4. Mental Status Exam Flashcards Preview

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Flashcards in 4. Mental Status Exam Deck (33)
1

What is Mental Status? what is it analogous to?

objective description of the patient's current state. akin to the physical exam. NOT a history.

2

what are the 7 categories covered in the mental status exam?

general description
speech
mood and affect
thought process
thought content
cognition
insight/judgment

3

what is involved in the General Description?

-appearance (clothing, hygeine, grooming, physical health, appropriateness of appearance)
-behavior (facial expressions, psychomotor agitation or retardation
-movements (mannerisms and tics, catatonia)
-attitude toward examiner (cooperative, hostile, paranoid)

4

what could be the cause of psychomotor agitation?

mania, ADD, drug use

5

what could be the cause of psychomotor retardation?

schizophrenia, depression, drug use

6

what could be the cause of abnl, bizarre movements?

side effects, hallucinations

7

what are the things we pay attention to with speech?

rate, volume, idiosyncrasies

8

what is Mood?

overall feeling, as experienced by the pt. use pt's own words if possible.

9

what is Affect?

the objective observation of how the patient is feeling. may be described as flat, blunted, labile, full, inappropriate, congruent

10

what does labile mean?

unstable/fluctuating affect

11

what does an inappropriate affect mean?

inappropriate response to circumstance ie laughing while describing sad events

12

what does a congruent affect mean?

appropriate to the stated mood, ie a depressed person appears depressed

13

what are the different types of Thought Processes we may find?

1. Goal-directed
2. circumstantial
3. tangential
4. flight of ideas
5. loosened associations

14

what does a circumstantial thought process look like?

straying from the point but eventually returning

15

what does a tangential thought process look like?

gets derailed from the topic, never to return.

16

what does a 'flight of ideas' thought process look like?

moving quickly from one idea to another, with some connection between the thoughts

17

what does a 'loosened associations' thought process look like?

jumping from thought to thought without connections between them

18

what are some Thought Contents we pay attention to?

-suicidal ideation/intent/plan
-homocidal ideation/intent/plan/victim
-delusions
-perceptual disturbances

19

what are a few types of delusions?

FIXED false beliefs which are not generally held.
-paranoid (FBI out to get me)
-grandiose (i am the president)
-referential (the TV is sending me messages)
-somatic (my liver is sick)
-thought broadcasting (my thoughts are being announced)
-thought insertion (someone is controlling my thoughts)

20

what are a few types of perceptual disturbances?

hallucinations, illusions

21

how do we test cognition?

use specific tools or questions, very directed

22

how do we test orientation?

questions about time, place, person.

23

how do we test attention?

use a digit span (say 3 digits and have pt repeat)

24

how do we test concentration?

ability to sustain attention. can use subtracting sevens from 100, spell WORLD backwards, days of week backwards

25

what are the 5 types of memory we test for?

-registration (immediate recall)
-short term (seconds to minutes)
-long term (recent, like cramming, or remote, very long term)
-constructional ability
-abstraction

26

how would we test registration?

immediate recall of 3 words

27

how would we test short term memory?

recall of 3 words 5 min after hearing them

28

how would we test long term memory?

semantic: general knowledge. name the last 4 presidents
episodic (more tightly held/personal): facts from a person's life

29

how would we test constructional ability?

involves visuospatial and visuomotor skills. have them draw an analog clock at 2:30.

30

how would we test for abstraction ability?

ask how is a dog similar to a tree? (they are both alive)
ask them to interpret a proverb (what do we mean by 'dont cry over spilled milk'?

31

how do we test for insight/judgment?

reasoning capabilities: what would you do if....

32

what is good about the MOCA?

widely used, good inter-rater reliability

33

what is bad about the MOCA?

only tells you that there is a problem, not what it is. somewhat depends on a person's education level