PMHNP Exam Prep Flashcards
Mnemonic for History of Present Illness (HPI):
OLDCARTS or COLDSPA (Characteristics (of symptoms), Onset, Lingering (symptoms how long–days, weeks…?), Duration (how long do symptoms last?), Stressors, Precipitating factors/triggers, Alleviating factors
Examples of Autosomal dominant diseases (2)?
Huntington’s, Neurofibromatosis type 1
Diseases that will present in MORE than one generation; 50% will pass on trait:
Autosomal dominant
Diseases expressed in ONE generation as inherited from the unaffected parent; 2 copies must be present; parents could be carriers but not affected
Autosomal recessive
3 examples of Autosomal recessive diseases:
CF, Sickle cell, Tay-Sachs
Stages of sleep:
Non-REM (three stages-N1, N2, N3); then REM sleep occurs around 90 mins after falling asleep; cycle repeats 3-4 times per night
Mnemonic to remember Mental Status Exam:
“All Borderline Subjects Are Tough Troubled Characters”: (Appearance, Behavior, Speech, Affect, Thought process, Thought content, Cognitive exam)
Name some ways to test a patient’s memory:
Recall short sentences 5 mins later; Name last three presidents; 3-object recall after a few mins
Mini-Mental State Exam (MMSE) components (11):
ORAL R23 RWD: Orientation: (place, time) Recognition: (repeat three objects right now) Attention: (serial 7's) Language
Recall: (3 objects 5 mins later)
2: identify 2 objects (i.e. clock, chair)
3: Follow a 3-step command: (i.e. take this paper, fold in half, put on the ground)
Reading: (read a statement to yourself, do what it says, but don’t say it out loud; i.e. “close your eyes”)
Writing: (write a sentence)
Drawing: (copy a design)
The maximum score for MMSE?
30
MMSE score that may indicate delirium/dementia?
18-23 (mild); 0-7 (severe impairment)
Highest score on SLUMS (St. Louis University Mental Status)?
30
Scores on SLUMS that can indicate a disorder?
27-30 (normal); 21-26 (suggests mild NCD); 0-20 (indicate dementia)
Assessing suicidality: SLAP mnemonic means what?
Social support, Lethal (plan), Access (to the means to end life), Plan/Previous attempts… also family history
Suicidal risk: IS PATH WARM mnemonic means what?
Ideation, Substances (abuse), Purpose (for living seems lost), Anxiety, Trapped (feeling), Hopelessness, Withdrawing (from friends/fam), Anger (with rage), Reckless (behavior), Mood changes (dramatic ones)
Per DSM-V, depression must last how long?
most of the day, nearly every day, for at least two weeks
SIGECAPS mnemonic for depression:
Sleep disorder, Interest deficit (anhedonia, sexual desire), Guilt (worthlessness, hopeless, regret), Energy (deficit), Concentration (deficit), Appetite disorder, Psychomotor retardation, Suicidality
The highest score on the Hamilton Depression Rating Scale (HDRS; HAM-D) is what?
76 (worst score)
What score represents a very severe score on the HDRS (aka HAM-D)?
more than 23 (up to max of 76)
What score represents no depression on the HDRS (aka HAM-D)?
0-7 (max is 76)
What is the worst score on the Beck Depression Inventory (BDI)?
63
What score on the BDI indicates no depression?
0-9 (max 63)
What score on the BDI indicates severe depression?
30-63 (63 is max)
What is the highest score on the Patient Health Questionnaire (PHQ-9)?
27
What scores indicate severe depression on the PHQ-9?
15-19=moderately severe; 20-27=severe depression (27 is max)
What is the scoring range for the Hamilton Anxiety Rating Scale?
0-56 (worst)
What scores on the Hamilton Anxiety Rating Scale indicate moderate to severe anxiety?
25-30 and above (up to 56 max)
What score indicates severe anxiety on the Generalized Anxiety Disorder Screening (GAD-7)?
15-21
What are two screening questions for Bipolar Disorder?
“Have you ever felt so happy that others told you that you were talking too fast or behaving strangely/differently?”…. “Have you ever been in arguments due to feeling hyper and irritable?”
DIGFAST mnemonic for Bipolar disorder:
Distractibility, Indiscretion, Grandiosity, Flight (of ideas), Activities (increased), Sleep (deficit), Talkativeness (pressured speech)
