20. mental state exam Flashcards

1
Q

sections of a MSE

A

ASEPTIC

Appearance and behaviour
Speech
Emotion and Affect
Perception
Thought
Insight
Cognition

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2
Q

Appearance and behaviour

A

Describe someone so that someone could pick them out in a waiting room
Ethnicity, age, clothing, well-kempt

Body language : eye contact, rapport. E.g relaxed, agitated, intense eye contact, were able to establish a rapport, didn’t want to engage during the consultation

Abnormal movements : EPSEs - tremor, stiffness, gait, tardive dyskinesia (rhythmic abnormal movement, tongue protrusion) - it is difficult to treat. ⅓ will get better but lots of ppl it continues, oculogyric crisis

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3
Q

Speech MSE

A

Rate, tone, volume, rhythm
Fluency, coherency
Any dysphasias

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4
Q

Emotions/mood MSE

A

Objective: dysthymic, euthymic (in the middle) or elated/hyperthymic
Subjective (mood) : pt perspective/rate on a scale,
Affect : reactive (responds to humour, good news, bad mood etc)/flattened (restricted range) congruent/incongruent “in terms of emotions and mood - objectively her mood is x, subjectively she describes this as x. Her affect is x and this is mood congruent/incongruent”

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5
Q

Perceptions MSE

A

Illusions: false perception in the presence of an actual stimulus
Hallucinations

Auditory, visual, olfactory, gustatory, tactile

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6
Q

Thought MSE

A

Formal thought disorders
- circumstantiality
- tangentality
- Neoligisms
- Clang associations
- Word salad
- Knights move
- Flight of ideas
- Perseveration
- Echolalia
- Jargon dysphasia

Content
- overvalued ideas
- obsessions
- delusions
- thought alienation
- passivity
- is the thought content congruent with affect?

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7
Q

Insight MSE

A

Full, partial, none

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8
Q

Cognition MSE

A

Oriented to time place and person but not formally assessed

Attention - spell world backwards

MMSE, MOCA, ACE III

Capacity (to accept admission/treatment)

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9
Q

4 areas of risk assessment

A

To self
To others
Of exploitation
Of retaliation

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10
Q

what is circumstantiality

A

the inability to answer a question without giving excessive, unnecessary detail. However, this differs from tangentiality in that the person does eventually return the original point.

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11
Q

what is tangentality

A

wandering from a topic without returning to it.

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12
Q

what are neoligisms

A

new word formations, which might include the combining of two words.

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13
Q

what are clang associations

A

ideas are related to each other only by the fact they sound similar or rhyme

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14
Q

what is word salad

A

incoherent speech where real words are strung together into nonsense sentences

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15
Q

what is knights move thinking

A

a severe type of loosening of associations, where there are unexpected and illogical leaps from one idea to another. It is a feature of schizophrenia.

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16
Q

flight of ideas

A

thought disorder where there are leaps from one topic to another but with discernible links between them.

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17
Q

perseveration

A

Repetition of ideas or words despite an attempt to change the topic

18
Q

echolaia

A

repetition of someone else’s speech, including the question that was asked.

19
Q

overvalued ideas

A

somewhat shakable, not functionally impairing but they still believe it

20
Q

obsessions

A

recurrent intrusive thought that can be associated with compulsions

21
Q

delusion define

A

false or illogical belief that is unshakable and doesn’t fit with someone’s social or cultural background

22
Q

Belief that you have more power, wealth, intelligence or grand traits than is true

A

delusion of grandeur

23
Q

beliefs that they will be/or soon will be destitute

A

Delusion of poverty

24
Q

belief there are parasites/bugs under skin

A

Parasitosis (ekoms)

25
Q

belief that part of or all of someones body/soul is dead/rotting away

A

Cotard’s (nihilistic)

26
Q

a feeling of some change in the self, feeling detached from one’s own body, actions feel mechanical and patient feels like an apathetic spectator of their own activities

A

Depersonalisation

27
Q

experiencing thoughts, actions and feelings as being foreign or manufactured against their will by a foreign influence

A

Passivity

28
Q

types of passivity

A
  • Somatic passivity : delusional belief of body sensations from an external source
  • Made act passivity: actions feel controlled by an external influence
29
Q

false perception of being in a relationship/that someone has romantic interest in them, often a celebrity

A

Delusional erotomania (de clerambauts)

30
Q

other name for delusion of infidelity

A

othello syndrome

31
Q

a belief that a familiar person has been replaced by an imposter

A

capgras

32
Q

a belief that a stranger is a familiar person in disguise

A

Fregoli delusion

33
Q

types of delusion of misidentification

A

Capgras : that a familiar person has been replaced by an imposter (a delusion of misidentification)

Fregoli delusion : that a stranger is a familiar person in disguise (a delusion of misidentification

34
Q

a belief that unrelated occurrences in the external world have a special significance for the patient

A

Delusion of reference

35
Q

whata re elementary hallucinations

A

Elementary auditory hallucinations: sounds such as whistling, hissing, mumbling

Elementary visual hallucinations: seeing lights, colours, geometric shapes, and indiscrete objects

36
Q

2nd vs 3rd person auditory hallucibations

A

2nd person auditory hallucinations : “you are..”
3rd person auditory hallucinations : speaking about the person

37
Q

what is an extracampine hallucination

A

sense that someone is there eg someone standing behind you

38
Q

hallucinations associated with sleep

A

Hypnopompic: hallucinations when waking up

Hypnagogic: hallucinations when going to sleep

39
Q

negative symptoms what is affective flattening

A

unchanging and unresponsive facial expression, avoidance of eye contact, diminished body language

40
Q

what is alogia

A

poverty of speech, not speaking much. Lack of spontaneity and flow in conversation