Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Olivia MD3 1st semester > Examinations and histories > Flashcards

Examinations and histories Flashcards

1
Q

Briefly outline MSE

A
  1. Appearance
  2. Behaviour
  3. Speech
  4. Affect
  5. Thought
  6. Perception
  7. Cognition
  8. Insight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is a fatuous affect?

A
  • Vacant/silly/superficial
  • Often incongruent to situation
  • Think- psychosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what do we mean by thought stream?

A

Pace of thought generation

Slow/fast/pressured (manic) /latency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what do we mean by thought form

A

connectivity of ideas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what does ‘flight of ideas’ imply?

A

mania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe briefly the pelvic exam in O+G exam

A

Pelvic exam- inspection of external genitalia, speculum internal examination looking for any lesions, any discharge, look at cervix/vagina, bimanual internal examination assessing for any cervical excitation (ballot the cervix- for pain, if painful then blood in peritoneum and ectopic etc), also check for masses internally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how would you assess risk in psych history?

A

Risk assessment: risk to self (neglect, suicide, reputation, financial), risk to others (family, staff).

Suicide- static (previous attempts, FMH of suicide, chronic psychiatric disorder, widowed),

dynamic (suicide ideation, planned attempt, command hallucination, recent triggering event)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the components of a psych formulation?

A

biological
psychological
social factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some questions you can ask about depression?

A
  1. Low energy?
  2. Loss of interest?
  3. Lost confidence in yourself
  4. Have you ever felt hopeless?
  5. How long have you had a low mood?
  6. Unable to function properly?
  7. Ever felt like it was all too much and you didn’t want to live anymore?
    Do you ever feel guilty?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tell me about the falls exam- what would you do?

A
  1. General inspection- gait aids, glasses, amputations/prosthetics, footwear- ideally patient would be dressed in a gown. Muscle wasting/posture/deformities/frailty/any signs of injuries from previous falls.
  2. Gait, stand on toes and heels, walk on toes and walk on heels (if the patient can do it)
  3. Romberg’s test- feet together, closed eyes, watch for instability, I would like to do this for 1 min/60 seconds
  4. Sternal push/shoulder tug
  5. Vestibular stepping test: Keep eyes closed, take 50 steps on the spot, if there is a vestibular lesion, they will turn to the side of the lesion (I would like to do this)
  6. Step-up test
  7. Timed up and Go test- functional test
  8. Functional reach test- A4 paper stretch test
  9. I’d like to do: Postural BP (drop in 20 systolic/10 diastolic= postural drop)
  10. I’d like to do: Visual exam, cerebellar, CV, lower limb neuro exam, hip/knee joint exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe the gertsmann syndrome? what does it indicate?

A

the gertsmann syndrome comprises of 4 things:

  1. Left right confusion (incorrectly points to left and right body parts
  2. agraphia (can’t write name and write a sentence)
  3. finger agnosia (can’t tell which finger digit is being shown)
  4. acalculi (can’t calculate like subtraction/addition etc)

indicates lesion in dominant parietal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

where is the lesion if the patient seems to neglect their left side?

A

right parietal lobe usually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how might we test perserveration?

A
  1. you can get them to try alternating drawing triangles and squares
  2. you can try the luria test which is when you alternate between tapping a closed fist in one hand, and an open palm in the other hand on the table as fast as they can
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the frontal release signs and which one is most indicative for frontal lobe dysfunction? describe each sign

A

Grasp reflex- brushing object in the palm causes the patient to grasp it firmly (very sensitive)

Palmar-mental reflex- firmly stroking the thenar eminence causes contraction of the ipsilateral mental muscle

Snout reflex- positive if tapping on a patient’s chin with their mouth closed causes them to purse/pout their lips

Root reflex- stroking a side of the face e.g. cheek causes the patient to turn their head towards to the side of stimulation (severe dementia only)

Glabellar tap- tapping on the glabella the patient should stop blinking within a few beats. Positive when the patient continues to blink with each tap. (sensitive for parkinson’s disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

you are doing a cognitive assessment on an elderly patient. What does it mean if the patient has difficulty categorising things (e.g. when you ask them to list animals= category fluency) but are better at letter fluency (e.g. when you ask them to list as many words beginning with F in 1 min)?

what about if it is the other way round? category fluency > letter fluency?

A

category fluency (controlled by left temporal lobe) is more impaired in AD, so may indicate Alzheimers.

if it was the other way round it may indicate frontal temporal dementia as letter fluency is largely controlled by left frontal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the components of a neonatal history?

A
  1. Child well or unwell
  2. Child is feeding?
  3. Wet nappies? (fluid status)
  4. HOPC
  5. Birth history- any problems during pregnancy, vaccinations, how was the baby born, baby weight, any issues after birth, preterm or term?
  6. Past medical history + medications + allergies + immunisations
  7. Growth and development (4 domains: gross motor, fine motor (+ vision), language (hearing), social)
  8. Family history
  9. Social history- who is at home, who looks after the baby, does the baby go to childcare and any other child at home who is sick
17
Q

What are some key things you want to cover in an asthma counselling osce?

A
  1. Check what the parents know about the condition
  2. Explain what ventolin is, its use, SE
  3. Explain how to use a spacer- don’t forget to check exp date, Prime the spacer; wash with warm soapy water and air dry
  4. Explain how to use a daily preventer puffer- warn about oral thrush
  5. Asthma pamphlet/action plan; what is the 4x4x4 technique
  6. Advise to Avoid triggers + motivational interviewing to cease smoking if relevant
  7. Ensure parents understand what the signs and symptoms are of an acute asthma attack, and when to go to hospital.
  8. Ask parents to alert school teachers about asthma and to ensure ventolin is on hand
  9. Measure peak flow at home; show how to do this
  10. Regular follow up review with GP
18
Q

what are the components of Affect in the MSE you need to address?

A 
quality
stability
appropriateness
range
intensity

Olivia MD3 1st semester (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions