031215 mental status exam Flashcards

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1
Q

mental status exam describes present state only: true or false

A

true

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2
Q

components of mental status exam

A
appearance, attitude, behavior
speech
mood and affect
thought form/process and content
perception (hallucinations)
sensorium/cognition
insight
judgment

mnemonic: a snake moves toward prety silently in jungles

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3
Q

appearance

A

emphasize abnormalities like disheveled, long beard, strong odor, dressed in rags, etc

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4
Q

behavior

A

physical behavior (sitting motionless, rocking, shouting, etc)

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5
Q

speech

A

qualities of speech (rate, tone, rhythm, volume)

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6
Q

mood and affect may be incongruent in

A

some psychiatric syndromes (schizophrenia)

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7
Q

thought form/process

A

describes how pt is thinking

normal thought form is often “logical, linear, and goal-oriented”

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8
Q

abnormal thought form/processes

A

thought blocking-mind frequently goes blank

poverty of thought-very little thought occurring

circumstantiality-takes a long time to get to the point

tangentiality-logical but never gets to point

loose associations (derailment)-no connections btwn thoughts at all

Clang associations-thoughts are expressed thruogh sounds (rhyming) rather than meaning

neologisms (this and above two suggest psychotic)

perseveration-stuck on single thought

flight of ideas-rapid jumping from thought to thought (often seen in mania)-slight connection to thoughts

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9
Q

abnormal thought content

A

delusions (false beliefs)

ideas of reference

ideas of influence (another person or force is controlling pt’s thoughts)

obsessions

compulsions

phobias

hypochondriacal symptoms

thoughts of suicide

thoughts of violence

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10
Q

abnormal perceptions

A

hallucinations (often seen in schizophrenia)

illusions

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11
Q

sensorium

A

pt’s state of awareness and cognitive abiilties including:

  • alertness
  • orientation to person, place, time, situation
  • concentration (reverse spellings, serial 7s or 3s)
  • memory (immediate, recent, long-term)
  • calculation
  • fund of knowledge (geography, current events)
  • abstract reasoning (proverbs, similarities)
  • reading (doctor writes “close your eyes”-see if pt does it)
  • writing
  • visuospatial ability (draw clock, interlocking pentagons, or cube)
  • estimated intelligence
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12
Q

Folstein mini-mental status exam

A

one page that covers most of the sensorium items

numeric score is generated
emphasis is on cognition (delirious pt will score low but psychotic pt may or may not do well)

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13
Q

insight

A

describes pt’s capacity for self-reflection, awareness of illness, understanding of his or her present situation

often lacking in pts w chronic psychotic disorders, delirium, or severe personality disorders

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14
Q

judgment

A

pt’s capacity to make reasonable decisions

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