MSE

Question 1

what are the components of MSE

Answer 1

appearance
behaviour
speech 
mood + affect 
thought
perception 
cognition 
insight

Question 2

describe what you would look for in appearance

Answer 2

age 
gender
race
clothing 
grooming / kemptness
smell 
gait 
evidence of self harm, bruises 
posture 
involuntary movement - fidgeting, restless

Question 3

describe what you would look for in behaviour

Answer 3

rapport
eye contact 
overfamiliarity/social disinhibition  
withdrawn, psychomotor retardation 
fidgeting
distracted 
inappropriate
hand gestures

Question 4

describe what you would look for in speech

Answer 4

rate 
volume 
tone 
amount 
delay
pressure of speech 
poverty of speech 

can be described as appropriate, minimal…

Question 5

mood is objective/subjective

Answer 5

subjective
the patient tell you how they feel
use their own words

Question 6

affect is objective/subjective

Answer 6

objective

observe how the patient is during the appointment

Question 7

list the components of thought in MSE

Answer 7

thought control
thought forming
thought content + risk assessment

Question 8

describe thought control

Answer 8

thought insertion, withdrawal and broadcasting

Question 9

what is thought insertion

Answer 9

putting thoughts inside your head

Question 10

what is thought withdrawal

Answer 10

taking thought out of your head

Question 11

what is thought broadcasting

Answer 11

everyone walking down the streets can know your thoughts

Question 12

disorders of thought forming

Answer 12

neologisms
flight of ideas
loosening of associations

Question 13

disorders of thought content - give examples

Answer 13

delusions of: 
grandiose - inflated sense of worth 
paranoia 
persecutory - someone is out to get them 
guilt
sin 
nihilism - death, perished organs
disease
reference - signs that have specific meaning to them
perception 
religion

Question 14

what is a delusion

Answer 14

false belief held in firm place despite evidence to the contrary

Question 15

what do you assess in perception in MSE

Answer 15

hallucinations and illusions

Question 16

what is a hallucination

Answer 16

sensory experience/perception without an external stimulus

Question 17

in which modality do hallucinations occur

Answer 17

all sensory modalities
auditory 
visual 
tactile 
gustatory 
olfactory

Question 18

what kinds of auditory hallucinations can you get

Answer 18

2nd person - voice directly addresses the patient
3rd person - voices which discuss the patient
thought echo - patient experiences their own thoughts spoken/out loud

Question 19

what is an illusion

Answer 19

misperception of a real stimulus

Question 20

how can you assess cognition

Answer 20

4AT, MMSE
age, date, location
list months backwards

Question 21

how can you assess insight

Answer 21

is the patient aware of their condition, symptoms and need for treatment to make them better

Question 22

neologism

Answer 22

new made up word by the patient that makes sense to them

Question 23

circumstantiality

Answer 23

go off topic but eventually return to initial topic

Question 24

tangentiality

Answer 24

digress and never return to main topic

Question 25

clanging and punning

Answer 25

changing topic based on sounds and meaning of words

Question 26

loosening of association

Answer 26

unrelated jumping of ideas

Question 27

Knight’s move thinking

Answer 27

change topic based on words/ideas from previous sentence

Question 28

word salad

Answer 28

random words thrown together in a sentence

Question 29

flight of ideas

Answer 29

rapidly shifting thoughts

Question 30

poverty of speech

Answer 30

reduced / minimal / none

Question 31

pressure of speech

Answer 31

speaking rapidly

Question 32

describe examples of affect and cases where they are seen

Answer 32

reactive / congruent - changes according to topic: normal
flattened - unreactive regardless of topic: depression
blunted - ‘so what’ attitude: psychosis
elevated / incongruent - elated: mania