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Block 5 POM > Block 5; Week 4 Quiz > Flashcards

Block 5; Week 4 Quiz Flashcards

(48 cards)

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1
Q

What are some common things that you will need to explore on a History in a mental status exam?

A

disorientation & confusion
depression
anxiety

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2
Q

If someone is experiencing disoriented & confused…what are some associated help problems that you want to ask about?

A
  1. loss of vision or hearing
  2. brain: injury, vascular occlusion, neurological disorder
  3. systemic infection
  4. withdrawal from alcohol
  5. metabolic or electrolyte disorder
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3
Q

What are some associated symptoms that you want to ask about if someone is disoriented & confused?

A 
delusions
hallucinations
mood swings
anxiety
lethargy
agitation
insomnia
change in appetite
drug toxicity
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4
Q

What are some meds that you want to ask about if someone is feeling disoriented & confused?

A 
anticholinergics
benzodiazepines
opioid analgesics
tricyclic antidepressants
levodopa
amantadine
diuretics
digoxin
antiarrhythmia meds
sedatives
hypnotics
Therapies: ginkgo biloba or st. john's wart
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5
Q

What are some meds that can worsen depression?

A 
anti-HTN
Corticosteroids
Beta blockers
Ca++ channel blockers
barbituates
phenytoin
anabolic steroids
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6
Q

What are some associated symptoms of anxiety?

A

panic attacks
obsessive thoughts
compulsive

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7
Q

What are some meds that you should ask about if someone seems to have anxiety?

A

antidepressants
steroids
benzos
alternative therapy

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8
Q

What are some family hx questions that you want to ask about?

A 
mental illness
alcoholism
alzheimer disease
learning disorder
autism
MR
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9
Q

What are some questions you should ask of children in a mental status exam?

A 
speech
behavior
performance of self-care activities
personality patterns
school difficulties
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10
Q

What is lethargy?

A

Drowsy and falls asleep quickly, but once aroused responds appropriately

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11
Q

What is obtundation?

A

Sleepy and still drowsy when awakened, decreased alertness and limited interest in the environment

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12
Q

What is a stupor?

A

Responsive only to vigorous and repeated visual, verbal, and painful stimuli, becomes unresponsive without stimuli

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13
Q

What is a coma?

A

unresponsive even with painful stimuli

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14
Q

What is the MMSE?

A

mini mental status exam
brief screening tool to assess cognitive function and detect changes over time
11 items tested, takes 10 minutes

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15
Q

What are the mental functions that are tested by MMSE?

A 
orientation
registration
attention
calculation
recall
language
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16
Q

What qualifies a positive MMSE?

A

24-26/30

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17
Q

The MMSE naturally varies with which factors?

A

age
education
ethnicity

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18
Q

How do you test orientation to time on the MMSE?

A

What is the date?

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19
Q

How do you test registration on the MMSE?

A

say 3 words & repeat them back

up to 5 times, looks like the 1st time is what counts

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20
Q

How do you test naming in the MMSE?

Study These Flashcards
A

point to an object. Can you name that?

21
Q

How do you test reading on the MMSE?

Study These Flashcards
A

Read these instructions. Do what they say.

22
Q

This is a strange one. How do you test language on the MMSE?

Study These Flashcards
A

copying intersecting pentagons

draw a clock face

23
Q

Poor grooming could indicate what?

Study These Flashcards
A

depression
psychiatric disturbances
dementia

24
Q

When assessing emotional status, what are some noteworthy reactions?

Study These Flashcards
A

i. Carelessness
ii. Apathy
iii. Loss of sympathetic reactions
iv. Unusual docility
v. Rage reactions
vi. Excessive irritability

25
What are some signs of cognitive impairment?
1. Significant memory loss 2. Confusion 3. Impaired communication inappropriate affect 4. Personal care difficulties 5. Hazardous behavior 6. Agitation 7. Suspiciousness
26
If a patient can't understand analogies on MMSE...what could this indicate?
left or dominant cerebral lesion
27
If a patient can't explain a proverb (problem with abstract reasoning)...what could this indicate?
poor cognition, dementia, brain damage, or schizophrenia
28
If pt can't do simple arithmetic calculations...w/i 1 minute...what could this indicate?
depression | diffuse brain disease
29
If a person can't write a phrase or draw geometric shapes (if illiterate)...what could this indicate?
dementia parietal lobe damage cerebellar lesion peripheral neuropathy
30
What is apraxia? How does this relate to the MMSE?
cerebral disorder--inability to translate intention into movement **see on MMSE when you ask a pt to comb their hair & they can't.
31
How do you test immediate memory in the MMSE?
have pt repeat back a sentence | repeat 5-8 Numbers forward or 4-6 numbers backwards
32
How do you test recent memory in the MMSE?
show pt 4-5 objects & ask them what they were 10 minutes later. visually impaired: 4-5 unrelated words
33
How do you test remote memory in the MMSE?
ask patient to verify past events--mother's maiden name etc.
34
If a pt has memory loss, what might have caused it?
disease infection temporal lobe trauma
35
If a pt has impaired memory what might have caused it?
``` neurological disorder psychiatric disorder (i.e.anxiety & depression) ```
36
If you have recent & immediate memory loss, but remote memory intact...what is this?
dementia
37
So...you ask a pt to spell WORLD back & forwards...they can't. What are you testing? What are the implications of this?
testing attention span | **could be fatigue, depression, delirium, toxicity, metabolic dysfunction
38
How might you test a patient's judgment? What might decreased judgment indicate?
Ask patient solutions to hypothetical problems. | Impaired: MR, emotional disturbances, frontal lobe injury, dementia, psychosis
39
If a patient has tactile hallucinations...what is this usu indicative of?
alcohol withdrawal
40
What is circumlocution?
pantomime or hand gestures to cover up that a word has been forgotten
41
What is perseveration?
repetition of a word or phrase
42
What are neologisms?
these are words that only have meaning to the pt
43
What are common things that can affect mental status in infants & children?
brain infections brain trauma metabolic dysfunctions
44
What are noteworthy findings in infants & children?
``` lethargy drowsy stupor alert active irritable ```
45
What is the significance of a GCS score of 15? of 3?
15-optimal consciousness | 3-coma deep
46
If I am not oriented to person...what is my problem?
i. Cerebral trauma ii. Seizures iii. Amnesia
47
If I am not oriented to place...what is my problem?
i. Psychiatric disorders ii. Delirium iii. Cognitive impairment
48
If I am not oriented to time...what is my problem?
i. Anxiety ii. Delirium iii. Depression iv. Cognitive impairment

Block 5 POM (4 decks)

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