Week 1- history taking tutorials/lectures Flashcards Preview

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Flashcards in Week 1- history taking tutorials/lectures Deck (18)
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1
Q

What are the things you assess for in a mental state examination?

A
Appearance/behaviour
Speech
Mood- affect and mood
Thoughts- form and content
Hallucinations and dellusions
Perception
Cognitive function
2
Q

Give examples of things you are looking for under the category of appearance/behaviour?

A

Appearance- age, sex, unkempt, clothing/grooming, weight, posture, smell. Specificallu- gait, tremor, evidence of self harm etc.
Behaviour- eye contact, agitation, looking around, rapport, mannerisms

3
Q

Give examples of things you are looking out for under the category speech?

A

Rate, rhythm, volume
Pressured speech- almost like the words are bursting out of their mouth- different to quick speech.
Tone
Poverty of speech- can’t think of the words.

4
Q

How would you assess someones mood?

A

Rate your mood from 1-10. 1 being the worst mood you’ve ever felt and 10 being uncontrollably happy.
How are you feeling?

5
Q

What is the difference between mood and affect?

A

Mood- the overall feeling over a longer period of time
Affect- the way they react to what you’re saying e.g. they say they are feeling suicidal but their affect is them cracking jokes at the same time? doesn’t really add up.

6
Q

What is important to check when assessing mood?

A

Have you ever thought about harming yourself. If so- any plans?
Have you ever thought about committing suicide?

7
Q

What are the two things you are assessing in thought?

A

Thought form-the way the information comes out. Is the information relevant? is it goal driven (e.g. you ask a question and they are able to recognise and answer it)
Thought content- the things they are thinking about. Are they obsessing over something?

8
Q

What are delusions?

A

Dellusions are fixed beliefs that cannot be shaken despite logical argument, innapropriate to the patients socio-cultural background.

9
Q

What are illusions?

A

Misidentification/misinterpretation of a stimulus.
The nurses are trying to poison me
Or the table is a knife.

10
Q

What are hallucinations?

A

Perception in the absence of stimulus.

E.g. there is someone behind you watching me (no one is there).

11
Q

What sort of hallucinations are the most common?

A

Auditory hallucinations e.g. voices speaking to you.

12
Q

What important questions should you ask a patient with auditory hallucinations (voices)?

A

How many voices?
What are they saying?
Do you listen to them?

13
Q

How would you assess cognitive function?

A

Ask them where they are?
What day it is?
Who is the prime minister etc?

14
Q

What should the opening statement in a consultation (not mental state examination) be for a psychiatric patient?

A

During this consultation I am going to be asking you some personal questions, they all do serve a purpose but please let me know if they make you feel uncomfortable.

15
Q

Past psychiatric history questions?

A

Have you ever been treated for a psychiatric illness?

16
Q

What are the important areas to cover in a drug history?

A
Prescription drugs
Over the counter meds
Illicit drugs
Alcohol use
Smoking
Compliance.
17
Q

Key questions to ask in personal/social history?

A

Home arrangements- whats it like at home?
Relationships- have you got any family? Do you see your family? Are you in a relationship? How is that going?
Occupation- do you have a job? If they are steady enough to hold down a job then they are immediately at less risk.
Childhood- what was your childhood like?-really important for patients with personality disorders.
Hobbies- what do you do for fun?
Financial situation
Sexual history and psychosexual history
Children/marital status- are there people relying on this person?
Have you ever been involved with the police? Has any of your family ever been involved with the police?

18
Q

Why is family history important?

A

Psychiatric illnesses tend to run in families. Ask about their birth- any substance misuse while their mum was pregnant? Prematurity? Consanguineous relationships- inbreeding