Page 35 - Complementary and Alternative Medicine Treatments in Psychiatry

The Comprehensive Medical Exam in Psychiatry | 35

Initial algorithm steps:
1. Ask the patient to complete a 10-item Medical History
Checklist, assisting the patient as needed:
a. Have you ever had:
i. Fits, convulsions or epilepsy?
ii. Emphysema?
iii. Diabetes?
iv. Asthma?
v. High blood pressure?
vi. Thyroid disease?
b. Have any of the following symptoms been very
noticeable or worrisome to you in the past two months?
i. Have you noticed blood or pus in your urine?
ii. Have you noticed pain in your chest when resting?
iii. Have you had headaches associated with vomiting?
iv. Have you had loss of control of urine or bowels?
2. Obtain a sitting blood pressure measurement.
3. Have patient provide a urine sample.
4. Draw the blood specimens for the laboratory battery.
5. Get a lab panel of:
a. A hematocrit
b. White blood cell count
c. Serum aspartate aminotransferase
d. Serum alanine aminotransferase
e. Serum albumin
f. Serum calcium
g. Serum sodium and potassium
h. Serum cholesterol and triglycerides
i. Serum T4 and free T4
j. Serum vitamin B12
6. Patient’s urine should be examined by dipstick for:
a. Glucose
b. Blood
c. Protein