1 In certain patient populations (e.g., intoxicated patients, psychiatric patients, patients with a history of violent behaviour): Anticipate possible violent or aggressive behaviour. Recognize warning signs of violent/aggressive behaviour. Have a plan of action before assessing the patient (e.g., stay…
1 In a patient presenting with a symptom that could be attributed to stress (e.g., headache, fatigue, pain) consider and ask about stress as a cause or contributing factor. Acute Stress Physical Response Emotional Response ↑ACTH, epi + norepi, glucocorticoids…
Somatization Definition: Patients with somatization disorder experience their emotional distress or difficult life situation through physical symptoms, where no physiologic explanation can be found A syndrome of physical symptoms that are distressing (cause impairment in functioning) and may not be…
1 In patients, specifically pregnant women, adolescents, and perimenopausal women: a) Inquire about sexuality (e.g., normal sexuality, safe sex, contraception, sexual orientation, and sexual dysfunction). b) Counsel the patient on sexuality (e.g., normal sexuality, safe sex, contraception, sexual orientation, and…
1 In adolescents presenting with problem behaviours, consider schizophrenia in the differential diagnosis. Differential Diagnosis of Psychosis – GASPP General medical condition: head tumor/trauma, dementia/delirium, metabolic/infection/stroke, temporal lobe epilepsy Affective disorders: bipolar / depression with psychotic features Substance induced: intoxication/withdrawal,…
General Approach: ABCs, treat acute, serious injuries Ensure pt is not left alone & provide ongoing emotional support Set aside adequate time for exam (~1.5hr) Obtain consent for medical exam & Tx, collection of evidence, disclosure to police (notify police…
1 In a patient with subtle symptoms or signs of cognitive decline (e.g., family concerns, medication errors, repetitive questions, decline in personal hygiene), Initiate assessment of mental competency, including use of a standardized tool, Refer for further assessment when necessary.…
1 In the ongoing care of patients, ask about behaviours that, if changed, can improve health (e.g., diet, exercise, alcohol use, substance use, safer sex, injury prevention (e.g., seatbelts and helmets). 2 Before making recommendations about lifestyle modification, explore a…
Patients: 1 As part of the ongoing care of children, ask parents about their children’s functioning in school to identify learning difficulties. Parental concerns, usually when the child fails to achieve academic milestones alongside his/her peers (report cards, etc) Can…
1 In patients presenting with sleep complaints, take a careful history to: distinguish insomnia from other sleep-related complaints that require more specific treatment (e.g., sleep apnea or other sleep disorders, including periodic limb movements, restless legs syndrome, sleepwalking, or sleep…
Preparing for the CCFP Exam 2015 