Mental Status Examination

Question 1

What is the definition of “mental status”?

Answer 1

Total expression of a person’s emotional responses, mood, cognitive function, and personality

Question 2

A person’s mental status is closely linked to what other neurological process?

Answer 2

Executive functioning

Question 3

What neurological functions are processed in the frontal lobe?

Answer 3

Speech formation, emotions/affect, drive, awareness of self, short-term memory, goal-oriented behavior

Question 4

What neurological functions are processed in the parietal lobe?

Answer 4

Sensory perception, spatial sense and navigation

Question 5

What neurological functions are processed in the temporal lobe?

Answer 5

Perception/interpretation of sounds, Wernicke’s area, integration of behavior, emotion, personality, long-term memory

Question 6

What neurological functions are processed in the limbic system?

Answer 6

Survival behaviors, reactions to emotions and expression by affect linked to the frontal lobe

Question 7

What characterizes dementia?

Answer 7

Deteriorating cognition, behavior, and functional independence

Question 8

Dementia is usually related to what kind of brain change?

Answer 8

Structural disease, usually atrophy

Question 9

Dementia affects 3-11% of adults over what age?

Answer 9

65

Question 10

What is the DEMENTIA mnemonic for its causes?

Answer 10

Drugs/toxins, endocrine, metabolic/mechanical, epilepsy, nutrition/nervous system, tumor/trauma, infection, arterial

Question 11

How is delirium different from dementia?

Answer 11

Delirium is an ACUTE confusional state accompanied by a disorder of PERCEPTION (SUDDEN, FLUCTUATING, REVERSIBLE)

Question 12

What factors can affect the mental status examination (MSE)?

Answer 12

Culture differences, educational backgrounds, language barriers

Question 13

How long does the mini mental status examination take?

Answer 13

10 minutes

Question 14

What are the components of the MMSE?

Answer 14

Orientation, immediate/short-term memory, concentration, arithmetic ability, language, praxis (learning)

Question 15

What is the traditional threshold score for the MMSE?

Answer 15

23 or greater (scores 0-23 argue strongly for a dementia diagnosis)

Question 16

Why is it important for chiropractors to do MSEs?

Answer 16

Emotional/behavioral changes are often the first sign of organic brain disease, and we see them more frequently than other providers

Question 17

Does a poor score on the MSE mean that the patient is not competent with activities of daily living?

Answer 17

NO (could have a high school and have difficulty with normal daily activities and vice versa)

Question 18

What are the limitations of the MSEs?

Answer 18

1 interpretive bias 2 false-negative rates high 3 demographics and culture issues 4 less sensitive

Question 19

Where should the MSE be included in our patient’s report?

Answer 19

Neurology section of narrative history

Question 20

Does the MMSE require a separate CPT code?

Answer 20

NO; it is considered a component of the neurological portion