First aid Psychiatry: Examination and Diagnosis Flashcards
La belle indifference
patients are surprisingly calm and unconcerned when describing their symptoms
4 P’s for HPI
Predisposing to
Precipitating
Perpetuating
Protecting
What is the most important factor in formulating a diagnosis and treatment plan
history
What is an important question to ask if you are seeing a patient in the ER? other questions?
- how they got to the ER
- why patient is seeking treatment today
Why is it important to ask a patient if they use NSAIDS for psychiatry
NSAIDS decrease lithium excretion
- therefore increase lithium concentrations
akinesia
absence of movement
hypokineisa or bradykinesia
slowlness of movement
what are the components of the mental status examination (10)
appearance behavior Speech mood/affect thought process thought content perceptual disturbances cognition insight judgement/impulse
mood
emotion that the patient tells you he feels
labile affect
patient who is laughing one second and crying the next
inappropriate affect
A patient who giggles while telling you the he set his house on fire and is facing criminal charges
Affect
assessment of how the patient’s mood appears to the examiner
flat affect
patient who remains expressionless and monotone even when discussing extremely sad or happy moments in his life
thought process
how the patient expresses his or her thoughts
Circumstantiality
the point of conversation is eventually reached but much trivial information is put in
tangentiality
point of conversation never reached
loosening of associations
no logical connection from one thought to another
flight of ideas
thoughts change abruptly from one idea to another
Neologism
made-up words
word salad
incoherent collection of words
clang association
word connections due to phonetics rather than actual meaning
“My car is red, I’ve been in bed, It hurts my head”
thought blocking
abrupt cessation of communication before the idea is finished
thought content
types of ideas expressed by patient
Grandeur delusion
belief that one has special powers or is someone important
Paranoid delusion
belief that one is being persecuted
Reference delusion
belief that some event is uniquely related to patient
thought broadcasting delusion
belief that one’s thoughts can be heard by others
Religious delusion
conventional belief exaggerated ( Jesus is talking to me)
Somatic delusion
false belief concerning body image
I have cancer
Hallucination
sensory perceptions that occur in the absence of an actual stimulus
Illusion
Inaccurate perception of existing sensory stimuli
Derealization/Depersonalization
experience of feeling detached from one’s surrounding/mental process
Insight
patient’s level of awareness and understanding of his or her problem
Judgement
Patient’s ability to understand the outcome of his or her actions and use this awareness in decision making
Alcoholic hallucinosis is usually what type of hallucination
auditory
What is mini state examination
brief test used to asses gross cognitive functioning
what is included in the mini state examination
- orientation
- memory
- concentration/attention
- language
- complex command
- visuospatial ability
Tarasoff rule
if patient expresses imminent threats against friends, family or others, the doctor should notify potential victims and/or protection agencies when appropriate
what is the mean IQ and SD
100
15
Wechsler Adult Intelligence Scale (WAIS)
intellectual functioning for age 16-90
Wechsler Intelligence Scale fore Children WISC
intellectual functioning for age 6-16
What does Minnesota Personality Inventory (MMPI) asses
person’s personality and identify psychopathologies
What is Thematic Appreception test? what does it asses
- test taker creates stories based on pictures of peoples in various situations
- evaluate motivations behind behaviors
Roschach test? asses?
- interpretation of Inkblots
- identify thought disorders and defense mechanisms
automatisms
spontaneous, involuntary movements that occur during an altered state of consciousness
