Mental Status Exam Flashcards
What is included in the Mental Status Exam (12)
- Appearance
- Alertness and orientation
- Speech
- Motor Activity
- Affect
- Mood
- Thought Content
- Thought Process
- Intellectual Functioning
- Attention and Memory
- Judgment
- Insight
Appearance includes:
- Appearance consistent with age
- Unusual attire (i.e. indoors w/sunglasses, bright colors)
- Appropriateness (i.e. not enough clothes, overdressed)
Descriptions for alertness & orientation includes: (2)
- Alertness: Alert, sleepy, lethargic, unconscious
- Orientation: Standard: person, place, date & possibly day of week, season, city, state, county, room, floor
(alterness: you may say that they appeared generally oriented)
Descriptions of a patient’s speech include: (3)
- Rate: Normal, rapid, pressured (you have to interupt to speak or they won’t stop), slow
- Volume: Softer or louder than appropriate
- Inflection: Monotonous or animated
(Ex: If fast, they don’t speed up and slow down. It’s more constant)
Mental status exam: descriptions of motor activity
- Psychomotor agitation or retardation
- Tics
- Dyskinesia
Define affect
The way we present our emtions to the world
(range, stability & appropriatenous)
Mental status exam: affect
- Range: degree of reactivity, flat, blunted, full range
- Stability: stable or labile
- Appropriateness: Are responses appropriate to the context?
(We need to understand where a patient is coming from to understand affect. If they are going to die but are at peace about it, that may be appropriate affect).
Define mood
Sustained emotional attitude
(sometimes you need to ask them about their mood. ie. “patient stated they’re fine although tears were streaming down their face.”)
Mental status exam: mood
- Neutral: euthymic
- Depressed: dysphoric
- Euphoric
- Anxious
- Irritable
Mental status exam: thought content
- Delusions
- Hallucinations
- Homicide Ideation
- Suicide Ideation
Mental status exam: thought content - delusion examples (2)
Grandiose, paranoid, etc.
Mental status exam: thought content - Hallucinations (4)
- Visual
- Auditory
- Tactile
- Olfactory
Mental status exam: thought content - Homicide Ideation
- Plan
- Intent
- Identity of victim
Mental status exam: thought content - Suicide ideation includes (5)
- Thoughts
- Plan
- Means
- Intent
- Uncontrollable urges
Mental status exam: 5 categories of thought process
- Goal-oriented, linear
- Tangential, circumferential
- Loose associations
- Disorganization
- Thought blocking
Circumfrential thought process
Non-linear thought expressed as long-winded explanations and with multiple deviations from the central topic before a central idea is finally expressed
(i.e. how many children do you have? answer: my grandma has this many, my mom has this many, i have this many)
Define tangential thought process
Nonlinear thought expressed as a gradual deviation from a focused idea or question (provides multiple unnecessary details related to the question without actually answering the question)
(example when asked about medical history the patient describes the hospital’s they’ve stayed in without mentioning the medical condition)
Loose association/derailments (thought process)
Incoherent, illogical, sudden and frequent changes of topic
(ex: when asked about their job the patient remember some funny stories from their childhood and starts talking about the weather)
Mental Status: Intellectual functioning includes: (5)
- Fund of knowledge
- Vocabulary, grammar
- Problem-solving
- Calculation
- Abstraction
(90% have normal fxning, we typically base our judgement of other people’s intelligence on thier vocabulary and grammar)
Abstraction ability
- Analyze info
- Detect patterns & connections between 2 things (comparing apples and oranges)
How do you test a patient’s attention (2)
- Spelling
- Name 5 things that start with a common letter
How do you test a patient’s memory?
- Immediate: repeat three items
- Short-term: can remember items in 3-5 minutes
- Long-term: past events
Mental Status Exam: Judgment (2)
- The ability to make considerate decisions when performing a task based on their understanding of the current cirumstances
- problem-solving ability (higher cortical fxn)
(Are they inappropriate? Insights into their psychiatric dellusions? to stand trial, you need to understand your situation and why you’re in that situation)
Mental Status: Insight
How realistically does the patient assess his/her illness and life problems
(more likely to be compliant w/tx)
Labile affect
when someone flips a switch when they’re talking
Thought blocking thought process
The abrupt ending of a thought process → sudden interruption in speech
