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PCE > Psych > Flashcards

Psych Flashcards

1
Q

What are the components of the Mental Status Exam?

A
  1. Appearance/behavior
  2. Speech
  3. Motor activity
  4. Mood
  5. Affect
  6. Thought process
  7. Thought content
  8. Consciousness; Orientation/Alertness; Cognition
  9. Insight
  10. Judgement
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2
Q

Re: the MSE, describe appearance/behavior.

A

Grooming

eye contact

ill- or well-appearing

interpersonal behavior

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3
Q

Re: the MSE, describe motor activity.

A

posture

paucity or exaggeration of movements

facial expression

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4
Q

Re: the MSE, describe speech

A

quantity

rate (pressured, slow, regular)

volume (loudness or softness)

rhythm (i.e., prosody)

fluency

prosody

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5
Q

Re: the MSE, describe mood

A

patient’s own report of emotional state

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6
Q

Re: the MSE, describe affect

A

physician’s observation of the patient’s emotional state.

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7
Q

What is the difference between mood and affect?

A

Mood is the patient’s self-described emotional state, whereas affect is how the patient’s mood/emotional state appear to the examiner.

Affect can be congruent or incongruent with mood.

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8
Q

Re: the MSE, describe thought process

A

the patient’s flow of thought or form of thinking–how the patient uses language and puts ideas together.

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9
Q

Re: the MSE, describe thought content

A

Describes the types of ideas expressed by the patient, e.g.:

auditory/visual hallucinations

delusions

phobias suicidal/homicidal thoughts

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10
Q

Re: the MSE, describe insight

A

Patient’s understanding of his/her illness

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11
Q

Re: the MSE, describe judgement

A

Patient’s understanding of the consequences of his actions

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12
Q

What words can be used to describe a patient’s thought process?

A

logical

illogical

linear

tangential

disorganized

circumstantial

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13
Q

What is a MoCA?

A

Montreal Cognitive Assessment

Consists of the MMSE + more complex visuo-spatial and executive function.

Has a greater sensitivity for mild cognitive impairment than the MMSE

Can be administered in <10 minutes

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14
Q

What are the 6 components of the Mini-Mental Status Exam (MMSE)?

A
  1. Orientation - time
  2. Orientation - place
  3. Registration
  4. Attention/Calculation
  5. Recall
  6. Language
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15
Q

MMSE: components of orientation - time

A

What is the…

date

day

month

season

year

(1 pt each)

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16
Q

MMSE: components of orientation - place

A

Where are we in terms of:

country

state

town

hospital

floor

(1 pt each)

17
Q

MMSE: instructions for registration

A

Repeat these three words

e.g., house, orange, thirty-two

(1 pt each)

18
Q

MMSE: instructions for attention/calculation

A

-spell WORLD backwards (2 pts)

-count down by 7s from 100 (3 pts)

19
Q

MMSE: instructions for recall

A

Recall the three words that were repeated in registration

(1 pt each)

20
Q

MMSE: instructions for language

A
  1. name 2 objects as I point to them (e.g., pen, watch) (2 pts)
  2. Repeat a simple spoken phrase (“no ifs, and or buts”) (1 pt)
  3. Follow a three-step verbal command (“Take this paper in your hand, fold it in half, and place it on the floor) (3 pts)
  4. Read and obey a written command e.g., “clothes your eyes” written on a sheet of paper) (1 pt)
  5. Write a sentence (spontaneously generated) (1 pt)
  6. Copy the design (full point for two 5-sided figures forming a 4-sided figure)
21
Q

Interpretation of the MMSE score

A

>26 = normal

21-26 = mild impairment

11-20 = moderate impairment

=10 = severe impairment

cutoff score <23 is suggestive of cognitive dysfunction

22
Q

What are some strengths of the MMSE?

A
  • quick (5-10 minutes)
  • easy (done at the bedside, by anyone)
  • tests broad cognitive range
  • can track an individual over time
23
Q

What are some weaknesses of the MMSE?

A
  • poor test of frontal function
  • does not pick up mild impairments
  • does not correlate between individuals
24
Q

What does the clock-drawing test, test?

A
  • auditory comprehension and language
  • planning ability
  • visual-spatial and visual-motor skills
25
Q

How do you perform the clock-drawing test?

A

Give the patient a piece of paper with a large circular outline and ask him/her to fill in the numbers as they appear on the face of a clock. Then instruct them to draw the hands at a particular time (e.g., “10 minutes past 11”)

Document the actual response

26
Q

What dimensions can be used to describe the patient’s affect?

A
  1. quality
  2. Motility
  3. Appropriateness
27
Q

Describe quality re: a patient’s affect

A

the depth and range of the feelings shown

Parameters:

flat (none)

blunted (shallow)

constrcited (limited)

full (average)

intense (more than normal)

PCE (5 decks)

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