MSE Flashcards
1
Q
What are the 10 categories of the MSE?
A
- Appearance
- Behavior
- Mood
- Affect
- Speech
- Thought Process
- Thought Content
- Cognition
- Judgment
- Insight
2
Q
List 12 general categories of appearance.
A
- Demographics
- Hair
- Facial Hair
- Makeup
- Hygiene
- Odor
- Facial expression
- Eye contact
- Clothing
- Physical aids
- ID markings
- Relevant physical exam findings
3
Q
Descriptors of demographics?
A
Gender (M/F) Age (younger/older/stated age) Ethnicity Height (tall/short/petite) Weight (underweight/thin, overweight/husky/stocky, obese/moderately obese/morbidly obese, muscular/lean, emaciated, frail) Healthy/sickly Attractive/unattractive
4
Q
Descriptors of hair?
A
Color Length (long/short/bald) Grooming (neat/styled/disarray, pulled back from face/hiding face) Clean/dirty Straight/curly Lanugo
5
Q
Descriptors of facial hair?
A
Mustache/beard/goatee
6
Q
Descriptors of make-up?
A
Worn/not worn
Carefully done/carelessly done/overdone
Manicured nails/nail polish
7
Q
Descriptors of hygiene?
A
Clean/dirty
Meticulous
8
Q
Descriptors of odor?
A
Alcohol/smoke/MJ
Unbathed
Urine/stool
Cologne/perfume
9
Q
Descriptors of facial expression?
A
Smiling, animated, interested, excited, elated
Sad, worried, fearful, scowling, tense, preoccupied, suspicious, smirking
Perplexed, bored, blank, dazed, blushing
10
Q
Descriptors of eye contact?
A
Indirect Avoidant/downcast/none Staring at/through interviewer Fixed/staring Glaring Fleeting/darting/shifty/scanning Sporadic/intermittent Wearing sunglasses
11
Q
Descriptors of clothing?
A
Appropriate to age/season/occasion Clean/neat/tidy/meticulous New/worn Bright/dull colors Coordinated/mismatched Casual/formal Suit/blazer, shirt/tie, dress/skirt, blouse/short-sleeved/t-shirt (logo?), pants/jeans/sweats/shorts, boots/dress shoes/sneakers/sandals, hat (logo?)
12
Q
Descriptors of physical aids?
A
Glasses/sunglasses Hearing aid(s) Teeth braces Cast/brace Walker/wheelchair/scooter
13
Q
Descriptors of ID markings?
A
Jewelry (rings, necklaces, earrings, bracelets) Missing teeth Scars/bruises Tattoos Piercings Needle marks
14
Q
List 5 categories of behavior.
A
- Attitude/rapport
- Gait
- Movements
- Posture
- Handshake
15
Q
Descriptors of attitude/rapport?
A
Appropriate
Friendly, cooperative/compliant, pleasant, warm, playful
Evasive, negative, suspicious/frightened, demanding, threatening, defensive/aggressive/manipulative, angry/hostile, indifferent/aloof, withdrawn, distant, seductive/provocative, ingratiating, arrogant, shy, disinterested, passive, submissive, condescending, patronizing, puzzled
16
Q
Descriptors of gait?
A
Brisk Slow, hesitant Shuffling Ataxic Uncoordinated Dancing/chorea
17
Q
Descriptors of movements?
A
Purposeful/aimless/purposeless
Voluntary/involuntary
Grimaces, twitches, picking, lip smacking, tongue thrusting or rolling, chewing, facial dyskinesia, tics
Agitated/restless (handwringing, tapping foot, fidgeting, rocking, twisting, pacing, shifting in chair, drumming fingers, unable to sit still, disorganized, etc.)
Calm (sitting quietly, legs crossed, hands together, slowed movements, deficits that restrict movement)
Asterixis
Stereotyping (isolated, purposeless movement performed repetitively)
Echopraxia (repetitive imitation of movements of another person)
18
Q
Qualifiers of movements?
A
Rate - hyperactive/psychomotor agitation, psychomotor retardation, rapid, slow
Coordination - awkward, clumsy, agile
19
Q
Descriptors of posture?
A
Slouched, slumped, hunched over, stooped Relaxed Rigid, tense, stiff Erect Posturing/bizarre
20
Q
Descriptors of handshake?
A
Firm/weak Warm/cool Hearty, heavy Prolonged Resistant Refused
21
Q
Descriptors of mood?
A
Elated/euphoric Euthymic/happy Dysthymic/depressed/sad Angry/irritable/hostile Anxious/nervous/apprehensive Alexithymic
22
Q
Components of affect?
A
Range
Appropriateness
Congruence
23
Q
Descriptors of range, appropriateness, and congruence (affect)?
A
Range - full, guarded, constricted, blunted/flat, superficial, labile
Appropriateness - appropriate vs. inappropriate
Congruence - congruent/incongruent with mood
24
Q
List 8 categories of speech.
