Mental Status Exam Flashcards by Monika Eszterhazy

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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)

How well did you know this?

Not at all

Perfectly

Excessive motor activity (pacing, squirming, restless, inability to sit still)

Akathisia

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Term that may be used to describe the motor activity of a patient displaying immobility with muscular rigidity or inflexibility (waxy flexibility)

Catatonia

How well did you know this?

Not at all

Perfectly

Term that may be used to describe the motor activity of a patient with involuntary facial grimaces, choreothetic movements

Tardive dyskinesia

How well did you know this?

Not at all

Perfectly

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]

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

The _______ component of the mental status exam involves evaluation of a pts ability to name objects and their function

Gnosia

How well did you know this?

Not at all

Perfectly

The _______ component of the mental status exam involves evaluation of a pts ability to carry out intentional motor acts

Praxis

How well did you know this?

Not at all

Perfectly

_______ = inability to carry out motor acts; deficits may exist in motor or sensory systems, comprehension, or cooperation

Apraxia

How well did you know this?

Not at all

Perfectly

The _______ component of the mental status exam involves evaluation of a pts ability to perceive and manipulate objects and shapes in space

Visuospatial proficiency

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

_____ = the immediate and involuntary repetition of words or phrases just spoken by others

Echolalia

How well did you know this?

Not at all

Perfectly

_______ = the ability to recognize the emotional aspects of language using patterns of stress and intonation

Prosody

How well did you know this?

Not at all

Perfectly

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