H and P

Question 1

What is the order of abbreviated Psych H and P presentation?

Answer 1

• CC
• HPI
• Psych ROS
• Psych Hx
• Substance Use Hx
• Current Rx
• MSE
• Labs
• Assessment

Question 2

What is the order of full psych HPI?

Answer 2

• CC
• HPI
• Psych ROS
• Psych Hx
• Substance Use Hx
• Fam Psych Hx
• Current Rx
• PMHx
• SurgHx
• Allergies
• SocHx
• MSE
• Medical ROS
• Labs
• Assessment
• • Psych Dx
• • Medical Dx
• • Stressors
• •• BioPsychoSocialCulturalLifestyle

Question 3

What Qs to ask for psych HPI?

Answer 3

• Sx, duration, recurrences (reactive, episodic, chronic)
• Sx effects on home life, social relationships, and work
• Stressors
• Self-Tx and professional Tx attemps
• SI/HI (danger to self, others, or grave disability

Question 4

What are Qs for Psych Hx?

Answer 4

• First Sx, Dx
• Hospitalizations
• Rx trials
• Psychotherapy trials
• Self harm, SI and attempts, HI and attempts
• Confirm if lethal Rx
• Firearms

Question 5

What are Qs for Fam Psych Hx?

Answer 5

• Dx
• Rx successes and Tx
• Suicide attempts and completion

Question 6

What are Qs for PMHx?

Answer 6

• Thyroid
• Asthma
• Head trauma
• Seizures
• Stroke
• CV events
• DM, metabolic syndrome

Question 7

What are categorical Qs for substance use Hx?

Answer 7

• Onset, quantity, frequency
• Drug of Choice
• Legal difficulties
• Medical, social, educational, occupational difficulties
• Prior treatment
• Longest sobriety outside of Tx center

Question 8

What substances do we ask about?

Answer 8

• Caffeine
• Tobacco
• EtOH
• Cannabis
• Cocaine, speeds
• Opioids, heroin, pain Rx
• Benzos, Xanax, Valium, sleep
• Hallucinogens

Question 9

What are abbreviated Qs for SocHx?

Answer 9

• Occupation
• •Physical abuse
• • Emotional abuse
• • Sexual abuse
• Current relationships:
• Children:
• Parents, siblings
• Belief system
• Military service:

Question 10

What are full Qs to ask during SocHx?

Answer 10

• Born/grew up
• Pregnancy, birth, milestones
• Family life
• Abuse
• •Physical abuse
• • Emotional abuse
• • Sexual abuse
• Siblings
• Past relationships:
• Current relationships:
• Children:
• Friends
• Education
• Hobbies
• Spiritual and philosophical beliefs
• Occupation:
• Military service:

Question 11

What is the order of brief MSE?

Answer 11

• Appearance
• Attitude/Behavior/Orientation
• Mood
• Affect
• Psychomotor
• Speech
• Thought process
• Thought content and sensorium
• MMSE
• Insight
• Judgment

Question 12

What is order of brief MMSE?

Answer 12

Orientation: person, place, time
Attention and concentration: serial 7s, world backwards
Memory Very Short: recall three objects
Memory Short: 5 minutes
Memory Long: Personal, verifiable info
Fund of Knowledge: current events
Abstract thought: proverbs, analogies

Question 13

What Labs are most important to psych?

Answer 13

• CMP
• • elytes, BUN/Cr, glucose, AST/ALT
• CBC
• • RBC, WBC
• Utox
• Serum EtOH