General Survey and Mental Status

Question 1

6 observations to note for Physical Appearance during the general survey?

Answer 1

• Age: pt. looks stated age (older appearance could mean chronic illness)
• Sex: sexual development is app. for age. Note transgender & what stage
• Skin: even tone, color, app. for genetic background, intact, tattoo & piercing
• Facial Features: symmetrical w/ movement
• Level of Consciousnesses (LOC): place, time, situation
• Overall appearance: no acute distress

Question 2

3 observations to note when assessing Mobility

Answer 2

• Gait: feet shoulder width, symmetrical arm swing, smooth walk, even, maintain balance
• ROM: mobility of joints, deliberate, accurate, smooth, coordinated
• No involuntary movement

Question 3

observations to note for Mental Status

Answer 3

Thought content
Insight
Judgment
Affect
Mood
Language
Higher Cognitive Functions

Question 4

What mnemonic should be used to help with taking an HPI (hx of presenting illness)?

Answer 4

OLDCARTS
O: Onset
L: Location
D: Duration
C: Character
A: Aggravating/alleviating factors
R: Radiation
T: Timing
S: Severity of symptoms

Question 5

Difference between sensitivity vs specificity (use pregnancy as example)

Answer 5

Sensitivity: how many actually pregnant women does it correctly identify. (true positive)

Specificity: How many not-pregnant women does it correctly identify as NOT-pregnant. (true negative)

Question 6

What is a depression screener that can be used ( for 12 y/o and above)?

Answer 6

PHQ9

Question 7

On the PHQ9, what are the 2 high yield screening questions?

Answer 7

1: “over the past 2 weeks, have you felt down, depressed, or hopeless”
2. “over the past 2 weeks, have you felt little interest or pleasure doing things (anhedonia)”

Question 8

What is the highest risk demographic for fatal suicide attempt?

Answer 8

males, ages 18-25

Question 9

What screener can be used for anxiety

Answer 9

GAD-7

Question 10

What screener can be used for alcoholism?

Answer 10

CAGE or AUDIT-C