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Psych Rotation > History, MSE, Dx (Ch 2) > Flashcards

History, MSE, Dx (Ch 2) Flashcards

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1
Q

The 4 Ps

A

Pt’s psychosocial and environmental conditions Predisposing to, Precipitating, Perpetuating, and Protecting against the current episode

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2
Q

Neurovegetative symptoms

A

quality of sleep, appetite, energy, psychomotor retardation/activation, concentration

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3
Q

Importance of asking about caffeine/nicotine use

A

nicotine withdrawal may cause anxiety and agitation

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4
Q

NSAID effect on lithium

A

NSAID decreases Lithium excretion which increases lithium concentrations.

Exceptions may be sulindac and aspirin

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5
Q

Psychomotor retardation

A

slowness of voluntary and involuntary movements
aka hypokinesia or bradykinesia

Akinesia: absence of movement

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6
Q

Automatisms

A

spontaneous, involuntary movements during an altered state of consciousness

range from purposeful to disorganized

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7
Q

Pressured speech

A

usually uninterruptible

patient compelled to continue speaking

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8
Q

Assess patient’s intellectual functioning

A

Proverb interpretation: assess if patient has difficulty with abstraction

Vocabulary strategies: define a particular vocabulary word correctly and appropriately use in sentence reflects intellectual capacity

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9
Q

example of labile affect

A

laughing one second, crying the next

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10
Q

Affect

A

assessment of how the patient’s mood appears to the examiner - amount and range of emotional expression

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11
Q

Circumstantiality

A

point of the conversation is eventually reached but with over inclusion of trivial or irrelevant details

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12
Q

Tangentiality

A

point of conversation never reached, responses usually in ballpark

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13
Q

Loosening of associations

A

no logical connection from one thought to another

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14
Q

Flight of ideas

A

thoughts change abruptly from one idea to another, usually accompanied by rapid/pressured speech

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15
Q

Neologisms

A

made up words

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16
Q

Word salad

A

incoherent collection of words

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17
Q

Clang associations

A

word connections due to phonetics rather than actual meaning

“my car is red. I’ve been in bed. It hurts my head.”

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18
Q

Though blocking

A

Abrupt cessation of communication before the idea of finished

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19
Q

Grandeur delusions

A

belief that one has special powers or is someone important (Jesus, President)

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20
Q

Paranoid delusions

A

belief that one is being persecuted

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21
Q

Reference delusions

A

belief that some event is uniquely related to patient (e.g. TV show character is sending patient messages)

22
Q

Thought broadcasting delusions

A

belief that one’s thoughts can be heard by others

23
Q

Religious delusions

A

conventional beliefs exaggerated (e.g. Jesus talks to me)

24
Q

Somatic delusions

A

false belief concerning body image (e.g. I have cancer)

25
Q

Poverty of thought vs overabundance

A

Too few versions too many ideas expressed

26
Q

Delusions

A

fixed, false beliefs that are not shared by the person’s culture and cannot be changed by reasoning.

Classified as bizarre (impossible to be true) or non bizarre (at least possible)

27
Q

Phobias

A

persistent, irrational fears

28
Q

Obsessions

A

repetitive, intrusive thoughts

29
Q

Compulsions

A

Repetitive behaviors (usually linked with obsessive thoughts)

30
Q

Hallucinations

A

Sensory perceptions in absence of actual stimulus

Auditory (most common), visual, taste, olfactory, or tactile

31
Q

Types of auditory hallucinations

A

ringing, humming, whispers, or voices speaking clear words

32
Q

Command auditory hallucinations

A

voices instruct the patient to do something

33
Q

Hypnagogic hallucination

A

hallucinations only before falling asleep

34
Q

Hypnopompic hallucination

A

hallucinations only upon awakening

35
Q

Illusions

A

Inaccurate perception of existing sensory stimuli (wall appears to be moving)

36
Q

Derealization/Depersonalization

A

feeling detached to one’s surroundings/mental processes

37
Q

Alcoholic hallucination

A

auditory (usually), visual and tactile hallucinations occurring during or after period of heavy alcohol consumption

Patient aware they are hallucinations, not real

DTs - no clouding of sensorium and VS are normal

38
Q

Consciousness

A

Pt’s level of awareness

Alert, drowsy, lethargic, stuporous, coma

39
Q

Orientation

A

to person, place, and time

40
Q

Calculation

A

ability to add/subtract

41
Q

Immediate memory (registration)

A

dependent on attention/concentration and can be tested by asking a patient to repeat several digits or words

42
Q

Recent (short term) memory

A

Events w/in past few minutes, hours or days

43
Q

Remote memory

A

long term

44
Q

Fund of knowledge

A

Level of knowledge in context of the patient’s culture and education

Who is president? Who was Picasso?

45
Q

Attention/Concentration

A

Ability to subtract serial 7s from 100 or to spell “world” backwards

46
Q

Reading/writing

A

simple sentences (must make sure patient is literate first)

47
Q

Abstract concepts

A

Ability to explain similarities between objects and understand the meaning of simple proverbs

48
Q

Insight

A

level of awareness and understanding of problem

full, partial/limited or none

49
Q

Problems with insight example related to illness

A

complete denial of illness or blaming it on something else

50
Q

Judgment

A

ability to understand outcome of actions and use awareness in decision making

excellent, good, fair, or poor

51
Q

Tarasoff rule

A

If a patient expresses imminent threats against friends, family, or others, the doctor should notify potential victims and/or protection agencies when appropriate

Psych Rotation (9 decks)

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