10/10 Mental Status Exam - Tobia

Question 1

ABC STAMP LICKER

Answer 1

Appearance

Behavior

Cooperation

Speech, Thought, Affect, Mood, Perceptions

Level of consciousness, Insight, Cognitive (higher order) fx, Killer Endings (SI/HI), Reliability

Question 2

catatonia

terms associated with deficits (7)

Answer 2

marked BEHAVIORAL (psychomotor) disturbance

1. abnormal motor activity
   * decreased OR excessive OR peculiar
2. decreased engagement

decreased motor

• moderate immobility: catalepty
• severe immobility: stupor

excessive motor

• simple: agitation
• complex: mannerism OR stereotypy

decreased engagement

• moderate: negativism
• severe: mutism

Question 3

Speech

Answer 3

speech proper aka “thought process”

• two terms specific to speech
  
  • volume
  • articulation
• other terms able to be put under EITHER speech or thought process!
  
  • normal: Goal directed
  • abnormal: Circumstantial, Tangential, Derailment (flight of ideas, looseness of associations)

comprehension

• ask patient to read and obey a simple command to test

Question 4

Thought

Answer 4

“pros & cons”

• thought PROcess
  
  • disturbances of association
  • disturbances of rate/rhythm

normal: Goal directed (linear)
abnormal: Circumstantial, Tangential, Derailment (flight of ideas, looseness of associations-word salad)
* thought CONtent

Question 5

examples of thought_disturbances of association

Answer 5

• clang associations (one example of “looseness”)
• echolalia
• perseveration (record skipping)
• neologisms
• non sequiturs

Question 6

examples of thought_disturbances of rate/rhythm

Answer 6

prosody : does voice have normal lilt?

dysprosody : loss of normal rhythm

Question 7

examples of thought_content

Answer 7

“Killer Endings” (SI/HI)

delusional thoughts (psychotic disorders)

non-delusional thoughts : obsessions, preoccupations

Question 8

Affect & Mood

Answer 8

affect

• type
• intensity - report average as: normal, blunted, flat
• range - look at area under curve as: normal, constricted/restricted
• change pattern - steepness of affect over encounter as: over controlled, labile
• appropriateness - mood congruent, incongruent
  
  • ex. la belle indifference: lack of concern with changes caused by a conversion disorder

mood

• how you feel (in quotes)

Question 9

perceptual disturbances

Answer 9

hallucinations : UNCUED; manifest from any of the sensory modalities

illusions : CUED; misinterpretation of real environmental stimulus

Question 10

levels of alertness

Answer 10

alert

lethargy

drowsy

catalepsy

obtundation

stupor

veg state

psychogenic unresponsiveness

coma

Question 11

orientation

Answer 11

person

place

time

(sometimes: insight)

Question 12

cognitive functions

Answer 12

memory

• unconscious (procedural)
• conscious
  
  • short term memory : working
    
    • digit span test (STM, attention, auditory recall)
  • long term memory : episodic, semantic

concentration (test frontal lobe)

• digit repetition
• spelling 5-letter word

information/knowledge base

abstract thought

• similarities
• proverbs