MSE Flashcards
Apperance
Demographics
Apparant Age, sex, race
Level of arousal/consiousness
Alert, overly alert, subnormally alert and fluctuating
Position/posture
position - lying, sitting, kneeling
posutre-slumped, upright, leaing
Attire
unkempt, dischelleved or nealty dressed
Cleanliness/grooming
Eye contact
Evident physical abnormality
Other striking or bizarre feature
? malodor
Behaviour
Mannerisms/movements
PM agitation and retardation
Cooperation
Demeanor
Prominent adjectives describing how the patient acted towards you and in the interview
Speech/language
Rate
Increased, normal or slowed
Quantity
sparse to talkative
Quality
tone, volume and rhytm
Form
pressured?
thought process, content and perception
Thought disorders - Pathology in the way ideas are linked. Not the ideas themselves.
Goal is to assess the patient’s organisation, flow and production of thought.
Abnormal processes;
FOI
Thoughts move from abruptly from one idea to the other. Still connectedness between ideas and topics. Seen in manics
LOA
Breakdown in logical connection between ideas and overal sense of goal directedness. Implies psychotic illnesses pathway
Circum
Provides extra unnesscary info, but eventually gets to the point.
Tangen
Gives generally appropriate response without answering the Q. Inability to have goal directed train of thoughts.
Content
Psychiatric review of systems includes questions regarding the prescence of specific abnormalities of thought content, such as delusions, violent ideation, obsessions, phobias and mistaken perceptions (incl dereal and depers)
Affect
Affect
external and dynamic manifestation of a person’s mood
Your adjaective to describe their mood - Angry? Sad? Reserved? Dysthymic?
Range
Movement among the various possible emotions
Mobility is the rate of change
Intensity
blunted is zero intensity, manic is high intensity
Reactivity
A shift in response secondary to external cues
Appropriateness/congruence
is the patient’s mood appropriate
Mood
How does the patient feel in their own words at that time
Cognition
Orientation
Altered to time and place etc =”superficially intact”
Memory
Immediate/registration
Repeat back 3 objects
Recall
Recall the same 3 objects after 5 mins
Retrieve
What is their address? Where did they grow up?
Attention
Repeat 5294 after me
Concentration
Count backwards from 65 to 49 or Spell world backwards
Insight
Degree of awareness or understanding of their medical illness. Insight is the ability to be aware of internal and external realities
5 degress of insight
0- there is no problem
1 - the patient sporadically believes there is a problem
2 - the patient realises there is an issue but blames the issue on a general medical condition
3- the patienr realises there is a problem but blames the issue on the surrounding environment
4 - the patient relaises there is a problem intellectually but doesnt change their behaviour to help the problem go away
5 - the patient realises there is a problem intellectually and makes the necessary life changes to facilitate change.
Judegment
Judgement is a process of consideration and formulation regarding a particular issue or situation that can lead to a decision or action.
3 degrees of judgement;
1 - Testing
ask the patient what they would do if they were in a move theatre and they spotted a small fire burning in the corner of the theatre
2- Social
Is this person dealing with you appropriately
3 - Personal
sense of their own worth
Other
Can mention defense mechanisms if present also. Defense mechanisms = psychologic mechanisms of adaptation to stress and the environment.
Rapport
was it stable?
professional?
good , tenous , poor , fluctuating
What is the mmnemoic
A
B
S
T
A
C
I
J
R
