Term
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Definition
| Formal process for observing, evaluating and reporting on a patient's mental function at one point in time. |
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Term
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Definition
Exam has specific componenets.
Each component has specific tests. |
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Term
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Definition
Chief complaint.
HPI
Pt's Diagnosis
How you feel about pt. |
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Term
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Definition
Exam
Differential Dx
More testing
Final Dx |
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Term
| General info on MSE (5) things: |
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Definition
Starts when 1st see pt
A CONVERSATION, not questions.
Use all of your senses.
Can be done on any pt.
Varies in level of detail depends on pt |
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Term
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Definition
1. appearance and behavior.
2. speech and language.
3. mood and affect.
4. thoughts and perceptions.
5. cognitive function. |
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Term
| what to observe with appearance: |
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Definition
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Term
| What to observe with behavior: |
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Definition
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Term
| What to observe with consciousness: |
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Definition
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Term
| 2. Observe speech for 3 items: |
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Definition
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Term
| 2. also observe speech for (1) thing: |
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Definition
| defects: halting, slurred, mumbling, aphasia. |
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Term
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Definition
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Term
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Definition
| what pt says like i am happy, sad, depressed. |
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Term
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Definition
| what you see such as calm, euthymic, depressed, anxious, angry, incongruent. |
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Term
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Definition
| what the pt thinks about. can be recurring themes, the focus of their thoughts, delusions. |
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Term
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Definition
| thinks about child, spouse's betrayal, suicide, medical problems. can simply be appropriate. ALWAYS check suicidality and homicidality! |
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Term
| 4. under thougts/perceptions, delusions are |
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Definition
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Term
4. thoughts/perception definitions.
persecution: |
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Definition
| CIA is following them, neighbors are trying to hurt them. |
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Term
4. thoughts/perceptions.
grandeur: |
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Definition
| I have millions of dollars. I am Jesus |
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Term
4. thoughts/perceptions.
religious: |
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Definition
| Vodoo spirits are hurting me. |
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Term
4. thoughts/perceptions.
Jealousy: |
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Definition
| My wife of 50 years is cheating on me. |
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Term
4. thoughts/perception.
Somatic: |
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Definition
| I have bugs under my skin. (pt could be on meth for the cause). |
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Term
4. thoughts/perceptions.
reference: |
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Definition
| The TV is sending me message. |
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Term
4. thoughts/perceptions.
Exam thought processes for 4 things: |
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Definition
1. clear, logical, goal directed.
2. circumstantial.
3. tangential.
4. disorganized. |
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Term
4. thoughts/perceptions.
circumstantial means: |
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Definition
| Pt digresses into unnecessary details and inappropriate thoughts before communicating the central data. |
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Term
4. thoughts/perceptions.
tangentiality means: |
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Definition
| A disturbance in the associative thought process in which one tends to digress readily from one topic under discussion to other topics that arise through association. irrelevant replies to questions |
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Term
4. thoughts/perceptions.
flight of ideas means: |
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Definition
| a nearly continuous flow of rapid speech that jumps from topic to topic, usually based on discernible associations, distractions, or plays on words, but sometimes disorganized and incoherent. |
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Term
4. thoughts/perceptions.
thought blocking means: |
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Definition
| A sudden inability to finish a thought, or to recall what the thought was |
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Term
4. thoughts/perceptions.
Word salad means: |
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Definition
| incoherent speech consisting of both real and imaginary words, lacking comprehensive meaning |
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Term
4. thoughts/perceptions.
auditor is: |
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Definition
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Term
4. thoughts/perceptions.
visual is: |
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Definition
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Term
4. thoughts/perceptions.
Perceptions can be: |
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Definition
| tactile, olfactory, gustatory (relating to the sense of taste) |
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Term
4. thoughts/perceptions.
Remember abnormal perceptions are a ____ not a ____. |
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Definition
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Term
4. thoughts/perceptions.
medical causes of hallucinations: |
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Definition
| intoxication, withdrawal, delirium, dementia, epilepsy, infection (meningitis), tumors, meds, autoimmune (sle, lupus), endocrine (tsh) |
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Term
4. thoughts/perceptions.
non medical causes of hallucinations: |
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Definition
| depress. w/psychosis, mania, PTSD (ex. sexual trauma), hypnogogic/hypnopompic, misinterpretation. |
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Term
4. thoughts/perceptions.
Hypnogogic means: |
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Definition
| hallucinations that occur between sleeping and waking |
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Term
4. thoughts/perceptions.
hypnopompic means: |
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Definition
| Of or relating to the partially conscious state that precedes complete awakening from sleep |
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Term
5. cognitive function.
six domains are: |
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Definition
| 1. orientation, 2. attention/concentration, 3. memory, 4. language, 5. visuospatial, 6. abstraction - executive function |
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Term
5. cognitive function.
