Examination and Diagnosis Flashcards
(43 cards)
You should start a Psych interview by asking what type of questions?
Open-Ended Questions
What kind of questions do you use to obtain the remaining pertinent info?
Closed-Ended Questions
The patient should feel that the psychiatrist is what three things?
Interested, nonjudgemental and compassionate
In psychiatry, what is the most important factor in making a dx and tx plan?
History
The History of Present Illness (HPI) should include info about the current episode including what 5 descriptions of the current episode?
Symptoms, Duration, context, stressors and impairment in fxn
How should the chief complaint be written?
In the patient’s own words, no matter how bizarre
Analogous to performing a physical exam in other areas of medicine
Mental Status Examination
The mental status exam assesses the following?
Appearance/behavior, speech, perception, sensorium/cognition, insight/judgement
The mental status exam tells only about the mental status @?
that moment! it can change every hour or every day, etc
When assessing physical appearance you should take specific notice of the following which may be clues for possible diagnoses: Pupil size Bruises in hidden areas Eroding of tooth enamel superficial cuts on arms
Pupil size: drug intoxication/withdrawl
Bruises in hidden areas: Increased suspicion for abuse
Eroding of tooth enamel: eating disorder
superficial cuts on arms: self-harm
The emotion that the patient tells you he feels or is conveyed nonverbally
Mood
an assessment of how the patient’s mood appears to the examiner, including the amount and range of emotional expression.
Affect
The patient’s form of thinking- how he or she uses language and puts ideas together
Thought Process
no logical connection from one thought to another
Loosening of associations
thoughts change abruptly from one idea to another, usually accompanied by rapid/pressured speech
Flight of ideas
made up words
Neologisms
Incoherent collection of words
Word Salad
Word connections due to phonetics rather than actual meaning. “My car is red. I’ve been in bed. It hurts my head”
Clang associations
Abrupt cessation of communication before the idea is finished
Thought blocking
Point of conversation never reached due to lack of goal directed assocations between ideas; responses usually in the ball park
Tangentiality
Point of conversation is eventually reached but with overinclusion of trivial or irrelevant details
Circumstantiality
Describes the types of ideas expressed by the patient
Thought Content
Too few versus too many ideas expressed
Poverty of thought versus overabundance
fixed, false beliefs that are not shared by the person’s culture and cannot be changed by reasoning. Classified as bizarre (impossible to be true) or nonbizarre (at least possible)
Delusions
