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H&P Exam 3 > Behavior & Mental Status exam > Flashcards

Behavior & Mental Status exam Flashcards

1
Q

Unlike most organ systems, mental status and behavior are not areas you can _____ inspect, percuss, or palpate

A

objectively

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2
Q

As you talk to a patient, you will discern the patient’s level of ____

A

alertness, mood, orientation, attention, and memory

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3
Q

It is _____ to gather collateral information from those who live with or are around the patient.

A

appropriate

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4
Q

What are you asking for in gathering an HPI?

A

-Ask about the course of their symptoms (consistent, waxing and waning, episodic, sporadic…),
-life events that might have triggered symptoms, and give them opportunities to describe their symptoms to you

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5
Q

PMH Questions for behavior/mental status exam

A
  • Ask about conditions that could mimic or affect mental health conditions.
  • Ask about medications they are taking.
  • Ask about traumatic brain injury.
  • Ask about chronic conditions that affect mental health (like cancer or other chronic/terminal illnesses)
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6
Q

Past psychiatric history

A

Ask about suicide history, self harm, psychiatric hospitalizations, traumatic experiences, previous diagnosis
- past medication trials

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7
Q

Family history questions (mental health)

A
  • History of suicide attempts, drug use, psychiatric conditions
  • Ask what medications have worked for their family member for mental health conditions, as there are strong genetic links with medication effectiveness
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8
Q

Personal and social history questions

A
  • Employment and Education History
  • Drug and Alcohol Use
  • Legal history (like incarcerations, felonies…)
  • Marital/relationship status, as well as if they have children
  • Family and Social Support
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9
Q

ROS for mental status and behavior

A
  • Generalized Anxiety (For example, the GAD-2)
  • Panic Attacks (For example, have you ever had an anxiety attack - suddenly feeling fear or panic?)
  • Depressed Mood (For example, the PHQ-9 or the PHQ 2)
  • Elevated Mood (Screening for mania)
  • Memory Problems, Dementia, or Delirium
  • Substance Use Disorders
  • Insomnia
  • Symptoms of Psychosis
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10
Q

Assessing appearance and behavior

A
  • Level of consciousness
  • Posture and motor behavior
  • Overall appearance
  • Dress, grooming and personal hygiene
  • Facial expressions
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11
Q

A _____ is a lack of facial movement

A

Flat affect

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12
Q

Affect is is the _____ of a person expressed through facial expression, body movements, and voice

A

Observable mood

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13
Q

_____ Can be a significant window to their cognitive functioning

A

Language

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14
Q

_____: The delivery of a person’s language

A

Speech

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15
Q

When assessing Speech and Language it is Important to assess the:

A
  • Rate and volume of their speech
  • Quantity of their speech
  • Articulation of their words
  • Fluency
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16
Q

_____ : involves the rate, flow, and melody of speech

A

Fluency

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17
Q

_____: words or phrases are substituted for the word a person cannot remember

A

Circumlocutions

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18
Q

______: malformed words (“I write with a den”), wrong words (“I write with a branch”), invented words (“I write with a dar”)

A

Paraphasias

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19
Q

the thing you change your writing with” (eraser) is an example of _____

A

Circumlocutions

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20
Q

Normal mood is called

A

Euthymic

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21
Q

______: Awareness of objects in the environment to the five senses and their interrelationships

A

Perceptions

22
Q

____ is the awareness that thought, symptoms, or behaviors are normal or abnormal

A

Insight

23
Q

_____: process of comparing and evaluating different possible courses of action

A

Judgment

24
Q

______: speech characterized by indirection and delay due to the patient’s excessive use of details that have no connection to the point

A

Circumstantiality

25
Q

_____: accelerated change of topics in a very fast but generally coherent manner

A

Flight of ideas

26
Q

_____: speech in which a person shifts topics with no apparent relation between the topics

A

Derailment

27
Q

______: invented or distorted words

A

Neologisms

28
Q

Abnormalities in the thought process

A

Circumstantiality
Derailment
Flight of ideas
Neologisms

29
Q

_____: speech that is incomprehensible because it is illogical

A

Incoherence

30
Q

_____: sudden interruption of speech, before the completion of an idea

A

Blocking

31
Q

_____: fabrication of facts to hide memory impairment

A

Confabulation

32
Q

_____: persistent repetition of words or ideas

A

Perseveration

33
Q

_____: repetition of the words or phrases of others

A

Echolalia

34
Q

______: choosing a word on the basis of sound rather than meaning

A

Clanging

35
Q

Abnormalities of thought content

A

Compulsions
Obsessions
Anxiety
Delusions

36
Q

Difference between compulsions and obsessions

A

Compulsions: repetitive behaviors that a person feels driven to perform to prevent or produce some future state of affairs

Obsessions: recurrent, uncontrollable thoughts, images, or impulses that a patient considers unacceptable

37
Q

Phobias vs. General anxiety

A

Phobias: persistent fear of a stimuli the patient feels is irrational

General: free floating, general sense of dread

38
Q

_____: false, fixed beliefs that are not shared by other members of the person’s culture

A

Delusions

39
Q

Delusion of _____: believing an outside event or object has an unusual personal reference

A

reference

40
Q

Types of Delusions

A
  • Delusions of persecution, graneur, or jealousy
  • Delusion of reference
    -Delusion of being controlled by outside forces
  • Somatic delusions
  • Systematized delusion
41
Q

______: believing one has a disease or defect that he does not

A

Somatic delusion

42
Q

______: a single delusion with many elaborations around a single theme all systematized into a complex network

A

Systematized delusion

43
Q

____: Subjective external stimuli heard/seen that others do not hear/see and that the patient may not recognize as false

A

Hallucinations

44
Q

Abnormalities of perception

A

Hallucinations
Illusions

45
Q

_____: misinterpretations of real stimuli

A

Illusions

46
Q

_____: level of intelligence assessed by vocabulary, knowledge base, calculations, and abstract thinking. Includes

A

Cognitive Function

47
Q

Levels of attention

A
  • Alert: the patient is awake and aware
  • Lethargic: you must speak to the patient in a loud forceful manner to get a response
  • Obtunded: you must shake a patient to get response
  • Stuporous: the patient is unarousable except by painful stimuli (sternal rub)
  • Coma: the patient is completely unarousable
48
Q

_____: the process of recording and retrieving information

A

Memory

49
Q

Retrograde and Anterograde memory

A

Retrograde: assess remote memory and recent memory
Anterograde: assess new learning ability

50
Q

Tools for assessing abstract thinking

A
  • Interpreting proverbs
  • Similarity exercises
51
Q

“if you had a dollar’s worth of nickels and someone needed 65 cents how many nickels would you have left?” is an example of what

A

Calculating ability

52
Q

“Ask a patient to draw a clock face indicating 5:00” is an example of

A

constructional abiity

H&P Exam 3 (5 decks)

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