Past questions Flashcards

1
Q

Q: Patient is seeing doctor for light-headedness, sleeplessness and loss of appetite. 4 things doctor did that interfere with establishing initial rapport with patient. How did this make the patient respond? (5 mark)

A

A: -Doctor did not introduce herself

  • Doctor did not confirm patient name
  • Patient gave very brief initial response

(Not really sure about rest)

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2
Q

Q: Patient is seeing doctor for light-headedness, sleeplessness and loss of appetite. 5 things Doctor did to get a lot of info out of patient. (5 marks)

A

A: -Ask open question

  • Allowed patient to speak without interruption
  • Open body language + eye contact
  • Nods head regularly
  • Followed up on everything patient said????
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3
Q

Q: Patient is seeing doctor for light-headedness, sleeplessness and loss of appetite. State 5 things the doctor did to end the consultation.

A

A: ⁃ Summary of what patient said

⁃ Asks if anything missed

⁃ Asks if anything else worrying patient

⁃ Says will review info and come up with plan and book second appointment

⁃ Thank patient for time???

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4
Q

Q: A female patient comes in to see the GP with symptoms of chest pain. Identify 7 communication skills the GP used to open the consultation and build rapport.

A

A: -Greeted the patient by name

  • Confirmed the patient’s identity
  • Introduced herself (as doctor)
  • Stood up and shook the patient’s hand
  • Demonstrates Interest
  • invited patient in and to take a seat
  • doctor started conversation by asking a question (“how are you?”)
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5
Q

Q: A female patient comes in to see the GP with symptoms of chest pain. Identify 3 communication behaviours that impeded information gathering. (3 marks)

A

A: -The GP interrupted the patient’s answer to an early open question, “can you tell me more about the pain?”, before the patient had finished.

  • Multiple questions e.g. have you had shortness of breath, palpitations or dizziness, to which the patient only answered the last part of the question.
  • The use of jargon such as palpitations and describing the “character of pain”, which the patient did not understand
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6
Q

Q: What is ICE?

A

A: Ideas

Concerns

Expectations

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7
Q

Q: A female patient comes in to see the GP with symptoms of chest pain. What Zola’s trigger led the patient to consult the GP? (1 mark)

What did the patient say that suggested this trigger? (2 marks)

A

A: Sanctioning

She said that she had told her sister about her pain and she told her that she should go to the GP and a work colleague had been there when she was experiencing the chest pain and she said that she had a friend, about the same age, who had been diagnosed with angina and that she must go and see the doctor

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8
Q

Q: A female patient comes in to see the GP with symptoms of chest pain.The consultation ended with the patient appearing very confused. Suggest three things that could have been done to close the consultation better. (3 marks)

A

A: -Summarise the content of the consultation to remind the patient of what had been discussed

  • Ask the patient if she had any questions or if there was anything she didn’t understand
  • Ask the patient if she had any concerns as new concerns may had arisen during the consultation
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9
Q

Q: A female patient comes in to see the GP with symptoms of chest pain. State three questions from Helman’s folk model that the patient was trying to answer. (1 mark)

What was the patient’s answer to these questions? (1 mark)

A

A: -Why has it happened?

  • Why to me?
  • Why now?

-That the chest pain was because of currently increased levels of stress that she was experiencing

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10
Q

Q: Identify 2 verbal and non Verbal aspect doctor uses to encourage patient.

A

A: Non Verbal= head nodding, constant good eye contact.

Verbal= “tell me more” makes empathetic statement “that must have been scary for you” (encourages patient to express feelings further)

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11
Q

Q: 2 Negative questions doctor asked and why are they negative? talk about the patients response.

A

A: 1) Multiple questions “do you have chest pains, breathless and palpitations ” (palpitations not explained, should have clarified medical jargon, patient was confused and said in confused manner “I don’t…think so”)

2) What was the 2nd question?

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12
Q

Q: How did doctor elicit concern?

A

A: She outright said “you look worried”

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13
Q

Q: What was the power balance like?

A

A: Something like it was initially balanced, but then doctor kept asking lots of closed ended questions i.e “do you have kids” “do you work” “are you married” to which patient could only reply yes/no hence slight shift towards the doctor?

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14
Q

Q: Was the consultation Patient Centred?

A

A: Yes- ideas, concerns and expectations were all covered

No- Doctor didn’t provide enough explanation (patient had to ask for more explanation), doctor was very paternalistic and disregarding of the patient’s ideas about dust particles from buildings giving her headache

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15
Q

Q: Identify 6 communication skills that indicated that the doctor was actively listening to the patient.

A

A: - eye contact

  • nodding
  • posture
  • empathetic statements
  • affirmation
  • verbal sounds “hmm” “okay” etc
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16
Q

Q: Identify aspects of negative communication the doctor used and how this affected the consultation. (4)

A

A: -no summaries (patient was not reminded of what she said)

  • didn’t agree with patient on a management plan (lack of patient involvement)
  • lack of empathy used (patient may feel like she wasn’t listened to or sympathised with)
  • closed questions (could have influenced what patient said or how willing she was to give information. Element of recall bias added)
17
Q

Q: Which questions did the doctor use to elicit the patient’s concerns and expectations?

How did the doctor address these concerns and expectations?

A

A: Open ended questions.
“you mentioned worries, what are you worried about?”
“what are your concerns?”
“coming into the consultation were there any thoughts or ideas you wanted me to address?”

She reassured the patient and clarified what she thought the causes of her symptoms may be. Told her she would be receiving medication, gave a rough treatment plan

18
Q

Q: Identify 4 of Zola’s triggers and how they relate to the consultation?

A

A: - affected social (got headaches on holiday and on weekends)

  • affected physical (work, couldn’t get there)
  • interpersonal crisis (Friend’s sister died quickly of brain tumour)
  • pressure from someone to consult (husband was “nagging” and she made a “deal” with him)
  • symptoms lasted longer than target set (she got 4 headaches in 2 weeks rather than 2 headaches in 2 weeks)