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Year 3 - Mental Health > Mental State Examination > Flashcards

Mental State Examination Flashcards

1
Q

When conducting and presenting the findings of a mental state examination, in what order should this be approached?

A

Appearance and behaviour

Speech

Mood

Affect

Thought

Perceptions

Cognition

Insight

Risk

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2
Q

How should appearance and behaviour be examined?

A

Describe the patient

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3
Q

What aspects of a patients appearance and behaviour should be described?

A

Well kempt?

Clothing

Eye contact

Level of rapport

Psychomotor retardation

Other psychomotor signs

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4
Q

What types of eye contact may be particularly relevant?

A

Inappropriate eye contact

Reduced eye contact

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5
Q

How can level of rapport differ between psychiatric patients?

A

Can be easy to develop

Patient can be guarded

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6
Q

What other psychomotor signs could be commented on?

A

Parkinsonism

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7
Q

What aspects of speech should be analysed during a mental state examination?

A

Rate

Tone

Volume

Difficulty speaking?

Formal thought disorder?

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8
Q

How can rate of speech vary?

A

Delayed start

Slow

Fast

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9
Q

How can tone of speech vary?

A

Monotonous

Overly variable

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10
Q

How can volume of speech vary?

A

Quiet/loud

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11
Q

What types of difficulty speaking may a patient have?

A

Dysphasia

Dysarthria

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12
Q

What are some different types of formal thought disorder?

A

Loosening of associations

Flight of ideas

Circumstantiality

Tangentiality

Neologisms

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13
Q

What is loosening of associations?

A

A loss of connection between thoughts presenting as changing of topic between sentences or words with obvious links between topics.

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14
Q

At its wort how can loosening of ideas present?

A

Word salad

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15
Q

What condition does loosening of associations typically present in?

A

Schizophrenia

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16
Q

What is flight of ideas?

A

Rapid changing of topic between sentences with some identifiable link between topics

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17
Q

What condition does flight of ideas typically present in?

A

Mania

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18
Q

What is the major difference between loosening of associations and flight of ideas?

A

There is an identifiable link between topic changes in flight of ideas if speech is written down and analysed

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19
Q

What is circumstantiality?

A

Patient will go over the top with detail and move on to seemingly irrelevant topics before bringing the conversation back to answer the question

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20
Q

What is tangentiality?

A

The patient will move the conversation on to another topic and never return to answer the original question

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21
Q

What are neologisms?

A

Words made up by the patient with a specifically assigned meaning

22
Q

In what two ways should a patients mood be assess in a mental state examination?

A

Subjectively

Objectively

23
Q

How is a patient’s mood described subjectively?

A

Ask the patient to describe their mood

Can use a scale of 1-10

How has it changed from premorbid mood

24
Q

How is a patient’s mood describe objectively?

A

The assessor gives their view on the patient’s current mood

25
Q

In what ways may an assessor describe a patient’s mood?

A

Depressed

Manic

Anxious

Irritable

Euthymic (normal)

26
Q

What is affect?

A

How a patient appears to respond emotionally in certain situations

27
Q

In what ways may a patients affect be altered?

A

Blunt

Flat

Inappropriate

Labile

Reactive (normal)

28
Q

What is a blunt affect?

A

A decrease in the variation of emotional response displayed by a patient

29
Q

What is a flat affect?

A

Absence of any emotional response

30
Q

How may a patient’s affect be inappropriate?

A

May have the typically wrong response to a certain situation

E.g. finding a sad situation funny

31
Q

What is meant by a labile affect?

A

Rapid changes in emotional state

32
Q

What aspects of thought should be considered in a mental state examination?

A

Form

Content

33
Q

How can psychiatric pathology affect form of thought?

A

Delusions

Obsessions

Phobias

Intrusive thoughts

Paranoia

34
Q

How can content of thought be recorded?

A

Write exactly what the patient says in answer to some questions/some statements

35
Q

In what ways may a persons perception be altered?

A

Illusions

Hallucinations

36
Q

What is an illusion?

A

A misinterpretation of a stimulus that can occur in any modality

37
Q

Is an illusion a sign of pathology?

A

No - it is normal to sometimes see illusions

38
Q

What is a hallucination?

A

The perception of something (e.g. taste, smell etc.) in the absence of an external stimulus

39
Q

What type of hallucination is most common in functional psychiatry?

A

Auditory hallucination

40
Q

What type of hallucination is more common in organic psychiatry?

A

Visual hallucinations

41
Q

What conditions can 2nd person auditory hallucinations occur in?

A

Severe depression

Schizophrenia (some times)

42
Q

What condition are 3rd person auditory hallucinations more common in?

A

Schizophrenia

43
Q

How does a third person auditory hallucination often present in schizophrenia?

A

As a running commentary

44
Q

What is an important indicator of cognition?

A

Awareness of orientation of in time, place and person

45
Q

What can be used to assess cognition?

A

MMSE

46
Q

What is meant by insight?

A

A patient’s understanding of their experience/illness

47
Q

What must be considered when assessing a patient’s insight?

A

Do the believe they’re well?

Does their view differ from professional opinion?

Do they understand their condition?

48
Q

What risks must be considered when assessing psychiatric disease?

A

Risk to self

Risk to others

Risk to health

49
Q

How can a patient be a risk to themselves?

A

Self-harm

Suicide

Neglect

50
Q

How can a patient be a risk to others?

A

Protection of self

Command hallucinations

Aggression and irritability

51
Q

How may a psychiatric patient be a risk to their own health?

A

Not taking medication causing deterioration of mental/physical health

Not exercising

Eating disorders

Year 3 - Mental Health (12 decks)

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