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    Casc 2022-1

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    Casc 2022-1

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    CASC 2022-1

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    Casc 2022-1

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    of 4

    10 Jan 2022 (MONDAY)

    Morning

    [1] Explain Anti-dementia medications to patient daughter - explain benefits & side effects
    address carer’s concerns. Father diagnosed with Alzheimer’s - ZHANG

    [2] CBT in depression - address concerns. Know case of depression on mirtazapine 30 mg last 3
    month little improvement in symptoms. Take off sick 6 week from work due to work stress. No
    suicidal referred by GP. SPMM, ZHANG

    [3] Serotonin Syndrome - explain fidnings, dx & rx plan.

    Patient admitted with hx of feeling hot and clammy stiffness. Chart show BP 140/…PR 120,
    Temp 38.5, Elevated CPK, Brisk reflex and myoclonus on examination .Changing between
    sertraline 100 and venlafaxine 37. SPMM

    [4] Explain nature of Anorexia - Describe typical treatment And answer Q and concerns.
    ZHANG-367

    [5] Talk to the nurse discuss and formulate management plan Prisoner now in seclusion, had
    psychotic experience and suspected to take cocaine, was aggressive towards another inmate,
    nurse wanted him to be transferred back to prison. ZHANG -125 station may be

    [6] Discuss treatment options with patient Risk of valproate .Risk changing treatment during
    and after pregnancy . Risk of relapse .Address her concerns .On Valproate 500 mg bd for last 5
    yrs 5 week pregnancy. -SPMM

    [7] Assess patient hx and current presentation support diagnosis of Bulimia - identify prognostic
    factors. Patient had hx of anorexia when she was 13 no admission no other comorbidities-
    ZHANG 372

    [8] General cognitive function with specific lobe deficits - with hx of confusion hx of loss of
    vision in one eye hx of vascular dementia HTN high cholesterol. Thiguti- 167

    Evening

    [1] Explore whether mr Jon develop psychotic illness number of beast on tube

    Bar code 666. SPMM & THIGUTI

    [2] PTSD Return from Iraq after death of his commanding officer by a suicidal bomb

    Pleas assess this patient. Zhang - Station 29

    [3] Explore MSE Assess delusions and risk- led bonfire in garden brought by friend. SPMM

    [4] Do MSE to inform differential diagnosis- Brought by police after been found on the streets.

    shouting and strip his clothes Macrocytosis elevated LFT ALT and GGT was 150 3 month
    ago.

    [5] Take hx of her core symptoms clarify diagnosis -Ms Kate have accidents in the

    shop 9 month ago ==> panic disorder.

    [6] Assess patient view ideations obsession or compulsions Delivered 6 week cleaning baby
    bottles. ZHANG

    [7] Explore any aspect of risk Explore his content of belief – Patient confronted receptionist

    Erotomania.ZHANG( Imp) PG 453.

    [8] Take hx to establish and determine extent of problem- Referred by GP abuse heroin.
    ZHANG- station 90

    11.Jan.2022 (TUESDAY)

    AM Stations
    1. IPT- ZHANG 343
    2. Wt gain with olanzapine-SPMM with clozapine
    3. Manic pt... now depressed. On risperidone n sertraline . To get medical review to arrive to
    diagnosis and also Management
    4.residual Schizophrenia with depression. Discuss management plan, use the psychosocial
    Rehab principle. (https://www.cadabams.org/schizophrenia-rehabilitation/) use CTP vol 1
    Supported housing, supported employment, web based intervention, &dr Hossem
    5. Hx: Ptsd post RVA
    6.Dissociative stupor hx n management. ZHANG- 399-405
    7. Mse+ psychopathology - Brainwash- ?in SPMM
    8. ECT explanation (ZHANG- STATION 20)

    PM 11-01-2022
    History severe LD + autistic trait+ tuberous sclerosis with self biting behavior
    History gender dysphoria - asking for estrogen - Thiguti 25
    History & risk Manic Sinemet
    History & risk Alcohol hallucinosis
    OCD explore psychopathology & establish diagnosis
    Risk assessment : Morbid jealousy- ZHANG STATION 127
    MSE Bonfire (monday)
    MSE focusing on cognitive assessment (wernicke)- SPMM

    12 jan 2022 (WEDNESDAY)


    AM

    1 Patient with schiz negative symptoms management plan


    2 Self harm and borderline traits -ZHANG station 103
    3 Post partum depression and ocd and panic attacks
    4 Explain ect
    5 Angry mother with son care -SPMM
    6 Antidepressants and suicide risk discussion with mother ( copy paste hosem ji text)
    7 Patient in seclusion room dehydrated severly, management discussion with nurse
    8 Transfrence in psychotherapy-ZHANG- 101 station.

    PM
    1) explore asd in an adult- ?more personality disorder- SPMM , THIGUTI-32PG
    2) social phobia hx- ZHANG station 8
    3) cognitive assessment but states no writing physical exam or reading - THIGUT- pg 167
    4) capacity assessment in man with a neck wound with eupd and dissocal pd in A&E after dsh- ,
    THIGUTI NOTES and station 18.
    5) explore cbt in first episode of psychosis and assess suitability for this
    6) behaviour changes in a pt with severe ld- take hx from mum SPMM, ZHANG station 80.
    7) alcoholic hallucinations
    8) mse in paranoid schizophrenia

    13 jan 2022 (THURSDAY)


    AM
    1. Valproate in pregnancy with pt{10th AM}
    2. Serotonin syndrome with carer{10th AM}
    3. Anorexia management with carer{10th AM}
    4. Cognitive - general plus lobe{10th AM} (? Vascular dementia)
    5. Anti dementia drug with carer{10th AM}
    6. Bulimia - history and prognostic factors{10th AM}
    7. CBT discussion with pt {10th AM}
    8. Psychotic prisoner with nurse regarding transfer and managemnt{10th AM}

    PM
    1.PTSD in soldier {10th PM}
    2.Alcoholic hallucinosis {11th PM, 10th PM}
    3. Explore psychopathology - number of beast on blood tube {10th PM}
    4. Dead lady who wanted to burn body, mse and delusions {10th PM}
    5. Anxiety and panic attacks after rta {10th PM}
    6. OCD at young mother, assess intensity of obsessions and compulsions {10th PM}
    7. Erotomania, pt confronted receptionist risk assessment {10th PM}
    8. Opiate addict, take history to assess extent of impact {10th PM}

    14 Jan 2022 (Friday)


    AM

    1.ECG : heart block - SPMM


    2.FT (Family therapy)- SPMM, THIGUT-Pg-73
    3.Depression - psychopathology - ZHANG
    4.Bipolar affective disorder - management - SPMM
    5.Bipolar depression management ( may be repeat)-SPMM
    6.Clozapine induced metabolic syndrome -SPMM
    7.gender dysphoria -oestrogen (Tuesday)
    8,Morbid jealously - discuss with partner - ZHANG station 128

    PM
    1.Capacity assessment. Femoral shunt surgery
    2.OCD history taking (Tuesday)
    3.Alcoholic halucinosis (Tuesday)
    4.Panic disorder hx (monday)
    5.Fire setting aetiology and assess future risk -ZHANG-126 STATION
    6.Assess for normal grief (ABNORMAL GRIEF OR NOT) -ZHANG-ST-34,THIHUTI-Pg90
    7.MSE brain wash (Wednesday)
    8.Anorexia prognostic factors- ZHANG

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