Page 1 of 1: Anorexia Nervosa

jskanwal · Credits: 317 My Scrapbook

• Can u tell me what brought u here?( address both)If the female is brought by mom or friend
• Can u let me know your concerns, in details, regarding ur weight? ( address patient)
• How did you lose weight? Do you feel proud in losing weight? What weight, do you consider, is appropriate for you? Are you still losing weight?
• What was ur initial weight before these symptoms?
• Can u tell me ur maximum and minimum weight since u r experiencing these symptoms regarding ur weight?
• How much was ur average weight in the last year
• Have you ever been hospitalized or were you on some medication in the past for the same or some other ailments, and did u gain weight during that treatment?
• Do you have any allergies?
• Now I would like to know about ur diet. How’s ur appetite?
• What type of foods do u avoid and prefer? Can u tell me in details regarding your diet?
• How much food do consume and at what time, how many times, and do you feel something is making you eat a lot?
• When u consume such amount of food, do u feel guilty, or you think that you have no control over eating?
• What u do when you think that u ate a lot? Do you vomit?
• Are you using any laxative or diuretic to keep ur weight low or any other medication? How much and how many times?
• Do exercise to keep your weight low?
• Do you eat in front of others or you eat when you are alone?
• Did you ever hide food in your pocket?
• How many times do you think about your weight and do you measure your weight daily and how many times?
• Are you comfortable with your family and in school? Do you have any problems at school or with your family?
• Now I am going to ask you some question which I ask to all of my patients and these are very essential part of the medical history, these are the questions regarding sex. Are you comfortable in answering those questions?
• Are you sexually active?( partners: single or multiple; safe sexual practices )
• Do you feel interest in having sex or it is decreased?
• How about your menstrual cycle, what was your last menstrual date?( Label amenorrhea if missed >3 periods)
• How is your mood?
• How about your energy level? Do u get fatigued easily?
• Have you ever felt of harming yourself? Do you have specific plans?
• Are you using any street drug or alcohol?
• Do you smoke?
• Now can you tell me about your family? Do you know if some disease is running in your family? Is there any family member who is experiencing the same symptoms as you are experiencing?
• How many family members are there in your family? Is there any family member, who is in sexual contact with you?
• Do you have any bowel or urinary problems?
• Do you have or ever experienced constipation, chest pain, bloody vomiting, black stools, syncope, shortness of breath and loss of hairs?
• If something is important and you want to share with me, let me know.

diyapathak · Credits: 355 My Scrapbook

few points which r important for he counselling of anorexia
Always ask the patient for me you look very thin, how do you feel about your body image yourself?
Ask if they have any role model?(any film stars or any models)
Ask what she wants to do? Patient who usually wants to be a model are anorexic.
Always ask about the amenorrhoea?
If patiet is sexually active ask about the mode of contraception using.

rest is fine .............

jskanwal · Credits: 317 My Scrapbook

thanks for your valuable points

blue_mars · Credits: 32025 My Scrapbook My Reading List 3 Books

jskanwal · Credits: 317 My Scrapbook

ya I would like to know more about this station

blue_mars · Credits: 32025 My Scrapbook My Reading List 3 Books

jskanwal · Credits: 317 My Scrapbook

that is right

I will keep that in mind.

How about case wrap up?

go_chin_san · Credits: 254 My Scrapbook

It is also good to ask whether the pt has though of ending her life in addition of previous self harm. These 2 are different things

LondonStudDoc · Credits: 206 My Scrapbook

Yep I agree - ALWAYS ask about self harm / sucidal risk assessment - if not for the OSCE , for real life - lets face it - it would be a pretty serious omission and a law-suit waiting to happen!

A good way to approach this is:

"Sometimes when people are feeling down or upset with themselves they consider harming themselves or even ending their life... have you ever felt that way?" - then you can characterise it further to assess the risk properly.

Incidently, I don't know if its been mentioned in a previous post but a good thing to do in anorexia, where body dysmorphia is an 'overvalued idea', not a delusion - is to challenge their perceptions. A delusion is a fixed belief held in spite of evidence to the contrary, where in an over-valued idea, they may be a bit more moveable on the topic. Its just good to show that you know what you're talking about if nothing else.

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