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Flashcards in Neuro2 Deck (76)
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1

What's the prevalence of metal disorders in the US?

up to 27%

2

What specialty typically recognizes mental illness?

PCP

3

What are the 3 categories of symptoms in mental illness?

psychogenic (mood/anxiety)
physical (body sensation)
somatoform (lacks medical explanation)

4

What are the 6 types of patient symptoms?

conversion disorder (loss of body fxn)
somatization
hypochondriasis
body dysmorphic disorder
pain disorder
undifferentiated somatoform disorder

5

what are common unexplained SINGLE symptoms?

headache, back pain, MSK pain

6

what are common functional syndromes of mental illness?

IBS, FM, chronic fatigue, TMJ
(up to 70% of pts have FM and chronic fatigue)

7

What are some "red flags" that might alert you that your patient may have mental illness rather than medical illness?

1) "difficult patient" label
2) abuse of health care system
3) significant disability
4) medically unexplained symptoms
5) lots and lots of symptoms
6) chronic pain
7) symptoms >6 mo
8) recent stress
9) low SELF rating of health
10) substance abuse

8

Physical symptoms account for ________% of PCP office visits for patients with mental illness

50% (Unexplained symptoms, depression and anxiety exceed 50%)

9

What are the 5 most common mental illnesses seen in primary care?

somatoform, eating, mood, anxiety, substance abuse

10

What are the CAGE questions?

CUT DOWN
ANNOYED
GUILTY
EYE-OPENER
(have you ever felt need to cut down on drinking, are others annoying you by criticizing your drinking, do you feel guilty about drinking, have you felt need to drink first thing in the AM?)

11

true or false: conducting a mental status exam can be considered assault and battery if performed against a patient's will

true

12

WHat are some key questions to ask during your interview for mental health?

hx of psych illness, related meds, FHx, MURDER, patterns of abuse, marital status, employment status (absences, loss of job), edu hx (graduated? special ed? learning disability?), any kids? substance abuse, military hx, housing, siblings, affiliations (church, etc), legal problems, social life

13

_______________is a structured assessment of a patient's behavioral and cognitive functioning. It tells of mental status at that moment. It can be considered the physical portion of the mental exam

Mental Status Exam

14

Affect is like the __________. Mood is like the ____________-

weather, season

(meaning, affect is how you're feeling right now, whereas mood is how you feel on average)

15

WHat are the 8 components of the MSE?

1) appearance (behavior/attitude)
2) speech/language
3) emotion (mood/affect)
4) thought (content/process)
5) perception
6) cognition (A&Ox3, attention, calculation, memory, knowledge base, read/write, abstract)
7) insight
8) judgment

16

What is the most important thing to note while assessing behavior/attitude?

body language (non verbal communication) like expression, posture, eye contact, motor activity, etc

17

When evaluating speech, you look at rate, volume, articulation, fluency, ease of conversation. From any abnormalities you can gage probability of what disorders?

mood, anxiety, schizophrenia, organic pathology

18

manic patients may have what abnormalities with speech?

rapid speech, loud speech

19

__________is when a patient substitutes a phrase for a word they cannot recall. Ex: "what you write with" instead of "pen"

circumloculations

20

__________is when a patient malforms words, uses the wrong words, or invents words. Ex: instead of "pen", using "den", "bar", or "dar"

paraphasias

21

__________ is a disorder in producint and understanding languate

aphasia

22

You suspect your patient has aphasia. He speaks fluently and effortlessly with good articulation. However, speech doesn't make sense. Reading comprehension is impaired as well as writing. This patient has ___________aphasia and you suspect a lesion on the _________________

Wernickie's (speech comprehensive) aphasia
Temporal lobe

23

You suspect your patient has aphasia. His speech is slow and laborious. He has difficulty articulating words, but what he says does make sense. He is able to comprehend what you are saying, and is able to read. Writing is impaired. This is ________aphasia. You suspect a lesion on the ___________.

Broca's (speech production) aphasia
Frontal lobe

24

What's an easy way to test for speech comprehension?

Give 2 stage command. Ex: point to your mouth, then your knee.

25

Which type of aphasia allows patients to read aloud with little impairment?

Broca's can read aloud, Wernickes will replace written words with other nonsense words

26

Which type of aphasia allows patients to write normally?

TRICKSTER. Neither. Both will be impaired

27

When you are assessing affect, what are some factors you are considering?

Range (restricted, blunted, flat, expansive)
Appropriateness (incongruous, normal
Stability (stable, labile)

28

When you are assessing affect, what are some factors you are considering?

Happiness
Irritability
Stability

29

Should you use your professional objective language to document mood and affect? Or the patient's own words?

Use professional language for the affect you observe, and use patient's language for how they describe their mood

30

Your patient seems angry, hostile, suspicious, and evasive. This is consistent with ___________

paranoia