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PHC2 Practice > Acronyms & MSE > Flashcards

Acronyms & MSE Flashcards

1
Q

DEMENTIA mnemonic

A

D- drugs/alcohol/depression
E- ears/eyes
M- metabolic (hypoNa2+, DM, hypoThyroid)
E- emotional problems (loneliness)
N- nutrition (diet: vit B deficiency, teeth probs)
T- tumours/trauma (of CNS)
I- infection
A- arteriovascular Disease (cerebral insufficiency)

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2
Q

Geriatric ABCs

A

A- ADLs
B- balance, frailty test
C- cognition
D- depression/drugs/dentition (nutrition, weight, stability)
E- environment: home situation, social support, finances, ACPs etc.
F- falls risk (Hx & test it!)
G- gait speed
H- hearing/vision
I- incontinence

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3
Q

Consultation Sequence: x 6

A

History
Examination
Explanation (findings, DDx, management plan)
Ordering/conducting/explaining investigations
Treatment commencement
Disposition decisions (Tx/P5/Non-Tx)

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4
Q

Physical exam approach: x 5

A
  • hand hygiene
  • introduction/consent/chaperone
  • confidentiality
  • positioned comfortably
  • expose only as necessary
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5
Q

Physical observation general: x 10

A
  • first impressions
  • mobility
  • SOB
  • general appearance: jaundice, cyanosis, pallor, hair cond
  • vital signs
  • weight, body habitus, posture/gait
  • hydration/skin turgor
  • hands: fingernails/arthritis
  • smell: acetone, uraemia (renal failure), UTI, cigarettes, halitosis, alcohol, melaena
  • systematic approach/focused assessments: inspect, palpate, percuss, auscultate, +/- assessment of function
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6
Q

History sequence steps: x 7

A

1- Presenting symptom/reason
2- Hx presenting illness
3- medication & Rx Hx
4- PMHx
5- Social Hx
6- Family Hx
7- Systems review

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7
Q

Hx Presenting Illness: x 4

A
  • current illness/symptoms
  • prev similar episodes
  • extent of functional disability (if any)
  • effect of the illness
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8
Q

Medication & Rx Hx: x 4

A
  • current Rx (physically look at them)
  • drugs (OTC, Prescribed, Alternatives): dose, duration, indication (reason Vs Pt’s perception), & side effects.
  • past Rxs
  • allergies or reactions
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9
Q

PMHx: x 5

A
  • past illnesses
  • surgical operations
  • females: menstrual/reproductive Hx/issues
  • immunisations
  • blood transfusions
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10
Q

Social Hx: x 8

A
  • upbringing & education level/language barriers
  • martial status/social support/living cond/financial situation/pets
  • diet & exercise/mobility
  • occupation/hobbies
  • travel
  • smoking/ETOH
  • analgesic/illicit drug use
  • mood/sexual Hx
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11
Q

Family Hx: x 2

A
  • parents/siblings/dependents
  • any medical Hx that runs in the family
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12
Q

Systems Review: x 9 + 2

A
  • CVS
  • Resp
  • GIT
  • GU
  • Haematological
  • MSK
  • Endocrine
  • Reproductive
  • Neuro

Extras:
- ENT
- IntegSys

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13
Q

Mental Health Assessment : x 5

A
  • reason for call/Pt’s response to yr presence
  • PP/PPHx
  • Mental Health Hx
  • Fam MH Hx
  • substance use Hx
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14
Q

MSE Components: x 8 (Act PC IJM)

A

1- Appearance, physical activity & behaviour
2- Conversation, mood & affect
3- Thought form, content & process
4- Perceptions
5- Conscious Awareness
6- Insight
7- Judgement
8- Memory

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15
Q

Appearance: x 7

A
  • General appearance, ability to conduct ADLs & appropriateness of attire
  • Gender & ethnicity
  • Gen app: chronological age & apparent age
  • Physical characteristics - body build, posture, distinguishing marks
  • Clothing - condition of clothes, cleanliness, appropriateness to weather
  • Grooming - peculiarities of dress, use of cosmetics, jewellery, hair style
  • Gait
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16
Q

MSE Physical activity & Behaviour: x 7

A
  • observable behaviour, manner & attitude
  • posture, gait, gestures, tics, grimaces, tremors, mannerisms
  • Activity - overactive/underactive, purposeful/disorganised, pacing, restless, sedentary
  • Any signs of physically slowing down
  • Facial expression: alert, tense, worked, happy , sad, frightened, angry, laughing, smiling, suspicious
  • Rapport w interviewer: friendly or aloof
  • Attitude during interview: indifferent, friendly, dramatic, evasive, sullen, irritable, afraid, impulsive, embarrassed, sexually provocative
17
Q

