Psychiatry: MSE Flashcards Preview

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Flashcards in Psychiatry: MSE Deck (15):
1

Appearance

38 year old male presents to you complaining of tiredness

Carry out a mental state examination

Focus specifically on his appearance

obvious features
weight?
clean?
clothing?
scars from self harm?

2

Behaviour

28 year old female presents to you complaining of feeling anxious

Carry out a mental state examination

Focus specifically on her general attitude

good eye contact?
facial expression?
body language?
calm?

3

Thoughts and Delusions

18 year old male presents to you. Telling you he has been having suicidal thoughts

Carry out a mental state examination focusing specifically on his thought content. Also probe for delusions Bonus: what thought abnormalities may indicate schizophrenia

Do unpleasant thoughts go round and round in your head?

Do you believe that you have special abilities or that people take a special interest in you?


echo
insertion
withdrawal
broadcasting

(thoughts which are not your own)

Always ask
Suicidal thoughts
Violent thoughts

4

Mood

Mother of a 17 year old female presents to you complaining of her daughters obsession with losing weight

Carry out a mental state examination of her daughter focusing specifically on her mood

How are you feeling?
Current mood?
Euthymic? Hyperthymic? Dysthymic?
- low?
- anxious?

Does affect match mood?

Is affect
- fluctuating?
- blunted?

5

Speech

Wife of a 68 year old man presents to you complaining that her husband is having difficulty remembering things

Carry out a mental state examination focusing specifically on his speech

volume?
amount?
speed?
tone?

6

Cognition

Wife of a 78 year old man presents to you complaining that husband is becoming increasingly confused.

Carry out a mental state examination

Focus specifically on his cognition

AVPU / GCS

Time, place, person, identity

MMSE
West Register Street
Spell world backwards
Place index finger of right hand on your nose and then on your left ear

7

Thoughts and Delusions

22 year old male presents to you complaining of hearing voices and suicidal thoughts

Carry out a mental state examination probing specifically for delusions of reference and grandeur.

Probe for auditory hallucination

Have you felt people were interested moreso than normal?

Is there anyone trying to harm you or kill you?

Do you have any special powers that most people lack?

Always ask
Suicidal thoughts
Violent thoughts

8

Perceptions and Insight

19 year old male presents to you and confesses to regularly smoking cannabis and using amphetamines

Carry out a mental state examination

Focus specifically on his perceptions and insight

Hallucinations
Pseudohallucinations
illusions

Are you aware their might be a problem

What do you think is causing it?

Do you want help?

9

60 year old male presents to you complaining of difficulties sleeping since he quit his job

Then Diagnose, and Treat assuming the diagnosis is PTSD

tbc

10

Appearance

A wife of a 69 year old male presents to you complaining of a change in her husbands behaviour. He is more aggressive and says inappropriate things.

Then Diagnose, and Treat assuming the diagnosis is Dementia

tbc

11

Thoughts

28 year old female presents to you complaining of feeling anxious

Carry out a mental state examination focus specifically on the form of her thoughts

linear?
tangential?
circumstantial?
perseveration?

Always ask
Suicidal thoughts
Violent thoughts

12

Thoughts

22 year old medical student presents to you having difficulties

Carry out a mental state examination

Focus specifically on his thoughts

Do you find that you have to repeatedly check things such as gas taps, light switches, the front door locked?

Do you have to keep things in a special order?

Do you spend a lot of time repeatedly washing things?

Always ask
Suicidal thoughts
Violent thoughts

13

Thoughts and Delusions

18 year old male presents to you. Telling you he has been having suicidal thoughts

Then Diagnose, and Treat assuming the diagnosis is Depression

tbc

14

Thoughts and Delusions

18 year old male presents to you. Telling you he has been having suicidal thoughts

Then Diagnose, and Treat assuming the diagnosis is Generalised anxiety disorder

tbc

15

Thoughts and Delusions

18 year old male presents to you. Telling you he has been having suicidal thoughts

Then Diagnose, and Treat assuming the diagnosis is Panic Attacks

tbc