Mental Status Exam Flashcards
What is the difference between mood and affect?
Mood = SUBJECTIVE report of emotional state by patient
Affect = OBJECTIVE observation of patient’s emotional state by the physician
What are some components in your evaluation of a patient’s appearance and behavior?
Body habitus, eye contact, interpersonal style, style of dress, distinguishing features
What are some components of your evaluation of a patient’s mood and affect?
Euthymic, hyperthymic, or dysthymic
Body language, erratic or jerky movements, toe tapping, tight, tense
Facial expressions (tearfulness, smiles, frowns)
Stability (stable, fixed, labile)
Range (constricted, full)
Appropriateness
Intensity (flat, blunt, exaggerated)
Congruent/incongruent (whether mood and affect are compatible)
Excessive motor activity (pacing, squirming, restless, inability to sit still)
Akathisia
Term that may be used to describe the motor activity of a patient that is wringing their hands, rocking, picking at skin or clothing, rapid pacing, exaggerated gestures and movements
Agitation
Term that may be used to describe the motor activity of a pt with psychomotor retardation — slowing of physical and emotional reactions, lacking animation
Bradykinesia
Term that may be used to describe the motor activity of a patient displaying immobility with muscular rigidity or inflexibility (waxy flexibility)
Catatonia
Term that may be used to describe the motor activity of a patient with involuntary facial grimaces, choreothetic movements
Tardive dyskinesia
What are you assessing with the attention and executive functioning portion of the mental status exam?
Ability to focus based on internal or external priorities
The ordering and implementation of cognitive functions necessary to engage in appropriate behaviors
[testing each cognitive function involved in completing a task]
The _______ component of the mental status exam involves evaluation of ability to choose appropriate behaviors, i.e., if a patient repeatedly makes poor decisions despite adverse consequences and has inability to recognize consequences of actions
Judgement
The _______ component of the mental status exam involves evaluation of pt’s awareness and understanding of illness and need for treatment; i.e., denial would be an abnormal finding in this category
Insight
The _______ component of the mental status exam involves evaluation of a pts ability to name objects and their function
Gnosia
The _______ component of the mental status exam involves evaluation of a pts ability to carry out intentional motor acts
Praxis
_______ = inability to carry out motor acts; deficits may exist in motor or sensory systems, comprehension, or cooperation
Apraxia
The _______ component of the mental status exam involves evaluation of a pts ability to perceive and manipulate objects and shapes in space
Visuospatial proficiency
What are some components included in your evaluation of a pts language/speech during mental status exam?
Rate of speech (>100 wpm is normal; <50 wpm is abnormal)
Reading and writing appropriate to education level
Quantity (talkative, expansive, paucity, poverty)
Rate (fast, pressured, slow, normal)
Volume and tone
Fluency and rhythm
Coherent/incoherent
_____ = the immediate and involuntary repetition of words or phrases just spoken by others
Echolalia
_______ = the ability to recognize the emotional aspects of language using patterns of stress and intonation
Prosody
The memory component of the mental status exam involves evaluation of pt’s recall of past events. This includes _______ memory, which is recall of recent and past events, as well as _______, which is the ability to complete learned tasks without conscious thought
Declarative; procedural
The _______ component of the mental status exam involves evaluation of the pts ability to recognize his or her place in time and space [i.e., knows time, date, place, person, situation]
Orientation
The _______ component of the mental status exam involves evaluation of pts level and stability of consciousness, awareness, ability to respond to sensory input, may include Glasgow Coma Score
Sensorium
________ cognition may be evident during though content portion of mental status exam if pt expresses feelings of guilt, worthlessness, hopelessness, helplessness
Depressive
________ may be evident during though content portion of mental status exam if pt expresses persistent, unwanted, recurring thoughts
Obsessions
________ may be evident during though content portion of mental status exam if pt expresses obsessive dwelling on negative thoughts of failures, loss, and humiliations
Ruminations
________ may be evident during though content portion of mental status exam if pt expresses strong persistent fear of object or situation
Phobias
What term describes the phenomenon of an individual experiencing innocuous events or mere coincidences and beliving that they have strong personal significance, and would be documented in the thought content portion of the mental status exam?
Ideas of reference
What term describes fixed, false beliefs that one posseses superior qualities such as genius, fame, omnipotence, or wealth, and would be documented in the thought content portion of the mental status exam?
Ideas of grandeur
What term describes false beliefs kept despite no supportive evidence, no attempt at reality checking, and would be documented in the thought content portion of the mental status exam?
Delusions
Ideas of reference, ideas of grandeur, paranoid ideation, magical ideation, delusions, overvalued ideas, thought broadcasting, thought insertion, thought withdrawal, suicidal/homicidal ideation, depressive cognition, obsessions, ruminations, and phobias are documented regarding which category of the mental status exam?
Thought content
Term used to describe misinterpretation of actual external stimuli, documented as a perceptual disturbance
Illusion
Perceptual disturbance that involves a sense of eeriness, and the observer’s impression of seeing the situation for the first time, despite rationally knowing that he or she has been in the situation before
Jamais vu
[often described as the opposite of deja vu]
Jamais vu is sometimes associated with certain types of _____, ______, and _______
Aphasia; amnesia; epilepsy
The part of the mental status exam that evaluates thought processes looks at the organization of thoughts in a goal-oriented pattern.
________ thoughts = patient goes through multiple related thoughts before arriving at the answer to a question
Circumferential
The part of the mental status exam that evaluates thought processes looks at the organization of thoughts in a goal-oriented pattern.
________ thoughts = patient moves from one topic to another without organization or coherence
Disorganized
The part of the mental status exam that evaluates thought processes looks at the organization of thoughts in a goal-oriented pattern.
________ thoughts = patient listens to question and begins discussing related thoughts, but never arrives at the answer
Tangential
The part of the mental status exam that evaluates thought processes looks at the organization of thoughts in a goal-oriented pattern.
________ thoughts = the use of many words where fewer would do, as when having difficulty finding a word
Circumlocution
Name the 18 components of the mental status exam (lol I know)
Appearance and behavior Mood and affect Motor activity Attention Executive functioning Judgement Gnosia Language/speech Memory Orientation Sensorium Praxis Prosody Thought content Perceptual disturbances Insight Thought processes Visuospatial proficiency
Potential diagnoses if pt has disheveled appearance
Depression
Schizophrenia/psychotic disorder
Substance use
Potential diagnosis if pt displays irritability
Anxiety
Potential diagnoses if pt shows poor eye contact
Depression
Psychotic disorder
Potential diagnoses if pt displays akathisia
Anxiety
Drug overdose or withdrawal
Medication effect
Mood disorder
Parkinsonism
PTSD
Schizophrenia
Potential diagnoses if pt presents with bradykinesia
Depression
Medication effect
Schizophrenia
Potential diagnoses if pt presents with catatonia
Schizophrenia/psychotic disorder
Severe depression
Potential diagnoses if pt is unable to count by sevens or fives, or cannot spell a word backwards
ADHD
Delirium
Dementia
Mood disorder
Psychotic disorder
Potential diagnoses if pt presents with abnormalities in the following tests:
Clock drawing test — ask pt to draw a clock with hands set to 11:10
Trail-making test — ask pt to alternate numbers with letters in ascending order (e.g., A1B2C3)
Delirium Dementia Mood disorder Psychotic disorder Stroke
Potential diagnoses if pt presents with inability to identify an object and describe how it is used
Advanced dementia
Stroke
