MSE Flashcards

1
Q

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

A
  • Formal = set of question

- Informal = listening for things as you ask about other things

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2
Q

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

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

(JA, A BAPTISMS)

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3
Q

What is mood?

A

Subjective emotional experience of the patient

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4
Q

What is affect?

A

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

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5
Q

What is the thinking part of the MSE?

A
  • Logical vs illogical
  • Goal directed vs not
  • Delusions
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6
Q

What is the perception of the MSE?

A
  • Hallucinations

- Derealization or depersonalization

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7
Q

What is the insight of the MSE?

A

Do they understand their condition

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8
Q

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

A

If there is concern that a patient

  • is psychotic
  • Has any type of organic brain dysfunction
  • Is functioning so poorly to need hospitalization
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9
Q

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

A

True

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10
Q

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

A

True

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11
Q

Are direct questions asked in an informal MSE?

A

Not usually–based on responses to normal outpatient questions

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12
Q

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

A

True

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13
Q

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

A

-Includes patients’ motor behavior, mannerisms, etc

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14
Q

What is the attitude part of the MSE?

A

Describes the patient’s attitude toward the examiner

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15
Q

What is the speech part of the MSE?

A

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

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16
Q

True or false: thinking process is distinct from content

A

True

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17
Q

What is circumstantial thinking?

A

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

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18
Q

What is the tangential thinking?

A

Thinking that does not lead back to the original thought

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19
Q

What is derailment / loose associations?

A

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

20
Q

What is clang associations?

A

Linking words together based on sound, rather than content

21
Q

What is the flight of ideas?

A

Jumping from topic to topic quickly that are only loosely assocaited

22
Q

What is perseveration?

A

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

23
Q

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

A

Delusions that are plausible

Bizarre = delusions that are implausible

24
Q

What is the judgement bit of the MSE?

A

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

25
Q

What is the consciousness/alertness bit of sensorium?

A

Overall level of awareness of the environment

26
Q

What is the orientation bit of sensorium?

A

Person place and time

27
Q

What is the concentration bit of sensorium?

A

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

28
Q

What is the memory bit of sensorium? (3)

A
  • 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
Q

What is the fund of knowledge bit of sensorium?

A

Recall for basic facts about the world

30
Q

What is the abstract reasoning bit of sensorium?

A

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

31
Q

What is the reading and writing bit of sensorium?

A

Ask the patient to read a sentence and write a sentence

32
Q

What is the visuospatial ability bit of sensorium?

A

Ask the patient to draw a clock or copy a figure

33
Q

Does speech describe the content what is spoken?

A

No–only the physical characteristics of it

34
Q

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

A

Speech

35
Q

What is a normal affect?

A

Variable and appropriate to content

36
Q

What is an incongruent affect?

A

Affect that does not match mood

37
Q

What is thought blocking?

A

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

38
Q

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

A

Yes

39
Q

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

A

Yes

40
Q

What should you always begin the interview with?

A

Overview of what you intend to do with the time

41
Q

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

A

Open ended

42
Q

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

A
  • Look for their strengths

- Quick to understand, slow to offer advice

43
Q

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

A
  • lost to f/u
  • Leave out details
  • Strike back
44
Q

Is reflecting and summarizing what a patient said good?

A

Yes

45
Q

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

A
  • Substance use
  • H/o trauma
  • Occupation
  • Relationship
  • Social support

(SORTS)

46
Q

What should always be assessed with a suicidal patient?

A
  • Ideation
  • Plan
  • Means
  • Intent