Mental Status Flashcards
What test assesses Dementia vs Depression?
Folstein Mini-Mental State Exam
normal = 23-30
< 19 is impaired
When giving bad news, using open-ended questions can help with what?
assessment of the patient’s perception of the medical situation
Helps to assess denial, wishful thinking, unrealistic expectations
“You were perfectly correct to think that way” is an example of what type of statement?
Validating statement
“I can see how upsetting this is to you” is an example of what kind of statement?
Empathetic statement
Derailment, incoherence, poverty of content, circumstantiality, tangentiality, perception, echolalia
Thought disorder
patient’s level of arousal, attention & alertness
sensorium
time, place, person & situation
orientation
the patient’s ability to remember things in 3-5 minutes is an indication of
short term memory
assessed by asking patient to recall events that occurred in the more distant past
remote memory
assessed by asking the patient to name the last 4-5 presidents, capital of their state, etc
Fund of knowledge
Lobe of the brain associated with speech formation, goal-oriented behavior, ability to concentrate, short-term memory, emotions, affect, autonomic responses to emotional states
frontal lobe
lobe of the brain that processes sensory data (primary taste area, sensory association area)
parietal lobe
lobe of the brain responsible for perception & interpretation of sounds, comprehension of spoken & written language, integration of behavior, emotion & personality, long-term memory
temporal lobe
mediates patterns of behavior that determine survival: fear, mating, affection
limbic system
regulates level of wakefulness or arousal
disruption can result in altered mental status
reticular activating system (RAS)
location of the visual cortex
occipital lobe
slumped posture may indicate
depression or neurologic condition (Parkinsons)
patient should have an erect posture
time disorientation is associated with
anxiety, delirium, depression, cognitive impairment
brief screening tool for measuring cognitive function
Mini-Cog
involves: repeating 3 unrelated words, drawing the face of a clock, placing the hands of the clock to the appropriate time requested
responsive only to vigorous & repeated stimuli, becoming unresponsive without stimuli
stupor
unresponsive to painful stimuli
coma
standardized screening tool to assess cognitive function and detect changes over time
Mini-Mental State Exam
asking the patient to tell you the meaning of a fable, proverb or metaphor assesses
abstract reasoning
impairment of math skills may be associated with
depression
Patient should be able to subtract 7 from 50 & continue until the answer is 8.
Patient should be able to add 8 to 50 and continue until the answer is 98
omission or addition of letters, syllables, words or mirror writing may indicate
aphasia
the inability to translate an intention into action
apraxia
repetition of a word, phrase or gesture
perseveration
disordered words or sentences
flight of ideas or use of loose associations
meaningless, disconnected word choices
word salad
words with meaning only to the patient
neologisms
word choice based on sound so that words rhyme in a nonsensical way
Clang associations
repetition of another person’s words
echolalia
Word comprehension, reading comprehension intact
Speech flow & writing impaired
Broca Aphasia (expressive)
Cannot relate heard words to previous experiences
Reading & writing impaired
Fluent speech that may be incomprehensible
Wernicke Aphasia (receptive)
word comprehension reduced to patient’s own name
Absent speech
Severely impaired reading comprehension & writing
Global Aphasia (expressive & receptive)
used to quantify consciousness following brain trauma or hypoxic cerebral event
Glasgow Coma Scale
max score = 15; min = 3
looks at eye opening, verbal response, motor response
panic attacks
phobias
OCD
PTSD
anxiety disorders
What alternative therapies/remedies can cause confusion?
St. John’s wort; gingko biloba