MSE Conversation: x 4

A
  • how the person talks: quantity, rate volume
  • soft, loud, stuttering or hesitant
  • Flow of speech: even/uneven, slow/rapid
  • any references to: disordered, negative, unrealistic or unusual thoughts
18
Q

MSE Affect: x 2

A
  • the feeling or emotional state observed by the assessor on the Pt’s statements, appearance, behaviours
  • egs; full range (normal), blunted, flat, inappropriate/incongruent, labile (fluctuating) or restricted
19
Q

MSE Mood: x 1 w egs

A
  • the person’s subjective statements about their emotional state
  • egs; depressed, happy/sad, neutral/apathetic, irritable, anxious/angry, fearful/euphoric
20
Q

MSE Thought Form: x 5

A
  • amount of thought & its rate of production
  • Lack of ideas - cannot identity any thoughts
  • Flight of ideas - cannot remain on one topic
  • Loose associations- thinking jumps around without apparent connection
  • slow/hesitant
21
Q

MSE Thought Content: x 6

A
  • topics or areas that one thinks about
  • makes a judgement about what the person is saying: does it make sense; are the ideas related - do they flow logically
  • Ask about suicidal or self-harm ideation
  • Delusions
  • Obsessions
  • Compulsions
22
Q

Delusions: x 5 + 3

A

Fixed false beliefs or uncompromising beliefs;
- persecutory
- grandiose
- delusions of reference
- delusions of influence
- religious

May also involve:
- thought insertion (someone else’s thoughts inserted)
- thought broadcasting (sending out thoughts to others)
- thought withdrawal (thoughts taken out of one’s mind)

23
Q

Obsessions

A

Involuntary & unwelcome ideas that intrude on the person’s other thoughts
- they then demand attention even though the person may recognise them as irrational

24
Q

Compulsions

A

Insistent, repetitive & unwanted urges to perform a certain act

25
Q

Thoughts Process: x 6

A
  • the movement & dynamics of how one thoughts connects to the next
  • Logical thought
  • Loose associations (lack of connection between ideas)
  • Word salad (jumble of extremely incoherent speech)
  • Echolalia (unsolicited repetition of vocalisations made by another person)
  • Clang associations (putting words together because of how they sound, not their meaning)
  • Perseveration (‘getting stuck’ on a topic/thoughts/emotions)
26
Q

Perceptions: x 4

A

The person’s experience of their world through their senses, may include false or misperceptions;
- Hallucinations (auditory, visual, olfactory, gustatory or tactile)
- Illusions (misinterpretation of an actual external stimulus)
- Depersonalisation (feeling of unreality where the perception of self seems different or unfamiliar - out of body experience or - often associated w stress, fatigue & extreme anxiety)
- Derealisation (sense that the external world feels unreal, different or altered - feeling cut-off from the world - often associated w stress, fatigue & extreme anxiety).

27
Q

Conscious Awareness: x 4

A

LOC - A/V/P/U

Orientation - time, place, person

Concentration - count backwards from 100 in serial 7s OR spell WORLD backwards OR repeat a 3-part task.

Abstract Thinking - ability to deal with concepts & to extract meaning or to juggle more than one idea at a time (don’t put all yr eggs in the one basket).

28
Q

Insight

A

Degree to which the person realised the significance of their symptoms or illness & their current situation or the degree of self-understanding

29
Q

Judgement

A

Ability to make sensible decision based on expected consequences in everyday activities & social situations

30
Q

Memory: x 3

A

Remote past recall - coherent life story w dates & places

Recent past recall - Hx & events leading up to yr attendance

Immediate past recall - ability to recall a person’s name & 3 unrelated facts 5 mins post being given them.

31
Q

Additional Info req for MSE: x 10 egs

A
  • reason for presentation, nature of PP & PPHx
  • precipitating factors & recent stressors
  • compliance w current Rx
  • any urgent social issues that need addressing
  • support structures available to the person
  • strengths & any predisposing, precipitating & perpetuating factors
  • Medical Hx
  • Psychiatric Hx
  • Risk assessment - to self, others, falls, poor nutrition
  • Social Hx - per prev presentations
32
Q

SPACESPIT

A

S- size
P- position
A- attachments
C- consistency
E- edge
S- surface & shape
P- pulsation, thrills & bruits
I- inflammation
T- trans illumination

PHC2 Practice (13 decks)

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