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CMN 548 Module 1 study guide Questions and answers latest update
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CMN 548 Module 1 study guideGUIDE SADOCK Chapter 7.1 - 7.2, 7.6 - correct answer Complete the following table which outlines the
elements of the initial psychiatric
interview:
Identifying data Topic - correct answer Name, age, sex, marital status, religion, education, address,
phone number, occupation, source of referral
Identifying data Questions - correct answer Be direct in obtaining identifying data. Request specific
answers.
Identifying data Comments and helpful hints - correct answer If patient cannot cooperate, get
information from family member or friend; if referred by a physician, obtain medical record.
Chief complaint (CC) topic - correct answer Brief statement in patient's own words of why patient is in
the hospital or is being seen in consultation
Chief complaint (CC) questions - correct answer Why are you going to see a psychiatrist? What brought
you to the hospital? What seems to be the problem?
Chief complaint (CC) comments and helpful hints - correct answer Record answers verbatim; a bizarré
complaint points to psychotic process.
History of present illness (HPI): - correct answer Development of symptoms from time of onset to
present; relation of life events, conflicts, stressors: drugs; change from previous level of functioning
History of present illness (HPI): questions - correct answer When did you first notice something
happening to you? Were you upset about anything when symptoms began? Did they begin suddenly or
gradually?
,History of present illness (HPI): comments and helpful hints - correct answer Record in patient's own
words as much as possible. Get history of previous hospitalizations and treatment. Sudden onset of
symptoms may indicate drug-induced disorder.
Previous psychiatric and medical disorders: - correct answer Psychiatric disorders; psychosomatic;
medical, neurologic illnesses (e.g., craniocerebral trauma, convulsions).
Previous psychiatric and medical disorders: QUESTIONS - correct answer Did you ever lose
consciousness? Have a seizure?
Previous psychiatric and medical disorders: comments and helpful hints - correct answer Ascertain
extent of illness, treatment, medications, outcomes, hospitals, doctors. Determine whether illness serves
some additional purpose (secondary gain).
substance use/abuse - correct answer Substance use disorders can mimic or induce psychiatric
syndromes, elevate risk of suicide and violence, and have important impact on safe medication
prescribing.
Various tools can be used to aid in gathering the substance use history. Examples include the commonly
used CAGE questionnaire which has been modified to include other drugs (and now called CAGE-AID)
Past medical history - correct answer The interviewer is interested in obtaining an accounting of major
medical disorders both to develop a complete history and to identify illness that could mimic a
psychiatric disorder, contribute to the context of the presentation or factor into treatment planning.
Family History (FH): topic - correct answer Psychiatric, medical, and genetic illness in mother, father,
siblings; age of parents and occupations; if deceased, date and cause; feelings about each family
member, finances .
Because many psychiatric illnesses have a genetic predisposition, if not cause, a careful review of family
history is important to the assessment and can aid in diagnosis and establishing expected prognosis .
Family History (FH): question - correct answer Have any members in your family been depressed?
Alcoholic? In a mental hospital? In jail? Describe your living conditions. Did you have your own room?
,Family History (FH): comments and helpful hints - correct answer Genetic loading in anxiety, depression,
schizophrenia. Get medication history of family (medications effective in family members for similar
disorders may be effective in patient).
developmental and social history - correct answer The developmental and social history reviews the
stages of the patient's life from gestation to the present with an eye toward understanding the important
exposures, relationships, and events that shaped the person's life story.
It is often helpful to review the social history chronologically; doing so provides a natural flow to the
questions and ensures a complete history.
Review of systems - correct answer As in a general medical interview, the review of systems is intended
to capture any current physical signs and symptoms not already identified in the HPI or past medical
history (including Table 7.1-2 and is organized by asking sentinel questions about the major systems of
the body).
review of systems: sleep - correct answer Sleep phase problems (initial, middle, terminal insomnia), total
sleep time, abnormal sleep events
review of systems: mood depression - correct answer Depression: persistent sadness, reduced interest or
pleasure in usual activities, tearfulness, reduced or excessive sleep, reduced or increased appetite,
weight loss or gain, low energy, reduced concentration, low libido, excessive or inappropriate guilt,
psychomotor change (slowing or agitation), negative self-appraisal, helpless and hopeless thinking
thoughts of death or suicide. A common mnemonic used to remember the symptoms of major
depression is SIGECAPS (Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor agitation or
slowing, Suicidality).
review of systems: mood Hypomania/mania - correct answer Hypomania/Mania: elevated, expansive or
irritable mood, decreased need for or inability to sleep, excessive energy, marked increase in goal and
pleasure directed activity, increase amount and pace of speech and thought, grandiosity, heightened
libido, impulsivity and/or recklessness in behaviors such as spending and sex
review of systems: anxiety - correct answer Anxiety
Experience of panic attacks, somatic symptoms of anxiety, phobic, or social avoidance
, review of systems: psychosis - correct answer Experience of hallucinations, delusions, disorganized
behavior, speech or thought, negative symptoms
review of systems: obsessive-compulsive - correct answer Repetitive intrusive and unwanted thoughts,
compulsive behaviors to neutralize anxiety, hoarding behaviors
review of systems: trauma - correct answer Traumatic exposure; intrusive and avoidance symptoms,
negative alterations in cognitions and mood, excessive arousal and reactivity
review of systems: behavior - correct answer Substance use, gambling, impulse control problems,
disordered eating, repetitive self-harm
mental status exam - correct answer The MSE is the functional equivalent of the physical examination in
other areas of medicine.
It is a systematic collection of the observations (e.g., signs such as blunt affect or rapid speech) and
reported mental experiences (e.g., symptoms such as depressed mood or hallucinations) that produce a
picture of the patient's current mental state. The interviewer makes these observations throughout an
encounter and ultimately documents the findings together in the MSE section of the evaluation
document.
physical exam - correct answer Psychiatrists do not usually personally conduct comprehensive physical
examinations but may conduct focused examinations such as neurological or thyroid examinations. In
the outpatient setting, the psychiatrist generally relies on the PCP to conduct the physical examination
and it is useful in the initial evaluation to record the date of the most recent physical examination and
review of recent laboratories if results are available.
plan formulation - correct answer The formulation should include a brief summary of the relevant
findings from the history and examination including the psychosocial contexts in which the problem has
developed and comments on the relevant contributions to the presentation of personality function,
medical problems, social stress, and other social and cultural factors.
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