Mental Status Exam

Question 1

What is included in the Mental Status Exam (12)

Answer 1

1. Appearance
2. Alertness and orientation
3. Speech
4. Motor Activity
5. Affect
6. Mood
7. Thought Content
8. Thought Process
9. Intellectual Functioning
10. Attention and Memory
11. Judgment
12. Insight

Question 2

Appearance includes:

Answer 2

1. Appearance consistent with age
2. Unusual attire (i.e. indoors w/sunglasses, bright colors)
3. Appropriateness (i.e. not enough clothes, overdressed)

Question 3

Descriptions for alertness & orientation includes: (2)

Answer 3

1. Alertness: Alert, sleepy, lethargic, unconscious
2. Orientation: Standard: person, place, date & possibly day of week, season, city, state, county, room, floor

(alterness: you may say that they appeared generally oriented)

Question 4

Descriptions of a patient’s speech include: (3)

Answer 4

1. Rate: Normal, rapid, pressured (you have to interupt to speak or they won’t stop), slow
2. Volume: Softer or louder than appropriate
3. Inflection: Monotonous or animated

(Ex: If fast, they don’t speed up and slow down. It’s more constant)

Question 5

Mental status exam: descriptions of motor activity

Answer 5

1. Psychomotor agitation or retardation
2. Tics
3. Dyskinesia

Question 6

Define affect

Answer 6

The way we present our emtions to the world

(range, stability & appropriatenous)

Question 7

Mental status exam: affect

Answer 7

1. Range: degree of reactivity, flat, blunted, full range
2. Stability: stable or labile
3. Appropriateness: Are responses appropriate to the context?

(We need to understand where a patient is coming from to understand affect. If they are going to die but are at peace about it, that may be appropriate affect).

Question 8

Define mood

Answer 8

Sustained emotional attitude

(sometimes you need to ask them about their mood. ie. “patient stated they’re fine although tears were streaming down their face.”)

Question 9

Mental status exam: mood

Answer 9

1. Neutral: euthymic
2. Depressed: dysphoric
3. Euphoric
4. Anxious
5. Irritable

Question 10

Mental status exam: thought content

Answer 10

1. Delusions
2. Hallucinations
3. Homicide Ideation
4. Suicide Ideation

Question 11

Mental status exam: thought content - delusion examples (2)

Answer 11

Grandiose, paranoid, etc.

Question 12

Mental status exam: thought content - Hallucinations (4)

Answer 12

1. Visual
2. Auditory
3. Tactile
4. Olfactory

Question 13

Mental status exam: thought content - Homicide Ideation

Answer 13

1. Plan
2. Intent
3. Identity of victim

Question 14

Mental status exam: thought content - Suicide ideation includes (5)

Answer 14

1. Thoughts
2. Plan
3. Means
4. Intent
5. Uncontrollable urges

Question 15

Mental status exam: 5 categories of thought process

Answer 15

1. Goal-oriented, linear
2. Tangential, circumferential
3. Loose associations
4. Disorganization
5. Thought blocking

Question 16

Circumfrential thought process

Answer 16

Non-linear thought expressed as long-winded explanations and with multiple deviations from the central topic before a central idea is finally expressed

(i.e. how many children do you have? answer: my grandma has this many, my mom has this many, i have this many)

Question 17

Define tangential thought process

Answer 17

Nonlinear thought expressed as a gradual deviation from a focused idea or question (provides multiple unnecessary details related to the question without actually answering the question)

(example when asked about medical history the patient describes the hospital’s they’ve stayed in without mentioning the medical condition)

Question 18

Loose association/derailments (thought process)

Answer 18

Incoherent, illogical, sudden and frequent changes of topic

(ex: when asked about their job the patient remember some funny stories from their childhood and starts talking about the weather)

Question 19

Mental Status: Intellectual functioning includes: (5)

Answer 19

1. Fund of knowledge
2. Vocabulary, grammar
3. Problem-solving
4. Calculation
5. Abstraction

(90% have normal fxning, we typically base our judgement of other people’s intelligence on thier vocabulary and grammar)

Question 20

Abstraction ability

Answer 20

1. Analyze info
2. Detect patterns & connections between 2 things (comparing apples and oranges)

Question 21

How do you test a patient’s attention (2)

Answer 21

1. Spelling
2. Name 5 things that start with a common letter

Question 22

How do you test a patient’s memory?

Answer 22

1. Immediate: repeat three items
2. Short-term: can remember items in 3-5 minutes
3. Long-term: past events

Question 23

Mental Status Exam: Judgment (2)

Answer 23

1. The ability to make considerate decisions when performing a task based on their understanding of the current cirumstances
2. problem-solving ability (higher cortical fxn)

(Are they inappropriate? Insights into their psychiatric dellusions? to stand trial, you need to understand your situation and why you’re in that situation)

Question 24

Mental Status: Insight

Answer 24

How realistically does the patient assess his/her illness and life problems

(more likely to be compliant w/tx)

Question 25

Labile affect

Answer 25

when someone flips a switch when they’re talking

Question 26

Thought blocking thought process

Answer 26

The abrupt ending of a thought process → sudden interruption in speech