OSCE

Station 1 :

(ini ayat sendiri) Patient was admitted for first episode of depression,....bla..bla..bla.. has suicidal thought...bla.bla....doesn't want to take medication..bla..bla..

Q - Discuss with your patient about anti-depressant treatment, and bla..bla.. (soalan pun tak ingat!) ow. Does this patient need admission?

(dear patient, you act bukan main bagus tunjuk muka low mood, depressed..har..i pun terpaksa tunjuk muka empathy lah gitu...tengok you punya muka..i jadi tak tau nak start macam mana. huhu)

Candidate : er..hai hai..my name, your name, bla..bla.. I'm here to discuss with you about the treatment that we are going to carry on for your depression, is it okay for you? [my mood masih normal, takde tanda simpati, empati. LUPE nak tunjuk empathy lol]

Patient : I don't feel that i need to take medication because i don't feel that i'm sick.-dengan suara lemah, perlahan. (huh? adoiy..macam mana nak discuss treatment antidepressant kalau patient sendiri tak nak amek ubat. huhuhuhuuu..)

Candidate : Ow, erm..hmm..so you think you don't need treatment... (pergh..mcm mane nak tanya ni... -.-") I know you has a hard time now....can you tell me how do you feel right now? Do feel sad..what makes you depressed? what that feelings do with you..how does it affect your life? (tak kira...ni kena suruh patient setuju amek ubat jugak, kalau tak macam mana nak proceed..mula tunjuk empathy pada patient hhe)

Patient : I am not happy...i can't concentrate on my work..yea..it affect my relationship with family..

Candidate : [har tu dia. jawab pun] So you are currently sad and this affects your social functioning and relationship with the family, isn't it? Don't you think that you need treatment for that? [alamak not convincing enough ni] You know..we..yea..we have treatment and medication that might be helping you improve your feelings. Would you like to talk about this?

Patient : [mengangguk2..baru nak tunjuk minat pada ubat] hm..yea..ya

Candidate : OK [lega baru boleh start, tapi tak tau sebenarnya nak citer pasal ape.huhu] so we will give you a medication called antidepressant. This medication is not to cure your depression, but it helps to improve your mood and feelings... We will give SSRI (selective serotonine reuptake inhibitor), like fluoxatine. [er...kuantiti? bpe lama? kosong kosong kosong otak kosong!]

i suppose to say something like this but i didn't, despite reading it many times in the quarantine room. ~.~

• It acts on serotonine receptor in your brain, which is responsible for your mood to be happy. (REMEMBER yea, mechanism of action!).
• Antidepressants usually started to give effect after 2weeks, so you may find no improvement of your current mood in ther 1st 2 weeks following treatment. After 4 weeks, if there is still no improvement of the symptoms, we will change to other medication that might be effective to you. (duration of tx!)
• Even though you got improvement of the symptoms, means you are responding positively towards the medication, you should continue taking the medication for at least 6months-9months to prevent any relapse.
• Most patient (3/4) response positively towards the treatment. (ni pun tak cakap tadi.. the OUTCOME ok)

However, like any other medication it has it's own side effects like nausea, vomiting, giddiness.. and these symptoms usually only occurs at the initial of treatment, and will goes away gradually. So you don't have to worry so much about it. So far, do you have any question?

Patient : What if i take the medication overdose?

Candidate : [pulakkkk... makcik, sy xhafal toxic side effects of antidepressant larrrrrrrrrr] erm.. yea. if you take it overdose it will cause severe side effects on you such as..hrm..severe nausea.er.confusion. That's why it's important for you to follow the doses recommended by the doctor. May be you can have your family to supervise so that you will not go off the range. Hrm, can you tell me why are you thinking of taking overdose? [teringat soalan - suicidal thought!]

Patient : ..because i has very hard time now..i feel like ending my life.

Candidate : ow. hurm. (cepat2, tunjuk empathy ;p) I know it's hard for you. But.. please don't do that[apakahh..hahaha] because it's.. it's not a proper way to end your life. We can give medication that can help you to improve your feelings. So.. (xtau nak cakap ape dah)

tinggggggggggg!

(blur, terstop jap. eh ingat masa dah habis, ada 1 minit lagi rupanya - cEpAt End my discussion)

Candidate : So,we will admit you for the time being..in the hospital..to check your..physical heatlh..and to give you medication to treat your current illness. We will also refer you to Psychiatric Department so that they can help you to cope with this problem. Probably, we will follow up with.. therapy like CBT (cognitive behaviour therapy) to help you with your thinking that affect you emotion and behaviour...

tingggggggggg! TIME's UP

broken englis. of course

but happy now that i'm free!

terima kasih Tuhan tolong sy exam.. :))