Mock 11
Completion requirements
- Picture for Chickenpox station.
- Picture for
- Abdominal examination for intestinal obstruction should be done in the Simman room.
- Breast mannikin (for Lady with breast lump).
- Urine Dipstick for urinalysis.
15. Consultation for Trigeminal Neuralgia
Scenario: Consultation for Trigeminal Neuralgia
Background Information:
- You are a neurologist in a hospital or a specialty clinic.
- A patient presents with severe, episodic facial pain described as electric-shock-like sensations.
Patient Profile:
- Age 55, female, reports experiencing sharp, shooting pain in the face that lasts from a few seconds to a couple of minutes.
- Pain episodes are triggered by activities such as brushing teeth, chewing, or sometimes even touching the face.
Chief Complaint:
- Intense, recurrent facial pain affecting daily activities and quality of life.
Doctor's Task:
- Perform a thorough neurological examination to rule out other causes of facial pain.
- Discuss the diagnosis of trigeminal neuralgia, including potential causes and the typical pattern of pain associated with this condition.
- Explore and explain treatment options, ranging from medication to surgical interventions.
- Address patient concerns about the chronic nature of the condition and management of pain.
Patient Prompts:
Pain Description and History Taking:
- The patient describes the pain and its impact on daily life, mentioning specific triggers and the location of the pain.
- The doctor should ask about the duration, frequency, and intensity of the pain episodes, as well as any previous treatments or medications tried.
Diagnosis Explanation:
- Explain the likely involvement of the trigeminal nerve and why it causes such intense pain.
- Discuss how trigeminal neuralgia is diagnosed primarily through patient history and clinical presentation, and the role of MRI to exclude other causes.
Treatment Discussion:
- Introduce first-line treatment options, such as anticonvulsant medications like carbamazepine or gabapentin, explaining their effectiveness and potential side effects.
- Discuss additional treatments such as surgical options (e.g., microvascular decompression or gamma knife surgery) if medications are ineffective or not tolerated.
Long-Term Management and Support:
- Talk about the importance of regular follow-up to adjust treatment as needed.
- Provide information on support groups or resources for patients with chronic pain conditions.
Clinchers:
- Stress the importance of ongoing communication between the patient and the healthcare team to effectively manage the condition.
- Reassure the patient that many treatment options are available and that a strategy will be developed that is tailored to her symptoms and response to initial treatments.
Important Points to Keep in Mind:
- Recognize and empathize with the significant impact this condition has on the patient’s quality of life.
- Use clear and concise explanations to ensure understanding, avoiding overly technical language that may confuse the patient.
- Emphasize patient education and involvement in the treatment decision-making process.
Expected from the Doctor:
- Display a thorough understanding of trigeminal neuralgia, including its pathophysiology, diagnosis, and the spectrum of treatment options.
- Demonstrate sensitivity to the patient's pain and anxiety about the condition.
- Communicate effectively, offering reassurance and clear information about prognosis and management.
This scenario provides a comprehensive assessment of the candidate's ability to manage a challenging neurological condition with significant implications for patient quality of life, focusing on diagnostic skills, treatment planning, and patient communication.