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CASC Exam: Questions & Accurate Answers (Rated A+)
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CASC Exam: Questions & Accurate Answers (Rated A+)
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CASC Exam: Questions & Accurate Answers (Rated A+)General structure Right Ans - Play around depending on station
-HPC
-MSE for Dx (mnemonics)
-Ddx
-Risk (can be lower)
-History (can be higher)
MSE Right Ans - HPC: useful to start by getting circumstances around. Try
to link things temporally.
A+B+S: may be pointed out by commenting ('I notice you appear quite
agitated')
M: mood, appetite, sleep, self-harm, suicide;
T:
· Delusion questions
Do you have any beliefs that you feel aren't shared by others?
Have you been feeling worried about something in particular?
Grandiose: do you have any special purpose or calling?
Religious: do you feel like you are more connected to god these days?
Paranoid: do you feel like someone is targeting you?
Nihilisti delusions if depression: do you believe you are dead? Do you believe
your insides are rotten?
· Thought form: do you feel like your mind is racing
· Thought insertion, withdrawal, broadcast, control (if no time, are people
interfering with thoughts in any way?)
· Passivity phenomena
· Ideas of reference
P:
· Have you ever heard sounds that sound out of character to you?
· Have you seen things that seemed strange recently?
· Any strange sensations in your body?
· Any strange smells or taste?
,C: may be worth very quickly asking orientation questions if worried about
delirium
I: can you think of any alternative explanation to this? can your mind be
playing tricks on you? I think you may have a mental health problem, what do
you think about that?
Management Right Ans - Bio-psycho-social
Bio - meds
Psycho - therapies
Social - support groups, etc
Short-medium-long
-'We should start by'
-'In the event this fails' - go all the way
Actions Right Ans - Every ball raised needs a shot - if mentions diabetes,
discuss diabetes
Every concern needs adressing - if family/patient is concerning, say 'we
assure you we are doing our best and this measure is proportionate' etc
Think of the task! Right Ans - Forget the mnemonics if the task is not asking
you - focus on what is expected of you
Finish with, or in the middle, ask 'are there any questions you want to ask
me'? - that helps guiding and tayloring the station.
Risk!!! Right Ans - Remember risk, you are leaving this behind!
To self
To others
From others
Main differentials Right Ans - •Depression: physical health problems
(hypothyroidism), grief reaction, manic depression, adjustment disorder
,•Anxiety - rule out OCD, ask about panic, agoraphobia, specific fobia
•BDD - rule out OCD, psychosis, eating disorder, anorexia
•Gender dysphoria: rule out OCD, BDD, psychosis
-----OLD AGE
•Wandering: delirium, dementia, head injury (falls), depression (w/ cognitive
change)
•Dementia (7 main): medical conditions underlying, vascular dementia
(stepwise), lewy body (visual hallucinations or movement
problems/tremors), frontotemporal (personality changes, impulsivity,
disinhibition), depression (mood), psychosis, substances (quick screen,
specifically alcohol)
-----CAMHS
•Struggling in school/not achieving milestones - genetic disease, LD, ADHD,
depression, psychosis, trauma at home, separation anxiety
Borderline mnemonic Right Ans - ERAS E DIAS
-Emotional instabity
-Relationships (unstable) - ask about violence when risk ax
-Abandoment (fear)
-Self-image (disturbed)
-Emptiness
-Dissociative/psychotic (transient)
-Impulsive
-Angry
-Self-harm/suicide
Mania Right Ans - MESTIDIP
-Mood
-Energy levels
-Sleep
-Thoughts (fast)
-Irritability
-Disinhibition (sexual)
-Impulsivity (spending/money)
, -Psychotic symptoms (visual, auditory)
-Ask about medications probably causing this (e.g steroids, levodopa); ask
about dose changes if positive
-Other history
-Risk
Escapes Right Ans - •Politely cutting off manic patients
'I'm really interested in what you are saying and would like to come back to
this, but my time is short today and I would like to ask some questions - would
that be ok?'
•To take a step back and move to HPC before answering Qs:
'I need a bit more information so I can address your questions better, if that's
ok?'
•Dealing with someone angry about the wait
· 'I apologise for the delay. I understand that's frustrating. My time is yours
now, let's think about ways to help you'.
•Priming before difficult questions
'There are some questions that may be sensitive that I need to ask, if that's ok'
•Can I leave now?
-Are you ok to talk to me a bit more? Maybe I can help in any way.
Depression Right Ans - AH PESAMIS
-Anedonia
-Humor (low - depressed)
-Pensamento (cognition)
-Energia (anergia)
-Sono (disturbance)
-Apetite (disturbance)
-Motor (disturbance - agitation, slowness)
-Inutilidade (sentimento)
-Suicide/self-harm
In psychotic depression:
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