Mental Status Exam Flashcards
(Patient at rest)
- Age/gender, younger/older than stated age, body habitus, type of clothing, hygiene (e.g., smelling of alcohol, urine, feces, cigarette smoke, etc.), grooming, physical abnormalities (e.g., pupil size, bruises, needle marks/tracks, cuts, teeth, etc.), tattoos, body piercings
General Appearance
(Patient in action)
- Posture, eye contact, mannerisms, tics, activity level, psychomotor retardation/activation.
Behavior
Inner restlessness with inability to stay still.
Akathisia
Spontaneous verbal or motor behavior without patient awareness.
Automatism
Extreme motor inactivity or hyperactivity.
Catatonia
Involuntary combination of chorea (irregular migrating contractions) and athetosis (twisting/writhing).
Choreoathetosis
Twisting/repetitive movement or abnormal fixed posturing.
Dystonia
Unintentional, rhythmic, oscillatory movement.
Tremor
(Patient interaction)
- Cooperative/uncooperative, seductive, flattering, charming, eager to please, entitled, controlling, hostile, guarded, critical, antagonistic, childish
Attitude
Patient reported emotional tone in quotations. Equivalent of chief complaint.
Mood
Physical expression of a person’s immediate feeling state, typically focusing on facial expression
Affect
Normal display of emotion.
Euthymic
Intense display of emotion.
Hyperthymic
In an excited state of intense happiness.
Elevated / Euphoric
In a profound state of unease or dissatisfaction.
Dysphoric
Easily annoyed or angry.
Irritable
Feeling worried or nervous, typically over an uncertain future outcome.
Anxious
Depth and range of feelings shown.
- Intense > Full > Constricted > Blunted > Flat
Quality / Range
Shifting of emotional states.
- Labile > Supple/Stable > Sluggish
Motility
Appropriate or not appropriate.
Appropriateness to content
Rate, rhythm, articulation
Speech
Pressured > Rapid > Regular > Slowed
Pressured speech: Rapid, frenzied speech driven by an internal sense of urgency.
Rate
Prosody, cadence, latency (pauses before speaking), spontaneity (ability to make small talk)
Rhythm
Dysarthria, stuttering
Accent/dialect, tone, volume/modulation (loudness/softness)
Articulation
A mechanical dysfunction with speech.
Dysarthria
Meaningless repetition of another person’s spoken words.
Echolalia
Making up of new words.
Neologism
Groupings of words (usually rhyming), based on similar-sounding sounds, regardless of logical grouping.
Clang associations
Goal-directed/logical, Circumstantial, Tangential, Loosening of associations, Flight of ideas, Perseveration, Thought blocking
Thought Process
Linear progression of thought without veering from subject at hand.
Goal-directed/logical
Inability to answer a question without giving excessive, unnecessary detail. Does eventually return to the original point.
Circumstantial
Wandering from the topic and never returning to it or providing the information requested.
Tangential
Incoherent slippage of ideas further and further from point of discussion.
Loosening of associations
Rapid shift from one topic to another.
Flight of ideas
Repetition of a particular response (e.g., word or phrase), regardless of the absence or cessation of a stimulus.
Perseveration
Abrupt cessation of speech without explanation in the middle of a sentence
Thought blocking
Poverty of thought, Overabundance of thought, Delusions, Depersonalization, Derealization, Illusion, Hallucination, Obsession & Compulsion, Phobia, Suicidal & Homicidal ideations
Thought content
A global reduction in the quantity of thought.
Poverty of thought
A global increase in the quantity of thought.
Overabundance of thought
Fixed, false beliefs that do not change even when presented with evidence counter to them, and are outside of cultural, societal or religious norms.
Delusions
Delusion that one’s bodily function, sensation or appearance is abnormal.
Somatic delusion
Delusion of possessing superior qualities such as fame, wealth or supernatural powers.
Delusion of grandeur
Delusion of mistreatment, usually persecution (e.g., being spoken about behind one’s back, “people are out to get me”).
Paranoid delusion
Delusion where an otherwise insignificant event is misconstrued as having special significance specifically to oneself.
Delusion of reference
Delusion where one believes one’s thoughts to be externally placed from an outside party.
Delusion of thought insertion
Delusion where one believes one is being controlled by an outside party or parties, and self-control is lost.
Delusion of thought control
Delusion where one’s thoughts are made known to everyone in the outside world.
Delusion of thought broadcasting
Delusion where one believes that prominent figures or superstars are in love with or in a relationship with oneself, when that is not the case in reality.
Erotomanic delusion
Delusion where one believes that nothing is real. This is in contrast to derealization or depersonalization, which have more to do with an altered reality, not the lack of it.
Nihilistic delusion
Loss of all sense of identity, wherein one’s thoughts and feelings are no longer felt to be one’s own.
Depersonalization
A change in the perception or experience of the external world to where it feels unrealistic.
Derealization
A misinterpretation of existing stimuli.
Illusion
A perception perceived in the absence of any existing stimuli.
Hallucination
A hallucination experienced before falling asleep.
Hypnagogic hallucination
A hallucination experienced upon waking up from sleep.
Hypnopompic hallucination
Repeated intrusive and unwanted thoughts, images or urges.
Obsession
Repetitive behavior or mental acts in response to obsessions.
Compulsion
Persistent fear or an object or situation.
Phobia
Thoughts of, or preoccupation with, suicide.
Suicidal ideation
Thoughts of, or preoccupation with, homicide.
Homicidal ideation
Awareness/understanding of situation, illness and available choices
- Full > Partial/limited > None
Insight
Patient’s decision-making ability (based on HPI and recent behavior)
- Excellent > Good > Fair > Poor
Judgement
General consciousness, Orientation, Attention, Language, Calculation, Right hemisphere, Abstraction, Memory, Praxis
Cognition
Alert > drowsy > lethargic > stuporous > comatose
General consciousness
x4 (person, time, place, situation)
Orientation
WORLD backwards, serial 7s from 100
Attention
Name objects, repeat words/sentences
Language
Ability to add/subtract
Calculation
Intersecting pentagons, clock-face
Right hemisphere
Explain similarities between objects, understand simple proverbs
Abstraction
Immediate (repeat after me), short-term (what were the words?)
Memory
Engage, applying, exercising, realizing or practising ideas
Praxis
