Flashcards in Mental Status Exam Deck (38)
What is a mental status exam?
A mental status exam is the objective description of the patient's current state.
What are the 7 parts of the mental status exam?
1) General description
3) Mood and affect
4) Thought Process/structure of thoughts
5) Thought Content
What descriptors/notes should be made regarding a patient's "General Description"?
Include the patient's general appearance AND behavior:
- Psychomotor agitation/retardation
- Attitude toward examiner
What aspects of speech should be noted in a mental status exam?
Note these aspects of speech:
- Long/latent in response
- Idiosyncrasies of speech
How are mood and affect observed?
-Mood is the overall feeling tone => subjectively experienced
- Affect is how the patient expresses their feelings => objectively observed
What are variations in affect?
- Mood congruent
What is a goal directed thought process?
A goal directed thought process is interpreted as "normal"
- easy to follow
What is a loosening of associations (in regards to thought process)?
A loosening of associations represents a disconnection between thoughts. It usually represents unrelated thoughts
What is considered a flight of ideas?
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
In regards to thought process, what is "circumstantial" thinking?
When a patient speaks circumstantially they stray from a point but eventually return to the original point
What is considered tangential thinking?
The patient gets derailed from the topic and never returns to the original question
In regards to thought process, what occurs in "thought blocking"?
During thought blocking, a train of thought is interrupted before an idea is finished
In terms of thought process, what is "preservation"?
Preservation is the habit of persistently repeting words, phrases, or sentences in a relatively meaningless manner
What is a delusion?
Delusions are fixed, false beliefs which are not those generally held by society or subculture
What are various forms of delusion?
- Thought Broadcasting
- Thought Insertion
What is an example of a paranoid delusion?
"The FBI is after me"
What is an example of a grandiose delusion?
" I am the president"
What is an example of a referential delusion?
'The television is sending me messages"
What is an example of a somatic delusion?
"My heart is gone"
What is an example of a thought broadcasting delusion?
"My thoughts are being announced over the paging system"
What is an example of a thought insertion delusion?
"Someone is making me think about hurting my mother."
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
An illusion is a perception based on the misperception of a benign or irrelevant sensory impulse
Depersonalization is the feeling of having lost one's sense of personal identity
- Feeling strange or unreal
Derealization is the feeling that the environment around oneself is strange or unreal
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
What do cognition exams test?
- Orientation (time, place, person)
- Attention and concentration
How can attention be tested?
Digit span test => give the patient a progressively elongating list of numbers to recite
How can concentration be tested?
- Spell WORLD backwards