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Emma - Physical Diagnosis > PD - Mental Status Exam > Flashcards

PD - Mental Status Exam Flashcards

1
Q

appearance and behavior

A 
body type 
physical stigmata 
posture
bearing
clothes
grooming
alertness
level of comfort
ambulation status.

Also note unusual, inappropriate, or repetitive behaviors.

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2
Q

Components of the Mental Status Exam

A
  1. Appearance And Behavior
  2. Motor Activity
  3. Mood And Affect
  4. Speech And Language
  5. Thought Process
  6. Thought Content
  7. Perception
  8. Insight
  9. Judgment
  10. Cognition
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3
Q

motor activity

A

amount
speed
posture
gait

(Hyperactivity, Agitation, Tremor, Dystonia, Chorea, Tic, Bradykinesia, Akinesia, Stereotypy, Psychomotor retardation, Mannerism)

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4
Q

mood

A

patient’s self-described emotional state

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5
Q

affect

A

emotional response observed by examiner

range, intensity, stability, appropriateness, relatedness

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6
Q

terms to describe affect

A
  • congruent (vs. incongruent)
  • dysphoric
  • euophric
  • labile (highly variable/quick change)
  • flat
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7
Q

5 parameters of speech

A 
Amount
Speed
Volume
Clarity (articulation)
Fluency (Broca’s)
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8
Q

3 parameters of language

A

complexity, comprehension, and coherence

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9
Q

terms to describe speech

A
  • paucity [reduced amount]
  • Latency [to respond]
  • Pressured speech [uninterruptable]
  • dysarthria
  • incoherence
  • aphasia (receptive or expressive)
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10
Q

Thought process

A

Logical connectivity between thoughts.

Quantity, Tempo, Form/Coherence.

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11
Q

Thought content

A

Divided by preoccupations and disturbances/delusions [fixed, false beliefs].

Phobias, health preoccupation, SI/HI, delusions, obsessions.

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12
Q

Perceptual abnormalities

A

Hallucinations (sensory perception w/o stimulus)

illusions (misperception of a stimulus)

neglect (inattention)

depersonalization (self-disconnection)

derealization (world-disconnection)

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13
Q

insight

A

pt’s awareness that his or her sx are normal or abnormal

  • denial
  • minimization
  • indifference
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14
Q

Judgment

A

Cognitive ability to evaluate and compare alternatives.

Insight + Judgment necessary for consent.

Ask “what would you do if you found a stamped, addressed envelope”?, how do you handle affairs like cooking meals etc.

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15
Q

Cognition

A

general ability of the patient to think and reason, assessed w/ mini-mental state exam (orientation, registration, attention, recall, language.)

Also …

  • General intellectual function: Ask about current events.
  • Level of consciousness
  • Abstraction: Ask similarity/difference questions. (“How are a car and train alike?”)
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16
Q

delirium

A

Short duration mental disturbance, usually toxic etiology.

Illusions, hallucinations, delusions, excitement, restlessness, incoherence.

17
Q

dementia

A

Generalized insidious loss of intellect/cognition/memory.

Changes in personality (not including changes due to clouding of consciousness, depression, or other functional mental disorder)

18
Q

Clinical features of delirium

A

acute

fluctuating w/ lucid intervals

worse at night

lasts hours-weeks

always disrupted sleep/wake cycle

general med illness or drug toxicity may be PRESENT

19
Q

dementia

A

insidious

slowly progressive

lasts months-years

sleep is fragmented

general med illness or drug toxicity often ABSENT

20
Q

possible causes of delirium

A

delirium tremens (w/d from alcohol)

uremia

acute hepatic failure

acute cerebral vasculitis

atropine poisoning

21
Q

possible causes of dementia

A

reversible: vitamin B12 deficiency, thyroid disorders
irreversible: Alzheimer’s disease, vascular dementia, dementia via head trauma

22
Q

stereotypy

A

frequent, repetitive, seemingly driven, nonfunctional motor behavior (e.g., head-banging)

23
Q

receptive vs expressive aphasia

A

receptive: inability to understand speech/language
expressive: inability to express thought via speech/language

24
Q

poverty of thought

A

global reduction in amount of thought

25
Q

thought preservation

A

thought restricted to a limited set of ideas

26
Q

circumstantial thought

A

a symptom of disordered thought marked by tedious, unnecessary detail but where the speaker eventually reaches the point

form (coherence)

27
Q

Clang associations

A

words or phrases connected due to characteristics of the words themselves (rhyming, punning) rather than the meaning they convey

form (coherence)

28
Q

incoherence may represent

A

disordered thought process (words are placed together within sentences without any logical connection)

29
Q

Stuporous

A

decreased level of consciousness, responsive to stimulation

30
Q

terms to describe cognitive impairment

A

comatose
stuporous
distractible
amnesia

31
Q

delirium

A
  • disturbed level of consciousness
  • behavioral activity decreased or increased
  • hesitant/slow or rapid/incoherent speech
  • fluctuating mood
  • disorganized thought process, may be incoherent
  • delusions common
  • illusions/hallucinations (visual)
  • impaired judgment, varies
  • usually disoriented (to time)
  • attention fluctuates, easily distracted
  • immediate/recent memory impaired
32
Q

dementia

A
  • usu normal until late in illness
  • normal/slow behavior
  • difficulty finding words
  • flat/depressed mood
  • impoverished thought process, speech=little info
  • possibly delusions
  • possibly hallucinations
  • increasingly impaired judgment over course of illness
  • orientation fairly maintained until late illness
  • attention usu unaffected until late in illness
  • recent memory/new learning especially impaired
33
Q

dystonia

A

sustained abnormal posture or muscle spasm

34
Q

hyperactivity

A

Increased activity involving goal-directed behaviors

35
Q

tic

A

an involuntary, sudden, rapid, recurrent, non-rhythmic, stereotyped movement or vocalization

36
Q

abnormal vital signs suggest delirium or dementia?

A

delirium

37
Q

rapid onset
altered sensorium and level of consciousness
psychomotor agitation
vital signs

^ all suggest …

A

acute delirium

38
Q

chorea

A

irregular, rapid, uncontrollable, involuntary movements

Emma - Physical Diagnosis (12 decks)

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