MSE Flashcards
What is an MSE? What is summarized in an MSE?
Structured assessment of behavioural and cognitive functioning. Brief overview of a patient’s appearance, speech, actions and thoughts. Mental status can change daily or hourly.
What are the components of an MSE? (Hint: ASEPTIC) Provide 1-2 examples for each category.
Appearance (general behaviour, psychomotor activity)
Speech (tone, speed)
Emotion (mood and affect)
Perception (auditory and/or visual hallucinations)
Thought content and process (risk information, delusions)
Insight and Judgement (understanding of condition, willingness to seek treatment, ability to make sound decisions/connections in thinking)
Cognitive functioning (attention, memory)
What are extrapyramidal symptoms? What is echopraxia?
Movement dysfunction such as dystonia (continuous spasms and muscle contractions), akathisia (may manifest as motor restlessness), parkinsonism characteristic symptoms such as rigidity, bradykinesia (slowness of movement), tremor, and tardive dyskinesia (irregular, jerky movements).
Evidence of mimicking
What is the difference between mood and affect? What are some things about affect that you may note? About both in tadem?
Mood is how the patient is subjectively telling you they are feeling
Affect is how the client presents or what you observe
could note: appropriateness of affect given the situation, range in affect (broad or restricted), intensity of affect (blunted, flat, normal, hyper energized)
Congruence: is there congruency between mood and affect? is there congruency between thought content and affect?
How can perception be defined? What is the difference between an illusion and a hallucination?
A state of being or process of becoming aware of something through the senses
Illusion: misinterpretation of actual stimuli
Hallucination: perceptions in the absence of sensory stimuli in any of the 5 senses
What are some conditions that may prompt visual hallucinations? (Hint: psychiatric and/or neurological)
Dementia with Lewy bodies (clumps of protein forming inside brain cells)
Charles Bonnet syndrome (non-psychiatric) among people with serious vision loss (macular degeneration, glaucoma, and diabetic retinopathy)
Narcolepsy
What are the different types of delusions? (hint: 5, Eddie Gave Jeanie Shit Pants). If not a delusion what could it be? What is an idea of reference?
Erotomania, grandiose, jealous, persecutory, and somatic (also referential but whatever, I guess?)
Overvalued idea or unreasonable sustained belief (less intense than delusion)
Belief that everything one perceives in the world relates to ones own destiny eg thinking the news paper or tv is sending messages or hints to them
(Deep breath and) Define the following thought forms and processes:
1. Circumstantial
2. Tangential
3. Incoherent
4. Flight of ideas
5. Thought blocking
6. Preservation
7. Neologisms
8. Loose associations derailment
And the following speech patterns:
Clang association
Word salad
- Over-inclusive of trivial detail that impede ability to get to the point
- Answer to a question that veers off from the target but may still be useful or inferred by the clinician
- Not coherent (lol)
- Jumping from topic to topic without completing a train of thought (common to manic episodes)
- Loss of goals of communication and not able to return to topic
- Persistent inappropriate repetition of the same thoughts (e.g., I’m dead, I’m dead)
- Word created by the patient (gunt lel)
- Breakdown in logical connection between words and overall sense of goal-directedness. Words make sentences but the sentences do not giving hunni
- Words that sound alike lumped together
- Confused or unintelligible mixture of seemingly random words and phrases
What is MMSE and MoCA?
The Mini-Mental Status Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are two commonly used psychometric tests for cognitive screening.
Define poor, good/excellent and fair insight?
- complete denial of their symptoms or diagnosis or there may be some slight awareness
- overall a good intellectual and emotional understanding of their symptoms or difficulties
Acutely aware of their symptoms or illness and of their own strengths, their symptoms are likely to be in remission and they know how to reach for help and when to rely on themselves - may understand symptoms or diagnosis intellectually on paper but fail to understand it emotionally, or fully grasp the impact of it on their life
What is good judgment?
Aware and makes decisions in a way that does not put them or others in harm
What are some additional considerations not directly stated in MSE?
Physiological factors
Bowel habits
Sleep
Appetite and feeding
Accident or head injury
