Neuropsych examination Flashcards
What are the purposes of conducting a neuropsychological examination?
- To explain behaviour
- To aid in diagnosis
- To help with management, care and planning
- To evaluate the effectiveness of a treatment technique
- To provide information for a legal matter
- To do research
Define a differential diagnosis
The process of differentiating between two or more conditions which share similar signs or symptoms using questions concerning the nature or source of the condition
Define diagnostic questions
Questions that concern the nature of the patient’s symptoms and complaints in terms of their aetiology and prognosis
Define descriptive questions
Questions that inquire into the characteristics of the patient’s condition, such as behavioural descriptions, and competencies or deficits of the patient
What are the five relevant aspects of a patient’s background when conducting an examination?
- Social history
- Present life circumstances
- Medical history and current medical status
- Circumstances surrounding the examination
- Cultural background
Define syndrome analysis
When knowledge about an individual patient, such as their history, appearance, test performance and behaviour, can be compared to pre-established and well described neuropsychological conditions
What is evidence-based practice?
The integration of clinical expertise with the best research evidence and patient values to achieve the most accurate and appropriate conclusions
What are the important factors in a patient’s social history?
Important to know the patient’s highest level of functioning and when that was
- Education
- Work experience
- SES incl. social class and education of family members
- Marital history
- Attitudes toward examination
What are the important factors in a patient’s present life circumstances?
Beyond questions of a factual nature. E.g.:
- Employment: how long job has been held, whether they like the job
- Family life: common family concerns
- Illness, substance-abuse
- Sexual problems
What are the important factors in a patient’s medical history/current status?
Will usually come from a treating physician, medical charts and prior examinations. Important to integrate with social history
- Visual and auditory defects
- Sleeping habits
- Eating habits
- Exercise habits
What are the important steps in an examination?
- Initial planning
- Preparatory interview
- Observations
- Test selection
- Hypothesis testing
- Selection of additional tests
- Concluding hypothesis and interpretative interview
- Report
What are the eight topics that must be addressed in a preparatory interview with a patient
- Purpose of the examination -> reasons for referral
- Nature of the examination -> cognitive functioning
- What examination info will be used for -> who and how
- Confidentiality
- Feedback to the patient -> who and when
- How the patient feels about tests
- Brief explanation of test procedures
- (if needed) Payment
What are indirect observations during an examination?
Statements or observations made by others, or examples of patient’s behaviour, such as letters, art, grades, work proficiency
What are informal direct observations during an examination?
Examiner’s awareness of behaviour during interaction with the patient, such as:
- how they walk/talk
- how they respond to situations
- habits of dressing or grooming
- attitudes and emotional status
What are formal direct observations during an examination?
Test-based examinations to see how the patient deals with restructured situations in which the range of available responses is restricted
Define validity
The degree to which the accumulated evidence supports the specific interpretations that the test’s developers claim
Define face validity
The quality of appearing to measure what they test is supposed to measure
Define ecological validity
The degree to which a measure predicts behaviour in everyday situations
Define reliability
The regularity with which the test generates the same score under similar retest conditions
Define sensitivity of a test
The proportion of people with the target disorder who have a positive result
Define specificity of a test
The proportion of people without the target disorder whose test scores fall within the normal range
Define a positive predictive value
The probability that a person with a positive (abnormal) test performance has a target condition, taking into consideration both sensitivity and specificity
Define negative predictive value
The probability that a negative (normal) test performance signifies the absence of a condition
Define odds ratio
The ratio of the odds of the disorder for the experimental group over the odds of the disorder for the control group