A
- Clarity
- Fluency
- Impairments
- Flow
- Quantity
- Rate
- Tone
- Volume
25
Descriptors of clarity?
```
Clear/coherent
Dysarthria/dysphagia
Repetitive
Accent
Profanity
```
26
Descriptors of fluency?
Fluent or non-fluent (ability to produce sentences of normal length, rhythm, and prosody)
27
Descriptors of impairments?
Stuttering, slurring, mumbling, lisping, stammering, garbled, aphasic, accented
(Typical or new?)
28
Descriptors of flow?
```
Spontaneous
Hesitant/halting
Difficulty finding words
Long pauses
Rambling
```
29
Descriptors of quantity?
```
Talkative
Verbose
Minimal/brief responses
Impoverished
Spontaneous/non-spontaneous
Laconic (brief, empty replies)
```
30
Descriptors or rate?
Slow, hesitant, rapid, pressured, relaxed/conversational
31
Descriptors of tone?
```
Animated/excited
Sarcastic/angry
Monotone
Dysprosody
Inflection
```
32
Descriptors of volume?
```
Shouting
Loud
Conversational
Soft-spoken
Whispers
Inaudible
Mute
```
(Remember to check if someone is hearing impaired)
33
List 3 categories of thought process.
1. General
2. Loosening of association
3. Flow
34
General descriptors of thought process?
```
Logical/illogical
Goal-directed/sequential
Coherent
Circumstantial
Tangential
Flight-of-ideas (topic to topic, not completely disjointed)
```
35
Types of loosening of association?
```
Fragmentation
Verbigeration/palilalia
Coprolalia
Echolalia
Word salad
Incoherence
Neologisms
Clang associations
```
36
Define fragmentation.
Words and individual phases are intact but the phrases are disconnected, making sentences and ideas meaningless
37
Define verbigeration/palilalia.
Repeating words or sounds
38
Define echolalia.
Repeating whole phrases or sentences
39
Define word salad.
Words intact, but all sentence structure is lost
40
Define incoherence.
Words unintelligible, no phrases or sentence structure
41
Define neologisms.
New words created by a patient
42
Define clang associations.
Association of words similar in sound but not in meaning
43
Descriptors of flow?
Racing thoughts
Thought blocking
Derailment
Perseveration
44
Define racing thoughts.
Thoughts are so fast that the patient cannot articulate them or keep up with them
45
Define thought blocking.
Stop talking midsentence
46
Define derailment.
Speech stops suddenly and then restarts having shifted to another topic
47
Define perseveration.
Repetition of verbal responses despite changing questions
48
List 6 categories of thought content.
1. Thoughts of death, passive/active SI/VI/HI
2. Illusions/hallucinations
3. Obsessions/compulsions
4. Derealization/depersonalization
5. Phobias
6. Overvalued ideas/delusions
49
Types of delusions?
Paranoid/persecutory
Referential (random events are of some special significance)
Grandiose (unrecognized talent/insight/great discovery/special relationship to someone famous)
Jealous
Erotomanic (someone is in love with the patient)
Somatic
Bizarre (thought broadcasting/withdrawal/insertion, delusion of control)
50
List 5 categories of cognition.
1. Sensorium/level of consciousness
2. Attention/concentration
3. Memory
4. Fund of knowledge
5. Abstract thinking
51
Descriptors of sensorium/level of cognition?
Alert and oriented x4 (person, place, time, situation)
```
Sedated/groggy/drowsy
Clouding (impaired awareness of environment)
Stupor
Somnolent/lethargic
Coma
```
52
Descriptors of attention?
Sufficient/deficient
| Easily distractible/short attention span
53
Descriptors of memory?
Immediate (recall)
Remote (childhood data, important events, etc.)
Recent (recent news events from the past few months)
54
Components/score of the MMSE?
1. Orientation (10)
2. Registration (3)
3. Attention and Calculation (5)
4. Recall (3)
5. Language (9)
55
Test orientation (MMSE)?
1. What is the (day/date/month/year/season)? - 5 points
| 2. Where are we? (hospital/floor/city/country/state)? - 5 points
56
Test registration (MMSE)?
Name 3 unrelated objects and ask the patient to repeat them - 3 points
57
Test attention and calculation (MMSE)?
Serial 7's (stop after 5 subtractions, score = # of correct answers)
Spell WORLD backwards (score = # of letters correct)
5 points
58
Test recall (MMSE)?
As patient to recall the 3 items from the registration test
3 points
59
Components of language testing in the MMSE?
1. Naming
2. Repetition
3. 3-Stage Command
4. Reading
5. Writing
6. Copying
60
Test language (MMSE)?
