Mental state exam (MSE)

Question 1

first thing you do in MSE

Answer 1

write down patients name, DOB/DHI, date, time, your name and signature

Question 2

what is the pneumonic for remembering the categories of MSE

Answer 2

ASEPTIC

Question 3

A =

Answer 3

appearance and behaviour

Question 4

S =

Answer 4

speech

Question 5

P =

Answer 5

perception

Question 6

T =

Answer 6

thoughts

Question 7

E =

Answer 7

emotion - mood and affect

Question 8

I =

Answer 8

insight

Question 9

C =

Answer 9

cognition

Question 10

what do you comment on in appearance

Answer 10

age, BMI, gender, race
grooming - neat/disheveled  
clothes - bright/dark 
posture - slumped 
self harm?

Question 11

what do you comment on in behavior

Answer 11

eye contact 
rapport 
appropriate behavior? engagement with Qs?
body language 
withdrawn/agitated

Question 12

what do you comment on in speech

Answer 12

fast/slow
pitch - monotomous
interruptible/pressured?
amount - increased or decreased

Question 13

interruptible speech

Answer 13

mania

Question 14

what do you comment on in emotion

Answer 14

mood - how are THEY feeling (use own words)

affect - how do they appear to you 
flat, low, depression
anxious, irritated, angry 
elated 
euthymic (normal)

Question 15

what do you comment on in perception

Answer 15

hallucinations - 2nd person, 3rd person, visual

delusions - religious, grandiose

Question 16

what do you comment on in thoughts

Answer 16

form - flowing, logical, tangential, flight of ideas, knights move thoughts
passivity phenomena - thought interference eg thought insertion/blocking/broadcasting/withdrawal
content - negative, suicidal, their own thoughts?

Question 17

what do you comment on in insight

Answer 17

yes or no (can ask)

Question 18

what do you comment on in cognition

Answer 18

can do MMSE/adenbrookes if time

orientation - day, date, time, place, building, name, age DOB
concentration and attention - months of year in reverse order
memory - anterograde (recent), retrograde (past), personal

Question 19

flight of ideas

Answer 19

quickly changing topic of conversation, but understand how they got there

in mania

Question 20

knights move thought

what does it occur in

Answer 20

quickly changing topic of conversion, don’t know how they got form A to B

in schizophrenia

Question 21

what does rhyming and punning of words occur in

Answer 21

mania

Question 22

3rd person auditory hallucination

what does it occur in

Answer 22

people speaking about you across the room

schizophrenia

Question 23

verbigeration

Answer 23

obsessive repetition of random words

Question 24

delusion

Answer 24

a belief that is fixed and falsely held, conflcits with reality

Question 25

paranoia

Answer 25

feeling of being threatened eg someone watching you, or acting against you, with no proof/rationale why

Question 26

gedakenlantwerden

Answer 26

hallucination with voices speaking their thoughts at the same time they think them

Question 27

folie a deux

Answer 27

delusions shared by 2 people closely related eg married couples

Question 28

psychomotor retardation what does it occur in

Answer 28

slowing of movements eg speech, walk depression

Question 29

flashback what does it occur in

Answer 29

flashback - re-experiencing of event, NOT just a memory PTSD

Question 30

depersonalisation

Answer 30

cant feel emotion

Question 31

mitgehen

Answer 31

excessive movements, eg slight nudge would cause exaggerated movement

Question 32

nilhilistic delusions what syndrome are they associated with

Answer 32

delusions of having no organs/being dead (nil = none) cotards syndrome

Question 33

psychomotor agitation what does it occur in (3)

Answer 33

rapid speech, restlessness, pacing around room, tapping toes psychosis, mania, anxiety

Question 34

hallucination

Answer 34

false sensory perception without external stimulus eg seeing people in your house

Question 35

psuedohallucination

Answer 35

hallucination but you know its not real

Question 36

illusion

Answer 36

false sensory perception of real external stimulus eg mistaking a shadow for a person

Question 37

tactile hallucination occurs in

Answer 37

alcohol withdrawal

Question 38

visual hallucinations occur in

Answer 38

organic cause eg tumour, lewy body dementia, delirium (think of people in care home)