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Flashcards in mental status assessment Deck (27)
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1

mental disorder

person's response is much greater than expected reaction to traumatic life event
- significant behavioral or psychological pattern associated with distress

2

organic disorder

due to brain disease
- delerium, dimentia, alcohold, drug intoxication

3

psychiatric mental illness

anxiety disorder, schizophrenia

4

mental status exam

inferred through assessment of an individual's behaviors
- consciousness: aware of one's own existence, feelings, and thoughts and aware of environment.
- language: voice used to communicate thoughts and feelings.
- mood and affect: temporary expression of feelings and durable, prolonged display of feelings
- orientation: awareness of objective world in relation to self
- attention: concentration, ability to focus
- memory: ability to lay down and store experiences
- abstract reasoning: pondering a deeper meaning
- thought process: way a person thinks, logical train of thought
- preceptions: awareness of objects through 5 senses

5

children MSE

by school age most children can sit and concentrate for a period of time
- age 7 - thinking becomes more logical and systematic and child is able to reason and understand
- age 12-15 = abstract thinking and thinking of hypothetical situations

Behavior Checklist: used for kids 7-11 who have outgrown developmental checklist

DENVER II: detects developmental delays in infants and preschoolers for: gross motor, language, fine motor, social skills

6

aging adult MSE

takes longer for brain to process info
- recent memory decreases, remote memory does not
- age related changes in sensory can affect perception
- always check sensory status first, this can cause misdiagnosis if not checked 1st
GLASGOW COMA SCALE: useful for testing consciousness
- general orientation is good
MINI COG: 3 item recall test and clock drawing
- grief can interfere with MSE

7

Components of MSE

APPEARANCE: posture, body movements, dress, hygiene

BEHAVIOR: facial expression, speech, mood and affect

COGNITION: orientation, attention span, recent and remote memory, new learning

THOUGHT PROCESSES: thought process, thought content, perceptions, anxiety disorders, depression, suicidal thoughts,

8

MMSE

mini mental status exam
- used to demonstrate worsening or improvement over time.
- concentrates on cognitive functioning, not mood or process

9

levels of consciousness

1. Alert: awake or readily aroused, oriented, fully aware of external and internal stimuli
2. lethargic, somnolent: not fully alert, drifts to sleep, arounsed by name or but looks drowsy, thinking seems slow and fuzzy
3. obtunded: sleeps most of time, difficult to arouse, monosylabus, mumbled speech
4. stupor or semi-coma: spontaneously unconscious, responds to only persistent or various shaking,
5. Coma: completely unconscious, no response to pain or to external or internal stimuli
*Delirium: clouding of consciousness, inattentive, incoherent convos, impaired recent memory,

10

full mental exam is needed when:

- initial screening suggests anxiety or depression
- family members are concerned
- known brain lesions
- aphasia
- symptoms psychiatric illness

11

ABCT

Appearance, behavior, cognition, thought process

12

additional tests for patients with apasia

- word comprehension - point and identify
- reading - read and then do what it says
- writing - write subject and verb

13

delirium vs. dimentia

delirium: acute, reversible, identifiable factor for change in mental status (alcohol, drugs, oxygenation,

dimentia: progressive, not sudden, alzheimers. can result in death

14

Speech Disorders

* dysphonia: voice; difficulty talking with normal pitch and volume, due to laryngeal disease, voice horse or whispered but in tact
* dysarthria: ariculation; distorted speech sounds, unintelligible, basic language in tact
* Apasia: language comprehension and production; secondary to brain damage. true language disturbance.

15

mood and affect abnormalities

* flat affect: lack of emotion, no expression or feelings, voice monotonous
* depresson: sad, gloomy, dejected
* depersonalization: loss of identity, feels estranged, "i don't feel real"
* elation: joy and optomism, overconfidence,
* euphoria: excessive well being
* anxiety: worried, uneasy unknown anticipation of unknown danger
* fear: worried, uneasy, apprehensive
* irritability: annoyed, easily provoked, impatient
* rage: furious, loss of control
* ambivalence: love and hate towards self or other
* lability: rapid shift of emotions

16

abnormalities of thought process

* blocking: unable to complete full thought
* confabulation: fabricates events to fill in memoey
* neologism: coining a new word
* circumlocution: round-about expression, substituting a phrase when one word can be used
* circumstantiality: excessive and unnecessary detail, delays reaching point
* flights of ideas
* word salad: incoherent mix of words
* echolalia: imitation, repeats others' words or phrases. mumbling, mocking, mechanical tone

17

abnormalities of thought content

* phobia: stong, persistent, irrational fear of an object or situation
* hypochondriasis: morbid worrying about health
* obession: unwanted, persistent thoughts or impulses
* compulsion: unwanted, repetitive purposeful act
* delusions: firm, fixed, false beliefs

18

abnormalities of perception

* hallucination: sensory perceptions but no external stimuli
* illusion: misperception of an actual existing stimulus, folds of bed sheets appear animated

19

schitzophrenia

two or more in one month: delusions, hallucinations, disordered speech, gross disorganization, negative symptoms
- dysfunction at work, interpersonal relations, self care
- signs last at least 6 months

20

delerium

disturbance of consciousness, change in cognition, short period of time

21

dementia

memory impairment, aphasia, apraxia, agnosia, disturbance in executive functioning

22

amnestic disorder

memory impairment with abets of other significant cognitive impairment
- impair social or occupational functioning

23

major depressive episode

5 or more symptoms: depressed mood, diminished interest or pleaseure in most daily activities, weight loss, insomnia, psychomotor agitation, fatigue, dimished ability to think, thoughts of death

24

manic episode

2 weeks, two years, or bipolar is manic symptoms followed by depression

25

panic attack

intense fear or discomfort

26

agoraphobia

anxiety about being in places or situations from which escape might be difficult. situations are avoided (travel)

27

panic disorder

unexpected panic attacks, concern about more attacks, change in behavior