Psychiatry: MSE Flashcards
Appearance
38 year old male presents to you complaining of tiredness
Carry out a mental state examination
Focus specifically on his appearance
obvious features weight? clean? clothing? scars from self harm?
Behaviour
28 year old female presents to you complaining of feeling anxious
Carry out a mental state examination
Focus specifically on her general attitude
good eye contact?
facial expression?
body language?
calm?
Thoughts and Delusions
18 year old male presents to you. Telling you he has been having suicidal thoughts
Carry out a mental state examination focusing specifically on his thought content. Also probe for delusions Bonus: what thought abnormalities may indicate schizophrenia
Do unpleasant thoughts go round and round in your head?
Do you believe that you have special abilities or that people take a special interest in you?
echo
insertion
withdrawal
broadcasting
(thoughts which are not your own)
Always ask
Suicidal thoughts
Violent thoughts
Mood
Mother of a 17 year old female presents to you complaining of her daughters obsession with losing weight
Carry out a mental state examination of her daughter focusing specifically on her mood
How are you feeling? Current mood? Euthymic? Hyperthymic? Dysthymic? - low? - anxious?
Does affect match mood?
Is affect
- fluctuating?
- blunted?
Speech
Wife of a 68 year old man presents to you complaining that her husband is having difficulty remembering things
Carry out a mental state examination focusing specifically on his speech
volume?
amount?
speed?
tone?
Cognition
Wife of a 78 year old man presents to you complaining that husband is becoming increasingly confused.
Carry out a mental state examination
Focus specifically on his cognition
AVPU / GCS
Time, place, person, identity
MMSE
West Register Street
Spell world backwards
Place index finger of right hand on your nose and then on your left ear
Thoughts and Delusions
22 year old male presents to you complaining of hearing voices and suicidal thoughts
Carry out a mental state examination probing specifically for delusions of reference and grandeur.
Probe for auditory hallucination
Have you felt people were interested moreso than normal?
Is there anyone trying to harm you or kill you?
Do you have any special powers that most people lack?
Always ask
Suicidal thoughts
Violent thoughts
Perceptions and Insight
19 year old male presents to you and confesses to regularly smoking cannabis and using amphetamines
Carry out a mental state examination
Focus specifically on his perceptions and insight
Hallucinations
Pseudohallucinations
illusions
Are you aware their might be a problem
What do you think is causing it?
Do you want help?
60 year old male presents to you complaining of difficulties sleeping since he quit his job
Then Diagnose, and Treat assuming the diagnosis is PTSD
tbc
Appearance
A wife of a 69 year old male presents to you complaining of a change in her husbands behaviour. He is more aggressive and says inappropriate things.
Then Diagnose, and Treat assuming the diagnosis is Dementia
tbc
Thoughts
28 year old female presents to you complaining of feeling anxious
Carry out a mental state examination focus specifically on the form of her thoughts
linear?
tangential?
circumstantial?
perseveration?
Always ask
Suicidal thoughts
Violent thoughts
Thoughts
22 year old medical student presents to you having difficulties
Carry out a mental state examination
Focus specifically on his thoughts
Do you find that you have to repeatedly check things such as gas taps, light switches, the front door locked?
Do you have to keep things in a special order?
Do you spend a lot of time repeatedly washing things?
Always ask
Suicidal thoughts
Violent thoughts
Thoughts and Delusions
18 year old male presents to you. Telling you he has been having suicidal thoughts
Then Diagnose, and Treat assuming the diagnosis is Depression
tbc
Thoughts and Delusions
18 year old male presents to you. Telling you he has been having suicidal thoughts
Then Diagnose, and Treat assuming the diagnosis is Generalised anxiety disorder
tbc
Thoughts and Delusions
18 year old male presents to you. Telling you he has been having suicidal thoughts
Then Diagnose, and Treat assuming the diagnosis is Panic Attacks
tbc
