Bates Review Chapter 5 Flashcards
Behavior and Mental Status
Level of Consciousness
alertness or state of awareness of the environment
Attention
Ability to ficus or concentrate over time on one task or activity-an inattentive or distractible person with impaired consciousness has difficulty giving a history or responding to questions
Memory
Process of registering or recording information. Tested by asking for immediate repetition of material, followed by storage or retention of information.
Orientation
Awareness of personal identity, place, and time. Requires both memory and attention
Perceptions
Sensory awareness of objects in the environment and their interrelationships; also refers to internal dreams and hallucinations
Though process
What the patient thinks about including level of insight and judgement
Insight
Awareness that symptoms or disturbed behaviors are normal or abnormal; example distinguising between daydreams and hallucinations that seem real
Judgement
Process of comparing and evaluating alternatives when deciding on a course of action; reflects values that may or may not be based on reality and social conventions or norms
Affect
An observable, usually episodic, feeling or tone expressed through voice, facial expression, or demeanor
Mood
More sustained emotion that may color a person’s view of the world
Higher cognitive functions
Assessed by vocabulary, fund of information, abstract thinking, calculations, construction of objects that have two or three dimensions.
Recall info: president, large cities
Calulating ability: simple math
Abstract thinking: similarities apples/oranges
Constructional ability: Clock face; copy figures of increasing complexity
Paranoid
distrust and suspiciousness
Schizoid
detachement from social relationships, restricted range of emotional expression
Schizotypal
Eccentricities in behavior and cognitive distortions; acute discomfort in close relationships
Antisocial
Disregard for the rights of others; a dfect in the experience of compunction or remorse for harming other
Borderline
Instability in interpersonal relationships, self-image, and affective regulation. Very impulsive
Histrionic
Emotional reactivity, theatrical behavior, seductiveness
Narcissistic
Persisting grandiosity; need for admiration, lack of empathy for other
Avoidant
Social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation
Dependent
submission and clinging behavior
Obsessive-compulsive
Rigid, detail-oriented behavior, often associated with compulsions to perform tasks repetitively and unnecessarily
Early symptoms depression
low self-esteem, loss of pleasure in daily activities (anhedonia), sleep disorders, difficulty concentrating
Eval: Appearance and behavior
LOC; Posture/motor behavior; dress, grooming, personal hygiene; facial expression; manner, affect, and relationship to people and things
Speech and language
quantity, rate, loudness, articulation of words, fluency (monotone, hesitancies, disturbed inflections, circumlocutions, paraphasias
Mood
sadness, deep melancholy, contentment, joy, euphoria, elation, anger, rage, anxiety, worry, detachment, indifference
Obsessions
recurrent, uncontrollable thoughts, images, or impulses that a person considers unacceptable and alien
Phobias
Persistent, irrational fears, accompanied by compelling desire to avoid the stimulus
Anxieties
apprehensions, fears, tensions, or uneasiness that may be focused (phobia) or free-floating
Illusions
Misinterpretations or real external stimuli. May occur in grief reactions, delirium, PTSD, schizophrenia
Hallucinations
Subjective sensory perceptions in the absence of relevant external stimuli. The person may or may not recognize the experiences as false. Hallucinations may be auditory, visual, olfactory, gustatory, tactile, or somatic. May occur in delirium, dementia, PTSD, schizophrenia, alcoholism
Testing attention
Serial 7s-from 100 subtract 7. Normal is 1.5 minutes
MMSE
Brief test of cognitve dysfunction or dementia
Major Depressive episode
At least 5 symptoms over 2 weeks: depressed mood diminished interest or pleasure weight gain/loss insomnia/hypersomnia psychomotor retardation or agitation fatigue/loss of energy feelings of worthlessness/guilt inability to concentrate thoughts of suicide or death
manic
elevated, expansive, irritable mood: inflated self-esteem or grandiosity decreased need for sleep more talkative than usual flight of ideas increased goal directed activity excessive involvement in high risk activities
Schizophrenia
manifest at least 2 delusions hallucinations disorganized speech grossly disorganized or catatonic behavior neg sympotoms: flat affect