1. orientation is in what part brain and how to test? |
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Definition
frontal/temporarl
test w/person, place, time |
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Term
5. cognitive function.
2. attention/concentraction is what part of brain and how to test? |
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Definition
midbrain
digit span, serial sevens, spell "world" backwards, months of yr. backwards, days of week backwards. |
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Term
5. cognitive function.
3. memory tests what part brain and how to test? |
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Definition
temporal lobe.
Tests registration, recent, remote memory. (recent-3 word recal, days events, meds taken), remote (presidents, names of children or 9/11 |
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Term
5. cogntivie function.
5. visuospatial is what part of brain and how to test? |
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Definition
occipital lobe.
draw intersecting pentagons, cube, or clock |
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Term
5. cognitive function.
6. abstraction/executive function is what part of brain and how to test? |
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Definition
frontal lobes.
allows us to work a job, cook meals, raise kids, pay bills. hard to assess. schizo's can't do. 1st thing to see w/dementia. |
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Term
5. cognitive function.
6. abstraction/executive function more examples of tests are: |
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Definition
adl's and iadl's
similes such as: potato/carrot, cat/rabbit, hot/cold.
proverbs. |
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Term
common psych dx's.
what should prompt screening? |
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Definition
| medically unexplain. symptoms; positive ROS; freq. visits/hypochondriasis(imagined ill health); cfs,ibs, fibromy, chronic pain; neg. feelings toward pt;sub.abuse |
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Term
common psych dx's
6 categories are: |
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Definition
major depressive disorder (MDD)
mania
substance abuse
schizo.
dementia
delirium |
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Term
| major depressive disorder (MDD) guidelines are how long disorder been going on, symptoms, how many SIDECAPS |
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Definition
two weeks,
depressed mood or loss of pleasure,
5/8 sidecaps |
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Term
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Definition
| 1.sleep; 2. interest; 3. guilt(worries); 4. energy; 5. concentration; 6. appetite; 7. psychomotor; 8. suicidality. |
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Term
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Definition
meds
psychotherapy
ECT (most effective) |
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Term
| Bipolar most moods are ______, rare ____ or _____, generally pt is ______, and what is usually needed. |
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Definition
depressed,
rare mania or hypomania,
irritable (rarely euphoric)
and hospitalization is usually needed. |
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Term
| Bipolar mania remember DIGFAST which stands for: |
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Definition
distractibility
impulsivity
grandiosity
flight of ideas
activities
sleep (lack of)
talkativeness (rapid pressured) |
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Term
| What bipolar mania is NOT (2 things) |
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Definition
NOT daily mood variations
NOT borderline personality disorder.
Mood episodes last weeks, months, years |
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Term
| psych dx. of substance abuse/dependence. List 4 things that are 1st along w/abuse which is 2nd to be considered impairment or distress: |
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Definition
unable to fulfill a major role obligat.
use in situat. where it is physical. hazardous
legal problems
continues dispite problems |
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Term
| substance abuse/dependence. dependence means: |
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Definition
| maladaptive pattern of use leading to clinically significant impairment or distress w/3/7 on list. |
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Term
| name 7 substance abuse/dependence characteristics: |
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Definition
| 1. tolerance; 2. withdrawal; 3. more than intended; 4. can't cut down; 5. spending lots of time getting it; 6. loss of function (social,job, recreation); 7. continues despite prob. |
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Term
| how to screening for substance abuse/dependence: |
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Definition
has anyone expressed concern about your use of ________? or
how often have you had more than 6 drinks in the past year?
or CAGE questions. |
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Term
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Definition
cut down
annoyed by criticism
guilty
eye opener |
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Term
| statistics for schizo. 3 things: |
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Definition
usually starts in 20's
lifelong need for meds.
substance abuse is common |
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Term
| schizo. has 2/5 of these for at least 6 months: |
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Definition
hallucinations
delusions
disorganized speech, thoughts
disorganized or catatonic behavior
neg. symptoms-flat affect, apathy. |
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Term
| causes of dementia 4 things: |
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Definition
alzheimer's
vascular
lewy body
other. |
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Term
| three common tests for dementia: |
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Definition
folstein mini mental state exam
MOCA montreal cognitive assessment
clock drawing |
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Term
| six treatments for dementia: |
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Definition
stop bad meds
alter environment
cholinesterase inhibitors (aricept)
NMDA receptor modulators (namenda)
family counseling
alzheimer's association |
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Term
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Definition
| disturbance in ability to sustain attention. |
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Term
delirium has what etiologies?
how to fix it? |
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Definition
multiple
a medical problem not psych.
tx is to fix underly medical problems |
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Term
| most common risk factor for delirium is: |
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Definition
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Term
| common tests for delirium are 4: |
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Definition
digit span
"world" backwards
months of years backwards
days of week backwards
But A&O x3 does NOT exclude delirium! |
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