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Neuro > Interview & Assessment > Flashcards

Interview & Assessment Flashcards

1
Q

Purpose of interview

A

establish rapport & gather info

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2
Q

Three main steps in the interview

A
  1. formulate an impression of diagnosis
  2. develop a treatment plan
  3. produce a written document for patient’s medical record
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3
Q

Two main components of the interview

A
  1. History

2. Mental Status Exam (cognition and emotion status in interview)

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4
Q

what does the report start with?

A

identifying information like name, race, gender, reliability of informant

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5
Q

next section of report is the chief complaint

A

observes verbal/non-verbal
evaluate certain areas
important to use the words the patient uses - gives insight to what the patient thinks

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6
Q

next section is history of presenting problems

A

how did they function before the episode (aka PREMORBID FUNCTION = very important)
asking about vegetative state (sleeping & eating)

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7
Q

Premorbid function helps

A

establish a baseline, predictive, many disorders are similar with basic symptoms

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8
Q

after looking at history of presenting problems you look at

A

past psychiatric history

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9
Q

after psychiatric history you look at personal history

A

intent is to get as much about the person’s life
importance of early life cues: quality of bond with family, eye contact, what happened during toddler years (toilet training/separation anxiety)
adolescence, what important things happen)

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10
Q

after personal history you look at family history

A

variable degrees of heritability with some mental illness, provides context into patients developmental history

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11
Q

after family history you look at social history

A

what is currently happening in your life: residence, marital status, occupation/income, social supports, interests

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12
Q

after social history you look at medical history

A

a focus on anything that will predispose a patient to mental illness, chronic pain, trauma, car crash, abuse, head injury’s seizures, HIV

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13
Q

After the medical history you look at the second component

A

Mental Status Exam - symptoms observed at the interview. How they think, perceive, emotions, behavior

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14
Q

Main things looked at in the mental status exam: appearance

A

physical (grooming/dress)
behavior (cooperative/oppositional)
manner relating to examiner
movement

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15
Q

Main things looked at in the mental status exam: speech

A 
volume (normal, loud, soft)
rate (pressured, slowed)
spontaneity
syntax
vocab
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16
Q

Main things looked at in the mental status exam: thinking

A

thought form - how ideas are linked (goal directed, circumstantial, tangential, loose associations, flight of ideas)
thought content:
delusions, ideas of reference, obsessions

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17
Q

thought content: delusions

A

fixed beliefs odd, strange or eccentric and outside the realm of real possibility. associated mainly with schizophrenia
Types:
passivity - being controlled by something or someone else
grandiosity - elevated importance
jealousy - belief that spouse is unfaithful
persecutory - belief that been conspired against, prosecuted
religious - beliefs about second coming, possession by the devil
somatic - belief that body is diseased, abnormal or changed

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18
Q

thought content: ideas of reference

A

belief that everyday occurrences carry specific unique personal significance

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19
Q

thought content: obsessions

A

unwanted intrusive thoughts beyond patient’s control

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20
Q

Main things looked at in the mental status exam: perception

A

hallucinations: a sensory perception not experienced by others. Associated with schizophrenia, bipolar disorder, depression, delirium and substance abuse (auditory, olfactory and visual)
Illusions: fixed false beliefs

21
Q

Main things looked at in the mental status exam: mood

A

internal

depressed, anxious, euphoric

22
Q

Main things looked at in the mental status exam: affect

A

external

labile, appropriate/inappropriate, fat, euthymic (range variation)

23
Q

Main things looked at in the mental status exam: insight and judgment

A

insight: patients awareness of his illness
judgement: active demonstration of insight

24
Q

Main things looked at in the mental status exam: cognition

A

alertness, orientation, concentration, memory, general knowledge

25
Q

definition psychosis

A

beliefs and perceptual experiences that reidosynmratic, not experienced by others
includes delusions, hallucinations