1. Naming - show patient wristwatch and ask what it is; repeat for pencil - 2 points
2. Repetition - ask patient to repeat, "No ifs, ands, or buts" - 1 point
3. 3-stage command - 1 point for each step done correctly
4. Reading - print "Close Your Eyes" on paper and ask the patient to read it and do what it says - 1 point
5. Writing - ask the patient to write a sentence with a subject and a verb - 1 point
6. Copying - ask the patient to copy an image - 1 point
61
Scoring the MMSE?
21+ - mild cognitive impairment
10-20 - moderate
<10 - severe
62
Descriptors of judgment?
Ability to make and carry out plans consistent with reality, to control one's actions, and to predict what one would do in an imaginary situation
Good/fair/poor
63
Descriptors of insight?
Degree of awareness and understanding of illness
Good/fair/poor
Denial/blaming others, slightly aware, recognizes there is a problem, awareness/understanding of the illness (knows treatment is needed)
64
What psychiatric illness?
Appearance: decreased body weight, poor grooming, poor hygiene
Behavior: psychomotor retardation or agitation, withdrawn
Speech: decreased quantity, soft
Thought content: SI/HI
Cognition: poor concentration, indecisive
Major depression
65
What psychiatric illness?
Appearance: decreased body weight, baggy clothes, lanugo
Anorexia
66
What psychiatric illness?
Appearance: arcus senilis, bruising, palmar erythema, spider angiomata, poor grooming, poor hygiene
Alcohol abuse/dependence
67
What psychiatric illness?
Thought content: hallucinosis
Alcohol withdrawal
68
What psychiatric illness?
Thought content: formication
Cocaine intoxication
69
What psychiatric illness?
Appearance: pupil dilation/constriction, poor grooming/hygiene, sedated, groggy
Cognition: decreased alertness, disoriented, poor concentration
Substance intoxication/withdrawal
70
What psychiatric illness?
Appearance: needle marks/tracks, clothing to hide needle marks
IV drug use/dependence
71
What psychiatric illness?
Appearance: sunglasses, injected conjunctiva
Marijuana abuse
72
What psychiatric illness?
Appearance: fastidiously groomed
Behavior: repetitive behavior
Thought Content: obsessions and compulsions
OCD
73
What psychiatric illness?
Thought Content: preoccupation with rules, order, organization such that the point of the activity is lost
OCPD
74
What psychiatric illness?
Behavior: muscle tension, nervous, sweaty palms
Affect: guarded
Speech: increased quantity, rapid speech
GAD/anxiety disorders
75
What psychiatric illness?
Appearance: fastidiously groomed
Behavior: arrogant, entitled attitude
Thought Content: grandiose sense of importance, believes others are envious of him
Narcissistic personality
76
What psychiatric illness?
Appearance: excessive makeup, jewelry, brightly colored clothing
Behavior: demanding, provocative, seductive, restless, distractible
Affect: labile
Speech: increased quantity, rapid, pressured
Thought Process: racing thoughts, flight-of-ideas
Cognition: distractible, poor concentration
Mania
77
What psychiatric illness?
Appearance: excessive makeup, jewelry, brightly colored clothing
Histrionic personality disorder
78
What psychiatric illness?
Appearance: tattoos, scars
Behavior: calm, glib, manipulative, demanding
Anti-social personality disorder
79
What psychiatric illness?
Behavior: odd, eccentric, peculiar behavior
Thought Content: odd beliefs, suspiciousness or paranoid ideas
Schizotypal personality
80
What psychiatric illness?
Affect: flat
Speech: decreased quantity
Thought Process: looseness of association, derailment, incoherence (if severe)
Thought Content: delusions, SI/HI, any hallucination
Schizophrenia
81
What psychiatric illness?
Appearance: poor grooming, food stains on bib of clothes, body odor
Behavior: awkward social interaction, evasive, puzzled, calm or restless
Affect: labile, blunted, constricted
Speech: non-spontaneous, hesitant
Thought Process: errors in word choice and grammar
Thought Content: delusions, any hallucination
Cognition: memory impairment, poor abstract thinking, apraxia, agnosia
Dementia
82
Medications that can cause tremor as a side effect?
Lithium, depakote, conventional anti-psychotics
83
Medications that can cause tardive dyskinesia, dystonia, and akathisia?
Conventional anti-psychotics
84
Medications that can cause tremor with rigidity and akinesia?
Drugs causing parkinsonism, NMS, serotonin syndrome
85
What psychiatric illness?
Affect: labile or blunted
Thought Process: any disorder in thought process
Thought Content: delusions, any hallucination
Cognition: disorientation to situation, time, and place, rarely to person; very poor concentration (serial MMSE testing encouraged)
Delirium
86
What psychiatric illness?
Affect: guarded
Thought Content: suspicion that others want to harm him; preoccupied about the loyalty of others
Paranoid personality disorder
87
What psychiatric illness?
Thought Process: neologisms, echolalia
Autism
