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Case 10 > Mental State Examination > Flashcards

Mental State Examination Flashcards

1
Q

Anxiety types

A 
Panic disorder
Agoraphobia
Specific phobia
GAD
OCD
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2
Q

Autonomic symptoms of panic disorder

A

Palpitations, tremor, sweating, chest pain, nausea

Palpitations

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3
Q

Psychological symptoms of panic disorder

A

Derealization/depersonalization, fear of losing control, dying

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4
Q

Prevalence of anxiety

A

1.5-3.7% prevalence

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5
Q

Specific phobia prevalence and symptoms

A

12.5% prevalence

Recrrent/excessive, unreasonable symptoms of anxiety- unproportionable level of fear

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6
Q

GAD prevalence and symptoms

A

2.4-6.4%
Excessive worry
Apprehension about everyday events

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7
Q

OCD prevalence and

A

0.5-3% symptoms
Ideal image or impulse
Recognized as own
Repetitive, intrusive, distressing

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8
Q

Compulsion symptoms

A

Unnecessary, purposeless action
Avoids occurrence or adverse event- gets in the way of normal life
Relieves anxiety

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9
Q

Mood disorders tyes

A

Depressive episode
Manic/hypomanic episode
Bipolar 1/2

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10
Q

Depressive episode prevalence and symptoms

A

10-20% prevalence

Core symptoms: depressed mood, anergia- loss of energy, anhedonia- a loos of pleasure

Biological symptoms: reduced self- esteem, self-confidence, ideas of guilt unworthiness, ideas/ acts of self-harm/suicide

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11
Q

ICD- 10 classification of depressive episode

A

ICD- 10
Mild: two core plus two others- not intense

Moderate: two cores plus 3/4 others, marked intensity- more severe than mild

Severe: three core plue four others, severe intensity> 2weeks. (+/- psychosis)

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12
Q

Manic episode traits

A
  • Abnormally, persistent elevated, expansive/ irritable mood with 3 positive symptoms- 1week
  • Increased energy, overactivity, reduced sleeep
  • FTD- frontotemporal demential
  • Increased self esteem reduced attention
  • Psychotic symptoms
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13
Q

Hypomanic episode traits

A

Three of more symptoms over at least 4 days
Not severe enough to interfere with social/ occupational functioning
Require admission to hospital
Include psychotic feautures

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14
Q

Bipolar affective disorders

A

2+ episodes, one of which must be manic/hypomanic or mixed
Prevalence 0.3-1.5%
BPAD 1: mania- depressive and manic episodes
BPAD II: hypomania- depressive episodes and hypomanic episodes- depressive episodes MUCH more severe and longer lasting

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15
Q

Schizophrenia features

at least one of

A

At least one of
• Thought echo/ insertion/ withdrawal/ broadcast
• Delusions of control/passivity and delusional perception- other people are in control of your body / thoughts
• Audition hallucinations (3rd person, running commentary)
• Implausible delusions

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16
Q

Schizophrenia features at least two of

A
  • Persistent hallucinations with non-affective delusions
  • Breaks in train of thought
  • Catatonic behavior- very agitated or very excited
  • Apathy/blunting- not caring or not reacting very much to things
  • Loss of interest/ social withdrawal

FOR AT LEAST ONE MONTH

17
Q

Difference between positive and negative symptoms in Schizophrenia

A
  • Positive- added symptoms- added hallucinations

* Negative-things taken away

18
Q

MSE - appearance and behaviour

A
  • Level of consciousness
  • Appearance
  • Race
  • Grooming/hygiene
  • Dress
  • Build, posture, physical, condition, stigmata- harm themselves
  • Attitude to examiner
  • Facial expression, eye contact, rapport, engagement
19
Q

Abnormalities of movement

A
  • Amount- agitation, retardation, stupor
  • Goal-directed: mannerisms vs stereotype
  • Tics- motor vs vocal
    Dystonia- side effects of anti-psychotics
    Akathisia- inability to stay still
    Myoclonus- muscle jerk- hiccups
    Chorea- jerky involuntary movements- hips and face

Also induced movements (automatic, obedience, ambitendence, mitmachen- move people’s limbs to certain position, mitgehen, posturing- odd postures for hours on end , catalepsy, rigidity, negativism etc)

20
Q

MSE- Speech features

A 
Form vs content
Amount: logorrhoea vs poverty 
Rate: pressure, retardation, mutism
Volume
Tone 
Neologism, clang/pun
21
Q

MSE- Mood features

A 
Pervasive, sustained emotional state
Euthymic, anxious, irritable, depressed, euphoric, apathy
Blunted flat
Emotional incontinence
Incongruous
22
Q

MSE- Thought features

A

Stream, pressure, poverty, thought block
Dorm
Flight of ideas, move quickly, loosely associated
Loosening of associations: move quickly unconnected
Over-inclusive can’t preserve conceptual boundaries
Circumstantiality vs tangentiality
Derailment/ knight’s move
Thoughts
Delusions
A fixed belief held in the face of evidence to the contrary which cannot be explained by culture or religions
Primary: fully formed, irreducible/ un-understandable, autochthonous delusion perception, delusional memory, delusional mood
Secondary: arises from previous ideas/events (delusional elaboration)
Systematized: common theme, multiple elaboration
Persecution
Control: passivity of affect/impulse/volition/somatic passitivity
Misidentification : Capgras- people you know have been replaces vs Fregoli- people you see but don’t know are people you know wearing a disguise
Grandeur
Religious
Guilt
Nihilism- got no money/ house. Possessions/ part of your body
Jealousy/Love: organic/alcoholic: Othello- pathological jealousy- mainly in men who think their spouse is having an affair, de Clearbault syndrome- women when they believe that a perception is in love with them
Somatic: physical defect/medical problem
Thought insertion/withdrawal broadcast
Thoughts of self harm
Thoughts of harm to others

23
Q

MSE- Perceptions features

A

Sensory distortion
Depersonalisation/derealization
Illusion: misinterpretation of a stimulus
Hallucination: occurs in the absence of a stimulus, arising from external space, share the quality of a real perception
Sensory modality, content, mood congruence
Auditory 2nd/3rd person, thought echo
Olfactory, gustatory, tactile

24
Q

MSE- cognition features

A

Orientation: time, place, person
Memory: immediate/delayed recall, working memory
Formal cognitive assessment

25
Q

MSE- insight features

A

Awareness of phenomena

Case 10 (5 decks)

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