Mental Status

Question 1

What test assesses Dementia vs Depression?

Answer 1

Folstein Mini-Mental State Exam
normal = 23-30
< 19 is impaired

Question 2

When giving bad news, using open-ended questions can help with what?

Answer 2

assessment of the patient’s perception of the medical situation
Helps to assess denial, wishful thinking, unrealistic expectations

Question 3

“You were perfectly correct to think that way” is an example of what type of statement?

Answer 3

Validating statement

Question 4

“I can see how upsetting this is to you” is an example of what kind of statement?

Answer 4

Empathetic statement

Question 5

Derailment, incoherence, poverty of content, circumstantiality, tangentiality, perception, echolalia

Answer 5

Thought disorder

Question 6

patient’s level of arousal, attention & alertness

Answer 6

sensorium

Question 7

time, place, person & situation

Answer 7

orientation

Question 8

the patient’s ability to remember things in 3-5 minutes is an indication of

Answer 8

short term memory

Question 9

assessed by asking patient to recall events that occurred in the more distant past

Answer 9

remote memory

Question 10

assessed by asking the patient to name the last 4-5 presidents, capital of their state, etc

Answer 10

Fund of knowledge

Question 11

Lobe of the brain associated with speech formation, goal-oriented behavior, ability to concentrate, short-term memory, emotions, affect, autonomic responses to emotional states

Answer 11

frontal lobe

Question 12

lobe of the brain that processes sensory data (primary taste area, sensory association area)

Answer 12

parietal lobe

Question 13

lobe of the brain responsible for perception & interpretation of sounds, comprehension of spoken & written language, integration of behavior, emotion & personality, long-term memory

Answer 13

temporal lobe

Question 14

mediates patterns of behavior that determine survival: fear, mating, affection

Answer 14

limbic system

Question 15

regulates level of wakefulness or arousal

disruption can result in altered mental status

Answer 15

reticular activating system (RAS)

Question 16

location of the visual cortex

Answer 16

occipital lobe

Question 17

slumped posture may indicate

Answer 17

depression or neurologic condition (Parkinsons)

patient should have an erect posture

Question 18

time disorientation is associated with

Answer 18

anxiety, delirium, depression, cognitive impairment

Question 19

brief screening tool for measuring cognitive function

Answer 19

Mini-Cog
involves: repeating 3 unrelated words, drawing the face of a clock, placing the hands of the clock to the appropriate time requested

Question 20

responsive only to vigorous & repeated stimuli, becoming unresponsive without stimuli

Answer 20

stupor

Question 21

unresponsive to painful stimuli

Answer 21

coma

Question 22

standardized screening tool to assess cognitive function and detect changes over time

Answer 22

Mini-Mental State Exam

Question 23

asking the patient to tell you the meaning of a fable, proverb or metaphor assesses

Answer 23

abstract reasoning

Question 24

impairment of math skills may be associated with

Answer 24

depression
Patient should be able to subtract 7 from 50 & continue until the answer is 8.
Patient should be able to add 8 to 50 and continue until the answer is 98

Question 25

omission or addition of letters, syllables, words or mirror writing may indicate

Answer 25

aphasia

Question 26

the inability to translate an intention into action

Answer 26

apraxia

Question 27

repetition of a word, phrase or gesture

Answer 27

perseveration

Question 28

disordered words or sentences

Answer 28

flight of ideas or use of loose associations

Question 29

meaningless, disconnected word choices

Answer 29

word salad

Question 30

words with meaning only to the patient

Answer 30

neologisms

Question 31

word choice based on sound so that words rhyme in a nonsensical way

Answer 31

Clang associations

Question 32

repetition of another person’s words

Answer 32

echolalia

Question 33

Word comprehension, reading comprehension intact

Speech flow & writing impaired

Answer 33

Broca Aphasia (expressive)

Question 34

Cannot relate heard words to previous experiences
Reading & writing impaired
Fluent speech that may be incomprehensible

Answer 34

Wernicke Aphasia (receptive)

Question 35

word comprehension reduced to patient’s own name
Absent speech
Severely impaired reading comprehension & writing

Answer 35

Global Aphasia (expressive & receptive)

Question 36

used to quantify consciousness following brain trauma or hypoxic cerebral event

Answer 36

Glasgow Coma Scale
max score = 15; min = 3
looks at eye opening, verbal response, motor response

Question 37

panic attacks
phobias
OCD
PTSD

Answer 37

anxiety disorders

Question 38

What alternative therapies/remedies can cause confusion?

Answer 38

St. John’s wort; gingko biloba