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Clin Skills > pysch:clinical interview&mental status > Flashcards

pysch:clinical interview&mental status Flashcards

1
Q

what are the “three Ds” of pysch disorders?

A

Deviance
Discomfort
Dysfunction

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2
Q

3 part guide to Dx and txt (pysch interview)

A
  1. Gather information and monitor progress
  2. Develop, maintain, conclude the therapeutic process
  3. Educate the patient and implement treatment plans
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3
Q

what are the 3 stages of interview?

A
  1. Inception: Introduction, rapport
  2. Reconnaissance: Let pt tell their story, Gather basic information
  3. Detailed Inquiry: Gather detailed information
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4
Q

how do you “meet your pts where they are” in the interview?

A
  • Choice of your words
  • Same physical level
  • Match voice, intensity level or just slightly different (one stage below)
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5
Q

define “level of consciousness” , and “orientation”

A

how aware the person is of 
his environment
Orientation: aware of person (who they are), place (where they are), and time (when is it); this requires memory and attention

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6
Q

define “attention”

A

the ability to focus or concentrate

includes: alert, lethargic, obtunded, stuporous, coma

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7
Q

define “alert”

A

Alert: the patient is awake and aware

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8
Q

define “lethargic”

A

Lethargic: you must speak to the patient in a 
loud forceful manner to get a response

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9
Q

define “obtunded”

A

Obtunded: you must shake a patient to get a response
Stuporous: the patient is unarousable except 
by painful stimuli (sternal rub)

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10
Q

define “coma” (in terms of attention)

A

Coma: the patient is completely unarousable

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11
Q

define memory and the two types

A

the process of recording and retrieving information

  • Short-term memory covers events or memories 
that occurred minutes to days before
  • Long-term memory covers events or memories 
that occurred months to years before
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12
Q

define “thought processes”

A

the logic, coherence, and relevance of a patient’s thoughts as they lead to thoughts and goals; HOW people think as opposed to WHAT they think (thought content)

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13
Q

define “insight”

A

awareness that thought, symptoms, or behaviors are normal or abnormal; e.g., distinguishing that a daydream or hallucination is not real

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14
Q

define “judgement”

A

process of comparing and evaluating different possible courses of action

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15
Q

define “affect”

A

the observable mood of a person expressed through facial expression, body movements, and voice

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16
Q

define “mood”- what are 3 types?

A

the sustained emotion of the patient
Euthymic: normal
Dysthymic: depressed
Manic: elated

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17
Q

define “language”

A

the complex symbolic system for 
expressing written and verbal thoughts, emotion, attention, and memory

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18
Q

define “higher cognitive function”

A

level of intelligence 
assessed by vocabulary, knowledge base, calculations, and abstract thinking

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19
Q

assessing mental status includes what 5 parts?

A
  1. Appearance and behavior
  2. Speech and language
  3. Mood
  4. Thoughts and perceptions
  5. Cognitive function
20
Q

what does cognitive fxn include?

A

memory, attention, information and vocabulary, calculations, abstract thinking, and constructional ability

21
Q

5 parts of speech and language to look at

A

quantity, rate, volume, articulation of words, fluency

22
Q

what are the 4 different fluency types and what may they indicate?

A
  1. Hesitancies in speech
  2. Monotone inflections
  3. Circumlocutions:
  4. Paraphasias:
23
Q

fluency: what might monotone inflections indicate?

A

schizophrenia or severe depression

24
Q

fluency: hesitancies in speech may indicate what?

A

aphasia from stroke

25
Q

fluency: what are circumlocutions ?

A

words or phrases are substituted for the word a person cannot remember; e.g., “the thing you block out your writing with” for an eraser

26
Q

fluency: what is paraphasia?

A

words are malformed (“I write with a den”), wrong (“I write with a branch”), or invented (“I write with a dar”)

27
Q

10 types of abnormalities in thought PROCESS

A 
circumstantiality
derailment
flight of ideas
neologisms 
incoherence
blocking
confabulation 
preservation
echolalia
clanging
28
Q

thought process: circumstantiality

A

speech characterized by indirection 
and delay due to the patient’s excessive use of details
that have no connection to the point

29
Q

thought process: derailment

A

speech in which a person shifts topics with no apparent relation between the topics

30
Q

thought process: flight of ideas

A

accelerated change of topics in a very 
fast but generally coherent manner

31
Q

thought process: neologisms

A

invented or distorted words

32
Q

thought process: incoherence

A

Incoherence: speech that is incomprehensible because it is illogical

33
Q

thought process: blocking

A

Blocking: sudden interruption of speech, before the completion of an idea, occurs in normal people

34
Q

thought process: confabulation

A

Confabulation: fabrication of facts to hide memory impairment

35
Q

thought process: preservation

A

Perseveration: persistent repetition of words or ideas

36
Q

thought process: echolalia

A

Echolalia: repetition of the words or phrases of others

37
Q

thought process: clanging

A

Clanging: choosing a word on the basis of sound rather than meaning

38
Q

abnormalities of thought CONTENT

A

compulsions, obsessions, phobias, delusions

39
Q

thought content: compulsions

A

Compulsions: repetitive behaviors that a person feels driven to perform to prevent or produce some future state of affairs

40
Q

thought content: obesssions

A

Obsessions: recurrent, uncontrollable thoughts, images, or impulses that a patient considers unacceptable

41
Q

thought content: phobias

A

persistent fear of a stimuli the patient feels is irrational (spiders, snakes, the dark)

42
Q

thought content: delusions

A

false, fixed beliefs that are not shared by other members of the person’s culture

43
Q

somatic vs systematized delusion

A

Somatic delusion: believing one has a disease or defect that he does not
Systematized delusion: a single delusion with many elaborations around a single theme all systematized into a complex network; i.e., the KGB is after the patient

44
Q

two types of abnormality in thought PERCEPTIONS

A

illusions and hallucinations

45
Q

illusions vs hallucinations

A

Illusions: misinterpretations of real stimuli
e.g., the bird flying by is a UFO

Hallucinations: a subjective external stimuli the patient hears or sees that others do not hear or see and that the patient may not recognize as false; these can be auditory, visual, olfactory, gustatory, or tactile

e. g. Abe Lincoln speaks to the patient from the back of a penny
* Do not include false perceptions associated with dreaming/falling asleep

Clin Skills (25 decks)

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