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Psychiatry pro +1700 > MSE > Flashcards

Flashcards in MSE Deck (46):
1

What is the difference between a formal and informal mental status exam?

-Formal = set of question
-Informal = listening for things as you ask about other things

2

What are the major components of the informal mental exam? (11)

-Appearance
-Behavior
-Attitude toward exam
-Speech
-Mood
-Affect
-Thinking
-Perception
-Sensorium
-Insight
-Judgement

(JA, A BAPTISMS)

3

What is mood?

Subjective emotional experience of the patient

4

What is affect?

Objective assessment of the patient's emotional responsiveness, as inferred from facial expressions and/or behavior

5

What is the thinking part of the MSE?

-Logical vs illogical
-Goal directed vs not
-Delusions

6

What is the perception of the MSE?

-Hallucinations
-Derealization or depersonalization

7

What is the insight of the MSE?

Do they understand their condition

8

What are the three major indications for a full mental status exam?

If there is concern that a patient
-is psychotic
-Has any type of organic brain dysfunction
-Is functioning so poorly to need hospitalization

9

True or false: cognition tests (e.g. serial 7s) are a part of the full MSE

True

10

True or false: a full MSE is rarely indicated in the outpatient setting

True

11

Are direct questions asked in an informal MSE?

Not usually--based on responses to normal outpatient questions

12

True or false: the appearance part of the MSE can include clothing, grooming etc

True

13

What are the parts of the overt behavior of the MSE?

-Includes patients' motor behavior, mannerisms, etc

14

What is the attitude part of the MSE?

Describes the patient's attitude toward the examiner

15

What is the speech part of the MSE?

Describes the patient's physical characteristics of the patient's speech (e.g. volume, speed, impairments, etc)

16

True or false: thinking process is distinct from content

True

17

What is circumstantial thinking?

Extraneous information that are irrelevant, but comes back to original thought

18

What is the tangential thinking?

Thinking that does not lead back to the original thought

19

What is derailment / loose associations?

Loss of the logical connection between ideas or sentences as they are being spoken

20

What is clang associations?

Linking words together based on sound, rather than content

21

What is the flight of ideas?

Jumping from topic to topic quickly that are only loosely assocaited

22

What is perseveration?

Repetition of the same words to ideas over and over, despite the conversation moving on

23

What is a non-bizarre delusion? What about bizarre?

Delusions that are plausible

Bizarre = delusions that are implausible

24

What is the judgement bit of the MSE?

Is the patient able to understand the likely consequences of behavior and make decisions accordingly

25

What is the consciousness/alertness bit of sensorium?

Overall level of awareness of the environment

26

What is the orientation bit of sensorium?

Person place and time

27

What is the concentration bit of sensorium?

Capacity to focus on the conversation or can formally assess with serial 7s

28

What is the memory bit of sensorium? (3)

-Immediate-repeat a series of number
-Recent--Recall events from a few minutes to a few days ago
-Remote--Recall events from years ago

29

What is the fund of knowledge bit of sensorium?

Recall for basic facts about the world

30

What is the abstract reasoning bit of sensorium?

Can be tested by asking the patient to explain a proverb like, make hay while the sun shines

31

What is the reading and writing bit of sensorium?

Ask the patient to read a sentence and write a sentence

32

What is the visuospatial ability bit of sensorium?

Ask the patient to draw a clock or copy a figure

33

Does speech describe the content what is spoken?

No--only the physical characteristics of it

34

Talkative vs unspontaneous (only responsive to questions) is listed in what component of the PE?

Speech

35

What is a normal affect?

Variable and appropriate to content

36

What is an incongruent affect?

Affect that does not match mood

37

What is thought blocking?

When there is an abrupt stop or break in the flow of ideas

38

Does the perceptions part of the MSE include the content of a hallucination?

Yes

39

Does the perceptions part of the MSE include the time when a hallucination occurs?

Yes

40

What should you always begin the interview with?

Overview of what you intend to do with the time

41

Should you use leading questions or open ended questions during a MSE?

Open ended

42

How can you build a sense of collaboration between you and your patient?

-Look for their strengths
-Quick to understand, slow to offer advice

43

What are the three major problems if a pt feels shame during an MSE?

-lost to f/u
-Leave out details
-Strike back

44

Is reflecting and summarizing what a patient said good?

Yes

45

What are the five factors that should always be elicited with a psych history?

-Substance use
-H/o trauma
-Occupation
-Relationship
-Social support

(SORTS)

46

What should always be assessed with a suicidal patient?

-Ideation
-Plan
-Means
-Intent