Dear All

Dr Pamela has shared the Following important section for History and Management station when an adolescent / teenage is the Role player or subject. You will need to phrase the questions in your own ‘language’ and local / reginal context.

Teenagers: HEEADSSS

“This is a standard set of questions that I asked everyone. Please do not be alarmed. These are just questions that I asked everyone. “

• Home and relationships: How is home? How is relationship with your family?

• Education/employment: How is school? How are you with your friends? How is work?

• Eating: How is your eating habit?

• Activities and hobbies: Do you have any hobbies?

• Drugs/alcohol/tobacco: Do you take drugs, drink alcohol or smoke?

• Sex and relationship: Are you in any relationship with a partner? Are you sexually active?

• Self harm/depression: Do you feel sad? Do you harm yourself?

• Safety and abuse: Is there anyone harming you?

Today in RRR we discussed:

• Hemarthrosis
• Acute ataxia
• Cystic fibrosis: DD – Immune deficiency

H&M was with a 66 yr old young person with Diabetes who is referred back by GP for weight loss and being tired. Dr J took the hotseat, DR D and Dr A took the examiners hats. Dr J covered all the important points but important to address Role players presenting concerns – else they will keep coming back. Adolescent history points mentioned above are important.

The learning points are:

• Address Role player’s concerns
• Need not discuss in great detail ( communication scenario) and can park them
• Teenage females: always ask Menstrual history
• Following ‘+ve’ screening test – confirmation is essential
• Summarize at 9 minutes – will refresh for you what has been covered
• Management of Chronic diseases in Multi Disciplinary
• Use MDT members – you CANNOT KNOW EVERYTHING
• Carbohydrate count – get dietician advice
• There isn’t a specific dose of Insulin – do check compliance

Please visit www.mrcpchonline.org to add your comments or points I may have missed.

Anil Garg