Mental Status Exam Flashcards

1
Q

which lobe of the brain is associated with speech formation (Brocas area)

A

Frontal lobe

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2
Q

Which lobe of the brain is responsible for goal-oriented behavior, the ability to concentrate, and short term memory

A

Frontal lobe

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3
Q

Which lobe has associated areas related to emotions, affect, drive, and awareness of self and the autonomic responses related to emotional states

A

frontal lobe

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4
Q

which lobe is primarily responsible for processing sensory data as they are received

A

parietal lobe

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5
Q

Which lobe of the brain is involved in the integration of behavior, emotion, personality and long term memory

A

temporal lobe

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6
Q

THe _______ mediates certain patterns of behavior that determine survival such as mating, aggression, fear and affection)

A

limbic system

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7
Q

Expression of emotion and behavior is mediated by connections between what?

A

limbic system and frontal lobe

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8
Q

What in the brainstem regulates the level of wakefulness or arousal?

A

reticular activating system (RAS)

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9
Q

How is cognitive function affected by age?

A

speed at which new info is perceived, encoded, processed and retrieved
loss of recent memory
delayed response time
diminished ability to learn complex info

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10
Q

When does person disorientation take place?

A

cerebral trauma
seizures
amnesia

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11
Q

When does place disorientation occur?

A

psychiatric disorders
delirium
cognitive impairment

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12
Q

When does time disorientation occur?

A

anxiety
delirium
depression
cognitive impairment

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13
Q

What is the mini-cog screening tool?

A

ask the patient to repeat 3 unrelated words
draw the face of a clock
draw the hands of a specific time
ask the patient to repeat the 3 words

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14
Q

What is a negative mini-cog for dementia?

A

all three words are recalled OR when one or two words are recalled and the clock face is normal

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15
Q

What is the sensitivity and specificity of mini-cog for dementia?

A

sensitivity: 76-99%
specificity: 89%

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16
Q

What are signs of possible cognitive impairment?

A
significant memory loss
confusion
impaired communication
inappropriate affect
personal care difficulties
hazardous behaviors
agitation
suspiciousness
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17
Q

What level is consciousness is characterized by sleepy and still drowsy when awakened, decreased alertness and limited interest in environment?

A

obtundation

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18
Q

What level is consciousness is characterized by drowsy and falls asleep quickly but once aroused responds appropriately?

A

lethargy

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19
Q

Inability to describe analogies (similar or differences) may indicate what?

A

a lesion of the left or dominant cerebral hemisphere

20
Q

An inability to explain a phrase or abstract reasoning may indicate what?

A

poor cognition
dementia
brain damage
schizophrenia

21
Q

Impairment of arithmetic skills may be associated with what?

A

depression

diffuse brain disease

22
Q

Impairment when writing someones own name or address may indicate what?

A

aphasia (impairment in language function)

23
Q

Impairment when writing complex figures may indicate what?

A

dementia
parietal lobe damage
cerebellar lesion
peripheral neuropathy

24
Q

What is the inability to translate an intention into an action?

A

apraxia

25
Q

If judgement is affected what could the cause?

A
mental retardation
emotional disturbance
frontal lobe injury
dementia
psychosis
26
Q

What is a disorder of voice volume, quality (harsh, nasal) or pitch? What is it associated with?

A

Dysphonia; problem with laryngeal innervation or disease of the larynx

27
Q

What is a motor speech disorder, associated with stroke, inebriation cerebral palsy and Parkinson’s?

A

Dysarthria

28
Q

What are the word coherence characteristics that might be associated with psychiatric disorders? (8)

A
Circumloculation
Perseveration
Flight of ideas or loose associations 
world salad
neologisms
clang association
echolalia
utterances of unusual sounds
29
Q

What is curcumloculation?

A

patomime or word substitution to avoid revealing that a word was forgotten

30
Q

What is perseveration?

A

repetition of a word, phrase or gesture

31
Q

What is flight of ideas or loose associations?

A

disordered words or sentences

32
Q

What is word salad?

A

meaningless, disconnected words of choice

33
Q

What are neologisms?

A

words with meaning only to the patient

34
Q

What are clang associations?

A

word choice based on sound so that words rhyme in a nonsensical way

35
Q

What is echolalia?

A

repetition of another persons words

36
Q

What type of aphasia is expressive?

A

Broca Aphasia

37
Q

What type of aphasia is receptive?

A

Wernicke Aphasia

38
Q

What type of aphasia is expressive and receptive?

A

Global aphasia

39
Q

What are the characteristics of Broca aphasia?

A

word comprehension: fair to good
Spontaneous speech: impaired speech flow; telegraphic speech (omission of key words)
Reading Comp: intact
Writing: impaired

40
Q

What are the characteristics of Wernicke aphasia?

A

Word comp: can hear words but cannot relate them to precious experiences
Spontaneous speech: fluent speech uses neologisms, circumlocution, may be totally incomprehensible
reading and writing: impaired

41
Q

What are the characteristics of global aphasia?

A

word comp and spontaneous speech are absent or reduced to few
reading and writing are severely impaired

42
Q

What is evaluated to determine emotional stability?

A

mood and feelings
thought process and content
perpetual distortions and hallucinations

43
Q

What are the suicide risk factors?

A

older unmarried man living alone
adolescent who has recently lost face in an incident that might seem trivial to others
loss of loved one, social isolation
mood disturbance lasting longer than 2 weeks
uninterested in daily effort
change in eating sleeping alcohol habits in last 2 weeks
substance use disorder
successful or attempted suicide of family member
current or past psych illness
access to firearms or other means
has thought about a plan

44
Q

In patients over 71, one in ____ has some form of dementia

A

7

45
Q

What is important to rule out when there is change in cerebral function in older patient?

A

cardiovascular
hepatic
renal
metabolic disease