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Block 5 POM > Block 5; Week 4 Quiz > Flashcards

Block 5; Week 4 Quiz Flashcards

1
Q

What are some common things that you will need to explore on a History in a mental status exam?

A

disorientation & confusion
depression
anxiety

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2
Q

If someone is experiencing disoriented & confused…what are some associated help problems that you want to ask about?

A
  1. loss of vision or hearing
  2. brain: injury, vascular occlusion, neurological disorder
  3. systemic infection
  4. withdrawal from alcohol
  5. metabolic or electrolyte disorder
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3
Q

What are some associated symptoms that you want to ask about if someone is disoriented & confused?

A 
delusions
hallucinations
mood swings
anxiety
lethargy
agitation
insomnia
change in appetite
drug toxicity
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4
Q

What are some meds that you want to ask about if someone is feeling disoriented & confused?

A 
anticholinergics
benzodiazepines
opioid analgesics
tricyclic antidepressants
levodopa
amantadine
diuretics
digoxin
antiarrhythmia meds
sedatives
hypnotics
Therapies: ginkgo biloba or st. john's wart
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5
Q

What are some meds that can worsen depression?

A 
anti-HTN
Corticosteroids
Beta blockers
Ca++ channel blockers
barbituates
phenytoin
anabolic steroids
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6
Q

What are some associated symptoms of anxiety?

A

panic attacks
obsessive thoughts
compulsive

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7
Q

What are some meds that you should ask about if someone seems to have anxiety?

A

antidepressants
steroids
benzos
alternative therapy

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8
Q

What are some family hx questions that you want to ask about?

A 
mental illness
alcoholism
alzheimer disease
learning disorder
autism
MR
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9
Q

What are some questions you should ask of children in a mental status exam?

A 
speech
behavior
performance of self-care activities
personality patterns
school difficulties
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10
Q

What is lethargy?

A

Drowsy and falls asleep quickly, but once aroused responds appropriately

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11
Q

What is obtundation?

A

Sleepy and still drowsy when awakened, decreased alertness and limited interest in the environment

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12
Q

What is a stupor?

A

Responsive only to vigorous and repeated visual, verbal, and painful stimuli, becomes unresponsive without stimuli

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13
Q

What is a coma?

A

unresponsive even with painful stimuli

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14
Q

What is the MMSE?

A

mini mental status exam
brief screening tool to assess cognitive function and detect changes over time
11 items tested, takes 10 minutes

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15
Q

What are the mental functions that are tested by MMSE?

A 
orientation
registration
attention
calculation
recall
language
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16
Q

What qualifies a positive MMSE?

A

24-26/30

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17
Q

The MMSE naturally varies with which factors?

A

age
education
ethnicity

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18
Q

How do you test orientation to time on the MMSE?

A

What is the date?

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19
Q

How do you test registration on the MMSE?

A

say 3 words & repeat them back

up to 5 times, looks like the 1st time is what counts

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20
Q

How do you test naming in the MMSE?

A

point to an object. Can you name that?

21
Q

How do you test reading on the MMSE?

A

Read these instructions. Do what they say.

22
Q

This is a strange one. How do you test language on the MMSE?

A

copying intersecting pentagons

draw a clock face

23
Q

Poor grooming could indicate what?

A

depression
psychiatric disturbances
dementia

24
Q

When assessing emotional status, what are some noteworthy reactions?

A

i. Carelessness
ii. Apathy
iii. Loss of sympathetic reactions
iv. Unusual docility
v. Rage reactions
vi. Excessive irritability

25
Q

What are some signs of cognitive impairment?

A
  1. Significant memory loss
  2. Confusion
  3. Impaired communication inappropriate affect
  4. Personal care difficulties
  5. Hazardous behavior
  6. Agitation
  7. Suspiciousness
26
Q

If a patient can’t understand analogies on MMSE…what could this indicate?

A

left or dominant cerebral lesion

27
Q

If a patient can’t explain a proverb (problem with abstract reasoning)…what could this indicate?

A

poor cognition, dementia, brain damage, or schizophrenia

28
Q

If pt can’t do simple arithmetic calculations…w/i 1 minute…what could this indicate?

A

depression

diffuse brain disease

29
Q

If a person can’t write a phrase or draw geometric shapes (if illiterate)…what could this indicate?

A

dementia
parietal lobe damage
cerebellar lesion
peripheral neuropathy

30
Q

What is apraxia? How does this relate to the MMSE?

A

cerebral disorder–inability to translate intention into movement
**see on MMSE when you ask a pt to comb their hair & they can’t.

31
Q

How do you test immediate memory in the MMSE?

A

have pt repeat back a sentence

repeat 5-8 Numbers forward or 4-6 numbers backwards

32
Q

How do you test recent memory in the MMSE?

A

show pt 4-5 objects & ask them what they were 10 minutes later.
visually impaired: 4-5 unrelated words

33
Q

How do you test remote memory in the MMSE?

A

ask patient to verify past events–mother’s maiden name etc.

34
Q

If a pt has memory loss, what might have caused it?

A

disease
infection
temporal lobe trauma

35
Q

If a pt has impaired memory what might have caused it?

A 
neurological disorder
psychiatric disorder (i.e.anxiety & depression)
36
Q

If you have recent & immediate memory loss, but remote memory intact…what is this?

A

dementia

37
Q

So…you ask a pt to spell WORLD back & forwards…they can’t. What are you testing? What are the implications of this?

A

testing attention span

**could be fatigue, depression, delirium, toxicity, metabolic dysfunction

38
Q

How might you test a patient’s judgment? What might decreased judgment indicate?

A

Ask patient solutions to hypothetical problems.

Impaired: MR, emotional disturbances, frontal lobe injury, dementia, psychosis

39
Q

If a patient has tactile hallucinations…what is this usu indicative of?

A

alcohol withdrawal

40
Q

What is circumlocution?

A

pantomime or hand gestures to cover up that a word has been forgotten

41
Q

What is perseveration?

A

repetition of a word or phrase

42
Q

What are neologisms?

A

these are words that only have meaning to the pt

43
Q

What are common things that can affect mental status in infants & children?

A

brain infections
brain trauma
metabolic dysfunctions

44
Q

What are noteworthy findings in infants & children?

A 
lethargy
drowsy
stupor
alert
active
irritable
45
Q

What is the significance of a GCS score of 15? of 3?

A

15-optimal consciousness

3-coma deep

46
Q

If I am not oriented to person…what is my problem?

A

i. Cerebral trauma
ii. Seizures
iii. Amnesia

47
Q

If I am not oriented to place…what is my problem?

A

i. Psychiatric disorders
ii. Delirium
iii. Cognitive impairment

48
Q

If I am not oriented to time…what is my problem?

A

i. Anxiety
ii. Delirium
iii. Depression
iv. Cognitive impairment

Block 5 POM (4 decks)

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