Wednesday, June 16, 2010

2 down 2 more to go

my mental state examination (as of 15/6/10):

young girl with greasy messy hair and smelly clothes which looked as if they have not been changed for a week. Posture was rigid and tense with restless legs.
appeared to be tired and restless. But was agitated when mentioned the word OSCE. eye contact was difficult to maintain as eyes were buried in piles of books and notes.

speech was spontaneous and coherent with appropriate responses however was slightly fast in rate, tone and volume.

subjectively she described her mood as "not too bad"
objectively her mood was euthymic.

thought content:
no evidence of obsessive thoughts, delusions or phobias.
however she expressed feelings of helplessness and anxieties in the upcoming OSCE in the next two days. no suicidal ideation was elicited.

thought form:
she complained of episodes in which her thoughts have been sucked out by a vacuum leaving her mind empty.

she denied any visual, auditory or tactile hallucinations.
However, she was seen (a few episodes) to be talking loudly to an invisible person and seemed to be asking and answering questions of the invisible person. One example was she was seen talking about antidepressants treatment to an unseen person.

she was orientated in time place and person. Good concentration and attention. Memory was intact.

She has poor insight. Did not think she was unwell and therefore unwilling to accept treatment.


2 papers down another 2 more to go!!!

What is left is the OSCE. I'm starting to have palpitations and sweaty hands at the thought of the OSCE.

what if I get tongue-tied during exam? or what if I don't know how to answer the questions the patient ask? what if my mind goes blank during exam? I had an episode of how my mind can go blank during a practise osce last week and it was so scary. It's as if my thoughts were sucked out by a vacuum leaving my mind empty.

Please pray for calmness, peace and confidence for the OSCE. Also for clarity of mind and God's wisdom to ask the right questions and answer appropriately. thank you all who are praying for me!


mousie said...

When all the "what if" happens, you need to have a back-up plan... seriously lor...
1, take a deep breath in
2, start PPD!!!! IMMEDIATELY... helps to buy you some time and probably score some extra stars on the patient side
3, fall back to history taking
4, just hang on to whatever little knowledge you have/can come up with... you may never know, it is actually just all they need to hear from you
5, always refer to senior when in doubt! saves you lots of patient's arguments... damn sien

That's what I did... a senior actually forgotten everything about labour induction and just talked about the injection thingy and PPD... and she passed...

William said...

mousie: that is a good one!

rabbit: Be cool at all time. Don't panic. Communicate well. Smile always. I will pray for you:

Abba Father, send your angel to be with Janice when she is taking her OSCE. Lord, help her to be calm, give her extra dose of peace in mind and confidence for the OSCE. Father, grant her clarity of mind and God's wisdom to ask the right questions and answer appropriately.

In Jesus' name, Amen

Teresa Ting NH said...

Janice, you can do it, Jia you,jia you......

Do not panic or else you will not be able to think.

Must have enough sleep, rest and eat well.