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psychiatry exam 1 > MSE > Flashcards

MSE Flashcards

1
Q

What is MSE?

A

Part of psych eval including a “snapshot” description of patient with examiners observations (objective) and complaints/symptoms of patients (subjective) components

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2
Q

Outline of MSE (10)

A
  • Appearance/behavior
  • Psychomotor abnormalities
  • Speech
  • Mood
  • Affect
  • Thought process
  • Thought content
  • Sensorium/intellectual fxn
  • Insight
  • Judgment
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3
Q

Define appearance/behavior

A

Objective description of patient as observed (able to identify pt w/o seeing them)

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4
Q

Components of appearance/behavior

A
  • Physcial chars (sex, wt, physical health)
  • Apparent vs chronological age
  • Physical stigmata (Downs, FAS, tattoos)
  • Dress
  • Grooming
  • Posture
  • Facial expression
  • Eye contact
  • Receptiveness to interview (cooperative, attentive, seductive, hostile, guarded)
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5
Q

Define psychomotor activity

A

Amount and type of movement (retardation or agitation)

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6
Q

Bradykinesia

A

Slowness of activity, decrease in spontaneous movement

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7
Q

Akasthisia

A

Subjective feeling of muscular tension –> restlessness (often caused by 1st gen antipsychotics)

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8
Q

Catalepsy

A

Waxy flexibility, immobile position that is constantly maintained

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9
Q

Stereotypies

A

Repetitive, fixed pattern of physical action/speech (e.g. hand flapping, waving, body rocking, head banging); often associated w/ intellectual disability and/or autism

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10
Q

Cataplexy

A

Temporary loss of muscle tone precipitated by emotion (symptom of narcolepsy)

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11
Q

Tardive dyskinesia

A

Abnormal, involuntary, irregular choreoathetoid movements of head, limbs, or trunk – perioral most common (darting, twisting, protrustion of tongue; chewing/lateral jaw movements; lip puckering; facial grimacing)

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12
Q

Speech components

A

Quantity, quality, rate

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13
Q

Pressured speech

A

Rapid speech increased in amount and difficult to interpret

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14
Q

Wernicke’s aphasia

A

Receptive – speech is fluent but comprehension is impaired; normal effort; empty content of words and full of substitutions/neologisms (nonsense)

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15
Q

Broca’s aphasia

A

Expressive – speech is nonfluent; comprehension intact; effortful/frustrating; speech sparse/absent

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16
Q

Define mood

A

Pervasive/sustained emotion experienced by pt over time (subjectively reported)

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17
Q

Define affect

A

Outward expression of mood – objectively observed

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18
Q

Components of affect

A

Variability, intensity, appropriateness to mood

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19
Q

Labile affect

A

Rapid and abrupt changes in emotional tone, unrelated to external stimuli

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20
Q

Constricted/restricted affect

A

Reduction in intensity of feeling, less severe than blunted, but clearly reduced

21
Q

Define thought process

A

Way that a person puts together ideas/associations

22
Q

Normal thought process

A

Linear, goal-directed

23
Q

Tangential

A

Thought process with inability to have goal directed associations (never gets to end point)

24
Q

Circumstantial

A

Thought process where abundant in detail and delayed in reaching point, but gets there

25
Q

Flight of ideas

A

Rapid, continuous verbalization w/ constant shifting from one idea to next w/ idea connection (least severe can be followed)

26
Q

Loose associations

A

Flow of thoughts where ideas shift from one subject to another without relation; severe will be incoherent

27
Q

Word salad

A

Jumbled words/phrases w/o comprehensible meaning

28
Q

Components of thought content

A
  • Hallucinations
  • Delusions
  • Illusions
  • Recurring themes (e.g. negative ruminations, obesessions)
  • Suicidal/homicidal ideation
29
Q

Hallucinations

A

False sensory perception not associated with real external stimuli

30
Q

Types of illusions and assc. features

A
  • Auditory (usually voices; primary psychiatric illness; command w/ obligation to obey/unable to resist)
  • Visual (formed images or light flashes; usually psychosis from other illness)
  • Olfactory (assc. w/ another illness)
  • Gustatory (usually uncinate seizure)
  • Tactile (e.g. formication “bugs crawling under skin” as assc. w/ substance w/drawal)
31
Q

Hypnagogic hallucinations

A

False sensory perceptions that occur upon falling asleep (normal)

32
Q

Hypnopompic hallucinations

A

False sensory perceptions that occur when waking (normal)

33
Q

Delusions

A

Fixed false belief

34
Q

Types of delusions

A

Bizarre (couldn’t happen) vs. non-bizarre

35
Q

Non-bizarre delusion subtypes

A
  • Grandiose: exaggerated idea of one’s importance, power, identity
  • Reference: incorrectly interpreting casual incidents/external events as having direct personal reference
36
Q

Obession

A

Pathological persistence of an irresistible thought/feeling that can’t be eliminated from consciousness

37
Q

Illusion

A

Misinterpretation of real external sensory stimuli

38
Q

Recurring theme

A

Topic patient focuses on and continues to return to during interview (e.g. negative ruminations or obsessions)

39
Q

Suicidal and homicidal ideation considerations

A
  • Passive vs active

- Thoughts vs. plans

40
Q

Components of sensorium/intellectual fxn

A
  • Consciousness
  • Orientation
  • Attention/concentration
  • Memory
  • Abstraction
  • Fund of knowledge
41
Q

Consciousness descriptors

A

Alert, drowsy, comatose

42
Q

Orientation components

A

Person, place, time (maintained in that order)

43
Q

Attention and concentration tests

A
  • Serial 7s
  • Spelling word backwards
  • Repeating series of random #s
  • Repeating 3/4 unrelated objects after 5-10 min
44
Q

Memory tests – Immediate, recent, and remote

A
  • Immediate: repeat 3 words
  • Recent (events w/in 24 hrs): last meal
  • Remote (from life): DOB, # siblings
45
Q

Abstraction test

A

Ask for interpretation of proverb and look for either concrete or abstract answer

46
Q

Fund of knowledge test

A

Ask pt to name past presidents or world events (consideration: education dependent)

47
Q

Define insight

A

Awareness and understanding of illness (range from denial to true insight)

48
Q

Define judgment

A

Ability to make/carry out plans, discriminate accurately, and behave appropriately in social situations; can evaluated on history or imaginary scenario

psychiatry exam 1 (9 decks)

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