Mental Status Exam

Question 1

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

Answer 1

Frontal lobe

Question 2

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

Answer 2

Frontal lobe

Question 3

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

Answer 3

frontal lobe

Question 4

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

Answer 4

parietal lobe

Question 5

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

Answer 5

temporal lobe

Question 6

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

Answer 6

limbic system

Question 7

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

Answer 7

limbic system and frontal lobe

Question 8

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

Answer 8

reticular activating system (RAS)

Question 9

How is cognitive function affected by age?

Answer 9

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

Question 10

When does person disorientation take place?

Answer 10

cerebral trauma
seizures
amnesia

Question 11

When does place disorientation occur?

Answer 11

psychiatric disorders
delirium
cognitive impairment

Question 12

When does time disorientation occur?

Answer 12

anxiety
delirium
depression
cognitive impairment

Question 13

What is the mini-cog screening tool?

Answer 13

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

Question 14

What is a negative mini-cog for dementia?

Answer 14

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

Question 15

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

Answer 15

sensitivity: 76-99%
specificity: 89%

Question 16

What are signs of possible cognitive impairment?

Answer 16

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

Question 17

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

Answer 17

obtundation

Question 18

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

Answer 18

lethargy

Question 19

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

Answer 19

a lesion of the left or dominant cerebral hemisphere

Question 20

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

Answer 20

poor cognition
dementia
brain damage
schizophrenia

Question 21

Impairment of arithmetic skills may be associated with what?

Answer 21

depression

diffuse brain disease

Question 22

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

Answer 22

aphasia (impairment in language function)

Question 23

Impairment when writing complex figures may indicate what?

Answer 23

dementia
parietal lobe damage
cerebellar lesion
peripheral neuropathy

Question 24

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

Answer 24

apraxia

Question 25

If judgement is affected what could the cause?

Answer 25

``` mental retardation emotional disturbance frontal lobe injury dementia psychosis ```

Question 26

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

Answer 26

Dysphonia; problem with laryngeal innervation or disease of the larynx

Question 27

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

Answer 27

Dysarthria

Question 28

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

Answer 28

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

Question 29

What is curcumloculation?

Answer 29

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

Question 30

What is perseveration?

Answer 30

repetition of a word, phrase or gesture

Question 31

What is flight of ideas or loose associations?

Answer 31

disordered words or sentences

Question 32

What is word salad?

Answer 32

meaningless, disconnected words of choice

Question 33

What are neologisms?

Answer 33

words with meaning only to the patient

Question 34

What are clang associations?

Answer 34

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

Question 35

What is echolalia?

Answer 35

repetition of another persons words

Question 36

What type of aphasia is expressive?

Answer 36

Broca Aphasia

Question 37

What type of aphasia is receptive?

Answer 37

Wernicke Aphasia

Question 38

What type of aphasia is expressive and receptive?

Answer 38

Global aphasia

Question 39

What are the characteristics of Broca aphasia?

Answer 39

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

Question 40

What are the characteristics of Wernicke aphasia?

Answer 40

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

Question 41

What are the characteristics of global aphasia?

Answer 41

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

Question 42

What is evaluated to determine emotional stability?

Answer 42

mood and feelings thought process and content perpetual distortions and hallucinations

Question 43

What are the suicide risk factors?

Answer 43

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

Question 44

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

Answer 44

7

Question 45

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

Answer 45

cardiovascular hepatic renal metabolic disease