Mental Status Exam

Question 1

Which mneumonic is used for HPI for psychiatric complaint

Answer 1

SIG E CAPS

Question 2

Which mneumonic is used for HPI for mania complaint

Answer 2

DIG FAST

Question 3

Causes of person disorientation

Answer 3

Cerebral trauma, seizures, amnesia.

Question 4

Causes of place disorientation

Answer 4

Psychiatric disorders, delirium, and cognitive impairment.

Question 5

Causes of Time disorientation

Answer 5

Anxiety, delirium, depression, cognitive impairment.

Question 6

Describe the Mini-Mental State Exam (MMSE or Folstein test)

Answer 6

• Standardized, brief screening tool (takes about 10 minutes to administer) to assess cognitive function and to detect changes over time.
• Consists of 11 items measuring, orientation, registration, attention and calculation, recall, and language.

Question 7

Signs of possible cognitive impairment.

Answer 7

Significant memory loss.
Confusion.
Impaired communication.
Inappropriate affect.
Personal care difficulties.
Hazardous behavior.
Agitation.
Suspiciousness.

Question 8

How do you assess a patient’s abstract reasoning?

Answer 8

Ask the patient to tell you the meaning of a fable, proverb, or metaphor.
“a rolling stone gathers no moss”
“give an inch and they’ll take a mile”
“a bird in the hand is worth two in the bush”

Question 9

How do you test a patient’s arithmetic calculation

Answer 9

Ask the patient to do simple arithmetic without paper and pencil within 1 minute

Question 10

How do you test a patient’s writing ability

Answer 10

Ask the patient to write his/her name and address, or a dictated phrase

Question 11

How do you test a patient’s Execution of motor skills

Answer 11

Ask the patient to tie their shoe lace or comb their hair

Question 12

How do you test a patient’s memory?

Answer 12

• Immediate recall is tested by asking the patient to listen and the repeat a sentence or a series of numbers.
• Recent memory is tested by giving the patient a short time to view four or five objects, saying you will ask about them in a few minutes. Ten minutes later, ask the patient to list the objects.
• Remote memory is tested by asking the patient about verifiable past events.

Question 13

Memory loss may be a result of?

Answer 13

Memory loss may result from disease, infection, or temporal lobe trauma. Impaired memory occurs with various neurologic or psychiatric disorders.

Question 14

How do you test a patient’s attention span?

Answer 14

• Ask the patient to spell the word WORLD forward and backwards or say the days of the week.
• Ability to perform arithmetic calculations is another test of attention span

Question 15

How do you test a patient’s judgement

Answer 15

• How is the patient meeting social and family obligations?
• What are the patient’s plans for the future? Do they seem appropriate?
• Ask the patient to provide solutions to hypothetical situations (i.e. finding a stamped envelope, getting stopped by the police after driving through a red light).

Question 16

Impaired judgement of a patient may indicate

Answer 16

Impaired judgment may indicate mental retardation, emotional disturbance, dementia, or psychosis.

Question 17

How do you test a patient’s voice quality

Answer 17

Determine whether there is any difficulty or discomfort in phonation (volume quality or pitch).

Question 18

How do you test a patient’s articulation

Answer 18

• Evaluate spontaneous speech for pronunciation and ease of expression (slurring, stuttering, hesitations)
• Abnormal articulation includes imprecise pronunciation of consonants, slurring, difficulty articulation a single speech sound, repetitions, and stuttering.

Question 19

How do you test a patient’s comprehension

Answer 19

Ask the patient to follow simple one and two step directions (i.e. take this pen with your left hand and switch it to your right hand, fold this paper in half and place inside of the envelope).

Question 20

How do you test a patient’s coherence

Answer 20

• The patient’s intentions or perceptions should be clearly conveyed.
• Circumlocution: pantomime or word substitution to avoid revealing that a word was forgotten.
• Preservation: repetition of a word, phrase, or gesture.
• Flight of ideas or use of loose associations: disordered words or sentences.
• Neologisms: words with meaning only to the patient.
• Clang association: word choice based on sounds so that words rhyme in a nonsensical way.
• Echolalia: repetition or another person’s words
• Utterances of unusual sounds
• Aphasia

Question 21

What can cause aphasia

Answer 21

It can result from facial muscle or tongue weakness or from neurologic damage to brain regions controlling speech and language.