can do to help myself with this problem?
23
Q
Scenario 2 Opening Statement (2)
A
- “I’d like to discuss my stomach pains..” after a minute or so of questions
- “Do you think they could be becasue of my drinking?”
24
Q
Sc 2 What you have actually come about (5)
A
- You know you’re drinking too much
- You think this is causing the pain
- You are honest and open
- You will be best helped if the student listens to you and is non-judgemental
- You can come up with ideas of your own to help
25
Sc 2 Your Ideas (2)
- Think you have indigestion pain
- Bit worried the pain's coming from my liver as that's at the top of my stomach isn't it?
26
Sc 2 Patient perspective on drinking (3)
- Would like to cut down
- Wasn't sure how to bring it up so booked appointment for stomach pain and hoped drinking would come up
- First time you've been to the surgery (new patient) and not sure if the student saw I was worried about my drinking on the questionnaire
27
Sc 2 Stresses (3)
- Work stressful with deadline
- Snapping at partner and kids
- Not aggressive physically
28
Sc 2 Depressed? (2)
- Don't think so
- Think you can figure things out but need some support to do so
29
Sc 2 Hobbies
- Don't have time to go fishing, which I used to enjoy
30
Scenario 2 Drinking (5)
- Only in evenings
- Drinking to help me relax and forget worries
- What was one bottle has become two most nights
- Worried about health risks (especially with young kids)
- Worried about the cost of the drinking
31
Sc 2 Hopes (3)
- What is a 'healthy' amount to drink?
- Can anyone help me to cut down?
- Not looking for a referral or professional help.
32
Scenario 1 Overview (3)
- Student to focus on understanding the problem and gathering information
- Be vague about alcohol intake
- Don't want to discuss alcohol
33
Scenario 2 Overview (3)
- make it clear you're drinking too much
- you want advice on how to reduce your intake
- not necessarily looking for a referral or formal help
34
Sc 3 Character
- Dr Jones
- GP
35
Sc 3 Opening LInes
- Ask them to present the patient back to you
- Say: "Great job! Clearly a time waster, send them home and tell them to call AA, would you?"
36
Sc 3 Challenge (3)
- A second year medical student should not be seeing patients without a full review by the doctor.
- The student should express this to you and ask you to review the patient.
- Be dismissive of needing to see the patient and full of praise for how competent the student is.
- Only agree to see the patient is the student clearly asks for your help
