4. Mental Status Exam Flashcards
(33 cards)
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.
what are the 7 categories covered in the mental status exam?
general description speech mood and affect thought process thought content cognition insight/judgment
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)
what could be the cause of psychomotor agitation?
mania, ADD, drug use
what could be the cause of psychomotor retardation?
schizophrenia, depression, drug use
what could be the cause of abnl, bizarre movements?
side effects, hallucinations
what are the things we pay attention to with speech?
rate, volume, idiosyncrasies
what is Mood?
overall feeling, as experienced by the pt. use pt’s own words if possible.
what is Affect?
the objective observation of how the patient is feeling. may be described as flat, blunted, labile, full, inappropriate, congruent
what does labile mean?
unstable/fluctuating affect
what does an inappropriate affect mean?
inappropriate response to circumstance ie laughing while describing sad events
what does a congruent affect mean?
appropriate to the stated mood, ie a depressed person appears depressed
what are the different types of Thought Processes we may find?
- Goal-directed
- circumstantial
- tangential
- flight of ideas
- loosened associations
what does a circumstantial thought process look like?
straying from the point but eventually returning
what does a tangential thought process look like?
gets derailed from the topic, never to return.
what does a ‘flight of ideas’ thought process look like?
moving quickly from one idea to another, with some connection between the thoughts
what does a ‘loosened associations’ thought process look like?
jumping from thought to thought without connections between them
what are some Thought Contents we pay attention to?
- suicidal ideation/intent/plan
- homocidal ideation/intent/plan/victim
- delusions
- perceptual disturbances
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)
what are a few types of perceptual disturbances?
hallucinations, illusions
how do we test cognition?
use specific tools or questions, very directed
how do we test orientation?
questions about time, place, person.
how do we test attention?
use a digit span (say 3 digits and have pt repeat)
how do we test concentration?
ability to sustain attention. can use subtracting sevens from 100, spell WORLD backwards, days of week backwards