26
Q

positive symptoms of psychosis

A

delusions: persecutory, referential, religious, somatic
hallucinations: auditory, visual, olfactory
disorganized speech: tangentially, incoherent, derailment, circumstantial,
negative symptoms: decrease in normal functions, restriction in range of intensity of emotional expression, fluency and productivity of thought and speech, initiation of goal-directed behavior

27
Q

manic symptoms

A 
euphoric mood
increased activity
racing thoughts/flight of ideas
inflated self esteem
decreased need for sleep
distractibility
poor judgement
28
Q

depressive symptoms

A

dysphonia mood
change in appetite or weight
insomnia or hypersomnia
psychomotor agitation/retardation
loss of interest/pleasure, energy, feeling worthlessness
diminished ability to think or concentrate
suicidal ideation

29
Q

anxiety symptoms

A

excessive uncontrollable worry and fear associated with feelings of tension and physical arousal
panic attacks, agoraphobia, social phobia, specific phobia, obsessions, compulsions

30
Q

mental status exam

A

it is the equivalent of a physical exam, provides information about the persons thinking, emotions and behavior. This data combined with information from the history are the basis of formulating a differential diagnosis

31
Q

Speech

A

speech section of the mental status exam describes the physical production of speech, not the ideas being conveyed. Observations of speech may be made about volume, rate, spontaneity, syntax and vocabulary

32
Q

thought process

A

defined as how a patient organizes his/her thoughts

33
Q

though content

A

describes a patient’s ideas. Abnormalities of content include delusions, ideas of reference and obsessions

34
Q

delusions

A

are fixed, false beliefs that are not shared by others as part of a religious or subcultural group. They are rigidly held regardless of evident to the contrary

35
Q

Types of delusions

A

grandiose: patient believes they have special powers
religious: preoccupation with false beliefs of religious nature - possession by the devil
somatic: belief that the body is diseased, abnormal or changed
jealousy: belief that partner is cheating

36
Q

ideas of reference

A

belief that everyday occurrences carry specific, unique and personal significance

37
Q

obsessions

A

unwanted intrusive thoughts beyond patients control

38
Q

mood

A

internal, subjective aspect of the patient’s emotional state

39
Q

terms to convey mood

A

depressed - low or sad
anxious - distress of unease, fears of misfortune or harm
euphoric - elevated, distorted levels of happiness

40
Q

affect

A

external, objective aspect of the patients emotional state

41
Q

terms to describe affect

A

labile - more affective states evident than expected during the interview with the changes occurring rapidly
appropriate - affect matches described mood
inappropriate - affect does not match mood
euthymic - emotional range is evident
restricted/constricted - emotional range is limited but not completely absent
flat - no emotional range evident

42
Q

perception

A

abnormalities include hallucinationa nd illusions

43
Q

hallucinations

A

sensory perceptions generated whilly within the CNS in the absence of any external stimulus. They can occur in any sensory modality: auditory, visual, tactile, olfactory or gustatory

44
Q

illusions

A

originate with true sensory stimuli, which are then misprocessed or misinterpreted

45
Q

positive symptoms of psychosis

A

extra feelings or behaviors that are usually not present such as delusions, hallucinations, disorganized speech, disorganized behavior

46
Q

negative symptoms of psychosis

A

reflect a decrease in or a loss of normal functions. Represents a reduction of emotional responsiveness, motivation, socialization, speech and movement

47
Q

manic symptoms include

A 
euphoric mood
increased activity
racing thoughts/flight of ideas
inflated self-esteem
decreased need for sleep
distractibility
poor judgment
48
Q

depressive symptoms include

A 
dysphoric mood
change in appetite or weight
insomnia or hypersomnia
psychomotor agitation/retardation
loss of interest/pleasure, energy
feelings of worthlessness
diminished ability to think or concentrate
suicidal ideation
49
Q

anxiety is characterized by

A

excessive, uncontrollable worry and fear associated with feelings of tension and physical arousal

Neuro (15 decks)

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