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Psychiatry > MSE > Flashcards

MSE Flashcards

1
Q

What do you look for in Appearance

A 
Age
Self care
clothing
hygeine 
necglect
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2
Q

What do you look for in behaviour

A
  • Eye contact
  • engagement/rapport
  • Social behaviour: over familliar (mania) disorientated, preoccupied
  • Level of arousal: calm / agitated / aggressive
  • Any unusual features: tremors / choreiform movements
    (involuntary movements) / dystonia
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3
Q

What should you comment on Mood (subjective)

A 
How do you feel? How do you feel over a period of time
How would you rate your mood out of 10
Happiness
Irritability
stability
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4
Q

What should you comment on for affect (objective)

A 
Is it congruent with what they've said above
Elated
Euthymic
blunted
flat
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5
Q

What should you comment on for perception

A

Hallucinations
Illusions
Dissociative symptoms

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6
Q

What is a hallucination

A

Sensory perception without external stimuli
Unaware they are not real
Auditory, visual, smell, taste

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7
Q

What is illusions

A

Sensory perception without external stimuli but patient is aware they are not real

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8
Q

What are dissociative symptoms

A

Derealisation: the feeling the world or surroundings are not real
Depersonalisation: feeling detached from oneself

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9
Q

what should you comment on in thought form

A

• Linear – in a logical order
• Incoherent – makes no logical sense
• Circumstantial – lots of irrelevant/unnecessary details (not to the point)
• Tangential – the patient goes off on tangents relating loosely to the initial thought
• Perseveration – repetition of a particular response despite the absence/removal of the stimulus
- Flight of ideas

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10
Q

What should you comment on in thought posession

A
  • Insertion - putting thoughts into my head
    • Withdrawal - taking thoughts out of my head
    • Broadcasting - people can hear my thoughts
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11
Q

What should you comment on in thought content

A
  • Over valued ideas vs, delusions
  • Negative cognitions
  • Suicidal ideation
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12
Q

What are delusions

A

Fixed, false beliefs not consistent with the person’s background

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13
Q

What are over-valued ideas

A

unreasonable belief e.g. anorexic person thinking they’re overweight

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14
Q

When a patient admits to being suicidal, how do you break it down

A
  • Do they want their life to end, but not thought of ending it themselves
    o They want their life to end and have thought of doing it themselves
    o They have actively planned to commit suicide
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15
Q

What are persecutory delusions

A

False belief that one is being harmed, threatened, harassed or victim of a conspiracy theory

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16
Q

What are grandiose delusions

A

False belief that one is particularly powerful, important or talented

17
Q

What are delusions of reference

A

False belief that certain objects or people or events have intense personal significance and refer specifically to oneself

18
Q

What are religious delusions

A

False beliefs pertaining to religious themes, often grandiose in nature

19
Q

Delusions of love (etromania)

A

False belief that someone is in love with them

20
Q

Delusions of misidentification

A

False belief that ones family member has been replaced by an imposter

21
Q

What are delusions of infidelity

A

False belief that one’s lover has been unfaithful (careful as can be an overvalued idea, not a psychotic jealousy)

22
Q

what are Nihilistic delusions

A
  • False belief that ones self, others or the world is non-existent or about to end
  • insides rotting (somatic delusions)
23
Q

WHat are delusions of control

A

False belief that ones thoughts, feelings, actions or impulses are controlled or made by an external agent

24
Q

What should you consider when discussing insight

A
  • Do they know they have a problem
  • Can they attribute it to something e.g. illness
  • Do they think they’re physically or mentally ill
  • Do they think they need treatment
  • Are they willing to accept treatment
  • Do they think stress might be contributing towards there illness
25
Q

What should you consider when performing a risk assessment

A
  • Risk to self
  • Risk to others
  • Neglect (including self neglect)
  • Any children involved
26
Q

Risk factors for suicide

A 
S: sex- male
A: age (<19, >45)
D: depression
P: previous attempt
E: excessive Alcohol/drug use
R: rational thinking loss
S: social support lacking
O: organised plan
N: no spouse
S: sickness
27
Q

What features of a previous suicide increase the risk of a completed suicide at a later date

A 
efforts to avoid discovery
planning
leaving a written note
final acts such as sorting out finances
violent method
28
Q

What considered protective factors to prevent suicide

A

family support
having children at home
religious belief

Psychiatry (6 decks)

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