Psych CLI Review Flashcards
What are the components of a Mental Status Exam?
ABM, SMATT+P, CIJI:
Appearance Behavior Motor activity Speech Mood Affect Thought process Thought content Perceptual disturbance Cognition Insight Judgment Impulse control
What are the components of a MMSE?
- Orientation (person, place (5), time (5))
- Memory (Immediate, recent)
- Attention/Concentration (Serial 7s or spell WORLD backwards)
- Language (naming, repetition, comprehension)
- Reading/writing
- Visuospatial ability (copy of design)
What are common Suicide risk factors?
SAD PERSONS…
Sex-male
Age> 60yrs
Depression
Previous attempt*** Ethanol/drug abuse Rational thinking loss Suicide in family Organized plan/access No support (single, widowed) Sickness
**also access to weapons or fire arms
Topic: Motivational Interviewing
- increase change talk
- decrease resistance
- commitment talk is the actual predictor of behavior change
3 Elements of MI:
- Collaboration
- Evocation
- Autonomy
MI specific skills and Strategies:
- Open-ended elaboration questions
- Affirmations (recognize client strategies)
- Reflections (see the client from their perspective)
- Summary statement (recap on what has occurred)
What is the criteria for a Manic Episode?
DIG FAST …
Distractibility
Irritability/Irresponsibility (engaging in shopping sprees, sexual indiscretions, or foolish business investments)
Grandiosity
Flight of ideas of (“racing thoughts”)
Activity (goal-orientated activities/ psychomotor agitation)
Sleep (decreased need)
Talkativeness or pressured speech
What is the criteria for Depressive Episode?
Depressed Mood + SIG E CAPS…
Sleep disturbance
loss of Interest (anhedonia)
Guilt or feelings of worthlessness
Loss of Energy
Loss of Concentration
Appetite/weight changes
Psychomotor retardation or agitation
Suicidal ideations
What aspects of suicide must you explore?
- Suicidal Ideation (passive vs. active thoughts)
- Suicidal Intent
- Suicidal Plan
Also..Past attempts? Severity? Triggers? Thoughts?
What is the symptoms associated with a diagnosis of anxiety?
To meet GAD criteria, must have 3 or more of the following 6 symptoms:
- Restlessness or feeling keyed up or on edge
- Being easily fatigued
- Difficulty concentrating or mind going blank
- Irritability
- Muscle tension
- Sleep disturbance (difficulty falling or staying asleep, restless, unsatisfying sleep)
What are features of an brief cognitive evaluation?
Orientation: to place, to time
Concentration/Attention: Serial 7’s or “WORLD”
Memory: 3 objects
Fund of knowledge: Who’s the president today?
Ability to think abstractly: What is similar between a watch and a ruler?
What features must be covered in MSE: Appearance?
Stated age, attire, grooming and hygiene, physical abnormalities
What features must be covered in MSE: Behavior?
Eye contact, attitude toward examiner, calm vs. anxious
What is the structure of a Patient Note?
HPI:
Past Psych Hx: dx? tx? adherence? therapist? inpatient hospitalizations?
PMHx:
Meds/Allergies: NKA or NKDA
Family Psych Hx: dx? tx? substance abuse? SI/I/P?
SHx: family? school/job? hx of abuse/trauma?, sexual orientation/function? role of religion/spirituality? legal problems?
–> substance use including Caffeine, alcohol, cigarettes, drugs
Mental Status Exam:
Summary/Assessment/Plan?
What features must be covered in MSE: Motor activity?
Presence/absence of adventitious movements, psychomotor agitation/retardation, rigidity
What features must be covered in MSE: Speech?
Fluent, volume, quantity, rate, tone
What features must be covered in MSE: Affect?
Affect type, range (constricted), reactivity, stable vs. labile, appropriate, congruence
