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24 Cards in this Set
- Front
- Back
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What does the mental status exam assess?
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• general presentation
• attentiveness • form of thought • intellectual functioning • judgement • memory • mood and affect • orientation • perceptual ability • speech patterns • state of consciousness • thought content |
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What are things to look for when evaluating a patient's appearance?
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• appearance for age
• clothing • grooming • posture |
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How do you evaluate a person's behavior?
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• gestures
• mannerisms • psychomotor agitation or retardation • tics/twitches |
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When evaluating a patient, what are different attitudes a patient can have to their examiner?
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• cooperative
• defensive • evasive • hostile • seductive |
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What do you look for when evaluating a patient's level of consciousness?
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• level of alertness
• lethargy or sleepiness |
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Describe the different classifications of the Glascow Coma score
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• Eyes
- 4: Spontaneous - 3: To voice - 2: To pain - 1: none • Verbal - 5: oriented - 4: confused - 3: inappropriate words - 2: incomprehensible - 1: none • Motor - 6: obeys commands - 5: localizes pain - 4: withdraws to pain - 3: decorticate flexion - 2: decerebrate extension - 1: none/flaccid |
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Describe the response of a lethargic patient
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• patient appears drowsy but opens the eyes and looks at you
• responds to questions and then falls asleep |
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Describe the response of an obtunded patient
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• patient opens eyes and looks at you, but responds slowly and is somewhat confused
• alertness and interest in the environment are decreased |
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Describe the response of a stuporous patient
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• patient arouses from sleep only after pain stimuli
• verbal responses are slow or even absent • lapses intoan unresponsive state when the stimulus ceases • minimal awareness of self or the environment |
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What are the 3 types of memory and how do you test them?
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• Immediate memory (ask to remember 3 words and question after 5 minutes)
• Recent memory (ask about the last 24 hours) • Remote memory (ask about place of birth, schools attended, or historical information that most people would know |
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How do you determine if the patient can concentrate and pay attention?
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• ask to repeat a string of three to six numbers forward and backwards
• ask to spell the word WORLD backwards |
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How do you evaluate a patient's cognitive abilities?
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• abstract thinking (a rolling stone gathers no moss)
• copy a simple drawing • concrete thinking (describe how a pear and an apple are alike) • intelligence (factual knowledge, calculational ability) • see if the patient can read and write |
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How do you evaluate a patient's speech?
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observe the speech for:
• clear on unclear articulations • deficiencies in language • speech too loud or too soft • pressured speech |
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What is dysarthria?
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refers to defective articulation
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What are some abnormalities that suggest aphasia?
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• circumlocution: phrases or sentences are substituted for a word the person cannot think of
• disturbed inflections (ex. monotone) • hesitancies and gaps in the flow and rhythm of words • paraphasias: words are malformed |
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What is the difference between mood and affect?
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• Mood is a sustained emotional state (ex. depressed, euphoric, anxious, angry)
• Affect is the patient's current emotional state; the state the interviewer can observe |
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What are examples of abnormalities of thought processes?
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• blocking
• circumstantiality • confabulation • derailment • echolalia • flight of ideas • neologisms • perseveration |
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What are examples of abnormalities of though content?
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• anxieties
• compulsions • delusions • hypochondriacal symptoms • ideas of reference (believes that somone on TV is talking about them) • obsessions • phobias |
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A definitive diagnosis of mental disorder can be made using how many of the 5 axes?
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a definitive diagnosis can bemade using only the first 3 axes
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Describe axis I
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• the clinical disorder (ex. schizophrenia, panic disorder, major depression)
• other disorders - medication induced disorders - malingering |
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Describe axis II
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personality disorders (ex. avoidance, dependent, histrionic, mental retardation)
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Describe axis III
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• physical disorders relevant to the mental disorder
• ex. thyroid, diabetes, alzheimers |
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Describe axis IV
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• a listing of psychosocial and envoronmental problems
• ex. death of spouse or family member, job loss, divorce |
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Describe axis V
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• Global assessment of functioning (GAF)
• quantification of how well the patient is functioning in everyday life |
