Mental Health Assessment

Question 1

IN a patient with unexplained symptoms suspect

Answer 1

anxiety or depression

Question 2

Co-morbidities to mental illness

Answer 2

IBS, fibromyalgia, fatigue, sleep disturbances, HA, TMJ

Question 3

2-3 most common cause of death 15-25 y/o

Answer 3

Suicide

Question 4

Adolescent HEADSS questionnaire

Answer 4

Home environment, Education/employment, Activities, Drugs, Sex, Suicide/depression

Question 5

Depression in elderly manifests as

Answer 5

somatic pain (back pain, HA, etc) or lack of interest in personal care

Question 6

Glascow Coma Scale for Eye Response

Answer 6

4 = spontaneous eye opening
3 = eye opening to speech
2 = eye opening to pain
1 = no response

Question 7

Glascow Coma Scale for Verbal Response

Answer 7

5 = oriented
4 = confused
3 = inappropriate words
2 = incomprehensible sounds
1 = no response

Question 8

Glascow Coma Scale for Motor Response

Answer 8

6 = obeys commands
5 = moves to localized pain
4 = flexion withdrawal from pain
3 = abnormal flexion (decorticate)
2 = abnormal extension (decerebrate)
1 = no response

Question 9

Common causes of unresponsiveness

Answer 9

Focal: infarct, hemorrhage, tumor, trauma, abscess
Diffuse: drugs, metabolic, renal failure, pulmonary, hypothermia, hypoxic, meningitis, seizure

Question 10

Mini-Cog Exam

Answer 10

1. remember 3 words; 2. draw clock; 3. repeat 3 words

Question 11

If patient draws a normal clock but only remembers 1-2 words =

Answer 11

no cognitive impairment (2pts for normal clock, 1 pt per word)

Question 12

If patient draws an abnormal clock but can remember 1-2 words =

Answer 12

cognitive impairment

Question 13

Mini-Mental State Exam MMSE

Answer 13

1. Name, Date, 2. Location
2. 3 words 4. Count back from 100 5. repeat 3 words 6. identify objects 7. follow verbal commands 8. follow written command 9. write sentence
3. draw/copy a picture

Question 14

Inability to describe similarities or differences of analogies

Answer 14

lesion of dominant cerebral hemisphere (left)

Question 15

arithmetic impairment

Answer 15

depression, diffuse brain injury

Question 16

Inability of abstract reasoning (fable)

Answer 16

poor cognition, dementia, brain damage, or schizophrenia

Question 17

Uncoordinated writing or drawing

Answer 17

dementia, parietal lobe damage, cerebellar lesion, or peripheral neuropathy

Question 18

Omission or addition of letters, syllables, words, or mirror writing

Answer 18

aphasia

Question 19

Apraxia

Answer 19

inability to translate an intention into action unrelated to paralysis or lack of comprehension
= cerebral disorder

Question 20

Loss of immediate and recent memory with retention of remote memory

Answer 20

Dementia

Question 21

Memory loss

Answer 21

disease, infection, or temporal lobe trauma, Impaired memory from neuro or psych d/o (anxiety, depression)

Question 22

Impaired judgment may indicate

Answer 22

intellectual disability, emotional disturbance, frontal lobe injury, dementia, or psychosis

Question 23

Dysphonia

Answer 23

a disorder of voice volume, quality, or pitch = disease of larynx or laryngeal innervation

Question 24

Dysarthria

Answer 24

motor speech disorder =

conditions of nervous system-stroke, inebriation, cerebral palsy, & Parkinson’s dx

Question 25

Circumlocution:

Answer 25

pantomime or word substitution to avoid revealing a forgotten word

Question 26

Perseveration

Answer 26

repetition of a word, phrase, or gesture

Question 27

Flight of ideas or loose associations

Answer 27

disordered words or sentences

Question 28

Word salad

Answer 28

meaningless, disconnected word choices

Question 29

Neologisms

Answer 29

made up words; have meaning only to patient

Question 30

Echolalia

Answer 30

repetition of another person’s words

Question 31

Wernicke’s Aphasia

Answer 31

fluent word salad, with no comprehension (neologisms)

Question 32

Broca’s Aphasia

Answer 32

inability to form sentences, but comprehension intact

Question 33

Global Aphasia

Answer 33

comprehension, speech, writing all impaired

Question 34

Characteristics of major depression SIG E CAPS

Answer 34

SIGECAPS stands for Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidal

Question 35

What 2 questions screen for depression with high sensitivity?

Answer 35

Over the past 2 weeks, have you felt down, depressed, or hopeless?
Over the past 2 weeks, have you felt little interest or pleasure in doing things?

Question 36

Suicide Risks

Answer 36

social isolation, mental disorder, chronic illness, FHx of suicide, significant loss, plan for suicide, alcohol/substance abuse, access to firearms

Question 37

taste hallucinations

Answer 37

EtOH withdrawal

Question 38

Auditory & visual hallucinations

Answer 38

associated w/ psychiatric disorders, severe depression, acute intoxication, delirium, and dementia

Question 39

Postpartum mood disturbances onset

Answer 39

w/in 4 wks of delivery

Question 40

Postpartum blues

Answer 40

Usually resolved w/in 10 days

Question 41

Postpartum depression

Answer 41

lasts 2 wks - 1 year

Question 42

Postpartum psychosis

Answer 42

lasts days to 4-6 wks

Question 43

Isaac Set Test dementia

Answer 43

10 items from each group FACT
Fruit, Animal, color, towns
Dementia = score of less than 15

Question 44

If patient is concerned with interference of daily activity, suspect

Answer 44

cognitive decline

Question 45

If patient’s family is concerned, suspect

Answer 45

dementia or cognitive impairments

Question 46

Functional Assessment

Answer 46

ability of patient to perform activities of daily life (shop, cook, problem-solve, manage pills, manage finances, speak, write, remember appts, birthdays)