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45 Cards in this Set
- Front
- Back
What 3 things is the mental status examination used for?
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understanding clients presentation/functioning
observing and describing pts state of mind part of clinical assessment |
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What are the domains of the mental status exam?
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appearance, behavior, cooperation
speach, motor, mood, affect, thought process, thought content, cognition, insight, jugement |
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What is included in the Appearance portion of the MSE?
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apparent age, height, weight
gender manner of dress grooming |
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what is included in the behavior portion of the MSE?
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gait
eye contact childen: how they relate to caregiver or other adults in room |
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what is included in the cooperation/attitude portion of the MSE? what are the descriptors?
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this refers to the rapport between the patient and the interviewer
the pt. can be Cooperative, Uncooperative, Hostile, Gaurded, or Suspicious |
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What do you look at when evaluating speech?
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Rate, Rythm/Prosody, Volume
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What are the speech disturbances to know?
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pressure of speech- rapid speech, difficult to interrupt
Dysprosody- loss of normal speech melody Dysarthria- difficult articulation, not grammer Cluttering- erratic or dysrhythmic speech, rapid or jerky spurts dysphonia- difficult or pain in speaking |
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What do you look for when evaluating Motor?
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Agitation
Retardation Tics Tremors Mannerisms |
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What is Alexithyma?
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a pt is Unable to describe subjective mood (feelings and such)
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what are the 5 mood states? in descending order
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Euphoric- intense elation, with feelings of grandure
Elevated- air of confidence and enjoyment Euthymic- normal mood Dysthymic- not super happy Dysphoric- unpleasent mood |
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What defines affect? what is Range, and its descriptors?
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Range, Congruence to mood, Appropriateness
Labile- rapid and abrupt changes in emotional tone, not inresponse to stimulus Expansive- Full Range- all emotions are expressed in relation to the correct stimulus Restricted- reduced feeling tone, not blunted, but reduced Blunted- severe reduction in the intensity of externalized feeling tone Flat-no signs of affective expression, monotonous voice, face immobile |
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What are the portions of Thought Process examined in the Mental Status exam?
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Form (linear, circumstantial, tangential, loose associations)
Productivity (flight of ideas, rapid thinking, slow thinking, blocking) Logical vs. illogical future or goal orientation |
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What are the 4 Types of Form for thought processes? what are their descriptions?
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Linear- normal
Circumstantial- indirect speech that is delayed in getting to the point. usually over inclusion of details Tangential- inability to have goal directed associations of thought. never gets to the point Loose Associations-flow of thought shifts from one subject to another, may be severe |
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What are the 4 types of Productivity issues when discussion Thought Process? What are their descriptions?
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Flight of ideas- rapid, continuous verbalizations or plays on words, shifting ideas, which can be connected.
Rapid thinking- slow thinking- Blocking- abrupt interruption in train of though before a thought or idea is finished. No recall of what was being said |
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What are the 4 types of Language Impairments involved in Though Process? what are their descriptions?
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Incoherent- dirka dirka
Clang Associations- Words of similar sound but not in meaning, no logical connection. includes rhymes and puns Neologisms- new words created by the pt. combines syllables of other words Perseveration- persisting response to previous stimulus after new stimulus has been presented |
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What are the 5 types of thought disturbances and their descriptions, related to Thought Content?
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Delusions- (many, will go over in detail)
Illusions- Ideas of Reference-false belief that behavior of others refers to pt. Feels that others are talking about or to pt. (radio or tv or people) Thought Insertion- delusions that thoughts are being implanted by other people or forces Thought Withdrawal- belief that thoughts are being removed by other people or forces Thought broadcasting- belief that a persons thoughts can be heard by others |
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What are the 7 types of Delusions we looked at? what are their descriptions?
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Paranoid-
Erotomanic- the illusion that someone is deeply in love with them, more common in women then in men Persecutory- a paranoid delusion- someone thinks they are being mistreated Grandious- a paranoid delusion- someone exaggerates their importance Somatic- a false belief involving body function (melting brain) Mood congruent-the mood matches the delusion (depressed pt thinks they destroyed the world) mood incongruent- mood does not influence the delusion |
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What are the Perceptual Disturbances that are discussed in the MSE? what are their descriptions?
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Hallucinations- stuff isnt really there (auditory, visual, olfactory, tactile)
Depersonalization- a person subjective sense of being unreal, strange, or unfamiliar Derealization- the enviorment feels strange or unreal. feeling of changed reality |
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What is Insight
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this is a persons understanding of his or her own mental illness.
Must be able to understand problem and treatment options |
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what is judgment?
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this is the ability to state appropriate reactions to imaginary situations
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What are the levels of conciousness?
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Conscious Alert
Confused- reactions to enviormental stimuli are inappropriate Obtunded Stuporous- lack of reaction to surroundings Comatose |
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What are the two methods to evaluate cognition?
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Level of Consciousness
Abstraction (proverbs/comparisons) |
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What are more of the ways to define Cognition?
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Orientation
Calculation Attention/concentration Memory- (Anterograde- cant form new memories....Retrograde- cant remember the past) |
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Whats the max score on the MMSE? a low score?
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Max is 30
23 or less shows significant impairment |
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When using the mini mental status exam, what 5 areas of cognition are being tested?
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Orientation
Registration Attention Calculation Recall Language |
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What are the limitations of the MMSE? like what could cause someone to not score appropriately high on the test?
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Hearing/ vision impaired
intubated non-english speaker, stupid, communication disorder |
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what are the MMSE orientation questions?
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what is the year, sears, date, day, month
where are? |
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What are the MMSE registration questions?
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be able to rapidly identify objects within 1 second.
name objects and have pt repeat names |
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What are the MMSE attention and calculation questions?
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Serial sevens math questions
or, spell world backwards |
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what questions are used in the Recall portion of the MMSE?
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ask the pt to recall the 3 objects used in the registration question
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What are the questions used in the Language portion of the MMSE
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Name pencil and watch
repeat phrase follow 3 stage command obey written orders write something copy an image |
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What is included in Axis 1?
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Clinical disorders, including major mental disorders and learning disorders
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What is included in Axis 2?
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personality disorders and mental retardation
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what is included in axis 3?
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acute medical conditions, and physical disorders
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what is included in axis 4?
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pyschosocial and environmental factors contributing to the disorder
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what is included in axis 5?
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the global assessment scale of functioning
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What is the more defined range of things included in Axis 1?
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Mood disorders
Anxiety disorders pyschotic disorders eating disorders cognitive disorders substance related disorders |
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how old does a pt have to be for personality disorders to be diagnosed?
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18 years old
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What is the more defined range of things included in Axis 2?
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Personality Disorders...must be pervasive patterns of behaviors/symptoms
mental retardation- (the medical condition would be coded in axis 3) |
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In the active phase of 1st stage of labor, how fast does the cervix dilate?
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- nuligravida: >1.2cm/hr
- multigravida: >1.5 cm/hr |
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What can the DSM not be used for?
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Medical treatment options
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what axis does homelessness fall under?
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Axis 4- housing problems
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what axis does mental retardation fall under?
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Axis 2- mental retardation
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What axis does trisomy 21 fall under?
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Axis 3, acute medical conditions and physical disorder
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what axis does drug abuse fall under?
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axis 1
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