031215 mental status exam

Question 1

mental status exam describes present state only: true or false

Answer 1

true

Question 2

components of mental status exam

Answer 2

appearance, attitude, behavior
speech
mood and affect
thought form/process and content
perception (hallucinations)
sensorium/cognition
insight
judgment

mnemonic: a snake moves toward prety silently in jungles

Question 3

appearance

Answer 3

emphasize abnormalities like disheveled, long beard, strong odor, dressed in rags, etc

Question 4

behavior

Answer 4

physical behavior (sitting motionless, rocking, shouting, etc)

Question 5

speech

Answer 5

qualities of speech (rate, tone, rhythm, volume)

Question 6

mood and affect may be incongruent in

Answer 6

some psychiatric syndromes (schizophrenia)

Question 7

thought form/process

Answer 7

describes how pt is thinking

normal thought form is often “logical, linear, and goal-oriented”

Question 8

abnormal thought form/processes

Answer 8

thought blocking-mind frequently goes blank

poverty of thought-very little thought occurring

circumstantiality-takes a long time to get to the point

tangentiality-logical but never gets to point

loose associations (derailment)-no connections btwn thoughts at all

Clang associations-thoughts are expressed thruogh sounds (rhyming) rather than meaning

neologisms (this and above two suggest psychotic)

perseveration-stuck on single thought

flight of ideas-rapid jumping from thought to thought (often seen in mania)-slight connection to thoughts

Question 9

abnormal thought content

Answer 9

delusions (false beliefs)

ideas of reference

ideas of influence (another person or force is controlling pt’s thoughts)

obsessions

compulsions

phobias

hypochondriacal symptoms

thoughts of suicide

thoughts of violence

Question 10

abnormal perceptions

Answer 10

hallucinations (often seen in schizophrenia)

illusions

Question 11

sensorium

Answer 11

pt’s state of awareness and cognitive abiilties including:

• alertness
• orientation to person, place, time, situation
• concentration (reverse spellings, serial 7s or 3s)
• memory (immediate, recent, long-term)
• calculation
• fund of knowledge (geography, current events)
• abstract reasoning (proverbs, similarities)
• reading (doctor writes “close your eyes”-see if pt does it)
• writing
• visuospatial ability (draw clock, interlocking pentagons, or cube)
• estimated intelligence

Question 12

Folstein mini-mental status exam

Answer 12

one page that covers most of the sensorium items

numeric score is generated
emphasis is on cognition (delirious pt will score low but psychotic pt may or may not do well)

Question 13

insight

Answer 13

describes pt’s capacity for self-reflection, awareness of illness, understanding of his or her present situation

often lacking in pts w chronic psychotic disorders, delirium, or severe personality disorders

Question 14

judgment

Answer 14

pt’s capacity to make reasonable decisions