Mental Status Exam Flashcards

1
Q

What is a mental status exam?

A

A mental status exam is the objective description of the patient’s current state.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 7 parts of the mental status exam?

A

1) General description
2) Speech
3) Mood and affect
4) Thought Process/structure of thoughts
5) Thought Content
6) Cognition
7) Insight/judgement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What descriptors/notes should be made regarding a patient’s “General Description”?

A

Include the patient’s general appearance AND behavior:

  • Hygiene
  • Expressions
  • Psychomotor agitation/retardation
  • Mannerisms/Tics
  • Catatonia
  • Attitude toward examiner
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What aspects of speech should be noted in a mental status exam?

A

Note these aspects of speech:

  • Pressured?
  • Long/latent in response
  • Volume
  • Idiosyncrasies of speech
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How are mood and affect observed?

A
  • Mood is the overall feeling tone => subjectively experienced
  • Affect is how the patient expresses their feelings => objectively observed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are variations in affect?

A
  • Blunted
  • Flat
  • Labile
  • Inappropriate
  • Mood congruent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a goal directed thought process?

A

A goal directed thought process is interpreted as “normal”

  • logical
  • coherent
  • easy to follow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a loosening of associations (in regards to thought process)?

A

A loosening of associations represents a disconnection between thoughts. It usually represents unrelated thoughts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is considered a flight of ideas?

A

When a patient exhibits a flight of ideas, they move quickly from one thought to another.
- The ideas are rapid but also thinly spread in direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In regards to thought process, what is “circumstantial” thinking?

A

When a patient speaks circumstantially they stray from a point but eventually return to the original point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is considered tangential thinking?

A

The patient gets derailed from the topic and never returns to the original question

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In regards to thought process, what occurs in “thought blocking”?

A

During thought blocking, a train of thought is interrupted before an idea is finished

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In terms of thought process, what is “preservation”?

A

Preservation is the habit of persistently repeting words, phrases, or sentences in a relatively meaningless manner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a delusion?

A

Delusions are fixed, false beliefs which are not those generally held by society or subculture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are various forms of delusion?

A
  • Paranoid
  • Grandiose
  • Referential
  • Somatic
  • Thought Broadcasting
  • Thought Insertion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is an example of a paranoid delusion?

A

“The FBI is after me”

17
Q

What is an example of a grandiose delusion?

A

” I am the president”

18
Q

What is an example of a referential delusion?

A

‘The television is sending me messages”

19
Q

What is an example of a somatic delusion?

A

“My heart is gone”

20
Q

What is an example of a thought broadcasting delusion?

A

“My thoughts are being announced over the paging system”

21
Q

What is an example of a thought insertion delusion?

A

“Someone is making me think about hurting my mother.”

22
Q

Define “hallucination”.

A

A hallucination is sensory perception in the absence of any external sensory stimulus

  • Auditory, Visual, Tactile, Gustatory, Olfactory
  • Hearing voices is the most common hallucination among people with schizophrenia
23
Q

Define “illusion”.

A

An illusion is a perception based on the misperception of a benign or irrelevant sensory impulse

24
Q

Define depersonalization.

A

Depersonalization is the feeling of having lost one’s sense of personal identity
- Feeling strange or unreal

25
Define derealization.
Derealization is the feeling that the environment around oneself is strange or unreal
26
What is the purpose of the MOCA or MMSE?
The MOCA, MMSE, or other similar exams test cognition => only one part of the mental status exam - MOCA score <26 requires further evaluation
27
What do cognition exams test?
- Orientation (time, place, person) - Attention and concentration - Memory
28
How can attention be tested?
Digit span test => give the patient a progressively elongating list of numbers to recite
29
How can concentration be tested?
- Serial sevens | - Spell WORLD backwards
30
How is short term memory tested?
Recall words after 1-5 minutes
31
How is constructional ability (visualspatial/visuomotor functions) tested?
- Figure drawing | - Clock test
32
How is the ability for abstraction tested?
- Similarity test | - Proverb interpretation
33
Define insight.
Insight is considered knowledge involved in a decision/process - ie Insight into one's own illness
34
Define judgement.
Judgement is an opinion or conclusion the patient arrives at
35
Define psychomotor agitation
Motor restlessness: agitation may be the external, motoric manifestation of emotional state - e.g. anxiety, psychosis.
36
Define psychomotor retardation.
Body is slowed down | - Possibly due to e.g. depression
37
What major points should be noted when observing a patient's thought content?
- Suicidal Ideation - Homicidal ideation - Delusions -
38
How is long term memory tested?
Long term memory is tested by asking about "general" knowledge. - Ie Name the last 4 presidents